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find Keyword "黄斑水肿" 162 results
  • Development, problems and prospects of the treatment of diabetic macular edema

    Diabetic macular edema (DME) is a common ocular complication of diabetes patients. It mainly involve macular which is closely related with visual function, thus DME is one of the major reasons causing visual impairment or blindness for diabetes patients. How to reduce the visual damage of DME is always a big challenge in the ophthalmic practice. In the past three decades, there are tremendous developments in DME treatments, from laser photocoagulation, antiinflammation drugs to antivascular endothelial growth factor therapy. However, the mechanism of DME development is not yet completely clear; every existing treatment has its own advantages and weaknesses. Therefore DME treatment still challenges us to explore further to reduce the DME damages.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • Comparison of yellow micro pulse photocoagulation and traditional laser grid photocoagulation for diabetic macular edema

    Objective To compare the clinical results of yellow micro-pulse laser and traditional laser grid (MLG) photocoagulation for diabetic macular edema (DME). Methods Seventy-eight patients (106 eyes) with DME diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were enrolled in this study. The patients were divided into micro-pulse group (39 patients, 51 eyes) and MLG group (39 patients, 55 eyes). The patients of micropulse group underwent 577 nm yellow micro-pulse laser therapy, while the patients of MLG group underwent continuous wavelength laser photocoagulation with a 561 nm yellow green laser. All the patients were examined documenting corrected visual acuity, macular retinal thickness (CMT) and mean sensitivity within macular 10 deg; examination before and after treatment. Six months after treatment was considered as the judgment time for the therapeutic effects. The mean corrected visual acuity, CMT and MS were comparatively analyzed. Results Six months after treatment, the mean corrected visual acuity of micropulse group and MLG group were 0.45plusmn;0.20 and 0.42plusmn;0.20, which increased significantly compared to those before treatment (t=3.404,2.316; P<0.05). The difference of mean corrected visual acuity between before and after treatment of micro-pulse group and MLG group were 0.08plusmn;0.02 and 0.06plusmn;0.03, the difference was statistically significant between two groups (t=0.532, P>0.05). The mean CMT of micropulse group and MLG group were (323.94plusmn;68.30) and (355.85plusmn;115.88) mu;m, which decreased significantly compared to those before treatment (t=4.028, 2.039; P<0.05). The difference of mean CMT between before and after treatment of micro-pulse group and MLG group were (55.12plusmn;13.68) and (22.25plusmn;10.92) mu;m. The difference was not statistically significant between two groups (t=1.891,P>0.05). The mean MS of micro-pulse group and MLG group were (6.63plusmn;2.65) and (4.53plusmn;1.81) dB. The mean MS of micro-pulse group increased significantly compared to that before treatment(t=3.335,P<0.05). The mean MS of MLG group decreased significantly compared to that before treatment (t=3.589,P<0.05). The difference of mean MS between before and after treatment of micro-pulse group and MLG group were (1.10plusmn;0.33) and (-0.91plusmn;0.25) dB.The difference was statistically significant between groups (t=4.872,P<0.05). Conclusions In the treatment of DME, yellow micro-pulse laser therapy and MLG can improve visual acuity, and reduce CMT. In addition, yellow micro-pulse laser therapy can improve the MS, but MLG reduces MS.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • Subfoveal choroidal thickness in eyes of patients with diabetic macular edema

    Objective To observe the subfoveal choroidal thickness (SFCT) in eyes of patients with diabetic macular edema (DME). Methods Twenty patients (32 eyes) with DME were enrolled in this crosssectional observational study. The patients included 12 males and eight females, with a mean age of (47.3plusmn;10.2) years. All the patients were examined documenting best corrected visual acuity (BCVA), spectraldomain optical coherence tomography (OCT) and ophthalmological examination. According to OCT DME morphology, samples are divided into diffuse macular edema, cystoid macular edema, serous retinal detachment and hard exudate groups. The SFCT was measured by a Cirrus HD-OCT with enhanced depth imaging (EDI) and was compared with the average SFCT (286.84plusmn;28.80) mu;m of same age group. Correlation between SFCT and age, diopter, diabetic duration, fasting blood glucose, BCVA and central retinal thickness were analyzed by Pearson Analysis. SFCT of different DME types were analyzed by ANOVA Analysis. Results The mean SFCT of 32 eyes was (223.81plusmn;43.74) mu;m (ranging from 120.50 to 361.50 mu;m), which was lower by 63.03 mu;m (95% confidence interval, -78.80 to -47.26 mu;m, P<0.01) from normal SFCT. SFCT was independent of age (r=0.124), diopter (r=0.277), diabetic duration (r=0.286), fasting blood glucose (r=0.408), BCVA (r=0.087), and central retinal thickness (r=0.036). There was no significant difference of SFCT between different DME types (F=0.042,P>0.05). Conclusion SFCT is thinner in eyes with DME as compared to normal eyes of the same age.

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • 糖尿病黄斑水肿的治疗现状

    激光光凝、玻璃体切割手术及药物治疗是目前治疗糖尿病黄斑水肿(DME)的主要方法。传统激光光凝治疗相对安全、疗效作用持久,仍具有其无法取代的优势;玻璃体切割手术能解除一部分患者的DME,但手术风险及创伤较大;糖皮质激素类药物由于其明确的副作用,不能作为主要治疗方法;抗血管内皮生长因子药物治疗能从发病机制上阻断DME的发生发展,其疗效已经得到循证医学的认可,具有良好的应用前景,但疗效相对较短,反复治疗的潜在危险及全身副作用需要更大样本量的长期前瞻性研究进一步验证;联合治疗减少重复治疗次数、提高疗效、增强安全性,可成为将来的发展趋势。

    Release date:2016-09-02 05:18 Export PDF Favorites Scan
  • Expression of vasoactive molecules in aqueous humor of patients with macular edema secondary to central retinal vein occlusion

    Objective To observe the levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6) and monocyte chemotactic protein-1 (MCP-1) in aqueous humor of patients with macular edema secondary to central retinal vein occlusion (CRVO). Methods Forty eyes of 40 consecutive patients with macular edema secondary to CRVO (CRVO group) were enrolled in this study. The patients included 25 males and 15 females. The patient age ranged from 38 to 76 years. The control group was 20 patients with senile cataract who underwent phacoemulsification, including 10 males and 10 females. The levels of VEGF165, VEGF165b, IL-6 and MCP-1 in aqueous humor were determined by enzymelinked immunosorbent assay. The correlation of VEGF, and IL-6, and MCP-1 were analyzed. Results The median aqueous level of VEGF165, IL-6 and MCP-1 were 1089.0, 165.6, 1253.0 pg/ml respectively in CRVO group, which were higher than the control group's results (168.2, 4.7, 216.4 pg/ml respectively), the differences were statistically significant (Z=-4.549, -6.008, -5.343;P<0.001). The VEGF165b in CRVO group and control group were 834.0, 915.9 pg/ml respectively, the difference was not statistically significant (Z=-0.207,P>0.05). The ratio of VEGF165b to VEGF165 in CRVO group and control group were 2.71, 7.28 respectively, the difference was statistically significant (t=-3.007,P<0.05). There was a highly positive correlation between IL-6 and VEGF in CRVO group (r=0.526,P=0.001) and also mild positive correlation in control group (r=0.425,P=0.070). No correlation between MCP-1 and VEGF was observed in both groups (CRVO group: r=0.211,P>0.05. Control group: r=-0.019,P>0.05). Conclusions VEGF165, IL-6 and MCP-1 levels were increased in CRVO patients while the VEGF165b was normal. The ratio between VEGF165b and VEGF165 in aqueous humor of patients with macular edema secondary to CRVO was decreased.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 视网膜静脉阻塞继发黄斑水肿的治疗进展

    视网膜静脉阻塞(RVO)继发黄斑水肿(ME)传统的治疗方法主要为激光光凝和以曲安奈德、地塞米松为主的糖皮质激素治疗。近年来,雷珠单抗(商品名Lucentis)、贝伐单抗(商品名Avastin)等抗血管内皮生长因子药物玻璃体腔注射以及玻璃体视网膜手术治疗是RVO继发ME治疗探索的主要方向。虽然许多非随机、缺乏对照的临床试验结果表明这些新的治疗方法能明显改善ME并提高视力,但仍需进行大规模、多中心、随机对照临床试验研究,以更加客观地评价这些疗法的治疗效果和安全性。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • 副肿瘤性视网膜视神经病变诊疗进展

    视网膜和视神经受累的副肿瘤综合征包括癌症相关性视网膜病变(CAR)、癌症相关性视锥细胞功能障碍(CACD)、黑色素瘤相关性视网膜病变(MAR)、副肿瘤性视神经病变(PON)、双眼弥漫性葡萄膜黑色素细胞增生(BDUMP)、自身免疫相关性视网膜病变和视神经病变等。双眼无痛性、亚急性进行性视力下降,视野缺损,伴闪光感,症状与眼底病变程度不一致者应考虑到CAR、CACD、MAR、PON的可能;双眼不明原因的色素播散、色素上皮萎缩,伴或不伴视网膜血管炎、渗出性视网膜脱离者,要考虑BDUMP的可能。视觉生理检查是诊断该病的重要手段。仔细寻找原发或转移病灶是诊断该病所必需。

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Choroidal changes of macular edema with serous macular detachment in nonproliferative diabetic retinopathy patients

    Objective To observe the choroidal changes of diabetic macular edema (DME) with serous macular detachment (SMD) in non-proliferative diabetic retinopathy (NPDR) patients by optical coherence tomography (OCT).Methods Nine NPDR patients including DME with SMD in one eye (SMD group) and only DME in the other eye (DME group) were enrolled. These 18 eyes were also divided into PRP group (six eyes, received panretinal photocoagulation before) and non-PRP group (12 eyes). Spectral domain EDI (enhance depth imaging) OCT and fundus photograph were performed in all the eyes. The subfoveal choroidal thickness was measured. The choroidal simulation area acquired by horizontal EDI-OCT scan through the center of the fovea was calculated by Image Plus Pro 6.0 software. The difference between DME and SMD group was compared and analyzed with matched t- test; the difference between PRP and non-PRP group was compared and analyzed with F test.Results In SMD group, spindle-like or domelike low signal of detachment areas with intact external limiting membrane were found in the retinal detachment region, and the inner and outer segments (IS/OS) were separated from the retinal pigment epithelium (RPE) Bruch membrane. Both subfoveal choroidal thickness and choroidal simulation area in SMD group were significant greater than those in DME group (t=2.306, 2.306;P<0.05). Choroidal simulation area in PRP group was larger than that in nonPRP group (F=5.227,P<0.05). But there was no significant difference of subfoveal choroidal thickness between PRP and non-PRP group (F=3.276,P>0.05). Conclusion EDI-OCT detects spindlelike or domelike low signal areas in detachment region of SMD with DME in NPDR patients.

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
  • 玻璃体腔注射曲安奈德联合激光光凝治疗糖尿病黄斑水肿疗效观察

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
  • 玻璃体腔注射抗血管内皮生长因子单克隆抗体bevacizumab治疗视网膜分支静脉阻塞伴黄斑水肿的疗效观察

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