ObjectiveTo evaluate the clinical features of 18 cases of juxtapapillary capillary hemangioma.MethodsIn 18 cases of 18 cases of juxtapapillary capillary hemangioma,the clinical datd of 19 eyes,the results of funds fluorescein angiography(FFA) of 16 eyes ,and the follow-up observation of 7eyes were retrospectively analyzed.ResultsIn 18 cases,the sex retio of male and female is 1:2 with the average age of 28.9 years.Peripheral retinal angioma was found in 3 cases(4eyes). In19 eyes,thr center of hemangioma was located beyond the rim of optic,most of which was in inferotemporal quadrant of the optic (7/19) with the size of 1-2.5 disc diameter (DD).Most of the tumors were red in colour (12/19).In the result of FFA of 16 eyes ,wash-out at the late phase was found in 13 eyes.decreased acuity was found in all 7 cases that were followed up more than 12 months (including 5 cases treated by laser photocoagulation).retinal detachment did't occur in 6 cases without exudative retinal detachment after being follow-up for 54.5 months of the average term.ConclusionMost of the juxtapiallary capillary hemangioma are orange or red oval tumors.The center of hemangioma are located beyond the rim of the optic.The patients often complain gradually decreased visual acuity when they are in prime of their life with exudation and edema in different degree around the tumor,FFA is helpful for the diagnosis and differential diagnosis of this disease.(Chin J Ocul Fundus Dis，2004，20：1-4)
ObjectiveTo explore optimal intensity of oral anticoagulation for patients with prosthetic heart valves in Northeast China. MethodsA total of 856 patients in Northeast China who underwent prosthetic heart valve replacement in the Department of Cardiovascular Surgery,Second Hospital of Jilin University from January 2005 to June 2013 were enrolled in this study. There were 406 male and 450 female patients with their age of 45.2±13.3 years. All the patients received low-intensity oral anticoagulation [international normalized ratio (INR) 1.5-2.2,aortic valve replacement (AVR):1.5-1.8,mitral valve replacement (MVR):1.8-2.2]. Patients were followed up after discharge,and the incidence of anticoagulation-related complications was summarized. ResultsThese patients were followed up for 1-78 (18.3±12.2) months,and the follow-up rate was 75.4%. Twelve patients (1.86%) had thromboembolic complications and 10 patients (1.55%) had hemorrhagic complications. Average warfarin dosage was 3.4±0.8 mg/day,and average INR was 1.94±0.54 during follow-up. ConclusionFor patients with prosthetic heart valves in Northeast China,low-intensity anticoagulation can produce satisfactory clinical outcomes to reduce the incidence of anticoagulation-related thromboembolic or hemorrhagic complications.
Objective To observe the retinoblastoma (RB) reexamination of children with new and recurrence retinoblastoma under special circumstances.MethodsFrom January 2, 2020 to March 15, 2020, 30 children with RB who had fundus examination in Henan Children's Hospital were enrolled in this study. Among them, 14 were male, 16 were female; 18 were monocular and 12 were binocular. The average age was 37.07±18.15 months. The mean age of initial diagnosis was 20.23±13.77 months. Two patients had a family history (6.67%). In 42 eyes, stage B, C, D and E were 7, 8, 20 and 7 eyes, respectively. Twenty-one eyes had finished the treatment course and 21 eyes were during treatment. All the children underwent RetCam fundus examination, orbital MRI, ocular B-ultrasound and so on. Whether the children had new tumor or recurrence at different treatment stages was observed.ResultsAmong 7 eyes in stage B, there was no recurrence or new tumor at the end of treatment or in the process of treatment. Among 8 eyes in stage C, there were 1 eye with new tumor and 1 eye with activity tumor at the end of treatment. Among 20 eyes in stage D, there were 1 eye with recurrence tumor at the end of treatment, 3 eyes with new tumor and 7 eyes with activity tumor at the end of treatment. Among 7 eyes in stage E, 5 eyes had eyeball enucleation and 2 eyes were receiving treatment; there were 1 eye with activity tumor at the end of treatment, 1 eye with recurrence tumor, 1 eye with activity tumor. Among 18 monocular eyes, there were 11 eyes in the treatment process, 2 eyes with new tumor, 1 eye with recurrence tumor and 3 eyes with activity tumor. Of the 24 binocular eyes, 10 were receiving treatment and there were 3 eyes with new tumor, 6 eyes with activity tumor. Twenty-one eyes had finished the treatment course, the average time required for follow-up was 3.71±0.31 months, and the average time delayed for follow-up was 6.43±1.66 weeks. There was a recurrence of tumor in 1 patient who had finished the whole treatment, the incidence was 4.76%. In the course of treatment, 21 eyes were required to have a follow-up time of 3 weeks, and the average delayed follow-up time was 6.00 ± 1.89 weeks. There were 5 eyes with new tumors, with a incidence of 21.74%. Nine eyes still had activity and needed to be treated in time.ConclusionsThe higher the risk of tumor staging, the more relapses and new tumors. The patients who are being treated, the time of delayed follow-up, the higher the recurrence or new tumor than the children who have finished the treatment course and delayed the follow-up. The children who have relapsed or new tumor in the treatment course of binocular are higher than the children who have monocular.
ObjectiveTo summarize the indication and surgical experiences of valve replacement, high-risk factors and long-term results for aortic regurgitation and large left ventricle. MethodsWe retrospectively analyzed the clinical data of 42 patients with aortic regurgitation and left ventricle end-diastolic diameter (LVEDD) ≥70 mm and left ventricle end-systolic diameter (LVESD) ≥ 50 mm in our hospital from March 2004 through December 2012. There were 38 males and 4 females,aged 16-73 (45.86±14.99) years. The patients underwent aortic valve replacement, who were evaluated by echocardiography at pre-operation, pre-discharge and early follow-up. The follow up period was 12-132 months. ResultsEarly death occurred in one patient. And five patients died during the follow-up. One week after surgery in 41 patients, LVEDD (62.00±13.21 mm), LVESD (50.71±14.02 mm), indexed LVEDD (35.23±8.58 mm/m2), indexed LVESD (28.92±9.08 mm/m2), LVEF (46.41%±12.49%), were significantly smaller than those before the operation (P<0.01). Heart function grades, preoperative EF, LVEDD and indexed LVEDD were the predictors for left ventricular function recovery. One-year, 5-year, 10-year survival rate was 92.9%, 90.2%, 83.8%, respectively. ConclusionMost of patients with aortic regurgitation and large left ventricle still have indications for surgical treatment, but severe left ventricular dysfunction and ventricular arrhythmia are high risk factors for long-term survival.
ObjectiveTo analyze the clinical features, treatment and prognosis of asymptomatic patients with retinoblastoma.MethodsA retrospective series of case study. Eight asymptomatic patients (11 eyes) with the diagnosis of retinoblastoma by screening enrolled in Department of Ophthalmology of The Eye-ENT Hospital of Fudan University from January 2006 to March 2019 were included. There were 6 males and 3 females ranging from 2 days to 20 months, with a median age of 6 months. Five patients were unilateral retinoblastoma while 3 patients were bilateral. Based on the International Classification of Intraocular Retinoblastoma, 4 eyes were stage A, 3 eyes were stage B and 4 eyes were stage C. One patient had family history. Four patients were evaluated the Rb1 mutation. Routine ophthalmic examinations and ultra-wide field fundus imaging were performed on the 16 parents and 3 siblings of the 8 patients. Systemic intravenous chemotherapy was performed using the Carboplatin, Vincristine, Etoposide protocol, intra-arterial chemotherapy using Carboplatin and Melphalan, and local treatment involved cryotherapy and transpupillary thermotherapy. The mean follow-up time is 47.25 months.ResultsNone of the 8 children had any ocular symptoms. Six patients received intravenous chemotherapy (5-6 times), 1 patient received intra-arterial chemotherapy (3 times), and 1 patient just received local treatment. Among the 11 eyes, 9 eyes were treated with local cryotherapy and 8 eyes were treated with transpupillary thermotherapy. During the follow-up period, 2 patients had new tumor, and the average time was 6.3 months after the last chemotherapy. At the last follow-up, the tumor disappeared in 11 eyes, remained stable in 11 eyes. The eye protection rate was 100% (8/8) for patients without eyeball excision. The best corrected visual acuity was 0.1 for 3 eyes and 1.0 for 5 eyes. Three eyes were not found. One heterozygous mutation of Rb1 gene [1c.35_69del (p.T12fs)] was identified in 1 patient, and the other 3 patients were not detected. One had bilateral bulbar tuberculosis of the 16 parents, 1 had bilateral RB of the 3 siblings. They were the mother and brother of a child with bilateral RB.ConclusionsFundus screening is helpful for the detection of early RB. The eye protection rate is high and the long-term vision prognosis is good after systemic or topical chemical drugs (IVC, IAC) and ocular topical treatment (cryopreservation and transpupillary thermotherapy).
Objective To evaluate the prognosis of retinopathy of prematurity (ROP) following the screening and treatment guidelines of the Chinese Ministry of Public Health. Methods From December 2003 to December 2010, 1379 premature infants diagnosed with ROP were followed by binocular indirect ophthalmoscopy or fundus photography using RetcamⅡ digital camera. For the stage 1 ROP, eyes were followed every 2 weeks until the ROP regressed. For the stage 2 ROP or pre-threshold disease, eyes were followed weekly. If the ROP decreased, eyes were followed every two weeks until the ROP regressed completely. For the stage 3 ROP or acute progressive ROP (AP-ROP), eyes were followed 2-3 times weekly. If the ROP progressed to threshold or type 1 pre-threshold disease, laser therapy was performed within 72 hours. After laser treatment, eyes were followed every 1 -2 weeks. Laser or cryotherapy was conducted when the ROP progressed after first treatment. Scleral buckle and vitrectomy with closed triple incisions was conducted when the ROP progressed to stage 4 and stage 5. The period the infants were followed ranged from 6 months to 2 years (average 152.3 days). ResultsA total of 2758 eyes of 1379 infants were diagnosed with ROP. The gestational age range was 26 . 35 weeks (average 30.6 weeks) and the birth weight of 800-2200 grams (average 1424.6 grams). Four hundred eyes (14.5%) of 206 infants with threshold or type 1 pre-threshold disease were given laser treatment. Three hundred and forty-five eyes (86.2%) completely regressed, and 55 eyes (13.8%) progressed to unfavorable structural outcomes. All 2358 eyes that did not reach threshold or type 1 prethreshold disease regressed completely. The total regression rate of our study was 980%. The incidence of unfavorable structural outcomes was 2.0% including stage 4 in 32 eyes (1.2%) and stage 5 in 13 eyes (0.5%). The retina reattatched in all 6 eyes treated with scleral buckle but macular traction remained at the optic disc. In the 39 eyes treated using vitrectomy with or without lensectomy, the retina reattached completely in 17 eyes at stage 4a. In 15 eyes at stage 4b, the retina reattached completely in 10 and remained detached in 5 eyes. In the 13 eyes at stage 5, the retina reattached completely in 4, and reattached mostly in 1 eye. Conclusion The incidence of severe ROP leading to unfavorable structural outcomes can be effectively reduced by screening and timely treatment.
Objective To observe the changes of disease course and the prognosis of visual acuity of Chinese patients with polypoidal choroidal vasculopathy ( PCV).Methods Visual acuity and fundus photochromes of 20 eyes of 15 consec utive patients with PCV were followed up with a mean of 19.1 months (range from 2 to 64 months), in which the fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) of 14 eyes of 10 patients were followed up with a mean of 21.0 (range from 3 to 53) months.Results Among the 20 eyes, the visual acuity was more than 0.3 in 5 eyes (25.0%), between 0.1 and 0.2 in 6 (30%) and less than 0.1 in 9 (45.0%). During the follow-up, the visual acuity was improved in 2 (10.0%), stable in 10 (50.0%)), and regressed in 8 (40.0%). Only 1 eye (5.0 %) developed to macula scar. The result of ICGA revealed the polypoidal lesions that were unchanged in 4 eyes(28.6%), regressed in 2 (14.3%), grew in 6 (42.7%), repeatedly grew and spontaneously regressed in 6 (42.7%).Conclusions There is a large variation in the visual prognosis in Chinese patients with PCV. The polypoidal lesions can repeatedly grow and spontaneously regress in the natural course. (Chin J Ocul Fundus Dis，2004，20：8-11)
Objective To investigate the therapeutic effects of retinal angioma. Methods The clinical data of 16 cases(20 e yes) were retrospectively analyzed, and the patients included 5 males and 11 females of 23.3 yeras old on average. Four cases in this series affected by bilateral retinal angiomas were identified as von Hippel-Lindou disease. The retinal an giomas were divided into 5 stages according to their degrees of developmnet from simple angiom without vessel dilation to feeder vessel dilation and intraretina l exudates, local retinal detachemnt, massive retinal detachment and complication occurrence in proper order. The methods of treatment were laser photocoagulati on, trans-scleral cryotherapy and vitreoretinal surgery. The patinets were followed up for 37.8 months on average. Results There were 10 eyes (2 in stage 1, 7 in stage 2, 1 in stage 3)treated with laser photocoagulation, and all of the angiomas were controlled after the treatment. The visual acuity im proved in 2 eyes, decreased in 4 eyes, and remained unchanged in 4 eyes. Cryothe r apy was performed on 7 eyes(5 in stage 3, 2 in stage 4). The visual deteriortion was found in 5 eyes; and the state of illness was stable in 3 eyes in stage 3 a nd aggravating in 4 eyes (2 in stage 3, 2 in stage 4). Vitreoretinal surgery was performed on 4 eyes including 2 which had been given photocoagulation, and the visual acuity improved in 2 eyes, decreased in 1 eye, and was unimproved in 1 ey e . The visual acuity decreased to no light perception in an untreated eye after 1.5 year follow-up. New angiomas occurred in 3 eyes with Von Hippel-Lindou disease in the follow-up period. Conclusion Laser photocoagulation is effective in treating the angiomas from stage 1 to 3. Cryotherapy can cause massive exudation and proliferation, and it is only suitable for a few patients in stage 3. The visual prognosis is more favorable in vitreoretinal surgery tha n other therapies for the patients in stage 4. (Chin J Ocul Fundus Dis, 2001,17:296-298)