AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival su...AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival sutureless vitrectomy) in eyes with advancedproliferative diabetic retinopathy(PDR) with tractionalretinal detachment(TRD).METHODS: This is a prospective, interventional caseseries. Participants included 114(eyes) with advancedproliferative diabetic retinopathy and TRD. EBPD wasperformed in 114 eyes(consecutive patients) during23-gauge vitrectomy with the utilization of preoperativebevacizumab(1.25 mg/-0.05 mL). Patients mean age was 45 years(range, 21-85 years). Surgical time had a mean of 55 min(Range, 25-85 min). Mean follow up of this group of patients was 24 mo(range, 12-32 mo). Main outcome measures included best-corrected visual acuity(BCVA), retinal reattachment, and complications.RESULTS: Anatomic success occurred in 100%(114/-114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study(ETDRS) lines] was obtained in 69.2%(79/-114), in 26 eyes(22.8%) BCVA remained stable, and in 8 eyes(7%) BCVA decreased(≥ 2 ETDRS lines). Final BCVA was 20/-50 or better in 24% of eyes, between 20/-60 and 20/-400 in 46% of eyes, and worse than 20/-400 in 30% of eyes. Complications included cataract in 32(28%) eyes, iatrogenic retinal breaks in 9(7.8%) eyes, vitreous hemorrhage requiring another procedure in 7(6.1%) eyes, and phthisis bulbi in 1(0.9%) eye.CONCLUSION: This study demonstrates the usefulne-ss of using preoperative intravitreal bevacizumab and EBPD during smallgauge vitreoretinal surgery in eyes with TRD in PDR.展开更多
AIM: To evaluate the outcomes and complications of vitrectomy for diabetic retinopathy using preoperative bevacizumab and silicone oil(SO) tamponade. METHODS: Eighty-four eyes(64 patients) that underwent vitrectomy to...AIM: To evaluate the outcomes and complications of vitrectomy for diabetic retinopathy using preoperative bevacizumab and silicone oil(SO) tamponade. METHODS: Eighty-four eyes(64 patients) that underwent vitrectomy to treat severe proliferative diabetic retinopathy were enrolled in this retrospective, interventional, serial case study. All patients provided signed informed consent preoperatively and the off-label use of bevacizumab was discussed with the patients and confirmed in the signed consent forms. Bevacizumab injections and SO tamponades were used in all cases and intraoperative complications, postoperative complications and postoperative outcomes were analyzed. The primary outcome was the occurrence of intraop-erative and postoperative bleeding during and after vitrectomy and SO removal. The secondary outcomes were other complications that occurred during the two surgeries, the surgical time and the postoperative best-corrected visual acuity(BCVA) in log MAR scale compared with the preoperative BCVA in logM AR. The statistical analysis was performed with GraphP ad Prism 5(Graph Pad Software, La Jolla, CA) using a column analysis(column statistics and frequency distribution) for the noncomparative analysis and a paired t-test for the comparative study;P < 0.05 indicated statistical significance. RESULTS: Eighty-four eyes of 64 patients were included in the study. Of the 88 eyes initially recruited, 4 eyes(0.45%) developed phthisis bulbi and were excluded from the statistical analysis. Bevacizumab was injected between 1 and 10 d before surgery, with a mean of 3.7 ± 2.2 d. Forty-six eyes(54.8%) had no complications during the surgery;6 eyes(7.1%) had vitreous hemorrhage;21(25%) had a single retinal tear;7(8.3%) had two or more retinal tears, one of which was in the posterior pole, temporal to the fovea;2(2.4%) had retinal tears associated with hemorrhage;1(1.2%) had choroidal detachment;and 1 eye(1.2%) had dialysis in the temporal entrance of the trocar. After the surgery and SO removal, 60 eyes(71.4%) had展开更多
AIM： To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS： Eighteen ...AIM： To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS： Eighteen New Zealand white rabbits were divided into three treatment groups （groups 1 to 3） and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection （baseline） and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS： Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 （Kruskall-Wallis test, P=0.000）. By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealedno significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION： Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/O.1 mL in this rabbit model.展开更多
Purpose: To report the optical coherence tomographic (OCT)- findings in a case of Best’ s disease. Design: Observational case report. Methods: Optical coherence tomography was carried out to understand the pathogenes...Purpose: To report the optical coherence tomographic (OCT)- findings in a case of Best’ s disease. Design: Observational case report. Methods: Optical coherence tomography was carried out to understand the pathogenesis of Best’ s disease in a 13- year- old girl. Results: Optical coherence tomography demonstrated that the lipofuscin accumulated in a cystic space underneath the retinal pigment epithelium in the “ pseudohypopyon stage” of Best’ s disease. It also demonstrated the disruption of the photoreceptors in the “ scrambled egg” stage. Conclusions: These new OCT findings could explain the retention of good visual acuity in the “ pseudohypopyon stage” and the loss of visual acuity in the “ scrambled egg” stage of Best’ s disease.展开更多
Takayasu’s arteritis could result in chronic ocular ischemia with a spectrum of changes that is referred to as Takayasu retinopathy. The role of an ophthalmologist includes photocoagulation, monitoring for complicati...Takayasu’s arteritis could result in chronic ocular ischemia with a spectrum of changes that is referred to as Takayasu retinopathy. The role of an ophthalmologist includes photocoagulation, monitoring for complications, and timely referral for intervention. This article illustrates one such case that was effectively managed.展开更多
文摘AIM: To describe the en bloc perfluorodissection(EBPD) technique and to demonstrate the applicabilityof using preoperative intravitreal bevacizumab duringsmall-gauge vitreoretinal surgery(23-gauge transconjunctival sutureless vitrectomy) in eyes with advancedproliferative diabetic retinopathy(PDR) with tractionalretinal detachment(TRD).METHODS: This is a prospective, interventional caseseries. Participants included 114(eyes) with advancedproliferative diabetic retinopathy and TRD. EBPD wasperformed in 114 eyes(consecutive patients) during23-gauge vitrectomy with the utilization of preoperativebevacizumab(1.25 mg/-0.05 mL). Patients mean age was 45 years(range, 21-85 years). Surgical time had a mean of 55 min(Range, 25-85 min). Mean follow up of this group of patients was 24 mo(range, 12-32 mo). Main outcome measures included best-corrected visual acuity(BCVA), retinal reattachment, and complications.RESULTS: Anatomic success occurred in 100%(114/-114) of eyes. Significant visual improvement [≥ 2 Early Treatment Diabetic Retinopathy Study(ETDRS) lines] was obtained in 69.2%(79/-114), in 26 eyes(22.8%) BCVA remained stable, and in 8 eyes(7%) BCVA decreased(≥ 2 ETDRS lines). Final BCVA was 20/-50 or better in 24% of eyes, between 20/-60 and 20/-400 in 46% of eyes, and worse than 20/-400 in 30% of eyes. Complications included cataract in 32(28%) eyes, iatrogenic retinal breaks in 9(7.8%) eyes, vitreous hemorrhage requiring another procedure in 7(6.1%) eyes, and phthisis bulbi in 1(0.9%) eye.CONCLUSION: This study demonstrates the usefulne-ss of using preoperative intravitreal bevacizumab and EBPD during smallgauge vitreoretinal surgery in eyes with TRD in PDR.
文摘AIM: To evaluate the outcomes and complications of vitrectomy for diabetic retinopathy using preoperative bevacizumab and silicone oil(SO) tamponade. METHODS: Eighty-four eyes(64 patients) that underwent vitrectomy to treat severe proliferative diabetic retinopathy were enrolled in this retrospective, interventional, serial case study. All patients provided signed informed consent preoperatively and the off-label use of bevacizumab was discussed with the patients and confirmed in the signed consent forms. Bevacizumab injections and SO tamponades were used in all cases and intraoperative complications, postoperative complications and postoperative outcomes were analyzed. The primary outcome was the occurrence of intraop-erative and postoperative bleeding during and after vitrectomy and SO removal. The secondary outcomes were other complications that occurred during the two surgeries, the surgical time and the postoperative best-corrected visual acuity(BCVA) in log MAR scale compared with the preoperative BCVA in logM AR. The statistical analysis was performed with GraphP ad Prism 5(Graph Pad Software, La Jolla, CA) using a column analysis(column statistics and frequency distribution) for the noncomparative analysis and a paired t-test for the comparative study;P < 0.05 indicated statistical significance. RESULTS: Eighty-four eyes of 64 patients were included in the study. Of the 88 eyes initially recruited, 4 eyes(0.45%) developed phthisis bulbi and were excluded from the statistical analysis. Bevacizumab was injected between 1 and 10 d before surgery, with a mean of 3.7 ± 2.2 d. Forty-six eyes(54.8%) had no complications during the surgery;6 eyes(7.1%) had vitreous hemorrhage;21(25%) had a single retinal tear;7(8.3%) had two or more retinal tears, one of which was in the posterior pole, temporal to the fovea;2(2.4%) had retinal tears associated with hemorrhage;1(1.2%) had choroidal detachment;and 1 eye(1.2%) had dialysis in the temporal entrance of the trocar. After the surgery and SO removal, 60 eyes(71.4%) had
文摘AIM： To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection. METHODS： Eighteen New Zealand white rabbits were divided into three treatment groups （groups 1 to 3） and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection （baseline） and after 7, 14, 21 and 28d, followed by enucleation for histological examination. RESULTS： Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 （Kruskall-Wallis test, P=0.000）. By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealedno significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases. CONCLUSION： Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/O.1 mL in this rabbit model.
文摘Purpose: To report the optical coherence tomographic (OCT)- findings in a case of Best’ s disease. Design: Observational case report. Methods: Optical coherence tomography was carried out to understand the pathogenesis of Best’ s disease in a 13- year- old girl. Results: Optical coherence tomography demonstrated that the lipofuscin accumulated in a cystic space underneath the retinal pigment epithelium in the “ pseudohypopyon stage” of Best’ s disease. It also demonstrated the disruption of the photoreceptors in the “ scrambled egg” stage. Conclusions: These new OCT findings could explain the retention of good visual acuity in the “ pseudohypopyon stage” and the loss of visual acuity in the “ scrambled egg” stage of Best’ s disease.
文摘Takayasu’s arteritis could result in chronic ocular ischemia with a spectrum of changes that is referred to as Takayasu retinopathy. The role of an ophthalmologist includes photocoagulation, monitoring for complications, and timely referral for intervention. This article illustrates one such case that was effectively managed.
