Objective To observe the effectiveness of combined therapy of intravitreal injections of ranibizumab and macular grid laser photocoagulation for branch retinal vein occlusion (BRVO) with macular edema (ME).Methods Forty-six patients of BRVO with ME were enrolled in this study. All the patients were examined for corrected visual acuity of Early Treatment Diabetic Retinopathy Study (ETDRS), slit lamp microscope, direct ophthalmoscope, intraocular pressure, fundus color photography, fundus fluorescein angiography and optical coherence tomography. The patients were divided into three groups by different treatments: injection group (18 eyes) received intravitreal injections of ranibizumab only, joint group (17 eyes) received intravitreal injections of ranibizumab combined with grid laser photocoagulation, and laser group (11 eyes) received laser photocoagulation only. The follow-up ranged from three to 15 months, with a mean of (8.0plusmn;3.2) months. The same equipment and methods were used to return visit in follow-up period. Repeated injections were adopted in injection group and joint group according to the results of subsequent visits. Then the repeated times of injection in two groups were compared. The visual acuity, macular retinal thickness (CRT) and ocular and systemic adverse reactions about drugs and treatments were followed up. The last follow-up time was considered as the judgment time for the therapeutic effects. Results The mean repeat times of injection in the injection group was 5.4plusmn;0.4, which more than that in the joint group 3.2plusmn;0.6 (t=12.17,P＜0.05). No ocular or systemic adverse events were observed in follow-up period. ETDRS visual acuity of injection group, joint group and laser group increased by 7.30plusmn;8.68,8.50plusmn;6.04,1.55plusmn;6.85 letters respectively after treatment. The differences were statistically significant before and after treatment in injection group and joint group (t=3.58, 5.78;P＜0.05), but there was no significant difference in laser group (t=0.75,P＞0.05). The difference was not statistically significant between injection group and joint group (t=0.45,P＞0.05). The difference was statistically significant between injection group and laser group, but also between joint group and laser group (t=2.13, 2.81;P＜0.05). CRT of injection group, joint group and laser group decreased by (110.56plusmn;43.08), (125.47plusmn;35.19), (50.73plusmn;19.68) mu;m respectively after treatment, with statistically significant differences (t=-10.89,-14.70, -8.55;P＜0.05). Conclusion In the treatment of BRVO with ME, intravitreal injection of ranibizumab combined with macular grid laser photocoagulation can reduce repeat times of injection, improve visual function and relieve ME.
ObjectiveTo study changes in choroidal thickness(CT) with intravitreal injections of ranibizumab treatment. MethodsThis is a prospective, uncontrolled, open-label study. A total of 31 eyes of 31 patients diagnosed with wet age-related macular degeneration (AMD) and 33 eyes of 33 patients diagnosed with choroidal neovascularization (CNV) secondary to pathological myopia (PM) were included in the study. All affected eyes were treated with intravitreal ranibizumab 0.05 ml (10 mg/ml) and followed up monthly until 6 months. Enhanced depth imaging on Cirrus spectral-domain optical coherence tomography was used to measure the CT. The initial CT was compared with the data at 1, 3 and 6 month after treatment, and the correlation between of the decrease of CT at the 6 month and the number of injection times was analyzed. ResultsIn AMD group, the average CT respectively decreased by (9.68±11.02), (12.58±11.04), (13.84±11.67)μm at 1, 3 and 6 month, and the differences were significant(t=4.89, 6.34, 6.60;P < 0.001). In PM group, the average CT respectively decreased by (2.06±10.92), (3.64±8.78), (3.27±7.20)μm at 1, 3 and 6 month. The difference at 1 month was not significant (t=1.08, P=0.287). While after 3 months and 6 months, the differences were significant(t=2.38, 2.61;P=0.024, 0.014). The injection times were not correlated with the CT decreases at 6 month in both groups(r=0.04, 0.30;P=0.815, 0.099). ConclusionIntravitreal injections of ranibizumab can induce choroidal thickness reduction for wet age-related macular degeneration and choroidal neovascularization secondary to pathologic myopia.
ObjectiveTo observe the blood perfusion changes of peripapillary and macular vessels in patients with nonarteritic anterior ischaemic optic neuropathy (NAION).MethodsRetrospective cohort study. Thirty-six eyes (19 affected eyes and 17 fellow eyes) of 19 patients with NAION diagnosed in People’s Hospital of Wuhan University from November 2017 to January 2019 were included in this study. There were 10 males and 9 females, with the mean age of 55.05±7.11 years. Forty eyes of 20 normal subjects matched with NAION patients were included as controls. BCVA, fundus color photography, SD-OCT and OCT angiography were performed in normal controls and repeated in NAION affected eyes at 1-2 weeks, 1-2 months, 3-5 months intervals. OCT quantitative measurements: average retinal nerve fiber layer thickness (aRNFL) of the disc and its superior values (sRNFL) and the inferior values (iRNFL), average ganglion cell complex thickness (aGCC) in macular region and its superior values (sGCC) and the inferior values (iGCC). OCTA quantitative measurements: average radial peripapillary capillary density (aRPC) and its superior values (sRPC) and the inferior values (iRPC), average vascular density of superficial retina (aSVD) in macular region and its superior values (sSVD) and the inferior values (iSVD), average vascular density of deep layer retina (aDVD), areas of foveal avascular zone (FAZ). The differences of OCT and OCTA quantitative measurements between NAION eyes and the fellow eyes and normal controls were comparatively analyzed. Independent sample t test, paired sample t test or nonparametric rank sum test were performed for comparison among three groups. Pearson or Spearman correlation analysis were used to analyze the correlation between RNFL and RPC, GCC and SVD, RNFL and GCC, RPC and SVD.ResultsAt baseline, the aRNFL, aRPC and aDVD of NAION patients were significantly higher than those of normal controls. Compared with the fellow eyes, the aRNFL increased significantly and the aRPC decreased significantly in NAION affected eyes. The overall differences of aRNFL, aRPC, aGCC and aSVD at four intervals within NAION affected eyes were statistically significant (P＜0.05). The average sRNFL, sRPC, sGCC and sSVD at 1-2 months interval were significantly lower than the average iRNFL, iRPC, iGCC and iSVD (P＜0.05). Correlation analysis: at 1-2 months interval, aGCC was positively correlated with aSVD (r=0.482, P=0.037); at 3-5 months interval, aRNFL was positively correlated with aRPC (r=0.631, P=0.037).ConclusionThere is a sectorial reduction of vascular density of peripapillary RPC and macular SVD with the disease progression of NAION.
Objective To evaluate the clinical efficacy of intravitreal injections of antivascular endothelial growth factor monoclonal antibody ranibizumab in choroidal neovascularization (CNV) secondary to pathologic myopia (PM). Methods This is a prospective, uncontrolled, open-label study. 34 eyes of 34 patients with CNV secondary to PM were included in the study. All affected eye were treated with intravitreal ranibizumab 0.05 ml (10 mg/ml). Before the injection, bestcorrected visual acuity of early treatment of diabetic retinopathy study (ETDRS), noncontact tonometer, ophthalmoscope, fundus photography, fundus fluorescein angiograph (FFA) and optical coherence tomography (OCT) examination were necessary. The initial average letters of ETDRS acuity were 33.85plusmn;14.67, range from 0 to 69. The initial average central macular thickness (CMT) was（293.41plusmn;79.45） m, range from 210 m to 543 m. The patients were followed up for 3 to 12 months. Best-corrected visual acuity, OCT and ophthalmoscope examination were assessed monthly. If necessary, FFA was used. The letters of ETDRS acuity and CMT were compared before and after treatment. Results All eyes received an average of 1.68 injections, the final vision of follow-up increased （13.50plusmn;9.94） letters than before （t=7.92，P=0.00）, CMT decreased （71.14plusmn;72.26） m (t=4.62，P=0.00). There were no systemic or ocular serious side effects during the follow up. Conclusion Intravitreal ranibizumab for pathologic myopia choroidal neovascularization showed visual acuity improvement, retinal thickness reduction and safety.
Objective To investigate the expression of eotaxin-1, eotaxin-2 and eotaxin-3 in ARPE-19 human RPE cells after exposure to light. Methods Cultured human RPE cells (5th~10th generations) were divided into lightinduced group and control group. Cells light-induced group were exposed to the blue light at the intensity of (600plusmn;100) Lux for 12 h to establish the light damaged model. Eotaxin-1, eotaxin-2 and eotaxin-3 mRNA and protein were determined by real time polymerase chain reaction and Western blot at 0, 3, 6, 12, 24 hours after light-induced. Results In light-induced groups, mRNA levels of eotaxin-1 and eotaxin-2 were increased at 0 h (t1=6.05.t2=12.561) and 3 h （t1=2.95.t2=3.67） significantly(P＜0.05), but the mRNA level of eotaxin-3 had not changed （t3=1.57 and 1.00 respectively，P＞0.05） at that time. At 6 h （t1=4.73，t2=18.64，t3=28.48）, 12 h （t1=3.11，t2=20.62，t3=18.50）, 24 h （t1=8.25，t2=38.27，t3=18.60）, mRNA levels of eotaxin-1, 2, 3 were increased significantly （P＜0.05）. Except for the eotaxin-3 protein had not changed at 3 h （t3=1.28，P＞0.05）, protein expression of eotaxin-1, 2, 3 were increased significantly （P＜0.05） at 0 h （t1=4.85，t2=5.45，t3=6..21）, 3 h （t1=5.64，t2=4.55）, 6 h （t1=31.60，t2=6.63，t3=7.15）, 12 h （t1=14.09，t2=18.22，t3=15.76）, 24 h （t1=6.96，t2=10.47，t3=12.85）. Conclusion Eotaxin-1, eotaxin-2 and eotaxin-3 expression were increased after Light-damage, corresponding to the time after light exposure. Eotaxin-3 was the most prominent isoform.
ObjectiveTo observe the frequency domain optical coherence tomography (SD-OCT) features of Henle fiber layer (HFL) of health adults in china by changing the angle of the measurement beam. Methods Twenty-four subjects (28 eyes) who showed no abnormalities on routine eye examination were included in the study, including 15 males (16 eyes) and 9 females (12 eyes) with an average age of (35.51±3.54) years old, and mean refraction power of (-0.89±1.15) D. All subjects underwent corrected visual acuity, intraocular pressure, slit lamp microscope, direct ophthalmoscope, visual field and SD-OCT examination. The macular area was scanned by Zeiss Cirrus SD-OCT (5 HD line) single line scan mode. Based on the entry position of the SD-OCT beam through the pupil, the subjects were divided into 3 groups, including group A (center of the pupil), group B (near the temporal edge of the pupil) and group C (near the nasal edge of the pupil). The thickness of outer plexiform layer (OPL), HFL, and outer nuclear layer (ONL) were measured at 0.75 mm, 1.50 mm from the fovea. ResultsWhen entry position of the SD-OCT beam was near the temporal edge of the pupil (group B); there were two layer structures with different signal intensities in the weak reflectivity zones in front of the external limiting membrane (ELM). The signal of the inner layer was slightly higher than the outer layer. The OPL thickness at the decreased side (nasal) increased significantly compared with the other side, but the ONL thickness was significantly thinner than other side. When entry position of the SD-OCT beam was near the nasal edge of the pupil (group C), there were also two layer structures with different signal intensities in the weak reflectivity zones in front of the ELM. The signal of the outer layer was slightly higher than the inner layer. The OPL thickness at the decreased side (temporal) increased significantly compared with the other side, but the ONL thickness was significantly thinner than other side. The OPL thickness at the decreased side was significantly different between these 3 groups (P < 0.01). ConclusionsSD-OCT provided the possibility of distinguishing HFL from the actual ONL by changing the angle of the measurement beam. This finding has great clinical significance for related diseases affecting HFL or ONL.