色素失禁症患儿33例的眼底表现及临床分析

目的：分析色素失禁症(IP)患儿的眼部表现及IP相关性视网膜病变的临床特征,以期提高对该病的认识。

方法：回顾性分析2014-01/2018-12于湖南省儿童医院确诊的IP患儿33例的临床资料,随访1a,观察患儿的全身发育情况及眼底表现,根据眼底具体情况给予治疗。

结果：纳入患儿中女31例,男2例,首次就诊年龄5d～23月龄(平均3.38±5.02月龄)。眼部异常患儿14例,其中单眼受累5例,双眼受累9例,表现为角膜混浊1例1眼、白内障1例1眼、外斜视2例2眼、视网膜病变14例23眼。眼部异常患儿中1例在随访过程中因神经系统病变死亡; 1例行右眼玻璃体切除+左眼荧光素眼底血管造影(FFA)联合视网膜激光光凝术治疗; 1例患儿行右眼玻璃体切除联合晶状体切除+左眼FFA联合视网膜激光光凝术治疗。末次随访时,13例眼部异常的存活患儿中1例眼底检查示IP相关性1期视网膜病变,其余患儿眼底病变消退。

结论：IP患儿眼部临床表现多样,以视网膜病变最为常见,因此对确诊患儿进行规范的眼底筛查与随访至关重要。     

婴幼儿色素失禁症相关眼部病变的临床特征分析

目的:探讨色素失禁症(IP)患儿眼部病变的临床特征。方法:采用系列病例观察研究设计,对2013年1月至2019年12月于西京医院眼科就诊的13例IP患儿的临床资料进行回顾性分析。所有患儿均接受常规眼部检查,3例患儿接受荧光素眼底血管造影,5例6眼根据病情接受视网膜激光光凝术或抗血管内皮生长因子(VEGF)药物玻璃体腔注...     

视网膜下猪囊尾蚴病的眼底荧光血管造影表现

视网膜下猪囊尾蚴病的眼底荧光血管造影表现王雨生惠延年张鹏【关键词】囊尾蚴病猪疾病视网膜疾病荧光素血管造影术中国图书资料分类法分类号Ｒ５３Ｒ７７４．１Ｒ７７０．４２６．４３眼内猪囊尾蚴病的临床诊断主要靠囊尾蚴的典型形态和蠕动特征［１］。当猪囊尾蚴在玻璃...     

首都钢铁厂职工糖尿病患者眼底荧光血管造影分析

对３５０例糖尿病患者进行眼底荧光血管造影检查，共发现糖尿病视网膜病变患者６３例，检出率１８％，本文就眼底荧光血管造影与性别、年龄、血糖、病程关系进行探讨，并分析眼底荧光血管造影与检眼镜所见的符合率。     

18例小婴儿色素失禁症眼部临床特征分析及治疗

目的:观察小婴儿色素失禁症（IP）患儿的眼部临床特征及疗效。方法:回顾性临床病例研究。2017年10月至2021年2月于河南省儿童医院眼科就诊的0~3月龄小婴儿IP患儿18例36只眼纳入研究。所有患儿均在表面麻醉或全身麻醉下行眼底检查。行基因检测9例。根据眼底病变程度选择是否行视网膜激光光凝（LIO）、玻璃体腔注射康柏...     

色素失禁症相关视网膜病变12例患者临床分析

目的:观察并分析色素失禁症（IP）相关视网膜病变患者的临床特征、治疗方法及疗效。方法:回顾性临床病例研究。2015年1月至2018年12月于中山大学中山眼科中心检查确诊的IP或IP相关视网膜病变患者12例24只眼纳入研究。年龄>4岁患者行最佳矫正视力检查和眼压测量。所有患者均于表面麻醉或全身麻醉下行眼前节、玻璃体、眼底...     

糖尿病视网膜病变患者眼底荧光血管造影观察

目的分析糖尿病视网膜病变患者的眼底荧光血管造影结果。方法对231例糖尿病视网膜病变(diabetic retinopathy,DR)患者行眼底荧光素血管造影(fundus fluorescein angiography,FFA)检查。结果23例(453只眼)均表示出不同程度的眼底改变,DR的FFA检查结果比检眼镜的检出结果严重。结论FFA在DR诊断和治疗中有一定的临床价值。     

陈旧性视网膜中央静脉阻塞的眼底及荧光素眼底血管造影表现

视网膜中央静脉阻塞（CRVO）急性期具有典型的临床表现，一般都不会误诊和漏诊；但对于陈旧性CRVO，由于病史不明确，并且随着眼底出血的逐渐吸收，缺乏急性期的典型表现，易造成临床诊断的困难。我们对56例陈旧性CRVO患者58只患眼的临床资料进行了回顾分析，以探讨陈旧性CRVO的眼底表现和荧光素眼底血管造影（FFA）特征。     

眼底新生血管防治的研究进展

长期以来 ,由于眼底新生血管形成的发病机理未明 ,故无理想的治疗方法。对于视网膜新生血管 ,目前国内外临床上较多应用激光光凝来抑制其发展 ,有一定的疗效。其原理是用激光破坏高耗氧的病变视网膜 ,降低或消除缺氧刺激所产生的血管生长因子 ,从而抑制新生血管形成 ,或使已有的新生血管消退。不过 ,临床观察表明 ,激光治疗并非对所有患者有效 ,有的甚至会加重或诱发病变的发展。通过近年的研究 ,多数理论认为缺氧刺激产生的各种新生血管生长因子是刺激新生血管形成的主要因素。故去除病因 ,改善眼部血液循环 ,纠正缺氧状态等措施都是防治新…     

视网膜大动脉瘤的诊治进展

视网膜大动脉瘤(RAM)是一种获得性视网膜血管异常疾病。其发病机制尚未明确,与高血压、动脉硬化、高血脂等全身情况有关。视网膜大动脉瘤由于管壁薄弱高血压情况下易发生渗出或出血引发其他并发症,临床表现复杂多样,不易诊断。瘤体本身有自行退化倾向,病变未累及黄斑区者视力预后良好。但当渗出和/或出血累及黄斑时,严重影响视力,需一些可行性方案治疗。了解视网膜大动脉瘤的典型影像学表现,有助于明确诊断并给予相应的治疗措施。本文主要综述了多种检查方式下视网膜大动脉瘤的表现及不同类型视网膜大动脉瘤对应的多种治疗方案,旨在为未来早期诊断和治疗视网膜大动脉瘤提供参考。     

真实世界下玻璃体腔内注射抗VEGF药物治疗眼底疾病的实效性研究

目的:研究真实世界下玻璃体腔内注射抗VEGF药物治疗眼底疾病的疗效.方法:选择2012-09/2015-08在我科应用抗VEGF药物的临床病例,回顾性调查抗VEGF药物应用的病种、频次、用法、疗效、不良反应,以及其对视力、眼底情况及黄斑中心凹厚度等指标的影响.结果:选取接受抗VEGF药物玻璃体腔内注射治疗的患者305例340眼,其中53例60眼(17.6%)为湿性年龄相关性黄斑变性(AMD)、16例18眼(5.3%)息肉样脉络膜血管病变(PCV)、120例134眼(39.4%)为糖尿病性黄斑水肿(DME)、61例68眼(20.0%)为视网膜分支静脉阻塞(BRVO)合并黄斑水肿、29例32眼(9.4%)为视网膜中央静脉阻塞(CRVO)合并黄斑水肿、16例18眼(5.3%)特发性脉络膜新生血管、4例4眼(1.2%)高度近视伴发脉络膜新生血管、4例4眼(1.2%)新生血管性青光眼、1例1眼(0.2%)视网膜血管瘤样增生(RAP)和视乳头新生血管1例1眼(0.2%).年龄为16～90岁.247例275眼(80.9%)使用雷珠单抗注射液,58例65眼(19.1%)使用康柏西普注射液.所有患者共计接受抗VEGF药物治疗次数为565次,平均为1.7次/眼.其中,采用"3+按需治疗(PRN)"治疗方法的有98例109眼(32.1%),"1+PRN"治疗方法的有207例231眼(67.9%).单独使用抗VEGF药物69例77眼(22.6%),联合曲安奈德玻璃体腔注射10例11眼(3.2%),联合玻璃体切割手术35例39眼(11.5%),联合PDT治疗26例29眼(8.5%),联合单纯眼底激光治疗例165例184眼(54.1%).经抗VEGF药物治疗后,绝大多数的最矫正视力(BCVA)、眼底情况和黄斑中心凹厚度(CMT)均有明显改善,与术前相比较,差异有统计学意义(P<0.05).表明抗VEGF药物可以有效地改善眼底疾病的视功能和眼底情况.本组病例在应用抗VEGF药物治疗期间,除有3例出现皮肤发红、瘙痒、皮疹,1例出现低热和1例出急性脑梗塞等不良事件外,其余均未发生其他严重不良反应.结论:玻璃体腔内注射抗VEGF药物能明显改善眼底疾病的视功能和眼底情况,但临床尚存在一些不良事件的发生,需引起医务工作者的高度重视.     

The effects of anti-vascular endothelial growth factor agents on human retinal pigment epithelial cells under high glucose conditions

AIM: To investigate the effects of high glucose levels and anti-vascular endothelial growth factor (VEGF) agents (bevacizumab, ranibizumab and aflibercept) on retinal pigment epithelium (RPE) cells. METHODS: ARPE-19 cells were cultured at different glucose levels (5.5 mmol/L, 25 mmol/L, and 75 mmol/L). Cell viability was evaluated by MTT assay at 3d after treatment with D-glucose. Cell migration ability was measured by wound healing assay at 3d. A cell death detection kit was used to assess apoptosis at 3 and 14d. Cell proliferation was assessed by EdU assay at 3d. The culture medium was treated with anti-VEGF agents at clinically relevant concentrations. The experiment was then repeated at a different glucose level. RESULTS: The viability and migration of ARPE-19 cells were significantly decreased in the presence of 75 mmol/L as compared to 5.5 mmol/L glucose. The percentage of TUNEL-positive cells was significantly increased and the proliferative potential was decreased with 75 mmol/L compared to 5.5 mmol/L glucose. There were no significant differences in the results between 25 mmol/L and 5.5 mmol/L glucose. In the presence of 75 mmol/L glucose, the groups treated with anti-VEGF showed decreased cell viability and proliferation and increased apoptosis. However, there were no significant differences between the anti-VEGF groups. CONCLUSION: High glucose level decreases the viability, wound healing ability, and proliferation of RPE cells, while increasing apoptosis. Furthermore, anti-VEGF agents interfered with the physiological functions of RPE cells under high-glucose conditions, accompanied by decreases in cell viability and proliferation.     

抗VEGF药物在新生血管性青光眼治疗中的应用

新生血管性青光眼（neovascular glaucoma,NVG）是继发于眼底缺血性疾病的一类难治性青光眼.既往抗青光眼药物和手术治疗失败率较高.近几年抗血管内皮细胞生长因子（anti-vascu-lar endothelial growth factor,anti-VEGF）药物逐渐用于辅助小梁切除术、引流装置植入术、睫状体光凝/冷冻术、玻璃体切除术等综合治疗.其抗血管形成和抗成纤维细胞的特性可以有效改善视网膜缺血、迅速消除眼前段新生血管、防止术中术后前房出血和延长滤过泡寿命,明显提高了NVG手术的成功率,尤其是早期治疗的成功率.但抗VEGF在NVG治疗中的时机选择及安全性等方面还需进一步研究.     

Spontaneous or secondary to intravitreal injections of anti-angiogenic agents retinal pigment epithelial tears in age-related macular degeneration

AIM:To evaluate the visual function evolution of retinal pigment epithelial (RPE) tears in patients with age-related macular degeneration (AMD) according to type of occurrence [spontaneous or secondary to anti-vascular endothelial growth factor (anti-VEGF) injection] and the topographic location of the tear after a two-year follow-up period.METHODS:A total of 15 eyes of 14 patients with RPE tears in exudative AMD were analyzed retrospectively at the University Eye Clinic of Trieste. Inclusion criteria were:patient age of 50 or older with AMD and RPE tears both spontaneous occurring or post anti-VEGF treatment. Screening included:careful medical history, complete ophthalmological examination, fluorescein angiography (FA), indocyanine green angiography (ICG), autofluorescence and infrared imaging and optical coherence tomography (OCT). Patients were evaluated every month for visual acuity (VA), fundus examination and OCT. Other data reported were:presence of PED, number of injections before the tear, location of the lesion.RESULTS: Mean follow-up was 24wk (SD±4wk). A total of 15 eyes were studied for RPE tear. In 6 cases (40%), the RPE tears occurred within two years of anti-VEGF injections the others occurred spontaneously. In 13 cases (86.6%), the RPE tear was associated with pigment epithelial detachment (PED). In 7 cases (46.6%), the RPE tear occurred in the central area of the retina and involved the fovea. Two lesions were found in the parafoveal region, six in the extra-macular area. In all cases visual acuity decreased at the end of the follow-up period (P<0.01) independently of the type or the topographical location of the lesion.CONCLUSION:RPE tear occurs in exudative AMD as a spontaneous complication or in relation to anti-VEGF injections. Visual acuity decreased significantly and gradually in the follow-up period in all cases. No correlation was found between visual loss and the type of onset or the topographic location of the tears.     

猴眼玻璃体腔内注射抗VEGF药物对视网膜色素上皮层和光感受器内节VEGF含量的影响

目的：：研究比较抗血管内皮生长因子( VEGF )药物(贝伐单抗、雷珠单抗、阿柏西晋)行猴眼玻璃体腔内注射后对视网膜色素上皮层和眼内节VEGF的作用效果。方法：选取14只健康猕猴,4只双眼注射贝伐单抗,4只双眼注射雷珠单抗,4只双眼注射阿柏西晋,每种注射药物的4只猴双眼分别于注射药物后第一天和第七天分别摘除2只猴的眼球,剩余2只未注射任何药物猴的双眼作为对照。所有摘除后的眼球福尔马林固定,石蜡包埋,切片后给予抗 VEGF 抗体,用光学显微镜观察,经 Image-Pro Plus软件处理图片,用JMP10.0进行统计学分析。结果：这三种药物均能降低视网膜色素上皮( RPE)和光感受器內节( inner segment)的VEGF水平,贝伐单抗作用在三种药物中作用最强,雷珠单抗在注射后第一天与阿柏西晋注射后第一天相比,雷珠单抗作用较强,但二者在注射后第七天,作用基本相似。结论：这三种药物均能降低RPE和inner segment的VEGF水平。     

Retinal laser photocoagulation and intravitreal injection of anti-VEGF for hemorrhagic retinal arterial microaneurysm

AIM: To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) for hemorrhagic retinal arterial macroaneurysm (RAM).METHODS: This was a retrospective clinical study. Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments: a retinal laser photocoagulation therapy monotherapy group, an anti-VEGF intravitreal injection monotherapy group, a laser and anti-VEGF combination therapy group, and an observation group. Visual acuity (VA), central macular thickness (CMT), and retinal hemorrhage area (RHA) were collected.RESULTS: Forty-seven eyes of 47 patients were enrolled. VA improved and had a significant difference between baseline and final in each treatment group (logMAR; laser group: 1.90±0.53 vs 1.05±0.63, P<0.001; anti-VEGF group: 1.75±0.63 vs 1.12±0.54, P=0.009; combination group: 1.76±0.38 vs 1.01±0.52, P<0.001); however, VA decreased and had no significant difference in observation group (1.63±0.51 vs 1.76±0.61, P=0.660). CMT decreased and had a significant difference between baseline and final in each group (laser group: 815.16±310.83 vs 252.05±83.90 μm, P<0.001; anti-VEGF group: 725.00±290.79 vs 203.56±69.89 μm, P=0.001; combination group: 595.50±186.51 vs 253.13±55.06 μm, P=0.001; observation group: 758.88±195.65 vs 267.00±120.90 μm, P=0.001). RHA were 28.99±28.15, 25.94±11.58, 19.64±8.97, and 27.45±13.76 mm2 in laser group, anti-VEGF group, combination group and observation group, respectively. RHA was statistically correlated with final VA (P=0.032) in the observation group.CONCLUSION: Both laser and anti-VEGF treatments are effective for hemorrhagic RAM. Combination therapy reduces the number of injections of anti-VEGF. RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.     

The role of intravitreal ranubizumab in the treatment of familial exudative vitreoretinopathy of stage 2 or greater

AIM: To evaluate the role of intravitreal ranubizumab (IVR) in the treatment of familial exudative vitreoretinopathy (FEVR) of stage 2 or greater either as primary or an ajunct to conventional treatments. METHODS: Retrospective, non-controlled clinical study. Thirty patients (37 eyes) diagnosed with FEVR were enrolled. Twenty patients (66.67%) were male and 10 patients (33.33%) were female. Age ranged from 0.4 to 35 years old (median 3y). IVR was used either as primary or as a combined therapy according to the retinal neovasuclar activities. The follow up ranged from 1 to 57mo with mean 16.73±15.73 (median 11)mo. The treatment effect of retinal neovasuclar activites were recorded as well as the ocular and systemic side effects. RESULTS: Among 30 patients (37 eyes), 10 eyes received single IVR, 1 eye received 2 injections. Three eyes were treated with IVR and simutanous laser photocoagulation. Laser indirect ophthalmoscopy (LIO) was applied in 5 eyes 1mo after the primary IVR. Seven eyes were treated surgically following the primary IVR due to persistent retinal neovasuclar activities and retinal traction. IVR was used as combined treatment with vitrectomy in 11 eyes. Retinal neovascular regression was notified 1mo following the primary IVR in all eyes. Neither systemic nor ocular complications were recorded. CONCLUSION: IVR may be an effective modality in the treatment of FEVR either as primary or as an ajunct to the conventional therapies. The long term effect and safty of IVR still need further research.     

Effect of anti-VEGF treatment on nonperfusion areas in ischemic retinopathy

In recent years, retinal ischemia such as that which occurs in diabetic retinopathy (DR) and retinal vein occlusion (RVO) has become a hotspot of ischemic retinopathy research. High levels of vascular endothelial growth factor (VEGF) are recognized as a major cause of macular edema (ME) in DR and RVO. High concentrations of VEGF in the vitreous can lead to serious retinal ischemia and hypoxia and form retinal nonperfusion areas (NPAs). Different levels of retinal ischemia can represent disease severity and progression. Anti-VEGF therapy as the first-line treatment for ME has been found to be effective in improving vision, but there are still disputes about whether anti-VEGF therapy could improve retinal ischemia and achieve reperfusion of previously developed retinal NPAs. Here, we review and summarize studies of the effects of anti-VEGF drugs on retinal ischemia, especially NPAs.