ObjectivesTo evaluate the effect of peeling of internal limiting membrane (ILM) on the postoperative visual acuity in patients with diabetic macular edema, and to detect the role indocyanine green (ICG) plays in the surgery of peeling of ILM. MethodsThirty patients (31 eyes) with diabetic retinopathy at proliferative stage with macular edema underwent vitrectomy. The patients were randomly divided into two groups: 16 eyes in group A underwent single vitrectomy with panretinal photocoagulation and ocular filling with 20% SF6; 15 eyes in group B underwent vitrectomy and peeling of ILM after the posterior pole was stained with ICG. All of the patients were asked to keep the posture of facing down for 10-14 days. The follow-up lasted 3-12 months.ResultsIn 16 eyes in group A, the visual acuity increase of 2 or more lines in 10 (62.5%) and alleviation of macular edema in 9 (56.2%) were found; the postoperative average macular retinal thickness examined by optic coherence tomography (OCT) was 393 μm. In 15 eyes in group B, the visual acuity increase of 2 or more lines in 14 (93.3%) and alleviation of macular edema in 14 (93.3%) were found; the postoperative average macular retinal thickness was 319 μm. The postoperative improvement of visual acuity in group B was much better than that in group A (X2=4.210, P=0.05), while the postoperative macular retinal thickness in group B was obviously lower than that in group A (P＜0.01). The operative sample was proved to be the ILM. ConclusionsVitrectomy is effective for diabetic macular edema and the curative effect may be improved by peeling of ILM; ICG can dye ILM well, which ensures the safe and accurate peeling of ILM.(Chin J Ocul Fundus Dis, 2005,21:138-141)
Purpose To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis for retinal vein occlusion (RVO)． Methods The investigation included 28 consecutive patients (28 eyes) with RVO．The non-ischemic group 18-cases (18 eyes) we re tre ated with the krypton red laser to induce chorioretinal venous anastomosis， the ischemic group underwent the same therapy and the grid or scattertype photoco agulation at the same time． All of the eyes were followed up for more than 5 mo nths， and with an average period of 6.6 months． Results Seven cases (7 eyes， 38．9%) of the non-ischemic group created successful chorioretinal venous anastomosis， with mean improvement of 4．43plusmn;0．7 8 standard deviation lines of best corrected visual acuity compared to0.19plusmn;0.67 lines for 11 eyes with unsuccessful anastomosis (Plt;0.001)．None of the seven eyes developed to ischemic state． Four of the 11 eyes with unsuccessful anastomosis converted to ischemic type (36.4%) ．Two cases of the ischemic group created successful anastomosis with improvement in visual acuity． The other cases had no change in visual acuity． Conclusion Laser-induced chorioretinal venous anasto mosis is a new therapeutic method for RVO， especially for nonischemic type and successful anastomosis can decrease the conversion rate of the vein occlusion to an ischemic state． (Chin J Ocul Fundus Dis, 2001,17:8-11)
Objective To evaluate the therapeutic effect of laser-induced chorioretinal venous anastomosis on macular edema of non-ischemic retinal vein occlusion. Methods Thirty-seven eyes of 37 cases of non-ischemic retinal vein occlusion received the treatment of laserinduced chorioretinal venous anastomosis and were followed up for 6～12 months. All affected eyes underwent the clinical examinations of visual acuity, ocular fundus photography, fundus fluoreceine angoigraphy (FFA) and light sensitivity of central 5 degree of the retina, and the pre- and post-operative clinical materials were analyzed. Results Successful chorioretinal venous anastomosis was formed in 18 eyes (48.6%) within 2 months after laser photocoaglation, with the mean best improved corrected visual acuity of (4.25±0.46) lines, while the mean best corrected visual acuity of the other 19 eyes with unsuccessful anastomosis decreased (0.20±0.54) lines（P＜0.001）. The light sensitivity of central 5 degree of the 18 eyes with successful anastomosis improved（P＜0.001）, with resolution of macular edema in 16 eyes, although cystoid macular edema in 2 eyes remained no change. The light sensitivity of central 5 degree of the 19 eyes with unsuccessful anastomosis have decreased（P＜0.05）, with aggrevation of the macular edema. Conclusion Successful laser-induced chorioretinal anastomosis can resolute the macular edema caused by retinal vein occlusion, especially for diffused macular edema caused by early retinal vein occlusion. (Chin J Ocul Fundus Dis,2002,18:10-12)