Removal of Epimacular Membranes

Vitreous surgery was used to remove epiretinal macular membranes in 328 cases, 184 (56%) of which had membranes that were considered idiopathic and 144 (44%) which were due to other causes. The 12- to 92-month follow-up showed that visual acuity improved two lines or more in 243 (74%) of the eyes, 79 (24%) were unchanged and 6 (2%) became worse. Recurrence of membranes was seen in 24 (7.3%) eyes and 27 (8%) eyes developed complications. In the idiopathic cases visual results were significantly better and complications fewer. Rapidly progressive nuclear sclerosis was noted in 23 (12.5%) eyes. The degree of cystoid edema had no relationship to the final visual result. Pseudoholes which were present in 14 (8%) of the idiopathic cases either became smaller or disappeared following successful surgery with an average increase in acuity of five lines.     

M2型巨噬细胞促分泌的IL-6因子对成纤维细胞活化的作用机制研究

特发性肺纤维化(idiopathic pulmonary fibrosis, IPF)通常伴有炎症反应,其中巨噬细胞与其密切相关,通过巨噬细胞与肺成纤维细胞共培养模型和博来霉素诱导的IPF小鼠模型,本文探究了巨噬细胞和白细胞介素-6(interleukin 6, IL-6)与IPF的联系。动物福利和实验过程均遵循天津中医药大学动物伦理委员会的规定。结果表明,博来霉素(bleomycin, BLM)诱导的IPF小鼠体内IL-6含量明显升高,且肺部有大量的炎性细胞浸润。划痕及免疫荧光实验结果表明,共培养36 h替代活化型(alternatively activated, M2)巨噬细胞可诱导成纤维细胞迁移及活化,且在共培养体系中IL-6的表达随之增多。划痕及天狼星红实验结果证明IL-6可促进成纤维细胞迁移和活化。研究结果证明, M2型巨噬细胞通过促进成纤维细胞分泌IL-6,从而诱导成纤维细胞活化及迁移,影响IPF发展。     

MicroRNAs in laser-induced choroidal neovascularization in mice and rats: their expression and potential therapeutic targets

Choroidal neovascularization characterizes wet age-related macular degeneration. Choroidal neovascularization formation involves a primarily angiogenic process that is combined with both inflammation and proteolysis. A primary cause of choroidal neovascularization pathogenesis is alterations in pro-and anti-angiogenic factors derived from the retinal pigment epithelium, with vascular endothelium growth factor being mainly responsible for both clinical and experimental choroidal neovascularization. MicroRNAs(miRNAs) which are short, non-coding, endogenous RNA molecules have a major role in regulating various pathological processes, including inflammation and angiogenesis. A review of recent studies with the mouse laser-induced choroidal neovascularization model has shown alterations in miRNA expression in choroidal neovascularization tissues and could be potential therapeutic targets for wet age-related macular degeneration. Upregulation of miR-505(days 1 and 3 post-laser), miR-155(day 14) occurred in retina; miR-342-5 p(days 3 and 7), miR-126-3 p(day 14) in choroid; miR-23 a, miR-24, miR-27 a(day 7) in retina/choroid; miR-505(days 1 and 3) in retinal pigment epithelium/choroid; downregulation of miR-155(days 1 and 3), miR-29 a, miR-29 b, miR-29 c(day 5), miR-93(day 14), miR-126(day 14) occurred in retinal pigment epithelium/choroid. Therapies using miRNA mimics or inhibitors were found to decrease choroidal neovascularization lesions. Choroidal neovascularization development was reduced by overexpression of miR-155, miR-188-5 p, miR-(5,B,7), miR-126-3 p, miR-342-5 p, miR-93, miR-126, miR-195 a-3 p, miR-24, miR-21, miR-31, miR-150, and miR-184, or suppression of miR-505, miR-126-3 p, miR-155, and miR-23/27. Further studies are warranted to determine miRNA expression in mouse laser-induced choroidal neovascularization models in order to validate and extend the reported findings. Important experimental variables need to be standardized; these include the strain and age of animals, gender, number and position of laser burns to the eye, laser parameters to induce choroidal neovascularization lesions including wavelength, power, spot size, and duration.     

Long-term efficacy of dexamethasone intravitreal implant in the treatment of Vogt-Koyanagi-Harada disease relapsing posterior uveitis

Purpose:To investigate the efficacy and safety of dexamethasone intravitreal implant in the treatment of relapsing posterior uveitis in patients with chronic recurrent Vogt–Koyanagi–Harada (VKH) disease.Methods: This was a prospective study of 29 eyes of 16 patients with posterior uveitis in chronic recurrent VKH disease. All patients received previous systemic steroid and immunosuppressive regimens. All patients underwent a comprehensive ophthalmic examination, including best-corrected visual acuity (BCVA), Indocyanine green angiography (ICGA), fundus fluorescein angiography (FFA), and spectral-domain optical coherence tomography (SD-OCT). All patients underwent intravitreal injection with sustained-release dexamethasone 0.7 mg implant (Ozurdex®). Primary outcome measures included mean change in BCVA and central foveal thickness (CFT) at 24 months of follow-up compared to the baseline.Results: At 24 month of follow-up, the mean BCVA improved from 0.82 ± 0.13 to 0.38 ± 0.06 logMAR (P < 0.0001). The mean CFT reduced from 505 ± 29 to 244 ± 23 um (P < 0.0001). The mean intraocular pressure (IOP) changed from 15.1 ± 2.2 to 16.9 ± 3.1 mmHg with no significant value (P-value = 0.0955). Twenty-one eyes (72.4%) received one injection, whereas eight eyes (27.6%) required two injections. The mean number of injections was 1.2 ± 0.60. The mean follow-up time was 24.75 ± 0.9 months. No serious ocular or systemic adverse events were noted during the follow-up period. Ocular hypertension was recorded in three (10.3%) eyes and controlled by IOP lowering medications. Cataract progression occurred in 11 (37.9%) eyes.Conclusion: Our cohort highlights the beneficial effects of the dexamethasone implant of 0.7 mg in the treatment of VKH disease relapsing posterior uveitis improving visual acuity, reducing macular edema, and minimizing the burden of systemic steroids in this sample study.     

Central macular thickness and subfoveal choroidal thickness changes on spectral domain optical coherence tomography after cataract surgery in pediatric population

Purpose:To evaluate the central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) changes on spectral domain optical coherence tomography (SD-OCT) after cataract surgery with intraocular lens (IOL) implantation in a pediatric population.Methods:This was a longitudinal, prospective, interventional study which included 90 pediatric patients who underwent cataract extraction with IOL implantation. Serial SD-OCT scans were done at postoperative day 1, 1-month, and 3-month follow-up. CMT and SFCT were measured at each visit.Results:A statistically significant increase in CMT was noted at 1 month (from 199.3 µm to 210.04 µm) post surgery, which declined over a 3-month period (202.70 µm, P = 0.0001). In case of SFCT, a constant increase was observed for over 3 months of follow-up (baseline: 296.52 µm; 1 month: 309.04 µm; and 3 months: 319.03 µm, P = 0.0001). The traumatic cataract group showed more pronounced changes in CMT and SFCT than the non-traumatic cataract group. No significant difference was observed regarding these parameters between those who underwent primary posterior capsulotomy (PPC) versus those who did not. None of the patients in the study group developed cystoid macular edema. These posterior segment–related anatomical changes did not affect the final visual outcomes.Conclusion:Cataract surgery induces potential inflammatory changes in the macula and choroid in pediatric patients. Such changes are more pronounced in trauma-related cases; however, they are not significant enough to affect the visual outcomes. Similarly, the additional surgical step of PPC does not induce significant anatomical or functional changes.     

Lenke1型青少年特发性脊柱侧弯胸主动脉与邻近椎体相对位置关系的初步研究

目的探讨青少年特发性脊柱侧弯胸主动脉与邻近椎体的相对位置关系。方法将患者X线片和CT图像进行分析,测量Cobb角、主动脉-椎体角α、椎体旋转角度β及主动脉离原点最小距离OB值,明确Lenke 1型青少年特发性脊柱侧弯胸主动脉与邻近椎体相对位置关系。结果不同性别组间主动脉-椎体角α、椎体旋转角度β、OB值比较差异无统计学意义(P0.05);年龄与主动脉-椎体角α、OB值之间无显著相关性,年龄与椎体旋转角度β存在轻度相关性;Cobb角与主动脉-椎体角α之间无显著相关性,与OB值之间存在轻度负相关,与椎体旋转角度β中度正相关。结论在Lenke 1型青少年特发性脊柱侧弯患者中,性别与胸主动脉位置无明显相关;椎体旋转角β和OB值可以作为临床Cobb角测量的有效补充;CT扫描可以清楚显示胸主动脉与椎体的相对位置关系,可在术前为临床医师提供手术风险评估及手术入路指导。     

Respuesta a antiangiogénicos en el edema macular secundario a necrosis retiniana aguda

A 55 year-old female patient with unilateral Acute Retinal Necrosis (ARN) developed macular oedema (MO) after the resolution of her necrosis. The macular oedema (MO) was managed and controlled for four years with intravitreal anti-VEGF injections. Anti-VEGF therapy could be useful for the treatment of MO secondary to ARN, the same as for treating MO resulting from panuveitis, where its efficacy has been already demonstrated.     

视网膜颞上分支静脉阻塞合并黄斑水肿的SD-OCT特征及视野分析

目的观察颞上视网膜分支静脉阻塞(branch retinal vein occlusion,BRVO)合并黄斑水肿的频域光学相干断层扫描(spectral domain-optical coherence tomography,SD-OCT)特征,分析视野改变特点。方法回顾性研究。随机选取2019年2月至11月于承德医学院附属医院眼科确诊为BRVO合并黄斑水肿患者34例(34眼)作为BRVO组,同期健康人16人(29眼)作为正常对照组。两组均行最佳矫正视力、裂隙灯显微镜、眼压、间接检眼镜、荧光素眼底血管造影(fundus fluorescein angiograph,FFA)、SD-OCT、自动静态视野计检查。比较两组采用SD-OCT测量的黄斑各分区视网膜厚度、视野平均光敏度(mean sensitivity,MS)及视野平均缺损(mean defect,MD)。结果 BRVO组中,黄斑区视网膜可呈海绵样弥漫型视网膜增厚、黄斑囊样水肿、浆液性视网膜脱离及混合型(前三种模式特征皆有)等多种形态表现。BRVO组黄斑中心凹,黄斑中心内外环的颞侧、上方、鼻侧、下方,共9个区域的视网膜厚度分别为...     

Complications of late capsulotomy

One hundred forty-two aphakic and pseudophakic eyes underwent capsulotomy six or more months after cataract extraction. The incidence of cystoid macular edema was 3.5%. The presence of an intraocular lens did not seem to alter the incidence or severity of cystoid macular edema. There is an increased risk of inflammation after a second intraocular procedure such as a posterior capsulotomy.     

Cystoid macular edema following secondary lens implantation

Retrospective review of 224 cases of secondary lens implantation found an increased incidence of postoperative cystoid macular edema when lens implantation was performed within a year of cataract extraction. A positive postoperative fluorescein angiogram and intraoperative vitreous loss also correlated with increased rates of cystoid macular edema.