Outcomes of conbercept therapy for choroidal neovascularization secondary to pathological myopia

AIM: To evaluate the one-year outcome of intravitreal conbercept injections for the treatment of choroidal neovascularization secondary to pathological myopia (pm-CNV) by optical coherence tomography angiography (OCTA). METHODS: The medical records of 26 consecutive eyes of 23 patients who received intravitreal injections of conbercept for pm-CNV with a follow-up of one year were retrospectively reviewed. All the patients were diagnosed by fundus fluorescein angiography (FFA) and OCTA at the first visit. All approaches were performed as “1+PRN” treatment. Outcomes included best-corrected visual acuity (BCVA), central foveal thickness (CFT) and the mean CNV area by OCTA. RESULTS: Mean Logarithm BCVA improved from (0.66±0.51) at baseline to (0.39±0.38) at one year (t=3.528, P=0.004). The CFT before treatment and after one year after were 275.08±48.74) μm and (205.15±43.74) μm respectively (t=4.630, P=0.001). The mean pm-CNV areas before treatment and after one year treatment were (0.48±0.24) mm2 and (0.15±0.11) mm2 respectively, with a significant difference among them (t=5.329, P=0.000). Twenty-one eyes had no needs after the first treatment. Four eyes received 2 injections and only one eye received 3 injections. No severe adverse events were noted relevant to the therapy. CONCLUSION: Intravitreal conbercept can improve the vision and relieve CFT and CNV area for the treatment of pm-CNV with “1+PRN” by OCTA for one year, however, long-term follow-up still need to be performed.     

Intraventricular aneurysms: Case reports and review of the literature

Background

Intraventricular aneurysms are rare, with only 49 cases have been reported to date in the literature. Treatment of these aneurysms is difficult because of their deep location, small size, and specific angioarchitecture.

Methods

We report four patients with intraventricular aneurysms. In the third patient, the aneurysm self-occluded during procedure of endovascular embolization, which has previously not been reported in the literature.

Results

The first patient was discharged without definitive treatment of his intraventricular aneurysm and died 1 year later. The third patient's aneurysm self-occluded during the procedure of endovascular embolization procedure. The aneurysms of the second and fourth patients were successfully embolized by coils and Onyx, respectively.

Conclusions

The conclusions drawn from our experience and a comprehensive review of the literature include the following: (1) intraventricular aneurysm should be considered in patients with isolated intraventricular hemorrhage; (2) intraventricular aneurysms are frequently very small (<5 mm diameter), and therefore, cannot always be detected on initial angiography; (3) small intraventricular aneurysms cannot usually be clipped or occluded without sacrificing the parent artery; (4) if an intraventricular aneurysm is identified, it should be treated by endovascular embolization or clipping rather than conservative treatment; (5) endovascular embolization should be the first treatment option, and craniotomy can also be considered.     

Contribution of VCAF-positive cells to neovascularization and calcification in atherosclerotic plaque development

Calcification of the vessel wall is a regulated process with many similarities to osteogenesis. Progenitor cells may play a role in this process. Previously, we identified a novel gene, Vascular Calcification Associated Factor (VCAF), which was shown to be important in pericyte osteogenic differentiation. The aim of this study was to determine the localization and expression pattern of VCAF in human cells and tissues. Immunohistochemical analysis of seven atherosclerotic arteries confirmed VCAF protein expression within calcified lesions. In addition, individual VCAF-positive cells were detected within the intima and adventitia in areas where sporadic 3G5-positive pericytes were localized. Furthermore, VCAF-positive cells were identified in newly formed microvessels in association with CD34-positive/CD146-positive/c-kit-positive cells as well as in intact CD31-positive endothelium in internal mammary arteries. Western blot analysis confirmed the presence of VCAF (18 kD) in protein lysates extracted from human smooth muscle cells, endothelial cells, macrophages, and osteoblasts. In fracture callus samples from three patients, VCAF was detected in osteoblasts and microvessels. This study demonstrates the presence of VCAF in neovessels and raises the possibility that VCAF could be a new marker for vascular progenitor cells involved in a number of differentiation pathways. These data may have implications for the prevention or treatment of vascular disease.     

Membrana neovascular yuxtapapilar asociada a drusas del nervio óptico

Clinical caseForteen year old patient presenting progressive decrease in visual acuity of the left eye after 3 months of evolution. On examination he presents bilateral drusen of papilla, associated with juxtapapillary neovascular membrane, which seriously compromises the vision and visual field of the left eye.ResultTreatment with 3 consecutive injections of intravitreal ranibizumab resulted in the inactivation of the neovascular membrane with reabsorption of subretinal fluid and improvement of the best corrected visual acuity of the left eye. After 9 months of follow-up, it was 20/20 and stable.ConclusionAlthough optic nerve head drusen are considered benign, neovascular membranes can be a complication. Anti-VEGFs are an effective alternative for treatment.     

脉络膜骨瘤的多模式影像分析

目的：探讨脉络膜骨瘤患眼的眼底多模式影像特征。

方法：回顾性病例观察研究。选取2015-10/2019-08在西安市第三医院眼科检查确诊且资料完整的脉络膜骨瘤患者9例15眼纳入研究。所有患者均接受眼底彩色照相、短波长眼底自发荧光(SW-AF)、红外眼底自发荧光(IR-AF)、眼底荧光素血管造影(FFA)、吲哚菁绿血管造影(ICGA)、光学相干断层扫描成像(OCT)以及眼眶X线电子计算机断层扫描(CT)检查。

结果：眼底彩色像显示15眼中,病变累及黄斑及视盘5眼(33%),仅累及黄斑8眼(53%),位于视盘旁2眼(13%); 所有患眼的脉络膜骨瘤均呈橙红色或黄白色,表面有色素沉着。SW-AF检查显示15眼(100%)的脉络膜骨瘤及其周围均有斑驳状低荧光及高荧光,而IR-AF检查则显示所有脉络膜骨瘤所在部位有点、片状高荧光及低荧光。FFA显示15眼(100%)的脉络膜骨瘤在造影过程中亮度逐渐增强,其中6眼(40%)有剧烈渗漏荧光的视网膜下新生血管(SRNV)呈现。ICGA显示9眼(60%)存在SRNV,造影早期所有脉络膜骨瘤对应部位呈低荧光,造影过程中瘤体亮度逐渐增强。OCT显示10眼(67%)的脉络膜骨瘤呈强、弱不均匀反射,5眼(33%)的脉络膜骨瘤呈弱反射,所有患眼均有视网膜神经上皮下暗反射腔。15眼(100%)的脉络膜骨瘤在CT图像上均呈高密度骨性肿块。

结论：脉络膜骨瘤呈橙红色或黄白色,其在CT图像上为骨性表现,这是诊断脉络膜骨瘤的重要依据。脉络膜骨瘤所在区域有视网膜色素上皮受损所致斑驳状强、弱不均的SW-AF及IR-AF。FFA及ICGA可明确病变区域异常循环状况。OCT可显示瘤体切面反射强弱不一,并有助于观察视网膜下积液及新生血管状况。     

Hyperbaric oxygen preconditioning promotes neovascularization of transplanted skin flaps in rats

To determine whether Hyperbaric oxygen preconditioning (HBO-PC) promotes neovascularization by increasing Stromal cell derived factor-1 (SDF-1) and CXC chemokine receptor 4 (CXCR4) in transplanted skin flaps of rats. The epigastric pedicle skin flap was established in a rat model. Rats were randomly assigned to the following five groups: 1) sham-operated group (SH); 2) ischemia followed by reperfusion 3 days postoperatively group (IR3d); 3) ischemia followed by reperfusion 5 days postoperatively group (IR5d); 4) hyperbaric oxygen preconditioning and ischemia followed by reperfusion 3 days postoperatively group (HBO-PC3d); and 5) hyperbaric oxygen preconditioning and ischemia followed by reperfusion 5 days postoperatively group(HBO-PC5d). For the groups receiving HBO-PC, animals underwent 1 hour of HBO at 2.0 ATA in 100% O₂ twice per day for 3 days consecutively prior to surgery. After perfusion, Laser Doppler perfusion imaging (LDPI) was performed, and skin flap tissue samples were harvested for histological evaluation and western blot analysis. Perfusion was significantly improved in the HBO-PC groups compared with the IR groups on postoperative 3 and 5. Microvessel density (MVD) was significantly increased by HBO-PC compared with IR groups postoperatively. Western blot analysis revealed that SDF-1 and CXCR4 expression in the HBO-PC groups was significantly increased compared with IR groups. HBO-PC promoted neovascularization via increasing expression levels of SDF-1 and CXCR4 in transplanted skin flaps of rats.     

PEDF抑制大鼠角膜移植术后新生血管作用的实验研究

目的：探讨局部应用色素上皮细胞衍生因子（pigment epithelium derived factor,PEDF）滴眼液抑制角膜移植术后角膜新生血管（corneal neovascularization,CNV）的作用及其可能机制。方法：建立大鼠同种异体间穿透性角膜移植模型,术后把72只大鼠随机平均分为实验组（10nM的PEDF眼液）和对照组（赋形剂滴眼液）。对术眼角膜用裂隙灯显微镜观察和照相,定量分析角膜新生血管面积,术后1w,2w,3w,1月,2月,3月,每个组随机处死6只动物,取其角膜标本进行免疫组化染色和透射电镜观察。结果：实验组角膜新生血管面积较对照组在术后1w,2w,3w,1月,2月显著减少（P〈0．01或P〈0．05）。结论：局部应用PEDF滴眼液可以抑制角膜移植术后角膜新生血管生长。