玻璃体腔内注射康柏西普与雷珠单抗治疗中老年视网膜静脉阻塞继发黄斑水肿的疗效比较

目的探讨玻璃体腔内注射康柏西普与雷珠单抗治疗中老年视网膜静脉阻塞(RVO)继发黄斑水肿的疗效。方法选取该院2016年5月至2017年5月临床确诊RVO继发黄斑水肿患者60例(60只患眼)。将患者随机分为康柏西普组和雷珠单抗组,康柏西普组、雷珠单抗组玻璃体腔内分别注射10.0 mg/ml康柏西普0.05 ml、10.0 mg/ml雷珠单抗0.05 ml,治疗6个月。比较两组治疗6个月后的临床疗效,比较治疗前、治疗3个月和6个月后的最佳矫正视力(BCVA)和黄斑中心凹厚度(CMT);记录初始治疗至6个月后玻璃体腔注射次数,比较两组治疗过程中眼部并发症发生率。结果康柏西普组总有效率高于雷珠单抗组,但差异无统计学意义(P0.05)。治疗3个月和6个月后康柏西普、雷珠单抗组BCVA、CMT值均显著低于治疗前(P0.05),治疗6个月后BCVA、CMT值显著低于治疗3个月后(P0.05),各时间点康柏西普组与雷珠单抗组BCVA值比较差异均无统计学意义(P0.05),而康柏西普组治疗6个月后CMT显著低于雷珠单抗组(P0.05)。康柏西普组平均注射次数显著低于雷珠单抗组(P0.05);康柏西普组眼部并发症总发生率低于雷珠单抗组,但差异无统计学意义(P0.05)。结论康柏西普与雷珠单抗治疗中老年RVO继发黄斑水肿效果相当,但康柏西普对CMT的降低作用更为明显,且能减少患者的注射次数。     

不同剂量的曲安奈德玻璃体腔注射联合光凝治疗视网膜分支静脉阻塞合并黄斑水肿的疗效观察

目的比较不同剂量的曲安奈德(TA)行玻璃体腔注射联合光凝治疗视网膜分支静脉阻塞(BRVO)合并黄斑水肿的疗效。方法本研究纳入缺血型BRVO患者78例78眼,病程均3月,将所有患者随机分为2组,A组40例(40眼),行玻璃体腔注射TA 2 mg,B组38例(38眼)行玻璃体腔注射TA 4 mg,2组患者均于2周后行视网膜局部光凝及黄斑区格栅样光凝治疗。分析比较2组治疗前后眼前节、最佳矫正视力(BCVA)、光学相干断层扫描(OCT)的改变。结果 A组、B组治疗前后BCVA及黄斑中心凹厚度(CMT)均较治疗前明显改善(P均0.05)。A组与B组间治疗后BCVA及CMT差异无统计学意义(P0.05)。A组、B组治疗前眼压比较无统计学差异(P0.05)。治疗后2周A组眼压与治疗前比较差异无统计学意义(P0.05),B组眼压与治疗前比较明显升高(P0.05);治疗后2周,B组眼压较A组显著升高(P0.05)。治疗后1,3,6月B组眼压与A组比较差异无统计学意义(P0.05)。结论不同剂量的TA玻璃体腔注射联合光凝治疗BRVO合并黄斑水肿均可起到持久的疗效,小剂量的TA玻璃体腔注射明显减少TA所引起的并发症,效果更佳。     

玻璃体腔内注射雷珠单抗联合激光手术治疗糖尿病黄斑水肿的疗效及对患者视力、眼压及并发症发生率的影响

目的 探讨玻璃体腔内注射雷珠单抗联合激光手术治疗糖尿病黄斑水肿的疗效及对患者视力、眼压及并发症发生率的影响.方法 选取2016年3月至2018年6月我院收治的糖尿病黄斑水肿患者90例(102眼),采用随机数字法分为两组,每组45例.对照组患者黄斑水肿50眼单纯采用激光手术治疗,观察组患者黄斑水肿52眼给予玻璃体腔内注射...     

雷珠单抗治疗老年患者视网膜静脉阻塞继发黄斑水肿的临床观察

目的分析玻璃体腔注射雷珠单抗对老年视网膜静脉阻塞(RVO)继发黄斑水肿(ME)患者的疗效。方法回顾性研究2018年1月—2019年12月,复旦大学附属华东医院眼科收治的37例(37眼)老年RVO继发ME确诊患者。所有患者均接受3+PRN治疗方案,玻璃体腔注射雷珠单抗。分别于治疗前和治疗后1、3、6个月时,检测患者最佳矫正视力(BCVA);通过光学相干断层扫描分析患眼黄斑中心凹视网膜厚度(CMT)、黄斑区平均视网膜厚度(MMT)及黄斑中心体积(CMV)的变化情况。结果与治疗前比较,治疗后1、3和6个月患者的平均BCVA改善(χ²=37.70,P<0.05),CMT(F=22.06,P<0.01)及MMT变薄(F=30.75,P<0.01),CMV减小(F=27.57,P<0.01)。研究期间2例患者出现球结膜下出血,未见其他严重不良反应。结论玻璃体腔注射雷珠单抗治疗能一定程度上提高老年RVO继发ME患者的视力,减轻ME,有助于恢复患者的视网膜正常结构。     

玻璃体腔注射雷珠单抗治疗湿性老年性黄斑变性的临床疗效

目的对比不同给药方案(玻璃体腔内注射雷珠单抗)治疗湿性老年性黄斑变性(wAMD)的疗效差异,探讨影响再治疗时机的因素。方法选择32例(32只眼)wAMD患者随机分为两组,A组:每月进行玻璃体腔内注射Lucentis 0.5 mg 1次。B组:最初每月1次进行玻璃体腔注射Lucentis 0.5 mg,连续3个月,后续再根据再治疗标准决定是否注药。随访时间为12个月。结果两组组间平均最佳矫正视力(BCVA)、黄斑中央区平均视网膜厚度(CMT)、黄斑中央区平均视网膜厚度(CMT)、平均病灶区视网膜厚度(CLT)、眼底荧光造影(FFA)5 min时视网膜新生血管渗漏面积(S)差异无统计学意义(P均0.05)。两组注药次数差异有统计学意义(P0.05)。再治疗影响标准中光学相干断层扫描(OCT)检查结果所占比较视力标准所占比高。结论两种给药方案(玻璃体腔内注射雷珠单抗)治疗wAMD均安全有效。评价病灶活动性决定注药时机时,OCT检查结果较视力更敏感。     

玻璃体腔注射抗VEGF药物联合激光治疗糖尿病性黄斑水肿的临床分析

目的研究糖尿病性黄斑水肿患者应用玻璃体腔注射抗VEGF联合激光治疗的效果。方法 2015年8月—2017年4月选取71例在该院接受糖尿病性黄斑水肿治疗的患者,按照随机数字表法分成3组,即对照1组(23例)、对照2组(23例)、研究组(25例);对照1组应用单纯玻璃体腔注射抗VEGF治疗,对照两组应用单纯激光治疗,研究组应用玻璃体腔注射抗VEGF联合激光治疗。结果对比3组患者治疗前CMT、BCVA差异无统计学意义(P0.05),经过有效治疗,3组患者CMT以及BCVA均获得一定程度的改善,研究组患者治疗前以及治疗后不同时段CMT差异有统计学意义(P0.05),治疗前后BCVA差异无统计学意义(P0.05);对照1组患者、对照两组患者治疗前以及治疗后不同时段CMT差异有统计学意义(P0.05),治疗前后不同时段BCVA差异无统计学意义(P0.05),治疗后不同时段3组患者CMT以及BCVA差异无统计学意义(P0.05)。3组患者并发症发生率差异无统计学意义(P0.05)。结论应用玻璃体腔注射抗VEGF联合激光治疗糖尿病性黄斑水肿患者的效果更优于单纯应用玻璃体腔注射抗VEGF治疗或者单纯应用激光治疗,临床治疗过程中可结合患者的实况选择适合治疗方案,以改善预后,减少并发症的发生,提高预后生活质量。     

糖尿病黄斑水肿给予激光疗法加用雷珠单抗的综合效果观察

目的观察糖尿病黄斑水肿给予激光疗法加用雷珠单抗的综合效果。方法将该院2013年4月—2016年1月确诊并收治的122例糖尿病视网膜病变继发黄斑水肿患者依照随机数字法分为研究组和对照组各61人。研究组先实施雷珠单抗玻璃体腔注射,而后给予激光治疗。对照组单纯给予激光治疗。对比两组治疗前、治疗后1个月、治疗后3个月的最佳矫正视力(VAcc)、CMT、视网膜新生血管(RNV)渗漏面积的变化情况。而后统计两组不良反应。结果两组治疗前VAcc、CMT、RNV渗漏面积差异无统计学意义(P0.05),各指标治疗后1个月及治疗后3个月均比本组治疗前显著改善(P0.05),研究组治疗后1个月与治疗后3个月各指标与同期对照组相比显著更优(P0.05)。研究组1人结膜下微量出血、1人角膜轻度擦伤,不良反应率3.28%,对照组1人结膜下微量出血,不良反应率1.64%。两组相比差异无统计学意义(P0.05)。所有并发症患者未实施干预即自行痊愈。结论糖尿病黄斑水肿给予雷珠单抗玻璃体腔内注射并激光疗法疗效确切,可显著恢复视力、消除黄斑水肿及RNV渗漏,安全性好。     

玻璃体腔注射康柏西普、雷珠单抗在糖尿病性黄斑水肿治疗中的应用效果

目的 研究玻璃体腔注射康柏西普治疗糖尿病性黄斑水肿（diabetic macular edema, DME）的效果。方法选取2021年10月—2023年7月期间芜湖市眼科医院收治的40例DME患者作为研究对象,随机数表法分为对照组（n=20,玻璃体腔注射雷珠单抗）和研究组（n=20,玻璃体腔注射康柏西普）。观察两组治疗前、治疗后1、3、6个月的最佳矫正视力（best corrected visual acuity, BCVA）、黄斑中心凹厚度（macula fovea thickness,CMT）、平均黄斑容积（average macular volume, AMV）、黄斑中心凹下脉络膜厚度（subfoveal choroidal thickness, SFCT）,并统计两组6个月的重复用药次数及不良反应。结果 治疗后,两组BCVA值均升高,AMV、CMT值降低,且研究组治疗1、3、6个月的BCVA值均高于对照组,AMV值低于对照组,差异有统计学意义（P<0.05）;治疗1个月,两组CMT值比较,差异无统计学意义（P>0.05）;研究组治疗3、6个月的CMT值低于对照组,差...     

不同激光光凝治疗时机联合玻璃体注射康柏西普治疗视网膜中央静脉阻塞继发黄斑水肿的有效性及安全性

目的探讨不同激光光凝治疗时机联合玻璃体腔注射康柏西普对视网膜中央静脉阻塞(CRVO)继发黄斑水肿(ME)的临床效果。方法选取缺血型CRVO患者100例(均为单眼患病),按照随机、双盲的方式分为研究组和对照组。其中研究组50例,先行玻璃体腔注射康柏西普,3 d后行激光光凝治疗,第2、3个月重复;对照组50例,间隔1个月注射康柏西普1针,连续注射3个月,并于最后1针康柏西普注射3 d后行激光光凝治疗,以后每周行激光治疗1次。观察并比较两组患者治疗前及治疗后不同时间点最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)、玻璃体腔相关因子水平[血管内皮生长因子(VEGF)、白细胞介素(IL)-6、IL-8],同时比较两组治疗后相关并发症的发生率。结果治疗前,两组BCVA值相比差异无统计学意义(P0.05),治疗后,两组BCVA值均明显升高,研究组在治疗后1 w、1个月、2个月及3个月BCVA值均显著高于对照组(P0.05);治疗前,两组CMT值相比差异无统计学意义(P0.05),治疗后,两组CMT值均明显降低,研究组在治疗后1 w、1个月、2个月及3个月CMT值均明显低于对照组(P0.05);治疗前,两组玻璃体腔VEGF、IL-6及IL-8水平相比差异无统计学意义(P0.05),治疗后各指标均有下降,研究组IL-6水平在治疗后1 w、1个月、2个月及3个月均明显低于对照组(P0.05),VEGF及IL-8水平在治疗后1个月、2个月及3个月均明显低于对照组(P0.05),两组治疗后1 w VEGF及IL-8水平相比差异无统计学意义(P0.05);两组治疗后相关并发症的发生率相比差异无统计学意义(P0.05)。结论针对缺血型CRVO的患者,每次玻璃体注射康柏西普后3 d行激光光凝治疗,可明显促进患者视力恢复,改善黄斑水肿,降低玻璃体腔相关免疫因子水平。     

雷珠单抗治疗黄斑区脉络膜新生血管的疗效观察

目的观察玻璃体腔注射雷珠单抗治疗黄斑区脉络膜新生血管(choroidal neovascularization,CNV)的疗效及安全性。方法对26例26眼经光学相干断层扫描(optical coherence tomography,OCT)及眼底血管荧光造影(fundus fluoresceine angiography,FFA)确诊为黄斑区CNV(包括年龄相关性黄斑变性、高度近视性黄斑病变以及中心性渗出性脉络膜视网膜病变)的患者进行玻璃体腔内注射0.5 mg/0.05 ml雷珠单抗,随访3个月,观察患者最佳矫正视力(best-corrected visual acuity,BCVA)、黄斑区结构改变及不良反应。在随访期间,经OCT检查发现黄斑区神经上皮层仍有层间积液或视网膜下液、CNV未见明显缩小、FFA检查发现仍有荧光素渗漏者需行再次注射雷珠单抗。结果所有患者第一次治疗前BCVA(ETDRS字母表)的平均字母数为(17.65±13.96)个,3个月后的平均字母数为(34.23±16.36)个,3个月后与第一次治疗前的视力差异具有统计学意义(P0.05)。所有患者第一次治疗前黄斑中心凹厚度(central macular thickness,CMT)为(310.84±113.13)μm,随访第3个月时为(198.76±46.90)μm,前后相比差异具有统计学意义(P0.05)。术中、术后及随访期间未见眼部及全身不良反应。结论玻璃体腔内注射雷珠单抗治疗黄斑区CNV安全有效。     

The laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion: A protocol for systematic review and meta-analysis

Background:At present, laser is regarded as an effective treatment for macular edema secondary to branch retinal vein occlusion. With the breakthrough of anti-vascular endothelial growth factor drugs in ophthalmology clinical research, the intravitreal injection of ranibizumab is widely applied, but both methods have their limitations, so some clinical studies have combined and applied them together. However, the clinical results are inconsistent and controversial, and there is no relevant system evaluation for the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion now.Objective:Meta analysis is used to analyze and evaluate the effectiveness and safety of the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion.Method:CNKI, VIP, WANFANG, China Biology Medicine disc, Web of Science, PubMed, Embase, Cochrane Library have used random controlled clinical trial of laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion from the establishment of the database to October 2020. Two researchers conducted independent screening, quality assessment and data extraction for the literatures, and used RevMan5.3 to conduct Meta analysis for the included literatures.Result:The research has evaluated the effectiveness and safety of the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion through the aspects of the best corrected visual acuity 6 months after operation, macular center thickness and the incidence of adverse reactions such as elevated intraocular pressure, endophthalmitis, vitreous hemorrhage and cataract.Conclusion:Laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion has good effect, and the research has provided reliable evidence for the use of clinical treatment of the laser combined with intravitreal injection of ranibizumab for treatment of macular edema secondary to branch retinal vein occlusion.     

Exacerbation of branch retinal vein occlusion post SARS-CoV2 vaccination: Case reports

Rationale:In this paper, we report on 2 patients who developed branch retinal vein occlusion (BRVO) exacerbation 1 day after administration of the BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine.Patient concerns:Case 1: A 71 year-old female developed vision loss in her left eye 1 day after receiving a second dose of the SARS-CoV-2 mRNA vaccine. This patient was diagnosed with temporal inferior BRVO and secondary macular edema (ME) in her left eye. ME resolved after 3 doses of intravitreal aflibercept (IVA). After treatment, no recurrence of ME was observed.Case 2: A 72 year-old man developed vision loss in his right eye 1 day after receiving the first dose of the SARS-CoV-2 mRNA vaccine. This patient was diagnosed with temporal superior BRVO in the right eye without ME. The patient was followed up and did not undergo any additional treatment.Diagnoses:Case1: Temporal superior BRVO and secondary ME were observed in the left eye. Her best-corrected visual acuity (BCVA) was 20/30.Case2: Temporal superior BRVO recurrence and secondary ME were observed in the right eye. BCVA was 20/25.Interventions:Case1: Additional dose of IVA was administered. Case2: Two times of Intravitreal ranibizumab was administered twice.Outcomes:Case1: Subsequently, ME resolved BCVA was 20/20. Case2: Subsequently, ME resolved BCVA was 20/25.Lessons:Both cases showed a possible association between SARS-CoV-2 vaccination and the exacerbation of BRVO.     

Aggravated capillary non-perfusion after intravitreal bevacizumab for macular edema secondary to systemic lupus erythematosus and anti-phospholipid syndrome

A 22-year-old female with history of systemic lupus erythematosus (SLE) was referred for evaluation of decreased visual acuity in her right eye. Her best-corrected visual acuity (BCVA) at the time of presentation was 20/160. Widespread cotton wool spots and macular edema were seen on biomicroscopy. Fluorescein angiography (FA) revealed retinal arterial and venous obstruction with capillary nonperfusion at the superotemporal retina. Antiphospholipid syndrome (APS) was diagnosed based on positive lupus anti-coagulant and ocular manifestations. Scattered laser photocoagulation was applied at the nonperfusion area but the visual acuity continued to deteriorate due to macular edema. Intravitreal bevacizumab (IVB) was administered for macular edema. One day after IVB, the BCVA decreased to count fingers. FA revealed extended non-perfusion from the superotemporal area to the posterior pole. Use of intravitreal bevacizumab for macular edema secondary to SLE or APS should be considered carefully and patients monitored closely for vascular complications.     

Intravitreal triamcinolone acetonide for patients with macular edema due to branch retinal vein occlusion

We designed a case series study to evaluate the outcome of intravitreal triamcinolone acetonide for the treatment of macular edema due to branch retinal vein occlusion (BRVO). The prospective comparative nonrandomized clinical interventional study included 27 patients (27 eyes) with macular edema due to BRVO. The study group consisted of 16 patients who had accepted an intravitreal injection (IVI) of 4 mg triamcinolone acetonide. The control group included 11 patients without IVI of triamcinolone acetonide. The mean follow-up was 103.00 +/- 36.24 days in the study group and 94.55 +/- 36.31 days in the control group. In the study group, visual acuity measurements improved significantly (p < 0.001) from 0.77 +/- 0.43 logarithm of minimal angle of resolution (logMAR) preoperatively to a best postoperative visual acuity of 0.44 +/- 0.43 logMAR. Fourteen eyes (87.5%) gained improvement in visual acuity, with 10 eyes (62.5%) showing an increase in visual acuity of at least two Snellen lines. All 16 patients showed significant macular edema resolution in optical coherence tomography examination (p < 0.001) and perivascular leakage decrease in fluorescein angiography post-IVI. In the control group, baseline best-corrected visual acuity and best-corrected visual acuity during the follow-up did not vary significantly (p = 0.294). In conclusion, IVI of triamcinolone acetonide can lead to an increase in visual acuity and a resolution of macular edema in patients with BRVO.     

Effect of intravitreal ranibizumab on serous retinal detachment in diabetic macular edema

PurposeTo evaluate the functional and anatomical results of intravitreal ranibizumab (IVR) treatment in diabetic macular edema (DME) with and without serous retinal detachment (SRD).Material and methodsFifty-one eyes treated with three consecutive intravitreal injections of ranibizumab for DME with and without SRD were retrospectively analyzed. Patients were divided into two groups according to optical coherence tomography (OCT) findings. Group 1 consisted of 25 DME patients with SRD, Group 2 consisted of 26 DME patients without SRD. After three consecutive IVR injections, changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) were analyzed and compared between groups.ResultsThe mean age was 64.16 ± 6.43 and 68.77 ± 7.19 years, respectively (p = 0.036). Initial BCVA was 0.55 ± 0.36, 0.62 ± 0.39 LogMAR, respectively (p: 0.613). Initial CMT was 548.7 ± 111.6 μm, 446.4 ± 104.1 μm in groups, respectively and it was significantly higher in Group 1 (p = 0.001). After three consecutive IVR, mean BCVA improved to 0.47 ± 0.30 LogMAR (p = 0.281) and CMT decreased to 331.6 ± 165.1 μm (p = 0.000) in Group 1. Mean BCVA improved to 0.40 ± 0.34 LogMAR (p = 0.005) and CMT decreased to 287.2 ± 148.8 μm (p = 0.000) in Group 2. While the decrease in CMT values was similar between the groups, the increase in BCVA was more pronounced in Group 2 after IVR treatment.ConclusionsSimilar morphological results were obtained in both of the groups, but the visual gain was lower in patients with SRD.     

改良糖尿病视网膜病变早期治疗研究组格栅样光凝与轻度黄斑格栅样光凝在治疗糖尿病黄斑水肿中的疗效比较

目的比较改良糖尿病视网膜病变早期治疗研究组（ETDRS）格栅样光凝及轻度格栅样光凝在糖尿病视网膜病变黄斑水肿治疗中的疗效。方法选取2008年1月至2010年1月于我院眼科门诊就诊及内分泌科会诊的伴有糖尿病黄斑水肿（DME）的轻至中度非增殖性糖尿病视网膜病变（NPDR）患者为研究对象,共72例97眼,其中男40例55眼、女32例42眼。入选患者均进行全面眼科检查,采用随机化分组表将患者分为改良ETDRS格栅样光凝组（36例48眼）及轻度格栅样光凝组（36例49眼）进行激光治疗,治疗后随访24个月。观察2组患者治疗前后视力、黄斑中心凹视网膜厚度等变化情况,数据采用SPSS16．0软件进行统计分析。统计学方法采用One．wayANOVA检验,两两比较采用t检验。结果改良ETDRS格栅样光凝组和轻度格栅样光凝组患者治疗后24个月均可见视力明显提高,与治疗前比较差异具有统计学意义（改良ETDRS格栅样光凝组：初始值55．4-21,治疗24个月后59±21;轻度格栅样光凝组：初始值544-11,治疗24个月后584-13,均P〈0．05）,但2组患者视力改善程度在各随访时间点差异均无统计学意义（P〉0．05）。改良ETDRS光凝组和轻度格栅样光凝组患者治疗后24个月内黄斑中心凹视网膜厚度均有所下降,与治疗前比较差异具有统计学意义（改良ETDRS格栅样光凝组：初始值395±174,治疗24个月后2044-16;轻度格栅样光凝组：初始值464±204,治疗24个月后2414-13,均P〈0．05）。但2组在各时间截点黄斑中心凹视网膜厚度改变差异均无统计学意义（均P〉0．05）。结论对轻、中度NPDR合并DME患者采用改良ETDRS光凝或轻度格栅样光凝治疗并随访24个月后发现2种光凝方法均在改善黄斑水肿患者远期视力方面具有一定疗效且无明显差异。     

Comparison of intravitreal injection of bevacizumab and triamcinolone acetonide in the treatment of uveitic macular edema

Background: Cystoid Macular Edema (CME) is one of the most common and sight threatening complications of uveitis. Intravitreal injection of corticosteroids and Anti-VEGF are two routine options for treatment. Objective: To compare the effects of intravitreal injections of Bevacizumab and Triamcinolone Acetonide for the treatment of persistent macular edema in non-infectious uveitis. Methods: In a randomized clinical trial, sixty eyes of 55 patients were enrolled in the study. Patients were divided into two groups with randomized digits table. 29 eyes received 4 mg of intravitreal triamcinolone acetonide, and 31 eyes received 1.25 mg of intravitreal bevacizumab. Two main outcome measures were changes in visual acuity, measured with logarithm of minimal angle of resolution, and central macular thickness, measured with optical coherence tomography. Results: The mean follow-up was 25.3 weeks. The best visual acuities were achieved 6 months after injection in both groups. Improvement in visual acuity at 6 months was achieved in 28/29 (96%) of eyes in Triamcinolone group and in 26/31 (83%) eyes in Bevacizumab group (p=0.196). None of the eyes showed worsening of visual acuity after 6 months. Mean of central macular thickness in the pre-injection time for intravitreal triamcinolone acetonide (IVTA) group was 295.62 μ, and 309.87 μ in intravitreal bevacizumab (IVB) group, which were decreased after six months to 199.27 μ and 221.06 μ, respectively (p<0.001). Conclusion: This study shows that IVT and IVB are both effective in improving vision in uveitic CME. Although effects of triamcinolone on Central Macular Thickness (CMT) are more apparent, this superiority is not seen on Best Corrected Visual Acuity (BCVA).     

Laser-induced choroidal neovascularization: A case report and some reflection on animal models for age-related macular degeneration

Rationale:Laser induced maculopathy includes retinal photoreceptor disruption, macular hole, macular hemorrhage, and rarely choroidal neovascularization (CNV). Here we report a case of laser induced CNV that was treated by intravitreal anti-vascular endothelial growth factor (VEGF) injection and resulted in visual improvement and CNV resolution during 1-year follow up. In addition, the case of laser induced CNV treated with intravitreal anti-VEGF injections are reviewed for the first time in literature.Patient concerns:A 7-year-old boy presented to our department with blurred vision in his right eye for 2 months. The symptom immediately happened after the boy staring at the laser beam for a few seconds. Examination of ocular fundus with slit lamp showed yellowish lesion in macula in his right eye.Diagnoses:CNV was confirmed by fundus examinations, including color fundus photograph, spectral domain optical coherence tomography, fluorescein angiography, and spectral domain optical coherence tomography angiography.Interventions:After the diagnosis of laser induced CNV, intravitreal ranibizumab (LUCENTIS, NOVARTIS) injection was performed.Outcomes:After 1 injection of intravitreal ranibizumab, the best corrected visual acuity improved from 20/50 to 30/50 and CNV gradually regressed during 1-year follow up.Lessons:For young patients with laser induced CNV, intravitreal anti-VEGF injections may be helpful in visual improvement and CNV regression. Moreover, age seems to be a significant factor thus we propose that old animals may be more appropriate for laser induced CNV animal models of age-related macular degeneration.     

Intravitreal steroid versus macular laser for treatment of diabetic macular edema

Diabetic macular edema is a leading cause of vision loss in the United States. Focal/grid laser photocoagulation has been the gold standard for treatment over the past two decades. Intravitreal pharmacologic treatments increasingly have been used over the past 5 years. Various studies have shown the possible benefits of intravitreal corticosteroids and anti-vascular endothelial growth factors in the treatment of diabetic macular edema. However, focal/grid laser photocoagulation continues to be the only proven safe and effective treatment for diabetic macular edema.