ObjectiveTo observe the efficacy of intravitreal injection of ranibizumab (IVR) and combined treatment for severe Coats disease. MethodsNineteen Coats disease patients (24 eyes) were enrolled in this retrospective non-comparative interventional clinical study. The patients included 17 males and 2 females. The age was ranged from 1 to 42 years old, with an average of (13.05±6.78) years. The patients included 15 children (age ≤14 years old) and 4 adults (age ≥18 years old). There were 13 patients with 3a stage and 6 patients with 3b stage. The treatment methods including IVR only, IVR combined with cryotherapy, IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, IVR combined with vitrectomy. Treatments were repeated if it was necessary at the first day, the first week and the first month after injection. The interval between treatments was ≥1 month. Eleven patients (57.9%) underwent one treatment, 3 patients (15.8%) underwent 2 treatments, 3 patients (15.8%) underwent 3 treatments, 2 patients (10.5%) underwent 4 treatments. The treatment frequency including 22 times of IVR only, 6 times of IVR combined with cryotherapy, 5 times of IVR combined with cryotherapy and sclerotomy to drain subretinal fluid, 1 time of IVR combined with vitrectomy. The follow-up period was ranged from 6 to 36 months, with an average of (19.11±7.05) months. Visual acuity, retinal reattachment and ocular adverse events were observed. ResultsThree children (15.8%) were failing to test the visual acuity. Visual acuity was improved in 2 patients (10.5%), stable in 13 patients (68.4%) and decreased in 1 patient (5.3%). Three patients (15.8%) achieved totally retinal reattachment after treatment, while 16 patients (84.2%) achieved partially retinal reattachment. One patient had vitreous hemorrhage. One patient had neovascular glaucoma. ConclusionIVR and combined treatment were effective for severe Coats disease.
ObjectiveTo compare the therapeutic effects of 577 nm laser panretinal photocoagulation (PRP) between one time multi-point scanning mode and multiple time single-point mode in the treatment of eyes with non-proliferative diabetic retinopathy (NPDR). MethodsThis is a prospective controlled study from August 2013 to February 2014. A total of 29 patients (46 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including the treatment group (12 patients, 22 eyes) and the control group (17 patients, 224 eyes). The treatment group received one time PRP of multi-point scanning mode, and the control group received 3-4 times of PRP with single-point mode. In order to evaluate its efficacy, the best corrected visual acuity was measured before treatment, and 1 day, 1, 2, 6 and 12 months after treatment. The average threshold sensitivity, a/b-wave amplitude of flash ERG (F-ERG) in the 30°-60° visual field, and fundus fluorescein angiography (FFA) of the change were also compared between the 2 groups. The laser energy and the number of laser spots were compared, and the laser energy density was calculated. ResultsThe response rate was 86.4% and 79.2%, respectively in the treatment and control group, the difference was not statistically significant (χ2=0.414, P > 0.05). Compare to the pre-treatment measurement, the average threshold sensitivity, a/b-wave amplitude of F-ERG in the 30°-60° visual field were reduced at 1 day after treatment both in treatment and control group, the differences were statistically significant (P < 0.05). The average threshold sensitivity, a/b-wave amplitude of F-ERG were no difference between treatment and control group at 2m, 6m and 12m after treatment (P > 0.05). The average laser power, number of laser spots and energy density were (537.50±64.69) mW and (339.09±132.09) mW, (1934.32±426.38) points and (2061.42±375.49) points, (0.35±0.12) mW o ms/μm2 and (1.95±0.86) mW·ms/μm2 in the treatment group and the control group, respectively. The average laser power and energy density was statistically different between the 2 groups (P < 0.05), while the number of laser spots was no difference (P > 0.05). Conclusions577 nm multi-point scanning laser can complete the PRP at one time, and achieve the same therapeutic outcomes with the single-point mode which need several times to complete the PRP in the eyes with severe NPDR, and have lower energy density, and thus relative minor function damage.
Objective To compare the therapeutic effects of 577 nm laser and 532 nm laser panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR). Methods This is a prospective controlled study. A total of 23 patients (41 eyes) with clinically diagnosed severe NPDR were randomly divided into two groups including 577 nm group (11 patients, 20 eyes) and the 532 nm group (12 patients, 21 eyes). 577 nm group and 532 nm group received 3 - 4 times PRP with single-point mode. The laser energy and the number of laser spots were compared, and the laser energy density was calculated. Before treatment and 1 day, 1, 3, 6 and 12 months after treatment, the changes of best corrected visual acuity (BCVA), average threshold sensitivity, a/b-wave amplitude of flash ERG (F-ERG) in the 30° - 60° visual field, and fundus fluorescein angiography (FFA) were compared between two groups. Results The response rate was 85.0% and 23.8%, respectively in the 577 nm and 532 nm group, the difference was statistically significant (χ2=15.43，P < 0.05).Compare to the pre-treatment measurement, the average threshold sensitivity, a/b wave amplitude of F-ERG and the 30° - 60°visual field were reduced at 1 day after treatment both in the 577 nm and 532 nm group, the difference were statistically significant (F=8.68, 7.57, 4.52; P < 0.05). The average threshold sensitivity (t=2.41, 3.48, 1.23), a/b wave amplitude (a wave: t=5.82, 4.45, 7.83；b wave: t=5.40, 3.23, 4.67) of F-ERG were different between 577 nm and 532 nm group at 3 , 6 and 12 months after treatment (P < 0.05). There was no retinal neovascularization and non-perfusion region in two groups at 6 months after treatment. The average laser power were (436.25±54.65) and (446.43±35.61) mW, number of laser spots were (1952.95±299.09) and (2119.05±302.69) spots, energy density were (7.60±1.30) and (7.60±3.00) mW×ms/μm2 in the 577 nm group and 532 nm group, respectively. There was no difference in average laser power (t=1.35), number of laser spots (t=2.85) and energy density (t=1.99) between two groups (P > 0.05). Conclusion Compared with the 532 nm laser, 577 nm laser treatment has better visual outcomes for NPDR patients.
Objective To cpmpare the assessment of retinal and choroidal disease using confocal scanning laser ophthalmoscope (cSLO) imaging and color fundus camera. Methods Sixty-seven patients (90 eyes) with fundus diseases were included in this study. There were 35 males (51 eyes) and 32 female (39 eyes), mean age was 51.32 years. All subjects underwent fundus imaging using cSLO technology and traditional color fundus camera, positive numbers of every retinal pathological change were calculated and compared. Spectral domain-optical coherence tomography (SD-OCT) was also done to compare the accordance rate between two modes of fundus imaging (cSLO technology and traditional color fundus camera) and SD-OCT in choroidal changes. Results The positive numbers of retinal microaneurysm (χ2=4.157, P < 0.05) and epiretinal membrane (χ2=5.428, P < 0.05) using cSLO fundus imaging were significantly higher than traditional color fundus camera, while the positive numbers of cotton wool spots (χ2=0.523), retinal hemorrhage (χ2=0.117), hard exudates (χ2=0.325) and macular hole (χ2=0.070) were no significant different (P > 0.05). The SD-OCT accordance rate of choroidal pathological changes using cSLO technology was higher than traditional color fundus camera (χ2=9.143, P=0.007). Conclusion In retinal and choroidal diseases, the imaging quality of cSLO fundus imaging technology is better than the traditional color fundus camera technology.
ObjectiveTo determine the positive results of confocal scanning laser ophthalmoscope (cSLO) based retinal imaging and traditional color fundus camera in screening epiretinal membrane (ERM) in elderly people. MethodsA total of 184 retired staffs from certain company (363 eyes) were included in this study, 153 were men (304 eyes) and 31 were women (59 eyes). The mean age was 74.35 years (range 47-92 years). All subjects were underwent fundus imaging using cSLO technology and traditional color fundus camera and Cirrus high definition optical coherence tomography (HD-OCT). The imaging quality of two technologies were analyzed and compared according to the evaluation standards. The positive accordance rate was used to compare between two modes fundus imaging (cSLO technology and traditional color fundus camera) and HD-OCT. ResultsIn 363 eyes, the positive number of screening ERM using HD-OCT was 122 eyes (33.6%); the positive number of traditional color fundus camera was 33 eyes (9.1%); the positive number of cSLO imaging was 76 eyes (20.9%). The HD-OCT positive accordance rate of screening ERM using traditional color fundus camera and cSLO technology were 27.0% vs. 62.3%. The HD-OCT positive accordance rate of screening ERM using cSLO technology was significant higher than traditional color fundus camera (χ2=30.81, P < 0.001). ConclusionThe HD-OCT positive accordance rate of screening ERM in elderly people was higher using cSLO technology than using traditional color fundus camera.