目的观察经结膜无缝线23 G玻璃体切割手术治疗玻璃体视网膜疾病的临床疗效、适应证和并发症。方法收集2010年2月至2012年12月期间广东省湛江中心人民医院眼科15例（15只眼）玻璃体视网膜疾病患者的临床资料,进行回顾分析。其中,特发性...目的观察经结膜无缝线23 G玻璃体切割手术治疗玻璃体视网膜疾病的临床疗效、适应证和并发症。方法收集2010年2月至2012年12月期间广东省湛江中心人民医院眼科15例（15只眼）玻璃体视网膜疾病患者的临床资料,进行回顾分析。其中,特发性黄斑裂孔者8例（8只眼）,特发性黄斑前膜者3例（3只眼）,视网膜静脉阻塞致玻璃体积血者4例（4只眼）,所有患者均采用经结膜无缝线23 G玻璃体切割手术进行治疗。具体术式,根据患者的病情行玻璃体切割＋前膜剥膜＋气液交换＋全氟丙烷（C3F8）气体眼内填充术。手术后对患者进行1~6个月的随访,平均随访时间为3个月。观察患者的手术时间、手术效果、眼压变化情况及手术切口愈合情况。结果手术中患者无特别不适,全部手术均顺利完成,手术时间较20 G系统明显缩短。23 G系统无需打开结膜而作巩膜切口,缝线固定灌注头可在术毕直接缝合巩膜及结膜切口。手术时间缩短为35~65min,平均约45 min。23 G系统手术切除效率类似于20 G手术,所有手术操作步骤均能按术者意愿顺利完成,无套管滑脱、弯曲情况发生,操作过程无损伤晶状体和视网膜的异常情况发生。15例（15只眼）玻璃体视网膜疾病患者中,有12例（12只眼）患者结膜下有来自于巩膜浅层的轻微出血,用棉签轻轻按压后自然止血;3例（3只眼）患者结膜下有气泡,将结膜复位并轻轻按压后气泡渗漏停止,无需缝合,且已渗漏的气体在5 d后全部吸收。所有患者在随访期内未发生持续性切口渗漏、长期低眼压、感染性眼内炎、医源性视网膜裂孔、视网膜脱离、脉络膜脱离及前段增生性玻璃体视网膜病变等并发症。术后第1天患者的平均眼压为（11.3±6.3）mm Hg（1 mm Hg=0.133 k Pa）;眼压低于8 mm Hg者4例（4只眼）,其中1例（1只眼）患者眼压为5.3 mm Hg,临床观察3 d后自行恢复正常;眼�展开更多
Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are...Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolite展开更多
In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,hig...In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,highlighted a strong link between early diabetes onset and major eye conditions,such as cataracts,glaucoma,agerelated macular degeneration,and vision loss,independent of glycemic control and disease duration.This finding challenges the previous belief that diabetic eye disease primarily correlates with hyperglycemia.As lifestyles evolve and the age of diabetes diagnosis decreases,understanding this relationship may reveal the complex pathogenesis underlying diabetes-related complications.This editorial summarizes potential mechanisms connecting the age of diabetes onset with four types of ocular diseases,emphasizing the significance of early diagnosis.展开更多
BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of di...BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively展开更多
Alteration of the outer retina leads to various diseases such as age-related macular degeneration or retinitis pigmentosa characterized by decreased visual acuity and ultimately blindness.Despite intensive research in...Alteration of the outer retina leads to various diseases such as age-related macular degeneration or retinitis pigmentosa characterized by decreased visual acuity and ultimately blindness.Despite intensive research in the field of retinal disorders,there is currently no curative treatment.Several therapeutic approaches such as cell-based replacement and gene therapies are currently in development.In the context of cell-based therapies,different cell sources such as embryonic stem cells,induced pluripotent stem cells,or multipotent stem cells can be used for transplantation.In the vast majority of human clinical trials,retinal pigment epithelial cells and photoreceptors are the cell types considered for replacement cell therapies.In this review,we summarize the progress made in stem cell therapies ranging from the pre-clinical studies to clinical trials for retinal disease.展开更多
文摘目的观察经结膜无缝线23 G玻璃体切割手术治疗玻璃体视网膜疾病的临床疗效、适应证和并发症。方法收集2010年2月至2012年12月期间广东省湛江中心人民医院眼科15例（15只眼）玻璃体视网膜疾病患者的临床资料,进行回顾分析。其中,特发性黄斑裂孔者8例（8只眼）,特发性黄斑前膜者3例（3只眼）,视网膜静脉阻塞致玻璃体积血者4例（4只眼）,所有患者均采用经结膜无缝线23 G玻璃体切割手术进行治疗。具体术式,根据患者的病情行玻璃体切割＋前膜剥膜＋气液交换＋全氟丙烷（C3F8）气体眼内填充术。手术后对患者进行1~6个月的随访,平均随访时间为3个月。观察患者的手术时间、手术效果、眼压变化情况及手术切口愈合情况。结果手术中患者无特别不适,全部手术均顺利完成,手术时间较20 G系统明显缩短。23 G系统无需打开结膜而作巩膜切口,缝线固定灌注头可在术毕直接缝合巩膜及结膜切口。手术时间缩短为35~65min,平均约45 min。23 G系统手术切除效率类似于20 G手术,所有手术操作步骤均能按术者意愿顺利完成,无套管滑脱、弯曲情况发生,操作过程无损伤晶状体和视网膜的异常情况发生。15例（15只眼）玻璃体视网膜疾病患者中,有12例（12只眼）患者结膜下有来自于巩膜浅层的轻微出血,用棉签轻轻按压后自然止血;3例（3只眼）患者结膜下有气泡,将结膜复位并轻轻按压后气泡渗漏停止,无需缝合,且已渗漏的气体在5 d后全部吸收。所有患者在随访期内未发生持续性切口渗漏、长期低眼压、感染性眼内炎、医源性视网膜裂孔、视网膜脱离、脉络膜脱离及前段增生性玻璃体视网膜病变等并发症。术后第1天患者的平均眼压为（11.3±6.3）mm Hg（1 mm Hg=0.133 k Pa）;眼压低于8 mm Hg者4例（4只眼）,其中1例（1只眼）患者眼压为5.3 mm Hg,临床观察3 d后自行恢复正常;眼�
基金supported by the National Natural Science Foundation of China,No.82171080Nanjing Medical Science and Technology Development Project,No.YKK23264Postgraduate Research&Practice Innovation Program of Jiangsu Province,Nos.JX10414151,JX10414152(all to KL)。
文摘Age-related macular degeneration is a serious neurodegenerative disease of the retina that significantly impacts vision.Unfortunately,the specific pathogenesis remains unclear,and effective early treatment options are consequently lacking.The microbiome is defined as a large ecosystem of microorganisms living within and coexisting with a host.The intestinal microbiome undergoes dynamic changes owing to age,diet,genetics,and other factors.Such dysregulation of the intestinal flora can disrupt the microecological balance,resulting in immunological and metabolic dysfunction in the host,and affecting the development of many diseases.In recent decades,significant evidence has indicated that the intestinal flora also influences systems outside of the digestive tract,including the brain.Indeed,several studies have demonstrated the critical role of the gut-brain axis in the development of brain neurodegenerative diseases,including Alzheimer’s disease and Parkinson’s disease.Similarly,the role of the“gut-eye axis”has been confirmed to play a role in the pathogenesis of many ocular disorders.Moreover,age-related macular degeneration and many brain neurodegenerative diseases have been shown to share several risk factors and to exhibit comparable etiologies.As such,the intestinal flora may play an important role in age-related macular degeneration.Given the above context,the present review aims to clarify the gut-brain and gut-eye connections,assess the effect of intestinal flora and metabolites on age-related macular degeneration,and identify potential diagnostic markers and therapeutic strategies.Currently,direct research on the role of intestinal flora in age-related macular degeneration is still relatively limited,while studies focusing solely on intestinal flora are insufficient to fully elucidate its functional role in age-related macular degeneration.Organ-on-a-chip technology has shown promise in clarifying the gut-eye interactions,while integrating analysis of the intestinal flora with research on metabolite
文摘In this article,we discuss Ye et al's recent article on the association between age at diabetes diagnosis and subsequent risk of age-related ocular diseases.The study,which utilized United Kingdom Biobank data,highlighted a strong link between early diabetes onset and major eye conditions,such as cataracts,glaucoma,agerelated macular degeneration,and vision loss,independent of glycemic control and disease duration.This finding challenges the previous belief that diabetic eye disease primarily correlates with hyperglycemia.As lifestyles evolve and the age of diabetes diagnosis decreases,understanding this relationship may reveal the complex pathogenesis underlying diabetes-related complications.This editorial summarizes potential mechanisms connecting the age of diabetes onset with four types of ocular diseases,emphasizing the significance of early diagnosis.
基金Supported by National Natural Science Foundation of China,No.32200545The GDPH Supporting Fund for Talent Program,No.KJ012020633 and KJ012019530Science and Technology Research Project of Guangdong Provincial Hospital of Chinese Medicine,No.YN2022GK04。
文摘BACKGROUND The importance of age on the development of ocular conditions has been reported by numerous studies.Diabetes may have different associations with different stages of ocular conditions,and the duration of diabetes may affect the development of diabetic eye disease.While there is a dose-response relationship between the age at diagnosis of diabetes and the risk of cardiovascular disease and mortality,whether the age at diagnosis of diabetes is associated with incident ocular conditions remains to be explored.It is unclear which types of diabetes are more predictive of ocular conditions.AIM To examine associations between the age of diabetes diagnosis and the incidence of cataract,glaucoma,age-related macular degeneration(AMD),and vision acuity.METHODS Our analysis was using the UK Biobank.The cohort included 8709 diabetic participants and 17418 controls for ocular condition analysis,and 6689 diabetic participants and 13378 controls for vision analysis.Ocular diseases were identified using inpatient records until January 2021.Vision acuity was assessed using a chart.RESULTS During a median follow-up of 11.0 years,3874,665,and 616 new cases of cataract,glaucoma,and AMD,respectively,were identified.A stronger association between diabetes and incident ocular conditions was observed where diabetes was diagnosed at a younger age.Individuals with type 2 diabetes(T2D)diagnosed at<45 years[HR(95%CI):2.71(1.49-4.93)],45-49 years[2.57(1.17-5.65)],50-54 years[1.85(1.13-3.04)],or 50-59 years of age[1.53(1.00-2.34)]had a higher risk of AMD independent of glycated haemoglobin.T2D diagnosed<45 years[HR(95%CI):2.18(1.71-2.79)],45-49 years[1.54(1.19-2.01)],50-54 years[1.60(1.31-1.96)],or 55-59 years of age[1.21(1.02-1.43)]was associated with an increased cataract risk.T2D diagnosed<45 years of age only was associated with an increased risk of glaucoma[HR(95%CI):1.76(1.00-3.12)].HRs(95%CIs)for AMD,cataract,and glaucoma associated with type 1 diabetes(T1D)were 4.12(1.99-8.53),2.95(2.17-4.02),and 2.40(1.09-5.31),respectively
文摘Alteration of the outer retina leads to various diseases such as age-related macular degeneration or retinitis pigmentosa characterized by decreased visual acuity and ultimately blindness.Despite intensive research in the field of retinal disorders,there is currently no curative treatment.Several therapeutic approaches such as cell-based replacement and gene therapies are currently in development.In the context of cell-based therapies,different cell sources such as embryonic stem cells,induced pluripotent stem cells,or multipotent stem cells can be used for transplantation.In the vast majority of human clinical trials,retinal pigment epithelial cells and photoreceptors are the cell types considered for replacement cell therapies.In this review,we summarize the progress made in stem cell therapies ranging from the pre-clinical studies to clinical trials for retinal disease.
