Laser photocoagulation for the treatment of bilateral late-onset retinopathy of prematurity-related retinal detachment in an adult male: A case report

Rationale:Retinopathy of prematurity (ROP) is one of the major leading causes of childhood visual morbidity worldwide. Retinal break and traction develop in regressed ROP can further result in rhegmatogenous or tractional retinal detachment years or even decades later.Patient concerns:Here, we reported a case of bilateral ROP related late complication in a 36-year-old male with a chief complaint of increased floaters in his left eye.Diagnoses:The fundus examination showed demarcation lines over temporal side in both eyes with tractional retinal detachment and retinal breaks anterior to the lines. A diagnosis of ROP-related late complication of combined tractional and rhegmatogenous retinal detachment was made.Interventions:Peripheral laser photocoagulation along the demarcation lines for confining the detachment area in both eyes was performed with a stable condition during follow up.Outcomes:After laser retinopexy, the patient was followed up at one week and four months later with stable laser scars and without progression of the retinal detachments.Conclusion:Regressed ROP-associated retinal detachment can occur at any time during life. Special care and follow-up may be necessary for these patients.     

Clinical efficacy and acceptability of panretinal photocoagulation combined with conbercept for patients with proliferative diabetic retinopathy: A protocol for systematic review and meta-analysis

Background:Although conbercept has been used for other diseases associated with new vascular formation, the effect of single-dose conbercept in combination with proliferative diabetic retinopathy (PDR) have not been established. We thus conducted this protocol for systematic review and meta-analysis to compare the efficacy and acceptability of panretinal photocoagulation (PRP) associated with intravitreal conbercept injections versus PRP alone in the treatment of patients with PDR.Methods:The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols reporting guidelines and the recommendations of the Cochrane Collaboration were followed to conduct this study. Reviewers will search the PubMed, Cochrane Library, Web of Science, and EMBASE online databases using the key phrases “panretinal photocoagulation,” “conbercept,” and “proliferative diabetic retinopathy” for all cohort studies published up to May 2021. The studies on cohort study focusing on PRP + conbercept and PRP alone for PDR patients will be included in our meta-analysis. At least one of the following outcomes should have been measured: PRP completion rate, proportion of eyes with visual gain/loss, central macular thickness, and incidence of complication. Review Manager software (v 5.4; Cochrane Collaboration) is used for the meta-analysis.Results:It was hypothesized that intravitreal conbercept plus PRP was more effective than PRP alone.OSF registration number:10.17605/OSF.IO/HCQ2S.     

合并弥漫性视网膜水肿和大片硬性渗出的糖尿病视网膜病变术后长期随访结果

目的 通过对长期随访结果的分析,评价手术(包括玻璃体切割、眼内激光光凝、长效气体充填)治疗糖尿病视网膜病变(DR)合并弥漫性视网膜水肿(DlDRE)及视网膜下大片硬性渗出(MSHE)的临床效果.方法 2001年10月-2006年12月,共筛选DR伴DDRE和MSHE的患者25例30眼,其中男性14例17眼,女性11例13眼,年龄36～68岁,平均54.6岁.术前进行最佳矫正视力(BCVA)、彩色眼底照相、眼底荧光血管造影(FFA)和光学相干断层扫描(OCT)检查.治疗方法为闭合式玻璃体切除、后界膜剥除,眼内视网膜激光光凝和长效气体充填.结果 术前30眼的BCVA均≤0.05.术后随访12～23个月,2眼视力无变化,其余28眼(93.3%)视力不同程度提高,BCVA有3眼提高至0.03～0.04,25眼≥0.09,其中1眼为1.0.术后视网膜水肿均明显消退,视网膜出血和其下的硬性渗出明显吸收或完全吸收,黄斑区视网膜厚度由≥450μm1下降到160～220μm.术后24～42个月,7眼(23.3%)视力下降,其中3眼(10%)为前部缺血性视神经病变,4眼黄斑水肿复发(其中2眼黄斑下重新出现硬性渗出物),黄斑区视网膜厚度310～410μm.视力为指数至0.04的5眼硬性渗出物吸收后黄斑旁中心凹和中心凹下视网膜下瘢痕形成.结论 包括后界膜的玻璃体切除、眼内视网膜激光光凝及长效气体充填术对DR伴DDRE和MSHE有较好的治疗效果.     

Laser Photocoagulation for Central Serous Retinopathy Associated with Graft-Versus-Host Disease

Purpose: To describe the clinical characteristics and treatment of recurrent central serous retinopathy (CSR) following bone marrow transplantation (BMT). Methods: Between June 1998 and September 1999, 116 patients underwent allogeneic BMT at Hadassah Medical Center. Ocular complaints were expressed by 57.8% of these patients, who were examined and followed by the same ophthalmologist every 2–4 weeks. The ocular examination included Schirmer's test, slit-lamp examination, tonometry, and dilated funduscopy. If fundus abnormalities were noted, fluorescein angiography and indocyanine-green chorioangiography were performed. Results: Three patients presented with BMT-induced relapsing CSR. The severity of the CSR correlated well with the dosage of the systemic corticosteroids. These patients were eventually treated with laser photocoagulation, which, in all cases, resolved the CSR and improved visual acuity. During a 3-4 year follow-up period, no recurrence of CSR was documented despite continuous systemic corticosteroid treatment. Conclusions: In BMT patients, chronic corticosteroid treatment can cause a persistent/relapsing CSR. Since corticosteroids cannot be discontinued in such cases, photocoagulation should be considered at an early stage to prevent continuous ocular morbidity.     

曲安奈德联合氪激光治疗视网膜静脉阻塞的临床疗效观察

目的 探讨曲安奈德联合氪激光治疗视网膜静脉阻塞(retinal vein occlusion,RVO)的临床疗效.方法 将60例(62眼)RVO患者随机分为试验组和对照组,试验组接受曲安奈德联合氪激光治疗,对照组仅接受氪激光治疗.随访3～6个月后,对两组患者治疗前后的视力及眼底病变情况进行比较.结果 术后3个月、6个月,试验组视力分别为0.39±0.10、0.41±0.09,对照组分别为0.25 ±0.09、0.26±0.11,两组比较差异均有统计学意义(均为P＜0.05).术后3个月、6个月试验组黄斑水肿好转率均高于对照组,差异均有统计学意义(均为P＜0.05).试验组术后1眼出现眼压增高,对照组5眼出现眼压增高,均经治疗好转,未发生眼内炎、视网膜脱离等并发症.结论 曲安奈德联合氪激光治疗RVO可显著改善患者视力,促进黄斑水肿吸收,减少并发症发生.     

Correlation with OCT and histology of photocoagulation lesions in patients and rabbits

Purpose:  To examine spectral domain optical coherence tomographic (OCT) and histological images from comparable retinal photocoagulation lesions in rabbits, and to correlate these images with comparable OCT images from patients. Methods:  508 rabbit lesions were examined by HE‐stained paraffin histology. 1019 rabbit lesions versus 236 patient lesions were examined by OCT, all at the time‐points 1 hr, 1 week and 4 weeks after photocoagulation. We analysed 100 μm lesions (in humans) and 133 μm lesions (in rabbits) of 200 ms exposures at powers titrated from the histological threshold up to intense damage. Lesions were matched according to morphological criteria. Results:  Dome‐shaped layer alterations, retinal infiltration by round, pigmented cells, outer nuclear layer interruption, and eventually full thickness retinal coagulation are detectable in histology and OCT. Horizontal damage extensions are found 1½ times larger in OCT. More intense irradiation was necessary to induce comparable layer affection in rabbit OCT as in histology. Restoration of the inner retinal layers is only shown in the OCT images. Comparable primary lesions caused more pronounced OCT changes in patients than in rabbits during healing. Conclusions:  Optical coherence tomographic images indicate different tissue changes than histologic images. After photocoagulation, they show wider horizontal damage diameters, but underestimate axial damage particularly during healing. Conclusions on retinal restoration should not be drawn from OCT findings alone. Retinal recovery after comparable initial lesions appears to be more complete in rabbit than in patient OCTs.     

糖尿病视网膜病变25例综合治疗临床分析

目的探讨糖尿病视网膜病变早期综合治疗的意义。方法对25例36眼糖尿病视网膜病变患者的临床治疗过程和结果进行回顾分析。结果随访6年,视力提高≥2行10眼,占27.8%,17眼视力无变化,占47.2%,9眼视力下降,占25.0%,新生血管消退32眼,占88.9%。无明显严重并发症。结论早期综合治疗糖尿病视网膜病变,可以控制或减轻糖尿病视网膜病变的进展,大部分病人可保存良好的视功能,激光光凝是目前治疗糖尿病视网膜病变最有效的方法。     

氩离子激光格栅样光凝治疗视网膜静脉阻塞性黄斑水肿

目的:评价氩离子激光格栅样光凝治疗视网膜静脉阻塞所致黄斑水肿的临床疗效。方法:视网膜静脉阻塞所致黄斑水肿56例56眼,采用氩离子激光眼科治疗仪进行黄斑区格栅样光凝,光斑直径50～100μm,曝光时间0.1s,激光能量100～200mW,需全视网膜光凝者在黄斑格栅样光凝完成后再进行,随访3～18mo,观察治疗前后视力及黄斑水肿变化情况。结果:在56眼中,视力改善37眼(66.1%),视力不变14眼(25.0%),视力下降5眼(8.9%);黄斑水肿完全消退31眼(55.4%),黄斑水肿好转21眼(37.5%),黄斑水肿不变甚至加重4眼(7.1%)。结论:早期黄斑区格栅样光凝有助于视网膜静脉阻塞引起的黄斑水肿消退,能有效保存甚至提高患眼视力。     

视网膜氩激光光凝术联合安多明胶囊治疗糖尿病视网膜病变近期疗效观察

目的:观察安多明胶囊(羟苯磺酸钙)对糖尿病视网膜病变(DR)激光治疗后的视网膜保护作用及对视功能的影响。方法:Ⅱ～Ⅳ期糖尿病视网膜病变患者72例(116眼)分为A、B两组。A组单纯使用科以人氩激光机进行光凝治疗36例(52眼),B组在进行光凝治疗的同时联合口服安多明胶囊治疗36例(64眼)。比较所有患者治疗后1,3,6mo的主观感觉、视力改善、眼底出血及渗出吸收范围、眼底荧光血管造影(FFA)中新生血管及无灌注区的变化。结果:随访6mo,A组52眼,其中显效10眼,有效30眼,无效12眼,总有效率76.9%;B组64眼,其中显效22眼,有效36眼,无效6眼,总有效率90.6%。总有效率B组较A组有显著性差异(P<0.05)。结论:氩激光光凝联合口服安多明胶囊,可增强DR单纯激光的治疗效果,减轻激光光凝的副作用,改善患者主观感觉和视力,延缓肾功能的损坏;作为DR的综合治疗方法,方便、经济,可予采纳。     

康柏西普联合激光光凝治疗视网膜分支静脉阻塞继发黄斑水肿

目的:分析康柏西普联合激光光凝对视网膜分支静脉阻塞继发黄斑水肿患者的影响。方法:根据随机数表法,将2019-01/2021-06在本院治疗的102例102眼视网膜分支静脉阻塞继发黄斑水肿患者分为观察组和对照组,每组各51例51眼。对照组采用激光光凝治疗,观察组采用康柏西普联合激光光凝治疗。比较两组患者黄斑中心凹视网膜厚度、最佳矫正视力、并发症发生率有无差异。结果:治疗3mo后,观察组黄斑中心凹视网膜厚度比对照组低(P<0.05),观察组最佳矫正视力优于对照组(P<0.05);两组并发症发生率无差异(P>0.05)。结论:康柏西普联合激光光凝治疗视网膜分支静脉阻塞继发的黄斑水肿,可有效改善黄斑中心凹视网膜厚度,提高患者视力,且并发症与单纯视网膜激光光凝治疗相比并未增加,安全有效。