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find Keyword "黄斑变性" 200 results
  • 雷珠单抗治疗新生血管性老年性黄斑变性的安全性研究

    随着对血管内皮生长因子(VEGF)的深入研究和抗VEGF药物的研发,新生血管性老年性黄斑变性治疗领域有了突破性进展。抗VEGF药物治疗新生血管性老年性黄斑变性的主要途径是玻璃体腔注射。任何一种新兴疗法的应用都要建立在可靠的安全性研究基础上。抗VEGF药物玻璃体腔注射的不良反应主要分为药物相关和注射相关不良反应。其中,眼部不良反应主要有眼内炎、视网膜脱离、视网膜裂孔、眼压升高、白内障等;全身不良反应主要有心肌梗死、卒中、尿路感染、高血压、鼻咽炎、咽痛、前列腺癌、骨关节炎、腹股沟疝等。与贝伐单抗(bevacizumab,商品名Avastin)比较,雷珠单抗(ranibizumab,商品名Lucentis)具有较低的不良反应发生率,其全身不良反应不明显。基于药物的安全性差异还有待于更大规模临床试验来证实。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 影响抗血管内皮生成因子治疗渗出型老年性黄斑变性预后的因素

    玻璃体腔注射抗血管内皮生长因子(VEGF)药物是治疗渗出型老年性黄斑变性(AMD)脉络膜新生血管(CNV)的安全有效方法 。但基线视力、年龄、首发症状、开始治疗的时间、对最初3次治疗的反应以及光相干断层扫描、荧光素眼底血管造影、眼底自身荧光检查结果不同的患者,其治疗预后差异较大;除了上述临床特征和指标外,基因及生物学标记物方面的差异对治疗预后也有影响。探讨影响渗出型AMD患者抗VEGF治疗预后众多相关因素中的主要因素并采取相应的对策,对于提升抗VEGF药物治疗效果具有积极意义。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Clinical Pathway of Age-related Macular Degeneration in China

    Objectives The prevalence of age-related macular degeneration (AMD) is rising in China in recent years, and there are more and more drug treatment modalities for this disease. However, all over the country many ophthalmologists have only limited knowledge of prevention and intervention of AMD. In most hospitals the management of AMD is personal experience-based without consensus. It is urgent to propose a standardized clinical pathway for AMD in China. Methods The clinical guideline and clinical pathway development committee of AMD is established under the Chinese Ocular Fundus Diseases Society. The committee proposed the Chinese AMD clinical pathway (hereinafter referred to as quot;clinical pathwayquot;), based on existed international guidelines, and updated clinical research evidence, the specific types of AMD and the current socio-economic status in China. Results This clinical pathway was developed on the basis of the clinical stages and clinical types of AMD, including the choice of examination items, treatment Methods , follow-up and low vision aids. The clinical pathway was designed in flow sheets, which is easy to understand and implement for ophthalmologists, thus to standardize AMD clinical management procedures. Conclusions The clinical pathway, which followed the basic principles of evidencebased medicine and combined with the actual demands of patients with AMD in China, provides principle guidance for the diagnosis and treatment of AMD. The clinical pathway was designed to meet the requirements of the majority of AMD patients; clinicians should also consider individual situations of patients, available treatment options, the patient's affordability and other factors when making treatment decisions.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Effect of photodynamic therapy combined with intravitreal bevacizumab on wet age-related macular degeneration

    Objective To investigate the effect of photodynamic therapy (PDT) combined with intravitreal bevacizumab on wet age-related macular degeneration (AMD). Methods In this retrospective study, 34 eyes (28 cases) diagnosed with wet AMD received PDT combined intravitreal injection of bevacizumab, including 25 eyes with classic CNV and 9 eyes with minimally classic CNV by fluorescein angiography; On optical coherence tomography (OCT), 23 eyes showed intraretinal fluid (IRF) and 11 eyes presented subretinal fluid (SRF). After signing informed consent, all patients underwent initial standard PDT followed by intravitreal bevacizumab (1.25 mg) within succeeding 3 to 7 days. Best corrected visual acuity (BCVA) and OCT with routine eye examinations were evaluated monthly. Additional bevacizumab (1.25 mg) was injected intravitreally if new or increasing fluid appreciated on OCT, or BCVA lowered more than 5 letters even with stabilized fluid. Injection was discontinued if no fluid was showed on OCT (quot;dry macularquot;), or BCVA was stabilized even with fluid after two consecutive injections. BCVA and central retinal thickness (CRT) were analyzed and compared between baseline and 6 month follow-up. The correlation between parameters such as baseline BCVA, greatest linear dimension (GLD), type of CNV, SRF or IRF and posttreatment BCVA will be analyzed. The injection number of bevacizumab and complications were recorded. Results Compared to baseline, BCVA improved (9.4plusmn;10.2) letters and reach 44.9plusmn;21.3 letters (t=5.438,P<0.01) and CRT decreased (184.6plusmn;214.6) mu;m (t=4.810,P<0.01) at 6 month visit. The average of injection number was 1.9plusmn;0.9 (including initial injection of combination therapy). With multiple lineal regression analysis, only baseline BCVA correlated to posttreatment BCVA at 6 month visit (r=0.802.P<0.01). The type of CNV, GLD, SRF or IRF on OCT and CRT at baseline were not associated to post-treatment BCVA (r=0.053, -0.183, 0.139 and 0.053, respectively.P>0.05). BCVA of eyes with SRF (14.7 letters) increased more than eyes with IRF (6.9 letters) on OCT (t=-2.207,P=0.035). The change of BCVA after treatment (t=-0.076), change of CRT (t=-1.028) and number of injections (Z=-1.505) were not different between classic CNV and minimally classic CNV (P>0.05). The change of CRT (t=-0.020) and number of injections (Z=-0.237) did not present difference between SRF and IRF (P>0.05). The change of BCVA (t=1.159) and number of injections (Z=-1.194) were not correlated to whether residual fluid or not at 6 month visit (P>0.05). No severe complications were noticed during follow-up.Conclusion For wet AMD patients, PDT combined intravitreal bevacizumab could improve visual acuity, reduce retinal thickness and control CNV progress in a short-term.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Promotion and implementing Chinese Clinical Pathway of Age-related Macular Degeneration to standardize the diagnosis and treatment practices of age-related macular degeneration in China

    Age-related macular degeneration (AMD), a set of age-related macular disease, is induced by a variety of factors. New intervention Methods help us to understand the AMD pathogenesis further; however, we only have limited knowledge of these novel Methods . To improve diagnosis and treatment practices of AMD, it is a priority to propose a standardized clinical procedure of AMD management in China. The Chinese Ocular Fundus Association has just proposed a Chinese AMD clinical pathway based on expertsprime;opinions and evidence based medicine. This clinical guideline is implementable for different stages and subtypes of AMD patients, and hopefully will be updated frequently with more clinical practice. Implementing this AMD pathway in China will improve the quality of clinical practice and research of AMD in China.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Histopathology observation of hemorrhagic age-related macular degeneration

    Ovjective To observe the surgically excised specimens from eyes with hemorrhagic age-related macular degeneration (AMD). Methods Thirty-six surgically excised specimens were captured from 36 patients with hemorrhagic AMD, 26 specimens were diagnosed as occult choroidal neovascular membrane (CNVM), 10 specimens were diagnosed as polypoidal choroidal vasculopathy (PCV). All specimens were routinely processed by hematoxylin and eosin, periodic acidSchiffprime;s stain and Masson stainings. At the maximum horizontal and vertical slice of the specimens, the category and amount of the cells in the specimen were recorded, as well as the relationship between the specimens and the surrounding tissue. Results The 36 specimens are categorized as neovascular membrane dominant (19/36), collagen fiber dominant (6/36), blood clot dominant (8/36) and degenerated thickened Bruch`s membrane dominant (3/36). Eighteen occult CNVM specimens and 1 PCV specimen are categorized as neovascular membrane dominant; all 6 collagen fiber dominant specimens are occult CNVM; 1 occult CNVM and 7 PCV specimens are categorized as blood clot dominant; and 1 occult CNVM and 2 PCV specimens are categorized as degenerated thickened Bruch`s membrane dominant. The occult CNVM categorized as neovascular membrane dominant present as small blood vessel with single endothelium cell attached; the PCV specimen categorized as neovascular dominant presents as big blood vessel with thick vessel wall under the Bruch`s membrane, retinal pigment epithelium and choroidal melanocyte are both observed in the PCV specimens. Conclusion The components of the specimens captured from eyes with hemorrhagic AMD are diversified.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 补体系统在老年性黄斑变性发病机制中的作用

    补体系统是机体固有免疫的重要组成部分,包含分布于血浆中或细胞表面的40多种物质,可通过经典途径、凝集素途径或替代途径激活。补体系统通过炎症免疫、血管内皮生长因子表达上调、氧化应激等途径参与和影响老年性黄斑变性(AMD)的发生发展过程;其相关分子的基因多态性与AMD的易感性息息相关;靶向补体系统的治疗对AMD也有一定的疗效。补体系统与AMD相互关系的研究将有助于进一步阐明AMD的发病机制并为其治疗提供新的方向。

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
  • 视网膜血管瘤样增生的眼底影像检查特征

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
  • 老年性黄斑变性患眼的共焦激光眼底成像检查

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
  • Effects of lutein supplementation on macular pigment optic density in patients with early age-related macular degeneration

    Objective To measure the macular pigment optical density (MPOD) and investigate the effects of lutein supplementation on MPOD in patients with early age-related macular degeneration (AMD).Methods Forty-two early AMD eyes, which have been diagnosed by visual acuity, fundus photography and indirect ophthalmoscopy, and 42 fellow eyes were enrolled in this study. Lutein was administered in dose of 15.1 mg daily for one month. The MPOD value before and after lutein supplementation were measured by heterochromatic flicker photometry. The relationship between the MPOD value and lutein supplementation was analyzed.Results The MPOD value of AMD eyes and fellow eyes before lutein supplementation was 0.347plusmn;0.182 and 0.426plusmn;0.173 respectively, the difference was statistically significant (t=-2.042,P=0.044). The MPOD value of AMD eyes and fellow eyes after lutein supplementation was 0.406plusmn;0.155 and 0.446plusmn;0.128 respectively, the difference was not statistically significant (t=-1.283,P=0.203). For AMD eyes, there was an increasing trend of MPOD values after lutein supplementation, but no statistically significant differences (t=-1.594,P=0.115). Furthermore, there was a negative correlation between the changes of MPOD and initial MPOD in both AMD eyes (r=-0.552,P=0.000) and the fellow eyes (r=-0.731,P=0.000).Conclusions Early AMD eyes have less MPOD. Lutein supplementation may play a role in enhancing the MPOD in these eyes.

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
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