糖尿病视网膜病变患者全视网膜激光光凝前后视网膜动、静脉循环时间的改变

目的 观察糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜激光光凝(pan-retinal laser photocoagulation,PRP)治疗前后视网膜动、静脉循环时间的改变.方法 经荧光素眼底血管造影(fundus fluorescein angiography,FFA)检查确诊为重度非增殖期及增殖期DR且符合PRP适应证的16例(16眼)患者纳入研究,并行PRP.治疗前、治疗后1～3个月,采用FFA对所有患眼视网膜动、静脉循环时间进行记录,观察视网膜动脉4个分支主干出现显影的时间、完全充盈的时间,视网膜静脉4个分支主干全部出现层流的时间、完全充盈的时间,计算得出视网膜动脉、视网膜毛细血管、视网膜静脉、视网膜动静脉通过时间,对比观察治疗前后患眼不同时段的视网膜通过时间的变化.结果 DR患者PRP治疗前视网膜毛细血管通过时间为(1.58±0.99)s,治疗后为(2.19±1.23)s,差异有统计学意义(P=0.叭1).DR患者PRP治疗前后的视网膜动脉、视网膜静脉、视网膜动静脉通过时间的差异均无统计学意义(均为P ＞0.05).结论 PRP是DR患者的最重要治疗方式,在PRP治疗后1～3个月视网膜毛细血管通过时间的血流动力学改变最为显著,较PRP治疗前有显著延长.     

糖尿病视网膜病变全视网膜光凝术后中长期随诊结果

目的：进一步了解糖尿病视网膜病变(DR)全视网膜光凝术(PRP)后中、长期随诊的激光量和疗效的临床结果。方法：63例增殖期糖尿病视网膜病变(PDR)PRP术后随诊12—132个月(平均43．2个月)的临床资料回顾分析。结果：63例PDR患者PRP术的平均视网膜光凝斑总数975个。视力改变：提高者占24．2％，不变者占35％，下降者占40．8％。主要晚期并发症是程度不等的玻璃体视网膜纤维膜形成及少数病例(4例5只眼)发生1—3次不同程度的玻璃体出血。结论：PDR眼病例PRP术后中、长随诊的激光量——平均总视网膜光斑数1000个左右；60％的病例视力保持不变或改善，40％的病例视力下降，病情控制。强调了适宜的视网膜光凝范围、适宜的激光波长和适宜的视网膜有效光斑是PRP术成功的关键。还讨论了DR激光治疗后视力下降的因素和主要晚期并发症。     

视网膜光凝对糖尿病视网膜病变患者神经纤维层厚度的影响

目的：探讨分析糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜激光光凝术(panretinal photocoagulation,PRP)治疗后1a视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度的变化。

方法：选取2014-05/2017-06在我院行PRP治疗的92例92眼DR患者,采用OCT的DISC CIRCLE程序,测量分析以视盘为中心、直径3.45mm范围DR患者PRP术前和术后1a(采用Follow-Up程序自动追踪模式)视盘周围RNFL厚度,按视盘上方(S)、下方(I)、鼻侧(N)、颞侧(T)4个象限分区所得的数值进行统计分析。

结果：DR患者PRP术后1a较术前视盘周围上方、下方、鼻侧、颞侧和全周平均RNFL厚度明显变薄,且差异有统计学意义(均P<0.05)。

结论：PRP治疗可导致视网膜RNFL变薄,临床上应充分重视和考虑RNFL的损伤,更好地保护视网膜神经细胞的机能对DR治疗具有重要意义。     

全视网膜光凝治疗糖尿病视网膜病变后黄斑区视功能的评价

目的 探讨糖尿病视网膜病变(diabetic retinopathy,DR)患者全视网膜光凝(panretinal photocoagulation,PRP)治疗后黄斑区视功能的变化及其与黄斑形态改变的相关性.方法 选取DR患者24例(41眼),行PRP治疗后随访3个月,对比分析患者PRP治疗前后患眼的中心视力,多焦视网膜电图(multifocal electroretinography,mfERG)和光学相干断层扫描(optical coherence tomography,OCT)检测黄斑区视功能的变化与黄斑形态改变,探讨PRP治疗后黄斑区视功能的变化及其与黄斑形态改变的相关性.结果 DR患者PRP治疗后3个月的中心视力和黄斑中心凹厚度分别为0.52 ±0.28、(257.55±124.30)μm,与治疗前的0.57±0.32、(241.15±103.43)μm相比,差异均无统计学意义(t=1.27,P=0.22;t=-1.00,P=0.33).mfERG N波4、5环及P1波3、5环的反应密度较PRP治疗前明显降低,差异均有统计学意义(t=2.48、3.69、2.23、2.40,均为P<0.05),但各波潜伏期相比差异均无统计学意叉(均为P>0.05);黄斑中心凹厚度与mfERG的测量结果无相关性(均为P>0.05).结论 PRP治疗虽然没有引起DR患者中心视力及视网膜厚度的变化,但导致了邻近未接受光凝区域的视网膜功能障碍,表现为mfERG反应密度的降低.     

视网膜光凝术后Tenon囊下注射曲安奈德对糖尿病大鼠视网膜厚度的影响

目的观察视网膜光凝术后Tenon囊下注射曲安奈德(posterior sub-Tenon injection of triamcinolone acetonide,PSTA)对糖尿病大鼠视网膜厚度的影响。方法 120只Brown-Norway大鼠随机分为正常组、糖尿病组和糖尿病鼠全视网膜光凝(panretinal photocoagulation,PRP)后1d组、3d组、7d组及PSTA后1d组、3d组、7d组,每组15只,正常组不做任何处理,糖尿病大鼠仅制作糖尿病模型,PRP组造模后予以激光光凝右眼鼻侧视网膜,PSTA组光凝后即刻行PSTA50μL。OCT3测量各组大鼠颞侧视网膜厚度,SPSS19.0统计软件对数据进行分析。结果正常组大鼠视网膜厚度为(203.2±12.2)μm,糖尿病组较正常组增厚,为(235.3±9.3)μm(P<0.05)。PRP后1d组、3d组、7d组视网膜厚度分别为(223.5±13.3)μm、(245.8±10.4)μm、(242.4±8.3)μm,均较正常组增厚(均为P<0.05),PRP后3d组较糖尿病组亦增厚(P<0.05)。PSTA后1d组、3d组、7d组大鼠视网膜厚度分别为(222.3±10.5)μm、(239.7±9.8)μm、(215.8±8.6)μm,均较各时间点PRP后降低,但仅PSTA后7d组较PRP后7d组差异有统计学意义(P<0.05),且PSTA后7d组亦较糖尿病组视网膜薄(P<0.05)。结论 PSTA不仅可以抑制由视网膜光凝导致的糖尿病大鼠视网膜厚度的增加,而且还可明显减轻糖尿病导致的视网膜增厚。     

改良超全视网膜光凝术治疗高危增殖性糖尿病视网膜病变

目的：观察应用改良的超全视网膜光凝术(extra panretinal photocoagulation,E-PRP)治疗高危增殖性糖尿病视网膜病变(high risk proliferative diabetic retinopathy,hsPDR)的疗效及安全性。
　　方法：将我院2011-02/2014-12通过荧光素眼底血管造影(fundus fluorescein angiography,FFA)确定为高危 PDR患者88例102眼纳入研究。采用倍频532激光对其中52眼行改良的 E-PRP 治疗,50眼行标准全视网膜光凝术(panretinal photocoagulation, PRP)治疗。激光治疗后每3mo 行 FFA 及彩色眼底照像,对新生血管未消退、大片无灌注区未消失的患者追加光凝,随访6~36mo。
　　结果：高危 PDR 经改良的 E-PRP 和 PRP 治疗后,两组患者视力比较差异无统计学意义( P>0.05)。经改良的E-PRP 治疗后视网膜无灌注区消失、新生血管消退35眼(67%),有效率88%;有6眼因严重玻璃体积血、纤维增殖及牵拉性视网膜脱离需行玻璃体切除手术治疗,占12%。经 PRP 治疗后视网膜无灌注区消失、新生血管消退23眼(46%),有效率66%。有17眼出现视网膜前出血或玻璃体积血,需行玻璃体切除手术治疗,占34%。两组比较,新生血管消退率及有效率差异有统计学意义(P<0.05)。
　　结论：改良的 E-PRP 是治疗高危 PDR 的安全、有效手段,其疗效优于传统 PRP。     

糖尿病视网膜病变全视网膜光凝后的视力损害

全视网膜光凝(PRP)是治疗严重的糖尿病视网膜病变的重要方法,但PRP可引起黄斑水肿而导致视力下降。作者通过研究证明黄斑中心凹厚度与视力预后相关。64例(64眼)非增生期或增生早期糖尿病视网膜病变患者参与了研究,患者均未曾对眼部并发症进行治疗,视力均≥1·0。所有患者进行了     

靶向视网膜光凝治疗糖尿病视网膜病变的研究进展

靶向视网膜光凝(TRP)即靶向光凝视网膜无灌注区(NPA),这一激光模式可以大幅降低全视网膜光凝(PRP)的并发症风险。超广角荧光素血管造影(UWFFA)可以清晰显示远周边部视网膜NPA,有利于TRP的精确定位与实施。目前,针对增殖性糖尿病视网膜病变(PDR)的TRP治疗方案短期安全性较好,但其长期疗效尚不确切。未来,TRP可能成为部分PDR患者的早期治疗选择,通过推迟PRP以维持视敏度及中心视野。抗血管内皮生长因子(VEGF)药物是目前治疗糖尿病性黄斑水肿(DME)的一线用药,对合并视网膜新生血管(NV)或依从性差的DME患者可考虑联合TRP治疗。缺血指数(ISI)用于量化分析UWFFA视野下的视网膜NPA,未来有望成为重要参考指标,指导临床TRP治疗方案的选择。     

广泛视网膜光凝及阿柏西普联合治疗视网膜中央静脉阻塞继发青光眼的效果

目的:评价广泛视网膜光凝(PRP)及阿柏西普(aflibercept)联合治疗视网膜中央静脉阻塞(CRVO)继发青光眼的临床效果。方法:回顾性研究。南阳市眼科医院2018年6月至2019年6月CRVO继发青光眼68例(68眼),按手术方式分为联合组与常规组,各34例。常规组单纯以PRP治疗,联合组以PRP及阿柏西普玻璃...     

全视网膜光凝治疗糖尿病视网膜病变对视野影响的研究进展

糖尿病视网膜病变(DR)早期视野改变往往比视力更能及时反映病情进展。而全视网膜光凝(PRP)治疗DR在延缓病情进展的同时也造成了患眼视力下降和视野缩小等副作用。有研究表明,PRP治疗后的DR患者可因中心20°范围内的视野缺损而导致驾驶测试失败。为保证PRP疗效同时达到降低并发症的目的,激光技术不断改进与发展,通过调整激光参数、使用新型激光系统、与抗血管内皮生长因子(VEGF)药物联合、中西医结合治疗等方式可一定程度改善患眼视野,实现更佳疗效。未来可考虑在缺血指数(ISI)量化分析下,对视网膜缺血程度进行分级,依据ISI指标和视网膜无灌注区分布探索PRP治疗建议的最佳阈值及光凝范围,从而为DR患者提供更及时、更合理的个性化治疗方案。文章就PRP治疗DR对视野的影响进行简要综述。     

玻璃体切割联合消毒空气填充术治疗特发性黄斑裂孔疗效的Meta分析

目的 系统评价玻璃体切割手术联合空气填充治疗特发性黄斑裂孔的疗效.方法 利用计算机检索Pubmed、Web of Science、Cochrane Library、Embase、中国知网及万方数据库,搜集玻璃体切割手术联合空气填充与全氟丙烷(C3F8)填充治疗特发性黄斑裂孔的相关文献.采用Cochrane系统评价的方法...     

玻璃体切割联合内界膜剥除术对孔源性视网膜脱离疗效的Meta分析

目的系统评价玻璃体切割术(PPV)治疗孔源性视网膜脱离(RRD)时,术中是否联合内界膜(ILM)剥除。方法检索Pubmed、Embase、Cochrane Librara、Clinical Trials.gov及CNKI数据库,检索自建库之始至2020年11月,搜集所有PPV联合ILM剥除与未联合ILM剥除治疗RRD的临床对照实验。由两位研究员独立筛选文献并提取术后黄斑前膜(ERM)发生率、最佳矫正视力(BCVA)、RRD复发率、椭圆体带缺损发生率及视网膜神经纤维层分离(DONFL)发生率等指标。文献研究间的异质性采用Q和I²检验。若I²>50%,则认为异质性较大,采用随机效应模型进行比较;反之,采用固定效应模型。二分类变量采用相对危险度(RR)及其95%可信区间(CI)表示;连续性变量采用均数差(MD)及其95%CI表示。结果初步检索获得相关文献893篇,排除重复、与本研究无关及不符合本研究结局指标的文献,最终纳入文献11篇,共计987只眼。其中,PPV联合ILM剥除术者有514只眼,未联合者有473只眼。各原始研究间具有较高同质性,结果稳健。各研究间患者ERM发生率的组间异质性较小(I²=26%)。PPV联合ILM剥除组患者术后的ERM发生率明显低于未联合组。经固定效应模型分析,两组比较的差异有统计学意义(RR=0.11,95%CI:0.07~0.18,P<0.05)。各研究间患者BCVA的组间异质性较大(I²=86%)。经随机效应模型分析,两组比较的差异无统计学意义(MD=0.08,95%CI:-0.05~0.21,P>0.05)。4项研究间患者RRD复发率的组间异质性较大(I²=73%)。PPV联合ILM剥除组患者术后RRD的复发率低于未联合组。经固定效应模型分析,两组比较的差异有统计学意义(RR=0.48,95%CI:0.30~0.76,P<0.05)。4项研究间患者椭圆体带缺损发生率的组间异质性较大(I²=73%)。经固定效应模型分析,两组比较的差异无统计学意义(RR=0.99,95%CI:0.38~2.53,P>0.05)。5项研究间患者术后DONFL发生率的组间异质性较小(I²=0)。联合ILM剥除组患者术后DONFL的发生率高于未联合组。经固定效应模型分析,两组比较的差异有统计学意义(RR=39.08,95%CI:11.35~134.60,P<0.05)。结论PPV联合ILM剥除可预防非复杂性RRD患者术后ERM的形成,降低术后RRD的复发率,但无显著视觉效果优势,且对黄斑有潜在危害。     

Choroidal thickness, myopia, and myopia control interventions in children: a Meta-analysis and systemic review

AIM: To investigate changes of choroidal thickness (ChT) in children with myopia and the effect of current myopia control interventions on ChT. METHODS: Major literature databases were searched for studies relevant to myopia in children. All studies used swept-source optical coherence tomography (SS-OCT) or enhanced depth imaging optical coherence tomography (EDI-OCT) to measure the ChT value. The weighted mean difference (WMD) and 95% confidence interval (CI) were pooled to evaluate ChT in myopia children. RESULTS: A total of 11 eligible articles, including 1693 myopic and 1132 non-myopic eyes, were included in the first Meta-analysis. The sub-foveal choroidal thickness (SFCT; WMD=-40.06, 95%CI, -59.36 to -20.75, P<0.001) and ChT at other sectors were significantly thinner in myopic eyes compared with the non-myopic eyes. The Meta-analysis revealed that the ChT decreased horizontally from the temporal sector toward the nasal sector in the pediatric myopia population. Another 11 studies reporting the effect of myopia control interventions were included in the second Meta-analysis for the relationship between myopia control treatments and ChT. SFCT significantly increased after orthokeratology (OK) treatment and OK combined with 0.01% atropine (OKA) treatment (WMD=19.47, 95%CI, 15.96 to 22.98, P<0.001; WMD=21.81, 95%CI, 12.92 to 29.70, P<0.001, respectively). The forest plots showed that SFCT changed little in myopic children receiving 0.01% atropine (P=0.30). Furthermore, the Meta-analysis showed that OK treatment had a stronger effect on the value of SFCT in myopic children as compared with 0.01% atropine (WMD=9.86; 95%CI, -0.21 to 19.93, P=0.05). There is no difference between the treatment with OK and OKA treatment in ChT in myopic children (P=0.37). CONCLUSION: The ChT in myopic eyes is thinner than that in non-myopic eyes in pediatric population. Myopia control interventions including OK and OKA lead to ChT thickening, but other treatments such as 0.01% atropine did not show an increase in ChT.     

非动脉炎性前部缺血性视神经病变视盘形态的Meta分析

目的 采用Meta分析的方法评价非动脉炎性前部缺血性视神经病变（Nonarteritic anterior ischemic optic neuropathy,NAION）患者视盘形态特点。设计 系统综述。研究对象 检索万方全文数据库、EMBASE和Pubmed 数据库中有关NAION 患者视盘定量测量的临床研究文献。方法 依据纳入和排除标准筛选文献,对纳入的研究进行数据提取并进行meta分析,统计学采用Stata软件进行异质性检验、合并WMD和敏感性分析。主要指标 视盘形态学参数。结果 共7篇文献符合纳入标准。NAION患者对侧健眼与正常对照比较,视盘面积（WMD=-0.20,95%CI：-0.37~-0.03）、视杯面积（WMD=-0.36,95%CI：-0.58~-0.14）、杯盘面积比（WMD=-0.15,95%CI：-0.23~-0.06）、视杯容积（WMD=-0.08,95%CI：-0.12~-0.05）、平均视杯深度（WMD=-0.10,95%CI：-0.13~-0.06）、视杯形态测量（WMD=-0.03,95%CI：-0.05~-0.02）均小于正常对照组,差异有统计学意义;而盘沿面积（WMD=0.05,95%CI：-0.15~0.25）、盘沿容积（WMD=0.05,95%CI：-0.07~0.16）两组间差异无统计学意义。NAION患者患眼与对侧健眼比较,盘沿容积（WMD=-0.08,95%CI：-0.14~-0.02）较健眼小,视杯形态测量（WMD=0.03,95%CI：0.00~0.06）较健眼大,差异有统计学意义;视盘面积（WMD=0.08,95%CI：-0.04~0.19）、视杯面积（WMD=0.08,95%CI：-0.01~0.17）、盘沿面积（WMD=-0.05,95%CI：-0.17~0.08）、杯盘面积比（WMD=0.02,95%CI：-0.02~0.06）、视杯容积（WMD=0.01,95%CI：-0.02~0.03）、平均视杯深度（WMD=0.00,95%CI：-0.02~0.03）差异两组间无统计学意义。结论NAION患者具有小视盘、小视杯的特点;NAION发生后,视杯有扩大趋势。（眼科,2014, 23： 235-239）     

飞秒激光小切口角膜基质透镜切除术与有晶状体眼后房型人工晶状体植入术矫正高度近视眼疗效的Meta分析

目的 系统评价飞秒激光小切口角膜基质透镜切除术(SMILE)与有晶状体眼后房型人工晶状体(ICL)植入术矫正高度近视眼的效果.方法 检索中国知网、万方数据库、维普数据库、PubMed、Medline及Cochrane Library,搜集行SMILE与ICL屈光术矫正高度近视眼的相关文献.采用Cochrane系统评价的...     

Comparison of conbercept and ranibizumab for the treatment efficacy of diabetic macular edema: a Meta-analysis and systematic review

AIM: To evaluate the efficacy of intravitreal injection of conbercept (IVC) and ranibizumab (IVR) in patients with diabetic macular edema. METHODS: Reviewers have searched 12 databases, including PubMed, Medline, EMBASE, Web of Science, Springer, ScienceDirect, OVID, Cochrane Library, ClinicalTrials.gov, cqVIP, WanFangdata and China National Knowledge Infrastructure (CNKI), up to December 28, 2018. RevMan 5.3 (Cochrane Library Software, Oxford, UK) was employed for statistical analysis. Fixed and random effects models were applied to assess heterogeneity. Odds ratio (OR) was applied for dichotomous variables; weighted mean difference (WMD) was applied for continuous variables. The confidence interval (CI) was set at 95%. Central macular thickness (CMT) and best-corrected visual acuity (BCVA) were employed to analyze the improvement of DME patients. Inclusion criteria for picking out studies were retrospective studies and randomized controlled trials (RCTs) that compared IVC and IVR for the treatment of diabetic macular edema. RESULTS: Four retrospective studies and five RCTs were included with a total of 609 patients. No statistically significant difference was observed in mean CMT and mean BCVA in the baseline parameters [BCVA (WMD: -0.48; 95%CI: -1.06 to 0.10; P=0.1), CMT (WMD: -0.83; 95%CI: -15.15 to 13.49; P=0.91). No significant difference was found in the improvement of BCVA and adverse event (AE) in IVC group, compared with IVR group after treatment of loading dosage [the 1st month BCVA (WMD: 0.01; 95%CI: -0.26 to 0.27; P=0.96), the 3rd month BCVA (WMD: -0.04; 95%CI: -0.14 to 0.06; P=0.46); the 6th month BCVA (WMD: -0.24; 95%CI: -1.62 to 1.14; P=0.73)], AE (OR: 0.84; 95%CI: 0.38 to 1.84; P=0.66)]. A slight difference was found in the effectiveness rate (OR: 1.70; 95%CI: 0.97 to 2.96; P=0.06), There were statistically significant differences between IVC and IVR treatment in terms of CMT [1st month CMT (WMD: -19.88; 95%CI: -27.94 to -11.82; P<0.001), 3rd month CMT (WMD: -23.31; 95%CI: -43.30 to -3.33; P=0.02), 6th month CMT (WMD: -74.74; 95%CI: -106.22 to -43.26; P<0.001)]. CONCLUSION: Pooled evidence suggests that both IVC and IVR are effective in the therapy of diabetic macular edema and affirms that IVC presents superiority over IVR therapy in regard of CMT in patients with diabetic macular edema, but no statistically significant difference with regard to visual improvement. Relevant RCTs with longer-term follow-up are necessary to back up our conclusion.     

飞秒激光制瓣的LASIK与SMILE术后角膜敏感性变化的Meta分析

目的系统评价飞秒激光制瓣的LASIK（FS．LASIK）和SMILE治疗近视术后角膜敏感性的差异。方法Meta分析。采用严密设计的检索策略检索Medline、Cochrane图书馆、中国生物医学文献数据库（CBMdisc）、中国期刊全文数据库（CNKI）,对比较FS—LASIK和SMILE术后角膜敏感性的文献进行Meta分析。分析内容主要包括术前,术后1周、1个月、3个月及6个月的中央角膜敏感性。采用RevMan5．0进行统计分析,计量资料以加权均数差（WMD）（95％CI）为疗效分析统计量。对检索文献的证据等级按照Jadad量表进行评价。结果共有4篇文献符合本研究的纳入标准,共198例（316眼）。Meta分析结果显示：术前FS．LASIK和SMILE中央角膜敏感性差异无明显统计学意义（WMD=O．28．95％CI：-0．73～1．29,P〉0．05）;然而,术后1周、1个月、3个月及6个月两者差异均有明显统计学意义（WMD-14．56,95％CI：-23．79～-5．34。P〈O．01;WMD=-15．29。95％CI：-22．46--8．11,P〈0．01;WMD=-13．12,95％CI：-18．77～-7．46,P〈O．01;WMD-3．45,95％CI：-5．72~-1．18,P〈0．01）。结论与FS．LASIK相比,SMILE术后角膜敏感性下降幅度可能更小,恢复更快：术后6个月时。SMILE术后角膜敏感性仍高于FS-LASIK。     

All-trans retinoic acid increases ARPE-19 cell apoptosis via activation of reactive oxygen species and endoplasmic reticulum stress pathways

AIM: To explore the apoptosis of ARPE-19 cells after the treatment with different doses of all-trans-retinoic acid (ATRA). METHODS: ARPE-19 cells were used in the in-vitro experiment. Flow cytometry assay was employed to evaluate the level of reactive oxygen species (ROS) and apoptosis. The effects of ATRA (concentrations from 2.5 to 20 μmol/L) on the expression of endoplasmic reticulum stress (ERS) markers in vitro were evaluated by Western blot and real-time quantitative polymerase chain reaction (qRT-PCR) assays. The contribution of ROS and ERS-induced apoptosis in vitro was determined by using N-acetyl-L-cysteine (NAC) and Salubrinal, an antagonist of NAC and ERS, respectively. RESULTS: Flow cytometry showed that ATRA significantly increased ARPE-19 cell apoptosis and ROS levels in each group (F=86.39, P<0.001; F=116.839, P<0.001). Western blot and qRT-PCR revealed that levels of CHOP and BIP were elevated in a concentration-dependent pattern after the cells were incubated with ATRA (2.5-20 μmol/L). The upregulation of VEGF-A and CHOP induced by ATRA could be inhibited by NAC (antioxidant) and Salubrinal (ERS inhibitor) in vitro. CONCLUSION: ATRA induces the apoptosis of ARPE-19 cells via activated ROS and ERS signaling pathways.     

Analysis of the rates of emulsification in intraocular silicone oil tamponades of differing viscosities

AIM:To investigate the rates of emulsification in silicone oil(SO)tamponades of differing viscosities used during pars plana vitrectomy(PPV)in the treatment of complicated vitreoretinal diseases.METHODS:This study was a prospective randomized clinical trial.Totally 290 cases with greater likelihoods of secondary detachment were included and randomly grouped into either Siluron 2000(n=143)or Siluron 5000(n=147)SO tamponades with 23-gauge PPV.Patient followups and data analyses were conducted 1,3,6,and 12 mo post-surgery.RESULTS:The time of the SO emulsification ranged from 1 to 17 mo,with a mean of 7.3±4.2 mo.The Siluron 5000 group showed a slower emulsification rate in comparison to the Siluron 2000 group.The Siluron 2000 group took a shorter time to show signs of emulsification,necessitating earlier SO removal.However,there were no significant differences in the occurrence of complications,including secondary retinal detachment,cataract,corneal abnormality,high intraocular pressure and hypotony.CONCLUSION:The Siluron 2000 SO tamponade shows a faster rate of emulsification than the Siluron 5000 SO,necessitating earlier removal.Both groups show similar results in terms of anatomical success and visual acuity outcome,and there is no significant difference between the SOs regarding the occurrence of complications.     

贝伐单抗和雷珠单抗治疗渗出型老年性黄斑变性有效性meta分析

目的 系统评价贝伐单抗和雷珠单抗治疗渗出型老年性黄斑变性（AMD）的有效性。方法 计算机检索荷兰医学文摘数据库Embase、美国临床医学期刊全文数据库Ovid、美国国立医学图书馆医学数据库Pubmed、中国知网、万方数据库、维普中文期刊数据库。收集国内外公开发表的关于贝伐单抗和雷珠单抗治疗渗出型AMD的随机对照试验。检索时限截止至2013年11月。按照纳入与排除标准筛选文献、提取资料和进行质量评价。用RevMan 5.2.6软件进行统计分析。比较贝伐单抗和雷珠单抗治疗前与治疗后3、6、12个月渗出型AMD患者的视力和黄斑中心凹厚度。结果 最终纳入5个研究,共1954例渗出型AMD患者。其中,贝伐单抗治疗组967例,雷珠单抗治疗组987例。Meta分析结果显示,贝伐单抗治疗组与雷珠单抗治疗组视力提高值比较,差异无统计学意义［3个月：加权均数差（WMD）=0.32,95%可信区间（CI）为-0.84~1.49,P=0.59;6个月：WMD=0.47,95%CI为-0.67~1.62,P=0.42;12个月：WMD=0.84,95% CI为-0.23~1.90,P=0.12］;贝伐单抗治疗组与雷珠单抗治疗组黄斑中心凹厚度降低值比较,差异无统计学意义（3个月：WMD=6.21,95%CI为-6.23~18.65,P=0.33;6个月：WMD=4.06,95% CI为-6.16~14.27,P=0.44;12个月：WMD=-5.39,95%CI为-14.41~3.63,P=0.24）。结论 贝伐单抗与雷珠单抗治疗渗出型AMD具有相似的治疗效果。