AIM : To evaluate the effect of bromfenac sodium on macular thickness and microcirculation in patients with diabetes mellitus ( DM ) after cataract surgery using optical coherence tomography angiography ( OTCA ). METHODS : Sixty patients ( 60 eyes ) with DM underwent cataract surgery. The observation group ( 32 cases, 32 eyes ) was treated with bromfenac sodium eye drops during perioperative period, and the control group ( 28 cases, 28 eyes ) was treated with glucocorticoid alone. The macular thickness and vascular density of the 2 groups were detected using OCTA before operation and 1 wk，4 wk after operation. RESULTS: The central macular thickness（CMT）of the operated eyes of the 2 groups was basically the same before surgery (P＞0.05 ), and increased postoperatively compared with the preoperative period, and the difference was statistically significant in the control group (P＜0.05). The area of foveal avascular zone ( FAZ ) reflecting macular blood supply was basically the same in the 2 groups before operation, and was enlarged in the 2 groups postoperatively compared with the preoperative period (P＜0.05 ), and it was significantly larger in the control group (P＜0.01 ). The vessel length density (VLD) and vascular perfusion density (VPD) of the superficial macular capillary network in the operated eyes of the 2 groups were basically the same preoperatively, and showed a decreasing trend in the postoperative period compared with the preoperative period, in which the difference between the VLD before and after surgery was not significant (P＞0.05), while the difference between the VPD in the postoperative period compared with that before the operation was larger ( P＜0.05), and the control group showed a certain elevation of the postoperative 1 wk compared with that before the operation ( P＜0.05). CONCLUSION: During the perioperative period of cataract surgery in patients with DM, the addition of bromfenac sodium eye drops can further reduce the increase of CMT caused by inflammation-induced vascular permeability and vasodilation compared with simple glucocorticoids.
Purpose : To analyze the postoperative period of patients with primary acquired nasolacrimal duct obstruction (PANDO) who underwent endoscopic dacryocystorhinostomy (En-DCR) in the day room mode of Current status of care and early outcome evaluation. Methods : Ninety patients with PANDO who underwent En-DCR surgery at the Department of Oculoplastics and Lacrimal Ducts, Zhongshan Ophthalmic Center, Sun Yat-sen University, China, from November 2021 to August 2022 were included, and they were given instructions on postoperative home medication, diet, and nasal and prosthetic duct care. One month after the operation, we returned to the hospital for nasal endoscopy, reviewed and recorded the nasal anastomosis, and used a questionnaire to record the current status of patients' postoperative care and subjective symptom improvement and lacrimal duct irrigation. Results : A total of 90 PANDO patients totaling 94 eyes were included. The mean age was 55.81 ± 12.19 years. The subjective surgical outcome was 62 eyes (70.0%) cured, 25 eyes (26.6%) improved, and 7 eyes (7.4%) ineffective. Surgical outcome was better in patients who followed postoperative nasal rinsing at least once a day, regular use of seroquelin hydrochloride with budesonide nasal spray, and did not suffer from upper respiratory tract infections (P=0.008, P<0.001, P=0.020). Local discomfort symptoms were associated with surgical outcome (R=0.43, P<0.001). Post-lacrimal duct placement discomfort was associated with higher psychological burden (R=0.39, P=0.00090). Frequency of nasal washings and presence or absence of prosthetic tubes had an effect on postoperative discomfort (P< 0.028, P< 0.043). Conclusion: Under the day ward model, healthcare professionals should provide guidance on personal care management for patients after En-DCR, including nasal rinsing at least once a day, regular use of anti-inflammatory nasal sprays and prevention of upper respiratory tract infections; they should focus on the local discomfort symptoms of patients with lacrimal duct placement in the postoperative period, and follow up on the Internet or by telephone to provide good nursing guidance and psychological counseling.
Objective: To study characteristics of the posterior vitreous liquefaction at early stage using wide-field en face swept-source optical coherence tomography (SS-OCT). Method: SS-OCT was used to capture 18*18mm cube scanning, a series of vitreous en face structure images were created and analyzed in 70 enrolled eyes of healthy juveniles (age range, 5-18 years). Result: In juveniles, there were four types of preretinal vitreous liquefaction structures: the posterior precortical vitreous pocket (PPVP), the preoptic area of Martegiani (AM), the prevascular vitreous fissure (PVF), and the cistern. The PPVP, AM, and PVF were detected in all study eyes, with 22 eyes (31.4%) showing the connection between PPVP and AM. Cistern was detected in 41 eyes (58.6%), with an average age older than that of individuals without cistern (P=0.01). The presence of cistern was positively correlated with age (r=0.315; P=0.008). The quadrant distribution frequency of cistern was supertemporal (90.2%), superior nasal (58.5%), infratemporal (36.6%), infranasal (24.4%), and the superotemporal cisterns were predominately noted (P<0.001). Conclusion: PPVP, AM, and PVF consistently presented in the posterior vitreous liquefaction at early stage. The occurrence of cistern was positively correlated with age and in the superotemporal quadrant more frequently, which might be the result of age-related vitreous liquefaction degeneration. These findings provide a theoretical basis for the study of the pathogenesis of vitreoretinal interface diseases.
【Abstract】Objective: To analyze the clinical characteristics of retinal arterial macroaneurysm. Design a retrospective case series. The research subjects were 19 patients (19 eyes) with retinal arterial macroaneurysms treated at the Aviation General Hospital and the General Hospital of the People's Liberation Army of China from January 2016 to December 2023. Method: All patients were asked about their medical history and underwent routine eye and fundus examinations (fundus photography,...) OCT, FFA, etc.) inspection. Main indicators: changes in fundus and clinical classification. As a result, the fundus showed only hard exudation in 4 cases (21.1%), bleeding involving subretinal, intraretinal, and retinal areas (3 cases, 15.8%), bleeding involving subretinal and intraretinal areas (3 cases, 15.8%), bleeding involving subretinal and intraretinal areas (3 cases, 15.8%), bleeding involving subretinal and retinal areas (2 cases, 10.5%) with combined hard exudation, only pre retinal bleeding (1 case, 5.3%), and intra retinal bleeding with combined hard exudation (1 case, 5.3%). One case (5.3%) showed gray white atrophic lesions in the tumor body, with a small amount of exudation visible around it (one case, 5.3%). According to the characteristics of fundus photography and fundus fluorescein angiography (FFA), the patients were classified into hemorrhagic type (14 cases, 73.7%), exudative type (4 cases, 21.1%), and stationary type (1 case, 5.3%). Conclusion: The fundus manifestations of retinal arterial macroaneurysm are diverse, with hemorrhagic Retinal arterial macroaneurysm being the most common type.
[Abstract]: Objective: To investigate the postoperative safety and efficacy of double pedicled conjunctival capsulonostomy. Methods:In retrospective study, 4 cases with 4 eyes of patients with severe lacrimal duct obstruction combined with conjunctival laxity treated in our hospital from september 2023 to March 2024 were selected as the study objects for double-pedicle conjunctival nasal anastomosis surgery. Postoperative follow-up was conducted for 6 months to observe the surgical effect, satisfaction and postoperative complications of the patients Results:1 month after surgery: cured 100%, improved 0%,ineffective 0%; 3 months after surgery: cured 100%, improved 0%, ineffective 0%. 6 months after surgery: 80% cured, 20% improved, 0% ineffective. Conjunctival laxity improved significantly after operation. Conclusion: Compared with the traditional operation, with the single nasal mucosal flap, the length of the nasal mucosal flap increases significantly, which can form the upper anastomotic valve from the nasal cavity to the inner canthus. Compared with the previous surgical methods, this method simplifies the surgical procedure, significantly reduces the difficulty of operation, has a high surgical success rate, fewer complications, is safe and effective, and can improve conjunctival relaxation to a certain extent. It is a very promising surgical method for patients with lacrimal duct obstruction or absence complicated with conjunctival relaxation.
Vitreoretinal lymphoma (Vitreoretinal lymphoma, VRL) is a rare fatal ocular malignancy; the vast majority of VRL is complicated by primary central nervous system lymphoma (primary central nervous system lymphoma, PCNSL), is its special subtype, and a few VRL primary without ocular involvement of the central nervous system and other organs outside the eye are called (Primary vitreoretinal lymphoma, PVRL). VRL lymphoma cells can invade the vitreous, retina, and uvea, leading to diversified clinical manifestations are similar to retinal vasculitis, uveitis, vitritis and other clinical symptoms, clinical symptoms and images are not specific, which is called "camouflage syndrome" is difficult to diagnose.
“锌”在青光眼研究舞台上正扮演着越来越重要的角色。糖皮质激素，作为人体内重要的激素之一，其对锌的调控已在诸多系统中被证实。研究发现，在糖皮质激素的影响下，小梁网中的锌离子转运受阻，导致细胞外基质降解失衡，从而干扰小梁网正常流出道功能，加重青光眼的病情。而视神经损伤后，锌离子在神经突触间的异常传递、不平衡分布与胞内异常累积影响视网膜神经节细胞存活和轴突的再生能力，进而损害视功能，可能成为青光眼视神经损伤发病及进展的关键因素。这些研究进展为视神经保护策略提供了新的视角，“锌”作为治疗靶点的潜力正在被逐步挖掘，通过调节锌水平来干预青光眼病理进程成为可能治疗手段。本期封面中将汉字“锌”设计为飞天舞者，其超越时空的永恒美感，呼应了“锌”在青光眼研究中突破传统、开辟新程的角色。轻盈与自由的飞天舞者，象征着“锌”在细胞内外穿梭，精妙调控生理功能，维系细胞的和谐与平衡，为青光眼患者带来新的治疗希望。
Background: Meningeal carcinomatosis (MC) is a rare complication associated with advanced hematologic and solid tumors. MC may have several ocular manifestations and diagnosis is usually made by magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) analysis. Most patients with MC require a combination of surgery, chemotherapy, and/or radiation; however, this disease is incurable and the survival rate is extremely low. Case presentation: A 46-year-old woman presented to the ophthalmology department complaining of vision loss. Funduscopy revealed an indistinct margin of the optic disc, along with bilateral papilledema, juxtapapillary exudates, and splinter hemorrhages. A computed tomography (CT) enhanced scan of the chest revealed pulmonary nodules in the apex of the left lung. Lumbar puncture showed the presence of malignant cells in the CSF compatible with a diagnosis of MC. Conclusion: MC is linked to a severe complication of systemic cancer that generally results in poor prognoses. Since ocular symptoms can sometimes be the primary complaint, MC should be suspected in patients with vision loss or diplopia in the absence of an intraocular cause, even without neurologic symptoms and the context of systemic cancer. Systemic examinations of major organs are important for the early discovery, diagnosis, and treatment of MC.
The choroid is a multifunctional, highly vascular, and dynamic tissue which contributes to ocular homeostasis and the regulation of eye growth in both animals and humans. Although challenging to reliably measure, recent advances in ocular imaging (particularly optical coherence tomography) has expanded the current understanding of the role of the choroid in ageing and refractive error development during childhood. This commentary considers recent advances in the field, particularly the impact of orthokeratology on choroidal thickness and contour in myopic children, and the potential use of choroidal metrics as a biomarker for future eye growth.
