Objective To investigate the effects of Hep-A and Hep-B on vascular endothelial growth factor (VEGF)-induced breakdown of blood-retinal barrier. Methods The mice were subcutaneously injected vehicle, Hep-A or Hep-B 10 mg/kg twice a day for 5 days. Then, 1 μl of 10-6mol/L VEGF were intravitreous injected. After 6 hours, 13.7×104Bq/g3H-mannital were injected intraperitoneally. The mice were sacrificed and the retinas, lungs, kidneys were removed and examined for radioactivity. The result were analyzed using SPSS software to calculate and compare retina/lung and etina/kidney leakage ratio among groups of different treatment. Result The retina/lung and retina/kidney leakage ratio were 0.38±0.04 and 0.21±0.03 respectively in normal mice; increased significantly to 1.05±0.11 and 0.46±0.04 respectively in model mice, both Plt;0.01 compared to those in normal mice; decreased to 0.59±0.06 and 0.32±0.03 respectively in mice treated with Hep-A, both Plt;0.01 compared to those in model mice; decreased 0.54±0.04 and 0.35±0.03 in mice treated with Hep-B,both Plt;0.01 compared to those in model mice. Conclusion Hep-A and Hep-B can significantly reduce VEGF-induced breakdown of blood-retinal barrier in mice. Chin J Ocul Fundus Dis，2004，20：352-354)
ObjectiveTo investigate the efficacy and safety of intravitreous injection with triamcinolone acetonide (TA) for cystoid macular edema (CME) due to central retinal vein occlusion (CRVO).MethodsFourteen eyes of 14 patients with CME due to CRVO underwent intravitreous injection with 0.1 ml TA (40 mg/ml). Best-corrected visual acuity, intraocular pressure (IOP), slitlamp examinaion, fundus fluorescein angiography, and optical coherence tomography (OCT) were performed on the patients before and after the injection. The follow-up period was 10-22.4 months, with the mean of 15.9 months.ResultsThe average visual acuity was 0.1 before the treatment; while 1 month and 3 months after the injection, the visual acuity of all of the patients improved, including ≥0.2 in 71.43% and 63.6% of the patients, respectively, and ≥0.5 in 429% and 27.3%, respectively. After then, the visual acuity of some patients decreased, and in the final visit, 4 eyes (28.6%) had a visual acuity of ≥0.2, and 1 eye (7.1%) of ≥0.5. Compared with that before the treatment, the visual acuity of 10 (71.4%) eyes improved and 4 (28.6%) eyes declined. One month after the treatment, the macular edema disappeared in 10 eyes (71.4%) and alleviated in 4 (28.6%). In the final visit, macular edema disappeared in 4 eyes, alleviated in 9, and aggravated in 1. In the follow-up duration, high IOP［22.3-40.1 mm Hg (1 mm Hg=0.133 kPa)］. In the final visit, posterior subcapsular cataract was found in 7 eyes.ConclusionIntravitreous injection with TA may be effective in reducing CME and enhancing the visual acuity in a short term with high IOP in some eyes. In the long-term follow-up period, the rate of recurrence of CME and incidence of posterior subcapsular cataract is high. (Chin J Ocul Fundus Dis, 2005,21:213-216)
Objective To observe the efficiency and safety of a single intravi treal injection of Bevacizumab (Avastin) in patients with diabetic macular edema. Methods Prospective, open label study of 18 eyes of 18 patients with diabetic macular edema which was diagnosed by examination of regular inspection, fundus fluorescein angiography(FFA) and optic coherence tomography(OCT). The patients without general or partial surgery contraindications, aged from 34-75 years with a mean age of 54plusmn;11 years. The best corrected visual acuity of logMAR was 1.023plusmn;0.45 and the retinal thickness of macular foveal was 486 mu;m before the treatment. The eyes have intravitreal injection with Bevacizumab at dose 1.5 mg (0. 06 ml). After the treatment, the follow-up period ranging from 12 to 20 weeks (m e an 16plusmn;4 weeks). The changes of visual acuity, intraocular pressure, OCT and FFA before and after the treatment were observed and analyzed. Results All 18 patients had a mean logMAR BCVA of 1.023plusmn;0.45 at baseline and at the follow-up weeks 1, 4, 12, the mean logMAR BCVA was significantly improved as 0.864plusmn;0.48 （P=0.001）, 0.739plusmn;0.51 (P=0.003), 0.792plusmn;0.50 (P=0.015) respectively, and the differences are statistically significant compared with before. Sixteen eyes (88.9%) had a improved or stable visual acuity, the BCVA increased 2 lines (0.2 logMAR vision) or better in 10 eyes (55.6%) and decreased in 2 eyes at 12 weeks after injection. OCT demonstrated that retinal thickness of macular foveal decreased from 486 mu;m to 413 mu;m at 4 weeks, decreased to 383mu;m at 12 weeks（P=0.002， P=0.001）, and the differences are statistically significant compared with before. There are remarkable resolution of central retinal edema in 13 eyes (72.2%) at 12 weeks after the injection. No local or systemic adverse events were observed in any patients. Conclusions The preliminary result in our observati on showed that int ravitreal injection of Bevacizumab therapy was well tolerated with a significant improvement in BCVA and decrease in macular edema for patients with diabetic macular edema. A randomly controlled multicenter clinical trial is necessary. (Chin J Ocul Fundus Dis,2008,24:172-175)
Objective To expolre the factors which affect the size of diabetic,macular fobeal avascss scular zone(FAZ). Methods Making ten years of duration of diabetes a limit,79 nonproliferative and early proliferative diabetic patients were divided into 2 groups.Diabetic retinopathy severity level was diveided into 4 stages,and the macular edema was subdivided into focal、diffuse and cystoid according to fluorescein leakage of foveomacular region.All patients were measured FAZ with Heidelberg scanning laser fluoresceion angiography system and then compaired the size of FAZ of patients with different duration of diabetes、diabetic retinopathy severity level and macular edema status.The results were performed analysis of variance and t test. ResultsThe study shown the size of FAZ was not directly related to the duration of diabetes(t=1.3854,Pgt;0.1);There were significant differences about the size of FAZ of patients with different diabetic retinopathy severity level(F=7.6251,P＜0.01)and macular edema status(F=5.4369,P＜0.01)． Conclusion The size of FAZ was significantly increased in diabetic patients.It was enlarged with the development of diabetic retinopathy severity level,but it was not related to duration of diabetes. (Chin J Ocul Fundus Dis,2000,16:155-156)
Objective To verify the effects of the treatment of krypton yellow laser for diabetic macular edema.Methods A total of 430 eyes in 251 cases of diabetic focal macular edema, diffuse edema and cystoid edema were treated with krypton yellow laser photocoagulation. Those with focal macular edema underwent the focal photocoagulation, and those with diffuse edema and cystoid edema underwent the grid photocoagulation.The visual acuity examination, fundus fluoresec in angiography and colour photography of the fundus were performed before and every 3 or 4 months after the treatment.The changes of macular edema after the treatment were analysed.The follow-up duration was 3 to 23 months (with an average of 15.5 months). Results After laser focal photocoagulation in 186 eyes with focal macular edema, visual acuity was improved or maintained in 183 eyes (98.39% ). Edema disappeared completely or partially in 184 eyes (98.93%). After laser grid photocoagulation in 175 eyes with diffuse macular edema, visual acuity was improved or maintained in 163 eyes (93.14%). Edema disappeared completely or partially in 164 eyes (93.71%). After laser grid photocoagulation in 69 eyes with cystoid macular edema, visual acuity was improved or maintained in 59 eyes (85.5% ). Edema disappeared completely or partially in 64 eyes (92.75%).Conclusion The linchpin of the treatment of krypton yellow laser for diabetic macular edema lies in the insurance of the effective laser macules and the adaptability of selecting the proper parameter of laser according to the degree and scope of the macular edema and the visual acuity. (Chin J Ocul Fundus Dis，2003，19：14-17)
Objective To observe the short-term effect of changing the sequence of PRP and MLP on the pre-proliferative or proliferative diabetic retinopathy patients with clinical significant macular edema (CSEM). Methods Sixty-three consecutive pre-proliferative or proliferative diabetic retinopathy outpatients (103 eyes) with clinical significant macular edema were selected and divided into two groups: 54 eyes in patients of group A accepted MLP one month prior to PRP and 49 eyes in patients of group B accepted the photocoagulative therapies in a contrary sequence. All the patients were followed up for 3 to 13 months and visual acuity. Light sensitivity of 5deg;macular threshold, and FFA were performed pre- and post-photocoagution. Results The improvement of visual acuity was found to be better in group A than that of group B (Plt;0.01) 2 months after the therapy, since then, there was no significant defference (Pgt;0.05) in both groups. Three and 4 months after the treatment, there was no significant difference in change of light sensitivity of 5deg;macular threshold in both groups. The macular leakages of 59 eyes, 32 ingroup A and 27 in group B, were well controlled. Conclusion Among the pre-proliferative or proliferative diabetic retinopathy patients with CSEM, visual acuity of those who accept MLP prior to PRP more rapidly than those who accept contrary sequence of photocoagulation, but the changing of therapeutic sequence might have no dramatic influence on light sensilivity of 5deg;macular threshold. (Chin J Ocul Fundus Dis,2000,16:150-152)
Objective To explore the correlation between retinal extracellular edema and vitreous contraction in rabbits. Methods Seventeen pigmented rabbit models with retinal vein occlusion (RVO)was set up by laser photocoagulation. Retinal vascularity area was pathologically examined 1 month later.The vitreous gellength under the gravity condition and the percentage of its weight in the rabbits with extraeellular edema was observed. The mechanisms were investigated by Western immunoblotting of type II collagen.Results Extracellular edema was found in 13 experimental eyes 1 month after the formation of RVO (76.5~) with contracted vitreous gel and released watery liquid, and the a component of type II collagen was cross-linked together to form high-molecular-weight components of 1] and 7, which weakened the stability of collagen net structure.Conclusions Vitreous contraction and retinal extracellular edemawere correlated. The main reason may be the cross-links of vitreous collagen that damages the stability of collagen structure. (Chin J Ocul Fundus Dis，2004，20：2-32)