PURPOSE:In search of the mechanism for photic retinal injury. METHODS:A visible light damage model was established in the primary cultured healthy,adult human RPE cells by using intense fluorescence light (2 400 Lx). RESULTS:Electron microscopy revealed swelling of the mitochondria and obscurity of nuclear membranous structure in the light damaged cells. The decrease or dissolution of organelle,vacuolization of cytoplasm and myelinic degeneration were found in some severely damaged cells. The level of intracellular SOD was decreased to 41% of that of the controls (P＜0.05). CONCLUSION:The structure of the RPE was damaged by the light radiation and the level of intracellular SOD was decreased. These suggested the light damage might be associated with the production of free radicals and the lipid perioxide reaction in membranous structure of cell. （Chin J Ocul Fundus Dis,1996,12: 174-175 ）
Macular edema is a common cause of visual loss in patients with retinal vascular diseases represented by diabetic retinopathy and retinal vein occlusion. Laser photocoagulation has been the main treatment for this kind of diseases for decades. With the advent of antagonist of vascular endothelial growth factor and dexamethasone implant, diabetic macular edema and macular edema secondary to retinal vein occlusion have been well controlled; the use of laser therapy is decreasing. However, considering possible risks and complications, lack of extended inspection of efficacy and safety of intravitreal pharmacotherapy, laser therapy cannot be replaced by now. Therefore, the efficacy and safety of laser therapy will improve by sober realization of role of photocoagulation and proper selection of treatment indication.
Retinopathy of prematurity (ROP) has become the leading blinding eye disease in children worldwide. In recent years, the recognition and treatment of acute stage lesions have achieved remarkable results. Fundus lesions could spontaneously regress in most of children with ROP, while the understanding of the law of spontaneous regression is still very limited. Although the fundus morphology is significantly improved after spontaneous regression, the long-term prognosis of visual function is not optimistic. The introduction of new technologies such as fundus fluorescence angiography and optical coherence tomography and angiography will help further understanding the nature of the spontaneous regression. To increase the study about spontaneous regression of ROP, which has significance for rationally arranging an economical and efficient screening time, formulating a scientific and individual treatment and follow-up plan, and improving the prognosis of visual function.
Purpose To investigate the pattern of subretinal neovascular membrane(SRNVM)in central exudative chorioretinitis(CEC). Methods With the help of a PC microcomputer,we performed a quantitative measurement of SRNVM in 32 eyes of 32 patients with Rieger is CEC. Results SRNVM-optic disc area ratio were 0.1151plusmn;0.0842．The foveola was on the top of SRNVM in 7 cases．The other 25 of SRNVMs were scattered in macular area around foveola,and 2 of them were nasal to it．The distance between the edge of SRNVM and foveola was less than 175mu;m in 13 cases,175～300mu;m in 4 cases and more than 300mu;m in 15 cases． Conclusion To be compared with the previous data,the present results suggested that laser photocoagulation might be one of the most important therapies for SRNVM in Rieger is CEC． (Chin J Ocul Fundus Dis,1998,14:114-115)
According to the best corrected visual acuity and the morphological changes of the macular fovea, responses to the neovascular age-related macular degeneration (nAMD) who receive anti-vascular endothelial growth factor (VEGF) therapy show large variability, including poor and non-responders. Various factors will be reviewed to account for poor and non-response to anti-VEGF therapy, such as the related susceptibility genes, factors related with the development of choroidal neovascularization and morphologic parameters, pharmacokinetics and tachyphylaxis. The future research should focus on comprehensive assessment of factors affecting the efficacy of anti-VEGF therapy to improve the therapeutic outcome of nAMD.
The optic nerve belongs to the central nervous system (CNS). Because of the lack of neurotrophic factors in the microenvironment of the CNS and the presence of myelin and glial scar-related inhibitory molecules, and the inherent low renewal potentials of CNS neurons comparing to the peripheral nerve system, it is difficult to spontaneously regenerate the optic nerve after injury. Protecting damaged retinal ganglion cells (RGCs), supplementing neurotrophic factor, antagonizing axon regeneration inhibitory factor, and regulating the inherent regeneration potential of RGCs can effectively promote the regeneration and repair of optic nerve. Basic research has made important progress, including the restoration of visual function, but there are still a lot of unsolved problems in clinical translation of these achievements, so far there is no ideal method of treatment of optic nerve injury. Therefore, it is rather urgent to strengthen the cooperation between basic and clinical research, to promote the transformation of basic research to the clinical applications as soon as possible, which will change the unsatisfactory clinical application status.
For choroidal neovascularization (CNV) secondary to pathological myopia, intravitreal injection of anti-VEGF has been widely used in clinic and achieved good outcome. However, due to the differences in the demographic characteristics, stages of disease progression and treatment procedure of CNV, the prognosis of the disease is variable. Complete ellipsoid band, smaller baseline choroidal neovascularization and better baseline vision are important predictors of good outcome of anti-vascular endothelial growth factor treatment. Chorioretinal atrophy or complications related to pathologic myopia indicate a poor prognosis. The influence of age, race, previous photodynamic therapy and early treatment on the prognosis of treatment need to be further studied.
ObjectiveTo observe the clinical efficacy of minimally invasive vitreous surgery (MIVS) for special rhegmatogenous retinal detachment (RRD) in children and adolescents.MethodsA retrospective clinical comparative study. Fourteen eyes with special type of RRD in 14 children and adolescents who received the MIVS treatment from January 2014 to January 2019 in Ophthalmology Department of The First Affiliated Hospital Ophthalmology of Air Force Military Medical University, were included in this study. Among them, 8 eyes from 8 males and 6 eyes from 6 females. The age of them ranged from 5 to 17, with the mean age of 12.64±4.11 years. The course of disease was ranged from 1 d to 1 year, and the average of it was 30 d. All the eyes developed the special type RRD, including pseudophakic and aphakic retinal detachment, giant retinal tear with retinal detachment, choroidal detachment associated with retinal detachment, and RRD with ocular dysplasia. In the 14 eyes, there was 2 eyes with retinal detachment in 1 quadrant, 4 eyes in 2 quadrants, 1 eye in 3 quadrants and 7 eyes in total 4 quadrants. All the eyes were treated with 23G or 25G MIVS and filled with irrigation solution, air and silicone oil. In addition, 10.4 months' follow-up for average after surgery were taken to observe the occurrence of retinal reattachment, BCVA and related complications in the eyes.ResultsIn the 14 eyes, 13 (92.9%) of them attained retinal reattachment and 1 eye (7.1%) got a poor retinal reattachment after one operation. At the last follow-up, all the 14 eyes (100.0%) attained retinal reattachment and 5 of them at the filling state of silicone oil. The vision of 8 eyes (57.1%) were improved, 4 eyes (28.6%) have no notable changes and 2 eyes decreased (14.3%). During the operation, iatrogenic retinal breaks were occurred in 1 eye, and silicone oil entered underneath the retina in 1 eye. After the operation, 1 eye suffered a relapse of retinal detachment after the removal of silicone oil and then were filled with it again.ConclusionsMIVS is a safe and effective way to treat the special type RRD among the children and adolescents. The rate of retinal reattachment is 92.9% after one surgery and 100.0% at the last follow-up. Therefore, MIVS can help most of eyes with special type RRD to get a stable and improved vision.
With high morbidity, branch retinal vein occlusion (BRVO) is a common retinal vascular disease in the clinic. Although the classic characteristics of BRVO have been recognized for a long time, the traditional understanding of BRVO has been challenged along with development and application of new imaging technologies, including the reasonable classification and staging of the disease, and the vascular characteristics at the occlusive site via multimodal imaging, etc. Thus, re-summarizing and refining these features as well as further improving and optimizing traditional imaging evaluation, can not only deepen the correct acknowledge of the entity, but also find biomarkers of prognosis of visual function, which is helpful to establish better diagnosis and treatment strategy. In the meanwhile, it is necessary that clinical characteristics of BRVO on imaging and the reliability of these imaging techniques are worth correct understanding and objective assessment.
ObjectiveTo observe the clinical effects of pars plana vitrectomy (PPV) combined with internal limiting membrane peeling (ILMP) for macular hole (MH) and macular retinoschisis in high myopic eyes, and to analyze factors affecting the MH closure rate.MethodsThis is a retrospective case study. 21 high myopic patients (22 eyes) with MH and macular retinoschisis were enrolled in this study. All eyes were examined for best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope, indirect ophthalmoscope, A and/or B-scan ultrasound, optical coherence tomography and visual electrophysiological examination. The BCVA was ranged from finger counting to 0.2. The axial length (AL) was ranged from 26.00 to 31.00 mm, with an average of 27.47 mm. Among 22 eyes, AL was between 26.00 mm to 27.00 mm in 9 eyes, 27.10 mm to 28.00 mm in 5 eyes, 28.10 mm to 29.00 mm in 3 eyes, 29.10 mm to 30.00 mm in 3 eyes, and longer than 30.00 mm in 2 eyes. The diameter of MH was ranged from 227 µm to 597 µm and with an average of 432 µm. Among them, the minimum diameter was between 200 µm to 400 µm in 4 eyes, 401 µm to 450 µm in 13 eyes, 451 µm to 500 µm in 3 eyes, 501 µm to 600 µm in 2 eyes. All the eyes were treated with PPV combined with ILMP surgery. The average follow-up time was 17 months after surgery. The efficacy was determined at the final follow up, including the MH closure, the state of macular retinoschisis and the BCVA. MH closure rate with different MH diameters and different AL were compared and analyzed.ResultsDuring the final follow-up, MH were fully closed in 17 eyes (77.3%), bridge-closed in 4 eyes (18.2%) and not closed in 1 eye (4.5%). Retinoschisis was resolved in 19 eyes (86.4%), partially resolved in 2 eyes (9.1%) and not changed in 1 eye (4.4%). MH with smaller diameter had higher MH closure rate (χ2=12.036, P=0.032). MH with longer AL had lower MH closure rate (χ2=16.095, P=0.003).The final BCVA was ranged from finger counting to 0.25. Among 22 eyes, BCVA or metamorphopsia were improved in 9 eyes (40.9%), stable in 8 eyes (36.4%). BCVA was reduced and metamorphopsia was more severe in 5 eyes (22.7%).ConclusionsPPV combined with ILMP is a safe and effective surgical treatment for MH (with minimum diameter ≤600 μm) and macular retinoschisis in high myopic eyes. After surgery, MH was closed and retinoschisis was resolved in most patients. The major factors affect the MH closure were the minimum diameter of MH and AL.