目的:探讨和血明目片联合雷珠单抗治疗视网膜静脉阻塞(RVO)伴黄斑水肿对患者黄斑形态学变化及预后随访。方法:选择启东市中医院2018年12月-2021年6月收治RVO伴黄斑水肿病患者128例(128只眼)为研究对象,按照随机数字表法将其分为试验组(6...目的:探讨和血明目片联合雷珠单抗治疗视网膜静脉阻塞(RVO)伴黄斑水肿对患者黄斑形态学变化及预后随访。方法:选择启东市中医院2018年12月-2021年6月收治RVO伴黄斑水肿病患者128例(128只眼)为研究对象,按照随机数字表法将其分为试验组(64只眼)和对照组(64只眼),每组64例。试验组采用和血明目片联合雷珠单抗治疗,对照组采用雷珠单抗治疗。对比两组视力疗效、最佳矫正视力变化、黄斑厚度变化、出血面积、视网膜渗漏变化及不良反应发生情况。结果:治疗后3个月,试验组视力提高率高于对照组(84.38% vs 73.44%)(P<0.05)。治疗后3个月,两组最佳矫正视力均高于治疗前,且试验组高于对照组,差异均有统计学意义(P<0.05)。治疗后3个月,两组黄斑厚度和出血灶面积均低于治疗前,且试验组均低于对照组,差异均有统计学意义(P<0.05)。试验组治疗后3个月渗漏面积总改善率高于对照组(89.06% vs 73.44%)(P<0.05)。两组治疗过程中均未出现任何不良反应情况。结论:RVO伴黄斑水肿患者选择和血明目片联合雷珠单抗治疗可提高患者视力,并且还能减轻黄斑水肿,改善视网膜渗漏面积,安全性高,值得临床大力推广及应用。展开更多
Purpose: To investigate macular morphology by spectral domain optical coherence tomography (SDOCT) in children with history of the retinopathy of prematurity (ROP). Materials and methods: In this cross-sectional study...Purpose: To investigate macular morphology by spectral domain optical coherence tomography (SDOCT) in children with history of the retinopathy of prematurity (ROP). Materials and methods: In this cross-sectional study we included 35 eyes of 18 patients, aged 4 to 8 years, with history of ROP. Twenty-one eyes had received treatment for type 1 pre-threshold ROP. The others showed spontaneous regression of the disease. A 7 × 7-mm retinal area was sampled using a 3-dimensional scanning protocol with high-resolution spectral domain optical coherence tomography (SOCT Copernicus REVO). The central foveal thickness, mean macular thickness, macular volume and foveal depression were measured. The macular anatomy and the foveal contour were examined. Results: The mean birth weight was 1338.29 ± 324.05 grams. Mean gestational age at birth was 29.37 ± 2.07 weeks. Twenty-one eyes were treated with laser or cryotherapy. All of them showed regression of the disease. The mean best corrected visual acuity was 20/28. The average central foveal thickness was 262.26 ± 37.39, with 68.57% of preterm > 240 μm and 22.86% > 220 μm. In all eyes, the foveal contour is abnormal. A foveal depression was absent in 25 eyes (71%). Conclusion: In the majority of children with a history of ROP, we found changes in macular morphology, including retention of inner retinal layers and absent foveal depression. In our study foveal hypoplasia was associated with good functional outcome.展开更多
This paper raises the question if intravitreal dexamethasone implant deserves to be utilized more effectively in a select subset of eyes with diabetic macular edema (DME). If so, what is the OCT morphology of such eye...This paper raises the question if intravitreal dexamethasone implant deserves to be utilized more effectively in a select subset of eyes with diabetic macular edema (DME). If so, what is the OCT morphology of such eyes? A retrospective consecutive case series is employed to answer these questions. Twenty consecutive eyes were studied: ten that have been treated with intravitreal anti-VEGF (Group A) injections and ten which have been treated with the steroidal implant (Group O) because they failed or were slow to respond to multiple injections of anti-VEGF medications. Specifically, 1) macular edema in the eyes were categorized for the type of OCT morphology and 2) their response to the respective treatments in terms of the resolution of the OCT morphology was determined. Results show that the OCT morphology of eyes that were in Group O predominantly (7/10) had the feature of posterior retinal leakage (subretinal fluid and large outer retinal cysts);this feature was rare in Group A (2/10). Further, each of these eyes (7/7) in Group O had a complete resolution of the macular edema after a single treatment with the dexamethasone intravitreal implant whereas neither eye with this feature (0/2) responded to the (anti-VEGF) treatment in Group A. This leads to the conclusion that there exists an OCT Feature that Identifies a Niche for Dexamethasone Intravitreal implant (FIND) in the treatment of anti-VEGF slow responders in DME. The clinical significance of the study is that selecting eyes with a priori FIND morphology on the OCT for treatment with dexamethasone implant prior to, or at the outset of, a series of anti-VEGF treatment may resolve DME promptly and lower the treatment burden for patients and cost to society.展开更多
文摘目的:探讨和血明目片联合雷珠单抗治疗视网膜静脉阻塞(RVO)伴黄斑水肿对患者黄斑形态学变化及预后随访。方法:选择启东市中医院2018年12月-2021年6月收治RVO伴黄斑水肿病患者128例(128只眼)为研究对象,按照随机数字表法将其分为试验组(64只眼)和对照组(64只眼),每组64例。试验组采用和血明目片联合雷珠单抗治疗,对照组采用雷珠单抗治疗。对比两组视力疗效、最佳矫正视力变化、黄斑厚度变化、出血面积、视网膜渗漏变化及不良反应发生情况。结果:治疗后3个月,试验组视力提高率高于对照组(84.38% vs 73.44%)(P<0.05)。治疗后3个月,两组最佳矫正视力均高于治疗前,且试验组高于对照组,差异均有统计学意义(P<0.05)。治疗后3个月,两组黄斑厚度和出血灶面积均低于治疗前,且试验组均低于对照组,差异均有统计学意义(P<0.05)。试验组治疗后3个月渗漏面积总改善率高于对照组(89.06% vs 73.44%)(P<0.05)。两组治疗过程中均未出现任何不良反应情况。结论:RVO伴黄斑水肿患者选择和血明目片联合雷珠单抗治疗可提高患者视力,并且还能减轻黄斑水肿,改善视网膜渗漏面积,安全性高,值得临床大力推广及应用。
文摘Purpose: To investigate macular morphology by spectral domain optical coherence tomography (SDOCT) in children with history of the retinopathy of prematurity (ROP). Materials and methods: In this cross-sectional study we included 35 eyes of 18 patients, aged 4 to 8 years, with history of ROP. Twenty-one eyes had received treatment for type 1 pre-threshold ROP. The others showed spontaneous regression of the disease. A 7 × 7-mm retinal area was sampled using a 3-dimensional scanning protocol with high-resolution spectral domain optical coherence tomography (SOCT Copernicus REVO). The central foveal thickness, mean macular thickness, macular volume and foveal depression were measured. The macular anatomy and the foveal contour were examined. Results: The mean birth weight was 1338.29 ± 324.05 grams. Mean gestational age at birth was 29.37 ± 2.07 weeks. Twenty-one eyes were treated with laser or cryotherapy. All of them showed regression of the disease. The mean best corrected visual acuity was 20/28. The average central foveal thickness was 262.26 ± 37.39, with 68.57% of preterm > 240 μm and 22.86% > 220 μm. In all eyes, the foveal contour is abnormal. A foveal depression was absent in 25 eyes (71%). Conclusion: In the majority of children with a history of ROP, we found changes in macular morphology, including retention of inner retinal layers and absent foveal depression. In our study foveal hypoplasia was associated with good functional outcome.
文摘This paper raises the question if intravitreal dexamethasone implant deserves to be utilized more effectively in a select subset of eyes with diabetic macular edema (DME). If so, what is the OCT morphology of such eyes? A retrospective consecutive case series is employed to answer these questions. Twenty consecutive eyes were studied: ten that have been treated with intravitreal anti-VEGF (Group A) injections and ten which have been treated with the steroidal implant (Group O) because they failed or were slow to respond to multiple injections of anti-VEGF medications. Specifically, 1) macular edema in the eyes were categorized for the type of OCT morphology and 2) their response to the respective treatments in terms of the resolution of the OCT morphology was determined. Results show that the OCT morphology of eyes that were in Group O predominantly (7/10) had the feature of posterior retinal leakage (subretinal fluid and large outer retinal cysts);this feature was rare in Group A (2/10). Further, each of these eyes (7/7) in Group O had a complete resolution of the macular edema after a single treatment with the dexamethasone intravitreal implant whereas neither eye with this feature (0/2) responded to the (anti-VEGF) treatment in Group A. This leads to the conclusion that there exists an OCT Feature that Identifies a Niche for Dexamethasone Intravitreal implant (FIND) in the treatment of anti-VEGF slow responders in DME. The clinical significance of the study is that selecting eyes with a priori FIND morphology on the OCT for treatment with dexamethasone implant prior to, or at the outset of, a series of anti-VEGF treatment may resolve DME promptly and lower the treatment burden for patients and cost to society.
