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.

Prevalence of refractive errors in Villa Maria, Córdoba, Argentina

Prevalence of refractive errors in Villa Maria, Córdoba, Argentina

:68-77
 
Background: Refractive errors are among the most frequent reasons for demand of eye-care services. Publications on refractive errors prevalence in our country are few. This study has the purpose to assess the prevalence of refractive errors in an adult population of Villa Maria, Córdoba, Argentina.
Methods: The Villa Maria Eye Study is a population-based cross-sectional study conducted in the city of Villa Maria, Córdoba, Argentina from May 2008 to November 2009. Subject’s aged 40+ received a demographic interview and complete ophthalmological exam. Visual acuity was obtained with an ETDRS chart. Cycloplegic auto refraction was performed. The spherical equivalent was highly correlated between right and left eyes, so only data of right eyes are presented. Myopia and hyperopia were defined with a ±0.50 diopters (D) criterion and astigmatism >1 D.
Results: This study included 646 subjects, aged 40 to 90 (mean age: 59.6±10.3 years old). Four hundred and sixty two (71.5%) were females. The mean spherical equivalent was +0.714±2.41 D (range, ?22.00 to +8.25 D) and the power of the cylinder was, on average, ?0.869±0.91 D (range, 0 to ?6.50 D). In this sample, 61.6% subjects were hyperopic, and 13.5% were myopic. Myopia prevalence was lower in men (9.8% versus 14.9%) but this difference among genders was not statistically significant. There were 141 subjects (21.8%) with anisometropia greater than 1 D, and 168 subjects (26.0%) with astigmatism greater than 1 D.
Conclusions: The present study shows the prevalence of cycloplegic refractive errors in an adult population of Argentina. The prevalence of hyperopia was high, while myopia prevalence was very low.
Background: Refractive errors are among the most frequent reasons for demand of eye-care services. Publications on refractive errors prevalence in our country are few. This study has the purpose to assess the prevalence of refractive errors in an adult population of Villa Maria, Córdoba, Argentina.
Methods: The Villa Maria Eye Study is a population-based cross-sectional study conducted in the city of Villa Maria, Córdoba, Argentina from May 2008 to November 2009. Subject’s aged 40+ received a demographic interview and complete ophthalmological exam. Visual acuity was obtained with an ETDRS chart. Cycloplegic auto refraction was performed. The spherical equivalent was highly correlated between right and left eyes, so only data of right eyes are presented. Myopia and hyperopia were defined with a ±0.50 diopters (D) criterion and astigmatism >1 D.
Results: This study included 646 subjects, aged 40 to 90 (mean age: 59.6±10.3 years old). Four hundred and sixty two (71.5%) were females. The mean spherical equivalent was +0.714±2.41 D (range, ?22.00 to +8.25 D) and the power of the cylinder was, on average, ?0.869±0.91 D (range, 0 to ?6.50 D). In this sample, 61.6% subjects were hyperopic, and 13.5% were myopic. Myopia prevalence was lower in men (9.8% versus 14.9%) but this difference among genders was not statistically significant. There were 141 subjects (21.8%) with anisometropia greater than 1 D, and 168 subjects (26.0%) with astigmatism greater than 1 D.
Conclusions: The present study shows the prevalence of cycloplegic refractive errors in an adult population of Argentina. The prevalence of hyperopia was high, while myopia prevalence was very low.

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.

增殖性糖尿病视网膜病变玻璃体 SDF-1 和 VEGE 的含量分析

Vitreous Levels of Stromal Cell-Derived Factor-1and Vascular Endothelial Growth Factor inDiabetic Retinopathy

:6-9
 
目的:研究增殖性糖尿病视网膜病变患者玻璃体基质细胞衍生因子(Strmalcell-derivedfactor-1, SDF-1)和血管内皮生长因子(Vascular endothelial growth factor, VECF)的浓度,及其相互作用关系。
方法:酶联免疫吸附法(Enzyme-linked immunosorbent assay, ELISA)检测玻璃体内 SDF-1 和 VEGF 的含量,每个标本重复3次。实验组为增性糖尿病视网膜病变(Proliferalive diabeticretinopathy, PDR)的住院患者30例,对照组为同期行玻璃体切除术的特发性黄斑裂孔患者12例。
结果: PDR 患者玻璃体 VECF 的平均浓度为(2865.87+387.85) pg/ml,明显高于特发性黄斑裂孔组[(142.42+21.03) pg/ml,< 0.0001]。增殖性糖尿病视网膜病变患者玻璃体 SDF-1的含量平均为(298.40+24.57) pg/ml,对照组为(86.91+15.89) pg/ml,两组的差异具有统计学意义(< 0.0001)。在30例PDR患者玻璃体内 VEGF 和 SDF-1 的含量表现为正相关(Peanson相关系数 r=0.62,< 0.001)。
结论:增殖性糖尿病患者玻璃体 SDF-1 和 VECF 的含量均高于非糖尿病患者,提示 SDF-1 和 VEGF 共同参与了增殖性糖尿病视网膜病变患者病理性新生血管的形成过程。
Purpose: To investigate the levels of stromal cell-derived factor-1(SDF-1) andvascular endothelial growth factor (VEGF) in the vitreous of patients with proliferativediabetic retinopathy.
Methods: The levels of $DF-1 and VEGF in the vitreous of 30 eyes of 30 patients withproliferative diabetic retinopathy(PDR)and 12 eyes of 12 patients with idiopathicmacular hole (MH) were measured by enzyme-linked immunosorbent assay. Vitreousfluid samples were obtained by vitrectomy.
Resuls: The vitreous concentration of VEGF was signifcantly higher in eyes with PDR(2 865.87+387.85 pg/ml) than in eyes with idiopathic macular hole (142.42+21.03 Pgml, P< 0.000 1). The vitreous level of SDF-1 was also significantly higher in eyes withPDR (298.40+24.57 pg/ml ) than in eyes with idiopathic macular hole (86.91+15.89Pg/ml, P<0.000 1 ). The vitreous concentration of SDF-1 correlated significantly with that of VEGF in eyes with PDR( [correlation coefficient]r=0.62,P<0 .001)
Conclution: Vitreous levels of both SDF-1 and VEGF in patients with PDR aresignificantly higher than those of nondiabetic patients. SDF-1 may be correlated withVEGF in angiogenesis in PDR.

泪膜改变对 Goldmann 眼压测量值的影响

Effect of Tear Film Changes on the Intr aocular Pr essur e Measur ement by Goldmann Applantion Tonometer

:27-61
 
目的: 探讨泪膜改变对 Goldmann 压平眼压计测量值的影响。
方法: 将 68 例(136 只眼) 受检者随机分为 2 组, 每组 34 例。随机选择一只眼作为实验眼, 另一只眼作为对照眼。A 组的实验眼采用右旋糖苷 70 滴眼液滴眼, B 组的实验眼采用粘弹剂 Viscoat 滴眼。采用 Goldmann 眼压计测量 2 次眼压, 比较滴眼前、后测量值的差异。
结果: A 组对照眼第 1、2 次的眼压测量值分别为(14.44±2.68) mmHg(1 mmHg = 0.133 KPa) 、(14.47 ± 2.69) mmHg, 两次眼压测量值的差异无统计学意义(= - 0.329, = 0.744) 。实验眼滴右旋糖苷 70 滴眼液前、后的眼压测量值分别为(14.41 ±2 .63) mmHg、(12.94 ± 2.59) mmHg, 两次眼压测量值的差异有统计学意义 (t = 13.949, P = 0.000) 。B 组对照眼第 1、2 次的眼压测量值分别为(14.29 ± 2.96) mmHg、(14.35 ± 3.12) mmHg, 两次眼压测量值的差异无统计学意义(t = - 0.466, P = 0.644) 。实验眼滴 Viscoat 前、后的眼压测量值分别为 (14.53 ± 3.13) mmHg、(11.18 ± 3.07) mmHg, 两次眼压测量值的差异有统计学意义( t = 22.126, P = 0.000) 。两组的实验眼滴眼后的眼压均呈一致性的下降。
结论: 泪膜的改变可以使 Goldmann 压平眼压计的测量值产生偏差。
Purpose: To explore the effect of tear film changes on the intraocular pressure (IOP) measurement by Goldmann applantion tonometer.
Methods: Sixty-eight normal subjects were randomly divided into two groups (Gruop A and B) , 34 in each group. One eye of each subject by random selection was given Dextran (in Group A) and Viscoat (in Group B) , respectively. And the fellow eyes were used as controls. IOP was measured in all subjects twice using Goldmann applantion tonometer. And the difference between first and second measurements was compared.
Result: In the control eyes of Group A, the average IOP of first and second measurements were (14.44 ± 2.68) mmHg (1 mmHg= 0.133 KPa) and (14.47 ± 2.69) mmHg, there was no difference between the two measurements (t =- 0.329, = 0.744) . In eyes given Dextran, the average IOP of two measurements were (14.41 ± 2.63) mmHg and (12.94 ± 2.59) mmHg, there was significant difference between the two mea-surements (t =13.949, P= 0.000) . In control eyes of Group B, the average IOP of first and second measurements were (14.53 ± 3.13) mmHg and (11.18 ± 3.07) mmHg, and there was no difference between the two measurements (t = -0.466, = 0.644) . In eyes given Viscoat, the average IOP of two measurements were (14.53 ± 3.13) mmHg and (11.18 ± 3.07) mmHg, and there was significant difference between the two measurements (= 22.126, = 0.000) . After being given Dextran or Viscoat, the IOP values decreased consistently in both Group A and Group B.
Conclusions: The change of tear film components can affect IOP values by Goldmann applantion tonometer.
论著

未行准分子激光角膜屈光手术的原因分析

Analysis of reasons for not performing laser refractive keratomileusis in refractive surgery candidates

:15-19
 

目的:分析有意愿接受准分子激光角膜屈光手术治疗近视的患者在术前检查后未行手术的原因。方法:选取20151月至20176月在安徽医科大学附属第一医院眼科激光中心检查的近视患者,分析其中未行激光手术的原因。结果:2 875例患者准备接受准分子激光角膜屈光手术,其中821(28.6%)检查后未进行手术,男462(56.3%),女359(43.7%),年龄18~51(23.69±5.85)岁。821例中社会心理因素影响484(59.0%),角膜薄或角膜厚度不足182(22.2%),超高度近视(>10.00 D)100(12.2%),高眼压19(2.3%),弱视13(1.6%),角膜曲率异常11(1.3%),眼底病变7(0.9%),角膜变性3(0.4%),其他2(0.2%)结论:近视治疗术前检查后未进行准分子激光角膜屈光手术的原因多种多样,其中社会心理因素及角膜厚度不足是最主要的原因。术前详细检查,严格掌握手术适应证和禁忌证以及充分医患沟通是手术安全的保障。

Objective: To analyze the reasons for not performing laser refractive keratomileusis surgery among refractive surgery candidates under regular preoperative examination. Methods: The patients with myopia examined in the Center of Ophthalmology in the First Affiliated Hospital of Anhui Medical University Laser between January 2015 and June 2017 were selected, the reasons for not performing laser refractive keraomileusis after regular preoperative examination were analyzed. Results: A total of 2 875 patients requested refractive surgery and 2 054 (71.4%) of them received refractive surgery. Among 821 (28.6%) patients who did not get laser refractive keratomileusis, 462 (56.3%) were male and 359 (43.7%) were female, aged 1851 years (range, 23.69±5.85 years). The most common reason for not offering refractive surgery were social psychological factors (59.0%), low central corneal thickness (22.2%), high myopia (12.2%), high intraocular pressure (2.3%), poor corrected visual acuity (1.6%), corneal topography anomaly (1.3%), retinal disease (0.9%), corneal (0.4%) and other diseases (0.2%). Conclusion: Reasons for not performing refractive surgery are quite diverse. Social psychological factors and inadequate corneal thickness were the most common reasons in the present study. Careful preoperative examination, strictly mastering indications and contraindications and full doctor-patient communication should be done for the safety of surgery.

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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