Objective To evaluate the visual prognostic factors in vitreoretinal surgery for diabetic tractional retinal detachment (DTRD). Methods 102 eyes of 86 consecutive patients with DTRD underwent vitreoretinal surgery were analyzed retrospectively. All cases diagnosed via indirect ophthalmoscope and B ultrasonic scan after mydriasis. Followup duration varied from 12 to 56 months (mean: 23 months). Best corrected visual acuity (BCVA) and anatomic success were observed postoperatively. The patients were divided into visual acuity improved group and didn't improved group. Ttest, Chisquare test and Multivariate Logistic regression analysis were performed to predict the prognosis of visual acuity. Results After primary vitreoretinal surgery, 87 eyes (85.3%) were anatomically reattached, 15 eyes (14.71%) needed reoperation because of the recurrence of retinal detachment (RD). Postoperative BCVA improved and better than 0.05 in 49 eyes (48.04%), reduced or increased but less than 0.05 in 53 eyes (51.96%). Comparing natural factors between these two groups, only combined cataract surgery and optic nerve atrophy were significant different (chi;2=5.266,9.274;P=0.022,0.002). Among post-operative complications only the RD recurrence was significant different (chi;2=12.059，P=0.000). Multivariate Logistic regression revealed recurrence of RD and optic nerve atrophy were two independent risk factors in the final BCVA (P=0.003,0.041;OR=33.518、4.079). Preoperative PRP was identified as the only protecting variable in the final BCVA(P=0.034，OR=0.270).Conclusion This study revealed recurrence of RD and optic nerve atrophy were two independent risk factors in final BCVA of DTRD patients.
Objective To investigate the response of retinal ganglion cells （RGC）in detached and reattached retina in adult rats, and the effect of IL-1beta antibody and IL-1Ra on the loss of RGC. Methods A total of 73 Sprague-Dawley (SD) rats were subretinally injected with healon GV（1.4% hyaluronate）and retrograde labeled with fluorogold (FG), and 10 ng IL-1 Ra and 500 ng IL-1beta antibody were injected into the subretinal space combined with healon GV. The retinal flakes were observed under the fluoroscope and the number of RGC was counted 2 hours, 1, 3, 5, 7, 10, 20, 50, and 90 days after deta chment; 10 days after detachment and 30 days after reattachement; 90 days after detachment and 20 days after reattachement, and 1 and 10 days after injection with IL-1beta antibody and IL-1Ra,respectively. And the control group was only developed an intraocular injection of the same valume of healon GV. Result Two hours after detachment, the RGC loss was found, reached the peak at first day, and decreased gradually. RGC loss was also found in the non-detached area. The reattachment 10 days after detachment (early reattachment) stopped the loss of RGC, and the reattachment 90 days after detachment (late reattachment) promoted the loss, which rested on a certain level. Subretinal space injection of IL-1Ra and IL-1beta antibody decreased the loss of RGCs in the detached retina. Conclusion The RGCs loss were found both in the detached and attached retina. Early reattachment may stop the loss of RGC, and late reattachment may promote the loss. Both IL-1beta antibody and IL-1Ra have neuro protective effect on RGC. (Chin J Ocul Fundus Dis，2004，20：233-236)
Objective To observe the clinical effects of surgical treatment of retinal detachment(RD) caused by macular hole(MH) in high myopia. Methods The clinical materials of 149 eyes of 149 high myopia patients with RD caused by MH were reviewed. The cases were divided into complete posterior vitreous detachment (PVD) group and incomplete PVD group. The anatomic successful rate of operative treatment was evaluated according to the applications of vitrectomy surgery and non-vitrectomy surgery respectively in each group. The visual acuity changes after the operations were also observed.Results The anatomic successful rates were as follow: 77.9% in total cases with vitrectomy surgery and 25.9% with non-vitrectomy surgery (P＜0.001); 75.5% in cases of incomplete PVD with vitrectomy surgery,and 15.0% with non-vitrectomy surgery (P＜0.001); and in non-vitrectomy cases, 57.1 % in complete PVD group and 15.0% in incomplete PVD group (P=0.05). The rates of visual improvement were 68.6% in complete PVD group and 57.0% in incomplete group (P＞0.05). Conclusions The scleral buckling combined with vitrectomy, gas intraocular tamponade and postoperative photocoagulation is an effective and optimal procedure for RD caused by MH in high myopia. (Chin J Ocul Fundus Dis，2003，19：8-10)
Objective To invesligate the treatment of retinal de tachment(RD) after silicone oil tamponades(SOT)． Methods The records of a consecutive series of 32 eyes with redetachment of retina after SOT surgery between 1998 to 2000 were reviewed retrospectively． The surgical techniques used for these cases included remove of silicon oil,peeling of preretinal membrane, retinotomy, endolaser photocoagutation, secondary vitrectomy and C3 F8 tamponades． Results In 28 of 32 eyes the retina was reattached (87．6%)． The postoperative visual acuity was improved in 12 eyes, redused in 4 eyes and remained no change in 16 eyes． The postop erative complications in 6 eyes included secondary glaucoma(3 eyes), hypotony (1 eye) and hyphema (2 eyes)． Conclusion The techniques of preretinal membrane peeling, retinotomy, endophotocoagulation and C3 F8 tamponades can be effectively used in combination to treat the redetachment of retina after the silicone oil tamponades surgery． (Chin J Ocul Fundus Dis,2001,17:214-215)
Objective To approach the clinical characters and therapeutic methods of retinal detachment(RD) after extracapsular catarat extraction(ECCE)with posterior chamber intraocular lens(PCIOL). Methods Sixty eight cases(68 eyes) of RD after ECCE with PCIOL were treated with sclerel buckling,microvitreo retinal surgery and intraocular gas,silicone oil injection and were reviewed. Results The retinas were totally reattached in 65 eyes(95.59%) which dropped to 94.12% in 6-60 months postoperatively.The resultant rate of visual acuity of the eyes with 0.1 or better was 79.41%,with 0.3 or better was 26.47%. Conclusion The main causes of RD after ECCE with PCIOL are similar to those of general RD,and most cases of RD after ECCE with PCIOL can be cured by surgical treatment. (Chin J Ocul Fundus Dis,1998,14:167-169)
ObjectiveTo investigate the therapeutic effects of vitrectomy for retinal detachment in patients with morning glory syndrome (MGS). MethodThe clinical data of 8 patients (8 eyes) who underwent vitrectomy for retinal detachment and MGS were retrospectively analyzed. Follow-up after treatment was performed for 8 months to 2 years. The visual acuity and retina reattachment were followed up. ResultsRetina was reattached in 5 eyes after vitrectomy. Retina was reattached in 2 eyes after second revision operation. Retina was not reattached in 1 eye after two operations. ConclusionsVitrectomy is effective in treating retinal detachment in patients with MGS.
ObjectiveTo analyze and discuss the clinical features and management of pediatric retinal detachment (RD) associated with morning glory syndrome (MGS). MethodsThe clinical data of 49 patients (51 eyes) with RD associated with MGS were retrospectively analyzed, including 27 males (27 eyes) and 22 females (24 eyes). The age at first diagnosis ranged from 1 week after birth and 13 years old (4.2±3.2) years. There were 33 eyes of exudative RD, 3 eyes of rhegmatogenous RD and 15 eyes of RD with undetermined cause. Twenty eyes of 20 patients had other congenital ocular abnormalities, including persistent hyperplastic primary vitreous, microphthalmia, choroidal coloboma, iris coloboma. Besides retinal detachment, other complications were found, including cataract, secondary glaucoma,corneal leukoma or edema, strabismus and nystagmus. Twenty-two cases (22 eyes) received treatment. Five cases of mild exudative retinal detachment took oral methazolamide tablets. Three eyes with mild and restricted retinal detachments got retinal laser photocoagulation around the optic disc. Fourteen cases of 14 eyes underwent surgery including vitrectomy, lensectomy, and phacoemulsification. Follow-up after treatment were three months or more, with an average of (20.3±11.8) months. The visual acuity, retinal reattachment and intraocular pressure and other complications after treatment were followed up. ResultsFive patients of exudative retinal detachment were remained stable by taking methazolamide tablets. Two of the 3 eyes remained stable after laser therapy; however, the remaining one eye was not controlled after relaser. Cataract and glaucoma were resolved by lensectomy in 7 eyes and phaco-emulsification surgery in 1 eye. Retina was re-attached in 6 eyes after vitrectomy. Among those treated, 10 eyes had records of visual acuity. Visual acuity was improved in 1 eye after laser therapy and remained stable in 9 eyes. There were no drugs and surgery-related complications. ConclusionsRetinal detachment was the main complication of MGS. The high incidence and poor prognosis call for the need of close follow-up and timely treatment, including medicine, laser and surgery.
Objective To observe the effects of the bone marrow mesenchymal stem cells (BMSCs) on the expression of neurotrophic factor protein gene in the retinal detachment (RD) rabbits. Methods 60 healthy rabbits were randomly divided into control group (group A), retinal detachment with PBS group (group B), retinal detachment with BMSCs group (group C), 20 rabbits in each group. RD model were established for rabbits in group B and C. 10 μl PBS was injected into the subretinal space of rabbits in group B, while 10 μl CM-Dil labeled BMSC PBS was injected into subretinal space of rabbits in group C. The rabbits in the group A received no treatment. At 1, 2 and 4 weeks after modeling, the mRNA expression of basic fibroblast growth factor (bFGF), brain derived neurotrophic factor (BDNF) and ciliary neurotrophic factor (CNTF) were measured by real-time quantitative PCR. Results At 1, 2 and 4 weeks after modeling, the mRNA expression of bFGF, BDNF, CNTF on retinal tissue were increased significantly in group C as compared with group A and B (P < 0.01). At 1 week after modeling, the mRNA expression of bFGF and CNTF on retinal tissue were increased significantly in group B as compared with group A, the mRNA expression of BDNF on retinal tissue in group B was similar with group C. At 2 and 4 weeks after modeling, the mRNA expression of bFGF, BDNF, CNTF were decreased in group B as compared with group A. Conclusion Subretinal transplantation of BMSC can increase the mRNA expression of bFGF, BDNF and CNTF on retinal tissue in RD rabbits.