Macular edema after cataract surgery in diabetic eyes evaluated by optical coherence tomography

AIM: To assess quantitative changes of the macula in diabetic eyes after cataract surgery using optical coherence tomography (OCT) and to estimate the incidence of development or worsening of macular edema (ME) in diabetic eyes with or without pre-existing ME. METHODS: In this prospective, observational study, 92 eyes of 60 diabetic patients who underwent cataract surgery were evaluated before surgery and 1, 3mo after surgery using OCT. Macular thickness was measured with OCT at nine macular subfields defined by the 9 zones early treatment of diabetic retinopathy study (ETDRS), as well as total macular volume obtained by OCT at 1, 3mo after surgery were compared with baseline features obtained before surgery. In addition, the incidence of development or worsening of ME was analyzed in diabetic eyes with or without pre-existing ME. RESULTS: The central subfield mean thickness increased 21.0 μm and 25.5 μm at 1, 3mo follow-up, respectively (P<0.01). The average thickness of inner ring and outer ring increased 14.2 μm and 9.5 μm at 1mo, 18.2 μm and 12.9 μm at 3mo. Central-involved ME developed in 12 eyes at 3mo, including 4 eyes with pre-existing central-involved and 8 eyes with pre-existing non-central involved ME. Pre-existing diabetic macular edema (DME) was significantly associated with central-involved ME development (P<0.001). CONCLUSION: A statistically significant increase could be detected in the central subfield as well as perifoveal and parafoveal sectors though the increase was mild. And eyes with pre-operative DME prior to cataract surgery are at higher risk for developing central-involved ME.     

Macular atrophy after combined intravitreal triamcinolone and photodynamic therapy to treat choroidal neovascularization

AIM: To report the appearance of choriocapillaris atrophy after combined high dose intravitreal triamcinolone acetonide (TA) and photodynamic therapy (PDT) to treat choroidal neovascularization (CNV) associated with age related macular degeneration (AMD). METHODS: The present study was retrospective about non-randomized interventional case series. Fifty-one consecutive eyes with subfoveal (all types) CNV associated with AMD were treated by PDT and intravitreal (19.4±2.1)mg per 0.1mL TA at the Alicante Institute of Ophthalmology. The appearance of macular choriocapillaris and retinal pigment epithelium (RPE) atrophy was considered at two years follow-up. Thirty consecutive eyes treated by PDT alone, matched for age, sex, and type and size of CNV were considered as control group. RESULTS: Twenty-one of 47 eyes in the study group (45%) and 7 of 30 eyes in the control group (23%) developed macular RPE and choriocapillaris atrophy in the treated area at month 24 (P=0.04, Chi-square test). The greatest diameter of the atrophic areas averaged (5044±1666)μm in the study group vs (4345±1550)μm in the control group. Mean final best corrected visual acuity (logarithm of minimal angle of resolution) was (0.87±0.33) in the cases with RPE atrophy vs (0.66±0.26) in the cases with no RPE atrophy in the study group (P=0.11, Mann-Whitney U test). CONCLUSION: The association of high doses of intravitreal TA and PDT may increase the risk for RPE and choriocapillaris atrophy.     

Calcium overload is associated with lipofuscin formation in human retinal pigment epithelial cells fed with photoreceptor outer segments

Purpose

To investigate the role of Ca²⁺ in lipofuscin formation in human retinal pigment epithelial (RPE) cells that phagocytize bovine photoreceptor outer segments (POSs).

Methods

Cultured human RPE cells fed with 2 × 10⁷ per l bovine POS were treated with flunarizine, an antagonist of Ca²⁺ channel, or/and centrophenoxine, a lipofuscin scavenger. The Ca²⁺ changes and lipofuscin formation were measured with fluoresence dye Fluo-3/AM ester, laser scanning confocal microscopy (LSCM) and flow cytometry (FCM). The activity of RPE cells was measured by methyl thiazolyl tetrazolium (MTT) assay and argyrophilic nucleolar organizer regions (AgNORs) assay.

Results

The Ca²⁺ fluorescence intensity (CFI) of RPE cells fed with POS was significantly increased compared with the controls (165.36±29.92 U). It reached a peak with 777.33±63.86 U (P<0.01) at 12 h, and then decreased but still maintained a high level of 316.90±36.07 U (P<0.01) for 4 days. Flunarizine and centrophenoxine significantly decreased the Ca²⁺ overload to 227.18±14.00 U at 12 h and 211.06±20.45 U at 4 days. FCM confirmed these changes. The drugs also showed an inhibitory effect on the lipofuscin formation. The proliferation rate of the cells fed with POS increased significantly. Both drugs had inhibitory effects on the activity of the cultured cells. This tendency was confirmed by AgNORs assay.

Conclusions

The Ca²⁺ inflow initiated lipofuscin accumulation in RPE cells fed with POS. Flunarizine and centrophenoxine can decrease Ca²⁺ overload and lipofuscin formation in RPE cells, accompanied by maintaining cellular vitality.     

Effect of microkeratome suction duration on corneal flap thickness and diameter in pigs

AIM: To determine the effect of suction duration on thickness and diameter of corneal flap created by microkeratome in porcine eyes in laser in situ keratomileusis (LASIK). METHODS: Sixty porcine eyes were randomly assigned to three groups according to different suction durations: group 1 (10 seconds), group 2 (20 seconds), and group 3 (30 seconds). A Moria M2 microkeratome (Moria, France) with a 160μm head was used to create a corneal flap. Corneal flap thickness was measured by automated ultrasonic pachymetry, and the flap diameter was measured by a vernier caliper. RESULTS: The flap thickness of group 1, group 2 and group 3 was (146.05±13.46)μm, (157.35±18.95)μm and (169.25±21.02)μm, respectively. There was a statistically significant difference among three groups (P=0.001). The mean flap diameter in groups 1, 2 and 3 was(8.63±0.19)mm, (8.89±0.24)mm and (9.06±0.18)mm, respectively. A statisti-cally significant difference was found among groups (P<0.01). CONCLUSION: In LASIK in porcine eyes, an increase in suction duration resulted in a thicker and greater flap.     

银杏叶提取物对光损伤后视网膜色素上皮细胞蛋白质表达的影响

目的 观察中药银杏叶提取物对光损伤后视网膜色素上皮(RPE)细胞蛋白质表达的影响,探讨银杏叶提取物保护RPE光损伤的分子机制.方法 生长良好的人RPE细胞(ARPE-19)融合生长到80%时,随机分为正常对照组、光损伤组和银杏叶提取物处理组.运用冷白光以(2200±300)1x光照ARPE-19,建立光损伤模型;以100 μg/ml的银杏叶提取物(EGb761)处理光损伤的RPE细胞.提取细胞可溶性蛋白,进行蛋白质双向电泳,ImageMaster凝胶软件分析差异蛋白质点,并选取表达差异蛋白进行质谱鉴定和生物信息学分析.结果 蛋白图谱差异分析显示,光损伤组与正常对照组比较,差异蛋白质有33个,其中蛋白质表达下调10个,蛋白质表达上调23个;银杏叶提取物处理组与光损伤组差异蛋白质有25个,其中,蛋白质表达上调3个,蛋白质表达下调22个.银杏叶提取物处理组与正常对照组比较,差异蛋白质有11个,其中,蛋白质表达上调4个,蛋白质表达下调7个.差异蛋白质的质谱鉴定和生物信息分析,成功鉴定出16个蛋白,包括组织蛋白酶B、热休克蛋白、细胞色素C还原酶等.结论 光损伤RPE细胞与银杏叶提取物处理后的光损伤RPE细胞及正常RPE细胞间的蛋白质表达有差异;银杏叶提取物光损伤保护作用涉及组织蛋白酶B、热休克蛋白、细胞色素C还原酶等多种蛋白.     

Accuracy of axial length measurements from immersion B-scan ultrasonography in highly myopic eyes

AIM:To evaluate the accuracy of axial length (AL) measurements obtained from immersion B-scan ultrasonography (immersion B-scan) for intraocular lens (IOL) power calculation in patients with high myopia and cataracts.METHODS:Immersion B-scan, contact A-scan ultrasonography (contact A-scan), and the IOLMaster were used to preoperatively measure the AL in 102 eyes from 102 patients who underwent phacoemulsification and IOL implantation. Patients were divided into two groups according to the AL:one containing patients with 22 mm≤AL<26 mm(group A) and the other containing patients with AL≥26 mm (group B). The mean error (ME) was calculated from the difference between the AL measurement methods predicted refractive error and the actual postoperative refractive error.RESULTS:In group A, ALs measured by immersion B-scan (23.48±1.15) didn’t differ significantly from those measured by the IOLMaster (23.52±1.17) or from those by contact A-scan (23.38±1.20). In the same group, the standard deviation (SD) of the mean error (ME) of immersion B-scan (-0.090±0.397 D) didn’t differ significantly from those of IOLMaster (-0.095±0.411 D) and contact A-scan (-0.099±0.425 D). In group B, ALs measured by immersion B-scan (27.97±2.21 mm) didn’t differ significantly from those of the IOLMaster (27.86±2.18 mm), but longer than those measured by Contact A-scan (27.75±2.23 mm, P=0.009). In the same group, the standard deviation (SD) of the mean error (ME) of immersion B-scan (-0.635±0.157 D) didn’t differ significantly from those of the IOLMaster (-0.679±0.359 D), but differed significantly from those of contact A-scan (-0.953±1.713 D, P=0.028).CONCLUSION:Immersion B-scan exhibits measurement accuracy comparable to that of the IOLMaster, and is thus a good alternative in measuring AL in eyes with high myopia when the IOLMaster can’t be used, and it is more accurate than the contact A-scan.     

Rac1 activates HIF-1 in laser induced choroidal neovascularization

AIM: To study the effect of Rac1 on the induction of HIF-1α in choroidal neovascularization (CNV) in mice. METHODS: One hundred C57BL/6J mice were laser photocoagulated to induce CNV, fifty mice of that were selected randomly for intravitreal injection of Rac1 inhibitor NSC23766 solution (1μL). After laser photocoagulation, fundus fluorescein angiography (FFA) was performed to verify the growth of CNV, Immunohistochemistry and Western blot were used to detect HIF-1α and Rac1 in posterior segment of eye globes. RESULTS: FFA verified that incidence of CNV was significantly reduced in the eyes with NSC23766 injection comparing with that of eyes without NSC23766 injection (P<0.01). Immunohistochemistry detected that HIF-1α and Rac1 mainly expressing in the new fibrovascular tissue. Western blot showed that HIF-1α and Rac1 was highly increased in tissue explants of retinal pigment epithelium （RPE） and choroid without NSC23766 injection. But for tissue explants of RPE and choroid with NSC23766 injection, both the expression of HIF-1α and Rac1 were inhibited. CONCLUSION: Rac1 is crucial to activate HIF-1 regulating the growth of CNV, and its inhibition may have potential therapeutic value.     

Corneal hysteresis in patients with dry eye

Purpose

To measure corneal hysteresis and intraocular pressure (IOP) in patients with dry eye and to compare with normal subjects.

Methods

This cross-sectional study consists of 70 eyes of 40 patients with dry eye (group 1) and 75 eyes of 40 normal subjects (group 2). Eyes were diagnosed as dry eye or normal according to the clinical symptoms, biomicroscopical evaluation, and Schirmer test. Corneal hysteresis (CH), corneal resistance factor (CRF), and cornea-compensated intraocular pressure (IOPcc) were measured by the Ocular Response Analyser (ORA).

Results

Mean CH values were 10.56±0.25 mm Hg and 10.34±0.26 mm Hg, mean CRF values were 10.75±0.28 mm Hg and 10.70±0.28 mm Hg, mean CCT values were 542±3.20 μm and 543±3.89 μm in group 1 and group 2, respectively. There was no statistically significant difference between the groups for these three parameters. IOPcc values measured with ORA were 15.73±0.36 mm Hg in group 1 and 16.60±0.33 mm Hg in group 2, and there was no statistically significant difference between the two groups.

Conclusions

Corneal biomechanical parameters such as CH and CRF are not influenced in dry eye. Also statistical difference was not found between the two groups according to CCT and IOPcc values.     

Pigment epithelium-derived factor protects the morphological structure of retinal Müller cells in diabetic rats

AIM:To investigate if pigment epithelium-derived factor (PEDF) has any protective effect on the retinal Müller cells of Sprague-Dawley rats suffering from diabetes mellitus.METHODS:Sixty Sprague-Dawley rats were randomly divided into a negative control group, a group receiving 0.1 μg/μL PEDF, another group receiving 0.2 μg/μL PEDF, and a group receiving balanced salt solution (BSS). Rats in both the PEDF and BSS groups were treated intravitreally based on previously established diabetic models. After 4wk of treatment, morphological alterations of Müller cells and protein expression of glutamine synthase (GS) and glial fibrillary acidic protein (GFAP) were analyzed.RESULTS:PEDFat either0.1 μg/μL or 0.2 μg/μL significantly improved the structures of both nuclei and organelles of Müller cells compared to the BSS-treated group. Expression of GS was significantly higher in the 0.2 μg/μL PEDF group than that in the BSS group (P=0.012), but expression of GFAP was significantly lower in the 0.2 μg/μL PEDF group than that in the BSS group (P=0.000); however, there were no significant differences in expression of these proteins between the 0.1 μg/μL PEDF group and the BSS group (P=0.608, P=0.152).CONCLUSION:PEDF protects the morphological ultrastructure of Müller cells, improves the expression of glutamate synthase and prevents cell gliosis.     

Effects of different concentrations of tetramethylpyrazine, an active constituent of Chinese herb, on human corneal epithelial cell damaged by hydrogen peroxide

AIM:To discuss the effects of different concentrations of tetramethylpyrazine (TMP), an active constituent of Chinese herb, on damaged Shandonghuman corneal epithelial cell (SDHCEC) induced by hydrogen peroxide.METHODS:We detected the combined effects of TMP with concentrations ranging from 4 mg/mL to 0.03 mg/mL and 800 μM hydrogen peroxide on SDHCEC. The methyl thiazolyl tetrazolium (MTT) assay was processed at 3, 6 and 12h separately while the detection of cell apoptosis at 6h only by flow cytometry.RESULTS:The viability of SDHCEC with 0.5 mg/mL, 0.25 mg/mL, 0.125 mg/mL and 0.06 mg/mL TMP joint with 800 μM hydrogen peroxide at 3h and 6h was significantly higher than that with 800 μM hydrogen peroxide only, P＜0.05. However, except 0.25 mg/mL, TMP with other concentrations joint with 800 μM hydrogen peroxide at 12h could not significantly inhibit decreased SDHCEC viability induced by 800 μM hydrogen peroxide. At 12h, TMP of 0.5 mg/mL, 0.25 mg/mL, 0.125 mg/mL and 0.06 mg/mL could significantly inhibit SDHCEC early apoptosis induced by 800 μM hydrogen peroxide, most remarkable at 0.25 mg/mL TMP, P＜0.05.CONCLUSION:Our results suggested that hydrogen peroxide can induce apoptosis related damage to SDHCEC. TMP can protect SDHCEC from the damage, and the protective effects may be associated with its anti-apoptosis mechanism.     

Effects of Multicurve RGP Contact Lens Use on Topographic Changes in Keratoconus

Purpose

To evaluate the effects of wearing rigid gas permeable (RGP) contact lenses on the topographic changes in keratoconus.

Methods

Seventy-seven keratoconic eyes that wore multicurve RGP contact lenses and 30 keratoconic eyes that wore no contact lenses were retrospectively analyzed. The mean follow-ups were 22.6 and 20.5 months in the lens-wearing and control groups, respectively. Visual acuity, comfort, daily wearing time, and corneal staining were evaluated for both groups. The changes in topographic indices were compared between the lens-wearing and control groups.

Results

Multicurve RGP lens corrected logarithm of the minimum angle of resolution visual acuity of the lens-wearing group significantly improved from -0.016±0.065 to -0.032±0.10 at follow-up (p=0.05). In the lens-wearing group with advanced keratoconus, the Sim Kmax, Sim Kmin, apical power, astigmatic index, and anterior elevation significantly decreased from 57.68±4.26 diopter (D), 50.50±2.32 D, 62.79±5.11 D, 7.20±0.55 D and 67.36±16.30 µm to 55.51±4.28 D, 49.62±3.26 D, 60.31±5.41 D, 5.90±0.51 D and 60.61±16.09 µm, respectively (paired t-test, p<0.05). The irregularity index of 3 mm did not significantly change. Meanwhile, in the control group, the apical power and irregularity index increased from 55.56±7.25 D and 3.06±1.68 D to 57.11±7.75 D and 3.25±1.71 D, respectively (paired t-test, p=0.008, p=0.01).

Conclusions

Properly fitted multicurve RGP contact lenses are not likely to contribute to the progression of keratoconus.     

Postoperative astigmatic outcomes based on the haptic axis of intraocular lenses inserted in cataract surgery

Purpose

This study was conducted to compare post-operative astigmatic outcomes of two groups, with-the-rule (WTR) and against-the-rule (ATR) astigmatism patients, according to the haptic axis of intraocular lenses (IOLs) inserted in cataract surgery.

Methods

Seventy-two eyes with WTR astigmatism and 79 eyes with ATR astigmatism had cataract surgery through a clear corneal temporal incision. These two groups of eyes were then each divided into 2 groups based on whether the haptic axis of the inserted IOL was at 180° or 90°. For ATR patients, the outcomes were analyzed according to the three types of IOLs.

Results

There was no difference in corneal astigmatism, but WTR patients with a 180° haptic axis of the inserted IOL and ATR patients with a 90° hepatic axis of the inserted IOL had a significant decrease in postoperative refractive astigmatism (p < 0.05). The changes in ATR astigmatism according to the IOL type were more effective in single-piece acrylic IOLs than in the three-piece polymethylmethacrylate haptic IOL group.

Conclusions

Insertion of the IOL at the 180° haptic axis in WTR patients and at 90° in ATR patients during cataract surgery may have an effect in reducing pre-existing astigmatism. This observed effect was not consistent among the different types of IOLs.     

Effects of corneal thickness on the intraocular penetration of travoprost 0.004%

Purpose

To determine whether the intraocular penetration of travoprost 0.004% is affected by central corneal thickness.

Methods

Sixty-four patients who were scheduled for cataract surgery without any other ophthalmologic pathology of significance were enroled in this study. At 120 min before surgery, one drop of travoprost 0.004% was instilled in the eye to be operated on. At the start of surgery, a sample of aqueous humour was extracted to subsequently determine its AL-5848 concentration. These concentrations were compared among three groups of patients established according to central corneal thickness measurements obtained by ultrasound pachymetry.

Results

Mean AL-5848 concentrations were 3.27±2.03 ng/ml in Group I (CCT<511 microns), 3.27±2.44 ng/ml in Group II (CCT≥511 and ≤574 microns), and 2.73±2.15 ng/ml in Group III (CCT>574 microns), indicating no significant differences among the groups.

Conclusions

We were unable to demonstrate the greater or lesser penetration of travoprost depending on corneal thickness, which could explain differences in patient responses to this drug.     

Expression of IGFBP-6 in a proliferative vitreoretinopathy rat model and its effects on retinal pigment epithelial cell proliferation and migration

AIM: To investigate the expression of insulin-like growth factor binding protein-6 (IGFBP-6) in a proliferative vitreoretinopathy (PVR) model and its effects on proliferation and migration in retinal pigment epithelial (RPE) cells.METHODS: A PVR Wistar rat model was established by the intravitreal injection of RPE-J cells combined with platelet-rich plasma (PRP). The expression levels of IGFBP-6 were tested by ELISA. ARPE-19 cell proliferation was evaluated by the MTS method, and cell migration was evaluated by wound healing assays.RESULTS: The success rate of the PVR model was 89.3% (25/28). IGFBP-6 was expressed at higher levels in the vitreous, serum and retina of rats experiencing advanced PVR (grade 3) than in the control group (vitreous:152.80±15.08ng/mL vs 105.44±24.81ng/mL, P>0.05; serum:93.48±9.27ng/mL vs 80.59±5.20ng/mL, P<0.05; retina:3.02±0.38ng/mg vs 2.05±0.53ng/mg, P<0.05). In vitro, IGFBP-6 (500ng/mL) inhibited the IGF-II (50ng/mL) induced ARPE-19 cell proliferation (OD value at 24h:from 1.38±0.05 to 1.30±0.02; 48h:from 1.44±0.06 to 1.35±0.05). However, it did not affect basal or VEGF-, TGF-β- and PDGF-induced cell proliferation. IGFBP-6 (500ng/mL) reduced the IGF-II (50ng/mL)-induced would healing rate [24h:from (43.91±3.85)% to (29.76±2.49)%; 48 h:from (66.09±1.67)% to (59.88±3.43)%].CONCLUSION: Concentrations of IGFBP-6 increased in the vitreous, serum, and retinas only in advanced PVR in vivo. IGFBP-6 also inhibited IGF-II-induced cell proliferation in a not dose or time dependent manner and migration. IGFBP-6 participates in the development of PVR and might play a protective role in PVR.     

Lower Energy to Make a Corneal Flap with a 60 kHz Femtosecond Laser Reduces Flap Inflammation and Corneal Stromal Cell Death But Weakens Flap Adhesion

Purpose

To compare corneal flaps created in rabbits with a 60 kHz femtosecond (FS) laser using different levels of raster energy and to measure early inflammation, corneal stromal cell death, and late postoperative adhesion strength.

Methods

Sixty rabbits were divided into three groups of 20 each. A flap 110 µm thick and 9.0 mm in diameter was made in one eye of each rabbit at raster energies of 0.7 µJ, 1.1 µJ, and 2.4 µJ. Histopathological evaluation for inflammation and apoptosis using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining was performed at 4 and 24 hours after flap creation. The adhesion strength of the flaps was measured with a tension meter at 1 and 3 months.

Results

Twenty four hours after flap creation, the 2.4 µJ group had more inflammatory and CD11b-positive cells than the 0.7 and 1.1 µJ groups. The number of TUNEL-positive cells increased with raster energy at 4 and 24 hours. The grams of force (gf) needed to detach the flaps at 3 months was significantly higher in 2.4 µJ group (170 gf) than in 0.7 µJ group (97.5 gf) and 1.1 µJ group (100 gf, p = 0.03).

Conclusions

Using raster energy lower than 1.1 µJ to make a flap with a 60 kHz FS laser decreases inflammatory cell infiltration and corneal stromal cell death in the central cornea but may result in a weaker flap than using higher raster energy (2.4 µJ).     

Comparison of conventional and directional freezing for the cryopreservation of human umbilical vein endothelial cells

AIM:To compare conventional slow equilibrium cooling and directional freezing (DF) by gauze package for cryopreservation of human umbilical vein endothelial cells (HUVECs).METHODS: HUVECs were randomly assigned to conventional freezing (CF) and DF by gauze package group. The two groups of HUVECs were incubated with a freezing liquid consisting of 10% dimethylsulfoxide (DMSO), 60% fetal bovine serum(FBS) and 30% Dulbecco’s modified Eagle’s medium(DMEM) and then put into cryopreserved tubes. CF group, slow equilibrium cooling was performed with the following program:precool in 4℃ for 30min, -20℃ for 1h, and then immersion in -80℃ refrigerator. DF group, the tubes were packaged with gauze and then directional freezing in -80℃ refrigerator straightly. One month later, the vitality of HUVECs were calculated between two groups.RESULTS: There was no significant difference in the survival rate and growth curve between CF and DF groups. The DF group was significantly better than CF group in adherent rates, morphological changes and proliferative ability.CONCLUSION:In the conventional cryopreserved method, cells are slow equilibrium cooling by steps (4℃, -20℃ and finally -80℃), which is a complicated and time-consuming process. But the improved DF by gauze package method is better than conventional method, for which is convenient and easy to operate.     

Retinal sensitivity improvement after intravitreal triamcinolone acetonide injection for macular edema secondary to branch retinal vein occlusion

Purpose:

To evaluate the effect of intravitreal triamcinolone acetonide (IVTA) on retinal sensitivity in cases of macular edema(ME) secondary to branch retinal vein occlusion (BRVO).

Materials and Methods:

Total of 14 eyes of 14 cases of BRVO were included in this prospective study. In each eye, at baseline and 1, 3, and 6 months after IVTA injection, logMAR visual acuity, central 4° retinal sensitivity by MP-1 microperimetry, and optical coherence tomography foveal thickness were assessed.

Results:

Cases ages ranged from 60 to 79 years (mean 68 ± 8 years). At 1, 3, and 6 months, the logMAR visual acuity had increased from 0.71 ± 0.21 to 0.42 ± 0.21, 0.46 ± 0.30, and 0.46 ± 0.27; the mean foveal thickness had decreased from 540 ± 88 μm to 254 ± 51 μm, 288 ± 84 μm, and 280 ± 91 μm; and the mean retinal sensitivity had increased from 4.7 ± 2.5 dB to 7.9 ± 2.7 dB, 8.2 ± 3.6 dB, and 8.3 ± 4.6 dB, respectively.

Conclusion:

In eyes with ME secondary to BRVO, IVTA injections result in a significant increase in not only the visual acuity but also the central 4° retinal sensitivity in 6 months follow-up.     

Correlation of serum insulin like growth factor-I with retinopathy in Malaysian pregnant diabetics

AIM: To study the association of serum insulin-like growth factor-I (IGF-I) with diabetic retinopathy. METHODS: Serum IGF-1 levels were measured in 25 pregnant diabetic patients and 25 pregnant non-diabetic patients who were matched for age, ethnicity, parity and period of gestation. Fundus examination was performed in both groups at 28, 32 and 36 weeks of gestation. RESULTS: The serum IGF-I level was significantly elevated in pregnant diabetics compared to pregnant non-diabetics (366±199μg/L vs 184±89μg/L, (P=0.0001) at 24 weeks, 535±251μg/L vs 356±89μg/L, (P=0.007) at 32 weeks and 404±166μg/L vs 264±113μg/L, (P=0.003) at 36 weeks of gestation). The pregnant diabetics with established diabetes had significantly higher IGF-1 level than gestational diabetes at 28, 32 and 36 weeks of gestation. The serum IGF-I level in pregnant diabetics with retinopathy was significantly higher than that in those without retinopathy at all periods of gestation. CONCLUSION: Increased serum IGF-1 in pregnancy may increase the risks for retinopathy.     

Attenuated age-related thinning of peripapillary retinal nerve fiber layer in long eyes

Purpose

To assess the impact of axial length on the age-related peripapillary retinal nerve fiber layer (RNFL) thinning.

Methods

This cross-sectional observational comparative case series included 172 eyes from 172 healthy Korean subjects. Peripapillary RNFL thickness was measured using an Optic Disc Cube 200 × 200 scan of spectral domain Cirrus HD OCT and the axial length was measured using IOL Master Advanced Technology. In age groups based on decade, the normal ranges of peripapillary RNFL thickness for average, quadrant, and clock-hour sectors were determined with 95% confidence intervals. After dividing the eyes into two groups according to axial length (cut-off, 24.50 mm), the degrees of age-related RNFL thinning were compared.

Results

Among the eyes included in the study, 53 (30.81%) were considered to be long eyes (axial length, 25.04 ± 0.48 µm) and 119 (69.19%) were short-to-normal length eyes (axial length, 23.57 ± 0.60 µm). The decrease in average RNFL thickness with age was less in long eyes (negative slope, -0.12 µm/yr) than in short-to-normal length eyes (negative slope, -0.32 µm/yr) (p < 0.001).

Conclusions

Age-related thinning of peripapillary RNFL thickness is attenuated in long eyes compared to short-to-normal length eyes.