Comparison of structural outcome between intravitreal bevacizumab and laser treatment for type 1 retinopathy of prematurity after long-term follow-up

Comparison of structural outcome between intravitreal bevacizumab and laser treatment for type 1 retinopathy of prematurity after long-term follow-up

:92-97
 
Background: To compare the structural outcome of intravitreal bevacizumab (IVB) and laser treatment for type 1 retinopathy of prematurity (ROP).
Methods: This is a retrospective comparative study. From December 2002 to April 2009, patients with type 1 ROP according to criteria of Early Treatment of Retinopathy of Prematurity (ETROP) study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern. From May 2009 to January 2015, we performed IVB for patients with type 1 ROP. The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group. The demographical data, postmenstrual age (PMA) for treatment, and fundus findings were recorded by chart review. The difference between laser and bevacizumab groups was compared by Student t-test and Fisher exact test.
Results: We collected 43 patients (86 eyes) with type 1 ROP, including 30 male and 13 female infants. Their mean gestation age and birth body weight (BBW) were 27.5 weeks and 1,034 gm. Zone I and zone II disease were found in 8 and 35 patients. The mean PMA for treatment was 37.3 weeks. The mean follow-up period was 54.4 months. Laser treatment was administered in 26 patients, and bevacizumab injection for 17 infants. Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization. Complete regression of ROP was found in 15 infants of bevacizumab group following the first IVB. Four eyes in two patients (2/17, 11.7%) had recurrence of ROP and received additional injections and adjuvant laser treatment. There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management.
Conclusions: Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes. Single session of laser ablation in nearly confluent pattern was sufficient for complete regression of ROP in laser group. Single IVB was appropriate for managing most of cases with ROP in bevacizumab group, but a small proportion (nearly one tenth) of them had recurrent episodes requiring adjuvant therapies.
Background: To compare the structural outcome of intravitreal bevacizumab (IVB) and laser treatment for type 1 retinopathy of prematurity (ROP).
Methods: This is a retrospective comparative study. From December 2002 to April 2009, patients with type 1 ROP according to criteria of Early Treatment of Retinopathy of Prematurity (ETROP) study were treated by peripheral retinal diode laser photocoagulation in nearly confluent pattern. From May 2009 to January 2015, we performed IVB for patients with type 1 ROP. The patients were closely followed until disappearance of retinal neovascularization in the laser group and regression of avascular zone in the bevacizumab group. The demographical data, postmenstrual age (PMA) for treatment, and fundus findings were recorded by chart review. The difference between laser and bevacizumab groups was compared by Student t-test and Fisher exact test.
Results: We collected 43 patients (86 eyes) with type 1 ROP, including 30 male and 13 female infants. Their mean gestation age and birth body weight (BBW) were 27.5 weeks and 1,034 gm. Zone I and zone II disease were found in 8 and 35 patients. The mean PMA for treatment was 37.3 weeks. The mean follow-up period was 54.4 months. Laser treatment was administered in 26 patients, and bevacizumab injection for 17 infants. Single session of laser was performed in all patients of laser group without recurrence of retinal neovascularization. Complete regression of ROP was found in 15 infants of bevacizumab group following the first IVB. Four eyes in two patients (2/17, 11.7%) had recurrence of ROP and received additional injections and adjuvant laser treatment. There was no unfavorable anatomical results such as retinal detachment or macular ectopia or complications such as cataract or endophthalmitis in either bevacizumab or laser management.
Conclusions: Laser therapy and IVB were both effective treatments for type 1 ROP to cause favorable anatomical outcomes. Single session of laser ablation in nearly confluent pattern was sufficient for complete regression of ROP in laser group. Single IVB was appropriate for managing most of cases with ROP in bevacizumab group, but a small proportion (nearly one tenth) of them had recurrent episodes requiring adjuvant therapies.

OCT对激光周边虹膜切开术治疗原发性闭角型青光眼效果的评价

Evaluation of the effect of OCT in the treatment of primary angle closure glaucoma by laser peripheral iris

:103-106
 
目的:通过光学相干断层扫描技术(optical coherence tomography,OCT)观察不同临床类型原发性闭角型青光眼(primary angle-closure glaucoma, PACG)行激光周边虹膜切开术(laser peripheral iris, LPI)前、后前房角开放距离变化,评价治疗效果。方法:选择明确诊断为PACG患者46例50眼,其中 急性闭角型青光眼临床前期及缓解期眼26例27眼,慢性闭角型青光眼20例23眼,行LPI治疗,通过OCT分别检查术前、术后2周距巩膜突500及750 μm处前房角开放距离,采用配对t检验。结果:急性闭角型青光眼LPI术前、术后2周前房角开放距离差异有统计学意义(P<0.05);慢性闭角型青光眼术 前、术后2周前房角开放距离差异无统计学意义(P>0.05)。结论:急性闭角型青光眼LPI术后前房角开放距离增加,治疗效果较好;慢性闭角型青光眼LPI术后前房角开放距离增加不明显,术后仍存在前房角闭塞趋向。
Objective: To observe the anterior chamber angle opening distance before and after laser peripheral iris (LPI) in patients with different clinical types of primary angle closure glaucoma (PACG) by using optical coherence tomography (OCT), and evaluate the effect of the treatment. Methods: Selected 46 cases (50 eyes) of patients with PACG, including 26 cases (27 eyes) of acute angle closure glaucoma at the preclinical stage and remission phase of ocular and 20 cases (23 eyes) of chronic angle closure glaucoma, implemented LPI, examined the anterior chamber angle opening distance at the point of 500 and 750 μm from posterior to the scleral before and after surgery for 2 weeks by OCT, using a paired t-test. Results: Compared the anterior chamber angle opening distance before and after surgery for 2 weeks, the difference in patients with acute angle closure glaucoma was statistically significant (P<0.05), but not statistically significant in patients with chronic angle closure glaucoma (P>0.05). Conclusion: The opening distance of the anterior chamber angle of the patients with acute angle  closure glaucoma after LPI was increased, and the treatment effect was better; but of the patients with chronic angle closure glaucoma after LPI, the distance was not obviously increased, the tendency of anterior chamber angle occlusion still existed after LPI.

Anti-vascular endothelial growth factor treatment for choroidal neovascularization secondary to angioid streaks in pseudoxanthoma elasticum: a case report and systemic review

Anti-vascular endothelial growth factor treatment for choroidal neovascularization secondary to angioid streaks in pseudoxanthoma elasticum: a case report and systemic review

:111-118
 
The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.
The present study reports a case of a patient with choroidal neovascularization (CNV) associated with pseudoxanthoma elasticum (PXE). We observed the functional and anatomical improvement of the patient treated with intravitreal vascular endothelial growth factor (VEGF) inhibitor bevacizumab. The study also systematically searched the database for similar cases to provide a literature review. Data concerning the clinical features, treatment strategies and outcomes were extracted and analyzed. Retrospective interventional case report and systematic literature review. A 56-year-old healthy Chinese woman with CNV secondary to PXE was reported. Examinations included best corrected visual acuity (BCVA), biomicroscopy, optical coherence tomography (OCT), fluorescein and indocyanine green angiography and digital fundus photography. The patient managed with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections (bevacizumab 1.25 mg/0.05 mL). The Cochrane Library, PubMed, OVID, and UpToDate databases were searched using the term pseudoxanthoma elasticum or Gr?nblad-Strandberg syndrome with the limits English. Articles that predated the databases were gathered from current references. Fundus examination revealed angioid streaks bilaterally and CNV in left eye (LE). After the patient underwent three intravitreal injections of bevacizumab, the LE showed absorption of the subretinal fluid and shrinkage of the CNV. Visual acuity (VA) was improved in her treated LE. Bevacizumab treatment was well tolerated with no adverse events reported. Approximately ten articles about 45 patients (49 eyes) describing CNV secondary to angioid streaks in PXE treated with anti-VEGF were found in the literature search. In the present case, bevacizumab of an initial three injection loading dose, achieved maintenance of visual function in the treatment of CNV associated with angioid streaks in PXE. Literature articles concluded that the intravitreal application of anti-VEGF is highly efficient for improving and stabilizing the lesion as well as the eyesight. So we believe that anti-VEGF therapy can be a great choice of treatment for CNV secondary to angioid streaks related PXE.

雷珠单抗和曲安奈德治疗视网膜中央静脉阻塞的黄斑水肿的配对病例研究

Comparison of ranibizumab and triamcinolone for treatment of macular edema secondary to central retinal vein occlusion

:35-39
 
目的:研究玻璃体腔注射曲安奈德(triamcinolone acetonide,TA)和雷珠单抗(Lucentis)治疗视网 膜中央静脉阻塞(central retinal vein occlusion,CRVO)的黄斑水肿的疗效。方法:配对病例对照研究。将2013年1月至2015年6月,在我院因CRVO并发黄斑水肿而接受玻璃体腔注射TA或Lucentis 的患者,根据患者基线水平的最佳矫正视力(best-corrected visual acuity,BCVA)(logMAR视力)和黄斑中心厚度(central macular thickness,CMT)将两组患者进行配对,选出12对患者,主要的观察 指标为随访1年时两组患者的BCVA和CMT。结果:TA组患者的BCVA由基线时的0.78±0.12提高到 0.55±0.24(P=0.005),CMT由基线时的(598.92±192.67) μm减少到(258.28±75.38) μm (P=0.002)。Lucentis组患者的BCVA由基线时的0.78±0.11提高到0.48±0.21(P=0.002), CMT由基线时的 (591.75±181.68) μm减少到(281.17±63.08) μm (P=0.002)。TA组和Lucentis组患者基线及最终的 BCVA和CMT直接均无显著差异。TA组的平均注药次数为(2.4±0.9)次,Lucentis组为(4.0±1.6)次, 两组有统计学差异(P=0.012)。结论:玻璃体腔注射TA或Lucentis均能减轻CRVO所致的黄斑水肿并提高视力,两者的疗效并无显著差异。TA的平均注射次数比Lucentis组少,但是TA更容易引起眼压升高。应该根据患者的综合情况制定个性化的治疗方案。
Objective: To compare the efficacy of intravitreal injections of triamcinolone acetonide (TA) and that of ranibizumab for macular edema secondary to central retinal vein occlusion (CRVO). Methods: In a retrospective assessment 12 TA-treated patients and 12 ranibizumab-treated ones with macular edema after CRVO were pairmatched according to initial best-corrected visual acuity (BCVA) and central macular thickness (CMT). BCVA and CMT were the main endpoints. Results: The initial BCVA of 0.78±0.12 increased significantly to 0.55±0.24 in the TA-treated patients (P=0.005). And the initial CMT of (598.92±192.67) μm decreased significantly to (258.28±75.38) μm (P=0.002). In the ranibizumab-treated patients, the initial BCVA of 0.78±0.11 increased significantly to 0.48±0.21 (P=0.002) and the initial CMT of (591.75±181.68) μm decreased significantly to (281.17±63.08) μm (P=0.002). There was no significance between the initial and final BCVA and CMT of TAtreated patients and ranibizumab-treated patients. Conclusion: Both treatments decreased the CMT and induced an improvement in BCVA from baseline.

改良式外路泪囊鼻腔吻合术联合泪道置管治疗沮囊黏液囊肿

Modified External Dacryocystorhinostomy withIntubation in the Treatment of Lacrimal Sac Cyst

:19-21
 

目的:探讨改良的外路泪囊鼻腔吻合术式联合泪道置管治疗泪囊黏液囊肿的临床疗效。
方法:
23例(23)泪囊黏液囊肿行改良式泪囊鼻腔吻合术,并联合泪道置管,术后行泪道冲洗,并观察泪溢情况。

结果:23例患者,1例术中改为泪囊摘除术20例完成12个月的追踪观察治疗1例术后6个月失访112个月时失访。随访1个月22例患者术后泪囊肿均消失,外观明显改善;随访12个月20例患者中18例溢泪症状完全消失,所有患者泪道冲洗通畅,1例患者因泪溢症状对手术疗效不满意。

结论:改良式外路泪囊鼻腔吻合术联合泪道置管治疗泪囊黏液囊肿,具有良好的临床效果值得推广

Purpose: To investigate the eficacy of modified external dacrocystorhinostomy (DCRwith intubation in the treatment of lacrimal sac cys.

Methods: Twenty-three lacrimal sac cyst cases (23 eyes) were enrolled and treated with DCR technique and tube intubation. The success was assessed based on lacrimalirrigation and symptomatic relief of epiphora.

Results: Among 23 patients, surgery was intenupted and converted to dacryocystectomy in l case, thus surgery was successfully performed in 22 cases. Among them, 1 case lost follow up at 6 month, 1 case lost follow up at 12 month. At 1 month visit, lacrimal sac cyst disappeared in 22 cases. At 12 month visit, epiphora was completed relieved in 18 out of 20 cases, irrigation indicated no obstruction in all 20 cases.

Conclusions :The modified DCR technique with intubation has satisfactory outcome for lacrimal sac cyst.

封面简介

角膜神经移植术治疗神经营养性角膜病变的研究进展

Research progress in the treatment of neurotrophic keratopathy with corneal neurotization

:-
 
神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病,角膜神经的知觉和营养功能受损,导致角膜上皮缺损、角膜溃疡甚至角膜穿孔。目前人工泪液、治疗性角膜绷带镜、泪点栓塞、羊膜移植,睑缘缝合等治疗措施仍是治疗神经营养性角膜病变的主要治疗方式,对于轻中度病变患者,具有较好的治疗效果,而对于重度病变患者,药物治疗及简单的手术干预治疗效果不佳,病情反复发作。由于重度神经营养性角膜病变患者的角膜神经完全消失,丧失角膜感觉,对未恢复角膜神经营养功能的角膜白斑或溃疡患者行角膜移植术,可能导致角膜移植术后上皮持续不愈合,因此恢复角膜神经营养功能是复明的重要保障手段。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能,提高角膜知觉,改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围,使神经末梢重新长入角膜基质,恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进,其良好的术后效果和优点已经渐渐突显。角膜神经移植术包括直接角膜神经移植和间接角膜神经移植,促使角膜神经重新生长,重建角膜神经的营养和知觉功能。角膜神经移植手术已有40年历史,1981年Samii等首次报告了角膜神经移植术,2009年Terzis等成功地实施了第1例直接角膜神经移植术,2014年Elbaz等进行了第1例以腓肠神经作为间置移植物的间接角膜神经移植。封面展示了神经营养性角膜病变患者未接受治疗前的和接受角膜神经移植术后的眼表角膜图像。由于角膜神经退行性改变,角膜失去神经支配,继而出现角膜上皮缺损,角膜缘新生血管形成,经角膜神经移植后,角膜上皮愈合,角膜透明度改善,同时角膜缘新生血管消退。
神经营养性角膜病变是一种与角膜神经退行性改变有关的疾病,角膜神经的知觉和营养功能受损,导致角膜上皮缺损、角膜溃疡甚至角膜穿孔。目前人工泪液、治疗性角膜绷带镜、泪点栓塞、羊膜移植,睑缘缝合等治疗措施仍是治疗神经营养性角膜病变的主要治疗方式,对于轻中度病变患者,具有较好的治疗效果,而对于重度病变患者,药物治疗及简单的手术干预治疗效果不佳,病情反复发作。由于重度神经营养性角膜病变患者的角膜神经完全消失,丧失角膜感觉,对未恢复角膜神经营养功能的角膜白斑或溃疡患者行角膜移植术,可能导致角膜移植术后上皮持续不愈合,因此恢复角膜神经营养功能是复明的重要保障手段。角膜神经移植术是重度神经营养性角膜病变患者恢复角膜神经营养功能,提高角膜知觉,改善角膜透明度的重要和有效的治疗方法。角膜神经移植术通过将具有正常功能的供体神经移植到麻痹眼角膜缘周围,使神经末梢重新长入角膜基质,恢复角膜知觉功能。随着角膜神经移植术的术式的不断改进,其良好的术后效果和优点已经渐渐突显。角膜神经移植术包括直接角膜神经移植和间接角膜神经移植,促使角膜神经重新生长,重建角膜神经的营养和知觉功能。角膜神经移植手术已有40年历史,1981年Samii等首次报告了角膜神经移植术,2009年Terzis等成功地实施了第1例直接角膜神经移植术,2014年Elbaz等进行了第1例以腓肠神经作为间置移植物的间接角膜神经移植。封面展示了神经营养性角膜病变患者未接受治疗前的和接受角膜神经移植术后的眼表角膜图像。由于角膜神经退行性改变,角膜失去神经支配,继而出现角膜上皮缺损,角膜缘新生血管形成,经角膜神经移植后,角膜上皮愈合,角膜透明度改善,同时角膜缘新生血管消退。
封面简介

超声睫状体成形术治疗青光眼的临床应用研究进展

Research progress on clinical application of ultrasound cycloplasty in the treatment of glaucoma

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青光眼是一组以病理性眼压升高为主要危险因素的,以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术,其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成,并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛,早期主要用于各类难治性青光眼患者,特别是晚期及绝对期患者,研究者发现其除降眼压外,还能够显著缓解该类患者的局部疼痛。近年来,UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中,也表现出了良好的降眼压效果,同时显示出较少的并发症和较轻的术后反应,并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异,且为达最佳治疗效果,其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法,测算精度并不适用于国人,然而精准度更高的模型法,其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量,但术后用药策略的调整仍可能导致眼压波动。综上,针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等,仍有待开展相关临床研究,以期为其临床应用提供更加可靠的依据。
青光眼是一组以病理性眼压升高为主要危险因素的,以青光眼性神经萎缩和视野缺损为主要特征的全球首位不可逆性致盲眼病。超声睫状体成形术(UCP)是一种新型非侵入性青光眼治疗技术,其降眼压主要原理为利用高强度聚焦超声破坏睫状突上皮细胞以减少房水生成,并增加葡萄膜巩膜通道的房水流出。UCP适应证广泛,早期主要用于各类难治性青光眼患者,特别是晚期及绝对期患者,研究者发现其除降眼压外,还能够显著缓解该类患者的局部疼痛。近年来,UCP在未经手术治疗的青光眼患者和早、中期青光眼病例中,也表现出了良好的降眼压效果,同时显示出较少的并发症和较轻的术后反应,并可重复治疗。然而不同类型青光眼UCP疗效存在一定差异,且为达最佳治疗效果,其治疗需匹配恰当的探头型号以及适当的治疗扇区。现有较广泛应用于国外的基于眼轴和白到白参数的公式计算方法,测算精度并不适用于国人,然而精准度更高的模型法,其便捷性仍有待进一步提高。UCP虽可减少降眼压药物用量,但术后用药策略的调整仍可能导致眼压波动。综上,针对UCP手术的适应证选择、手术参数设计、疗效预判以及术后管理策略等,仍有待开展相关临床研究,以期为其临床应用提供更加可靠的依据。
论著

飞秒激光辅助角膜内皮移植术治疗大泡性角膜病变的患者围手术期护理

Perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy

:6-9
 
目的:探讨大泡性角膜病变(bullous keratopathy,BK)患者行飞秒激光辅助的角膜内皮移植术(endothelium keratoplasty,EK)的围手术期护理。方法:回顾性分析在南京总医院眼科行飞秒激光辅助角膜内皮移植的BK20例患者,分析并总结患者术前的心理疏导、术前准备、眼科检查、术中如何配合医生、术后特殊体位、高眼压的护理及如何正确用药和出院健康教育等。结果:患者得到及时、有效的护理,术后视力均有所提高,内皮贴伏好,无排斥反应及其他并发症的发生。结论:通过对患者围手术期的护理,可提高护理质量,缩短患者住院时间。
Objective: To observe the perioperative nursing of femtosecond laser-assisted corneal endothelial transplantation in the treatment of patients with bullous keratopathy. Methods: A retrospective analysis of 20 patients with bullous keratopathy with femtosecond laser-assisted corneal endothelial transplantation in our department. The preoperative psychological counseling, preoperative preparation, ocular examination, how to cooperate with the doctors in operation, nursing of special position, high intraocular pressure after surgery, how to use eye drops correctly and health education after discharge were summarized. Results: Nursing were performed to the patients timely and effectively. Postoperative visual acuity of all the patients were improved, the endothelial and corneal stroma bed are well combined and no graft rejection and other complications occurred in the patients postoperatively. Conclusion: We concluded that the quality of nursing was improved and the time of hospitalization was shortened after perioperative nursing.
综述

眼移植物抗宿主病的临床诊疗新进展

Research progress on clinical diagnosis and treatment of ocular graft-versus-host disease

:299-305
 
随着移植技术逐年发展,异基因造血干细胞移植患者的生存期延长,长期并发症成为影响患者预后及生活质量的主要原因。眼移植物抗宿主病是异基因造血干细胞移植术后最常见的眼部并发症,发生率可高达50%以上。根据发病时间可分为急性及慢性眼移植物抗宿主病,临床上最常以慢性炎症及眼表组织纤维化为特点,主要表现为干眼和不同程度的角结膜炎,治疗较为棘手,可不同程度影响患者视觉质量及生活质量,严重可致盲。近年来眼移植物抗宿主病越来越受到国内外学者重视,其发病机制、临床特点、诊断及治疗相关研究逐渐深入,文章针对眼移植物抗宿主病的临床诊疗新进展进行综述。总体而言,眼移植物抗宿主病早期识别仍较为困难,早期诊断策略有待进一步探索。目前治疗对眼移植物抗宿主病的效果较为有限,或缺乏充足的循证医学证据,临床上缺乏针对不同严重程度及疾病活动度的分级诊疗策略,未来有待进一步探索新的治疗靶点及疾病活动监测指标,将有助于改善患者长期预后及生活质量。
Despite advancements in allogeneic hematopoietic stem cell transplantation techniques leading to improved overall survival rates, long-term complications have emerged as the primary contributors to poor prognosis and diminished quality of life. Ocular graft-versus-host disease (oGVHD), a prevalent complication affecting over 50% of patients post-transplantation, frequently manifests as refractory dry eye, often accompanied by keratoconjunctivitis. Patients with oGVHD routinely suffer from visual impairment and a decline in their quality of life.Currently, research into the mechanisms, clinical features, diagnosis, and treatment of oGVHD has progressively deepened. This article reviews the latest advancements in the clinical diagnosis and management of oGVHD. Notably, there is a pressing need for strategies focused on early diagnosis and treatment, as early recognition of oGVHD remains challenging. Existing treatments for oGVHD either exhibit limited efficacy or lack robust clinical evidence to support their use as the best available options.Further research is imperative to develop tiered diagnostic and treatment approaches, including the exploration of novel therapeutic targets and biomarkers for disease detection. Such endeavors hold the promise of enhancing patients' long-term prognosis and quality of life.
综述

他氟前列素在青光眼治疗中的神经保护作用及其分子机制

Neuroprotective effect of tafluprost in glaucoma treatment and its molecular mechanism

:285-290
 
青光眼是一种以视网膜神经节细胞(retinal ganglion cell, RGC)及其轴突的进行性变性和丢失为主要特征的眼病,是导致视力丧失的最常见原因。尽管其具体的发病机制尚未完全明确,但众所周知,眼内压升高是青光眼进展的主要危险因素。目前,通过药物和手术治疗降低眼内压是控制疾病进展的主要手段。他氟前列素因其能有效长期稳定地降低眼内压,且不良反应轻微、患者依从性高、无明显全身不良反应,已成为治疗原发性开角型青光眼及眼高压症的一线治疗药物。近年来的研究表明,他氟前列素除了具有降低眼内压的效果外,还可能具有神经保护作用。文章对他氟前列素的药理作用及其在神经保护方面的潜在效益进行综述,为开发更有效的治疗青光眼药物提供理论依据和科研基础。然而,目前缺乏充分的临床研究证据支持其神经保护效应,未来研究应进一步探索这一领域,以促进针对视神经保护的药物开发和基于视神经再生的视觉功能重建。
Glaucoma is characterized by the progressive degeneration and loss of retinal ganglion cells (RGC) and their axons,making it one of the most common causes of vision loss. Although the exact underlying mechanisms remain unclear, it is well known that elevated intraocular pressure (IOP) is a major risk factor for the progression of glaucoma. Currently, the primary means of controlling glaucoma involves reducing IOP through medication and surgery. Tafluprost, due to its effective and long-term ability to lower IOP, minimal side effects, high patient compliance, and absence of significant systemic side effects, has become the first-line treatment for primary open-angle glaucoma and ocular hypertension. Recent studies suggest that tafluprost may also have neuroprotective effects beyond its IOP-lowering effects. This article aims to review the pharmacological and potential neuroprotective effects of tafluprost, providing a theoretical basis and research foundation for developing more effective drugs for glaucoma treatment. However, there is still a lack of sufficient clinical evidence to support the neuroprotective effects of tafluprost, and further investigations are required to explore in this field to furnish critical theoretical backing for the development of drugs that target optic nerve protection and facilitate vision restoration through optic nerve regeneration.
其他期刊
  • 眼科学报

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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  • Eye Science

    主管:中华人民共和国教育部
    主办:中山大学
    承办:中山大学中山眼科中心
    主编:林浩添
    主管:中华人民共和国教育部
    主办:中山大学
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