Objective To investigate the visual function of idiopathic macular hole before and after macular surgery. Methods Vitreous-retinal surgery was performed in 19 patients(19 eyes) with idiopthic macular hole.Among them,3 eyes belonged to stage 2，10 eyes stage 3 and 6 eyes were stage 4. The visual function including international standard visual acuity,laser retinal visual acuity,photopic ERG intensity responses- and Humphrey 30deg;-2 visual field were tested and compared before and after the surgery. Results (1)International standard visual acuity was from 0.01 to 0.1 preoperatively,and from 0.04 to 0.4 post operatively,the difference was not significant(P＞0.0 5).(2)Laser retinal visual acuity was from 0.12 to 0.4 preoperatively,and from 0.2 to 0.63 postoperatively,the difference was significant (P＜0.05).(3)In photopic ERG intensity responses:the Log K value of bwave decreased after surgery (P＜0.05),but no obvious change found in Rmax and n Value after operation.(4)Humphrey visual field examination revealed the thresholds for 0-10deg; increased after surgery(P＜0.05),but not obvious for 15-30deg;． Conclusion The visual function of the macular cones are increased by macular surgery for IMH. (Chin J Ocul Fundus Dis，2000，16：213-284)
Objective To investigate the effect of long-term intraocular retention of domestic perfluorocarbon liquid (PFCL) on morphology and histology of ocular tissues. Methods A total of 18 New-Zealand rabbits were randomly divided into 3 experimental groups, whose left eyes underwent intraocular injection with 0.3, 0.6, and 1.0 ml PFCL, respectively. All of the right eyes of the rabbits were in the control group. The morphological, electrophysiological and histological changes of the ocular tissue were observed 4, 8, and 12 weeks after the injection. Results No clinically significant retinopathy but only mild morphological changes were found in group 1 and 2, while obvious morphological and histological changes were found in group 3. Mild morphological and histological changes were found in all of the rabbits 4-8 weeks after the injection while significant ones were found 8-12 weeks after the injection. The results of electroretinography indicated a statistically significant decline of amplitude of b wave in group 3. Conclusions Long-term intraocular retention of few PFCL may cause mild histological changes but not affect the clinical function. Plentiful PFCL remains in eyes may lead to toxic reaction to the ocular tissue. (Chin J Ocul Fundus Dis, 2006, 22: 128-130)
OBJECTIVE:To verify the safe dose of cephradine in intravitreal injection. METHODS:After injecting different doses of cephradine(100mu;g,200mu;g,250mu;g,300mu;g,400mu;g)into vitreous cavity of different group of rabbits the activities of the retinal enzymes (SDH,LDH )on different time (Id,3d, 7d ) were determined respectively, and the histological and ultrastructural changes of retinas were also observed simuhaneously. RESULTS:The activity of rellnal SDH and LDH was found to be decreased gradually with tbe icreasing of the dosage of intravitreal cephradine. The activities of SDH and LDH were found in the lowest level on tile 3rd and lsl day,but they recover to normal levels on tile 7th day after intravitreal in}eetion in 100mu;g,200mu;g groups,and still lower tban normal in the other groups. Histologically,retinal edema was found both in 100mu;g and 200mu;g groups,but degradation of retinal cells,and loss of cones and rods were round in the 250mu;g, 300mu;g and 400mu;g groups. CONCLUSION: The safe dose of intravitreal injection of cepbradlnc is 200mu;g. （Chin J Ocul Fundus Dis,1997,13:139-142 ）
ObjectiveTo observe the efficacy and safety of intravitreal injection of conbercept in the treatment of proliferatived diabetic retinophathy (PDR) complicated with vitreous hemorrhage by minimally invasive vitreoretinal surgery.MethodsProspective clinical study. A total of 50 patients with PDR complicated with vitreous hemorrhage clinically diagnosed in Tianjin Medical University Eye Hospital who needed vitrectomy were recruited in this study. According to the principle of informed consent, the patients were divided into two groups: postoperative injection group and the control group. Twenty-five eyes of 25 patients in each group were examined before operation. No significant proliferative changes in the posterior pole and traction retinal detachment were observed. There was significant difference of age between two groups (t=－24.697, P=0.030), but no significant difference of sex (χ2=0.330, P=0.564), duration of diabetes (t=－1.144, P=0.258), logMAR BCVA (t=－0.148, P=0.883), lens state (χ2=0.397, P=0.529), panretinal laser photocoagulation (χ2=1.333, P=0.248). The postoperative injection group was treated with intravitreous injection of 0.05 ml conbercept (10 mg/ml) immediately after 27G minimally invasive vitrectomy. The other treatment and follow-up were the same as those in the postoperative injection group except for conbercept injection. All patients underwent routine slit-lamp examination, indirect ophthalmoscope and B-ultrasound examination before operation. The main outcome measure included the time of operation, the incidence rate of iatrogenic retinal holes and silicone oil filling. The recurrence of vitreous hemorrhage, BCVA, intraocular pressure, central retinal thickness (CRT), postoperative complications and progression were recorded 1 week, 1 month, 3 months and 6 months after operation.ResultsAt 1 week and 1, 3, 6 months after operation, there was significant difference of logMAR BCVA between the two groups (t=－4.980, －4.840, －4.892, －5.439; P<0.001). At 3 and 6 months after operation, the recurrence of vitreous hemorrhage in the postoperative injection group was lower than that in the control group, but there was no statistical difference between two groups (χ2=3.030, 4.153; P=0.192, 0.103). At 1 week and 1, 3, 6 months after operation, the CRT in the postoperative injection group was lower than that in the control group, the difference was significant (t=－2.622, －2.638, －3.613, －3.037; P=0.012, 0.010, 0.001, 0.004, 0.005). There was no complications such as choroid detachment, proliferative vitreoretinopathy, retinal detachment, iris redness and neovascular glaucoma in all the eyes after operation.ConclusionsIntravitreal injection of conbercept in the treatment of PDR after operation is safe and effective. It can reduce the recurrence of vitreous hemorrhage after vitrectomy, improve the BCVA.
Objective To investigate the method and the effects of the surgical treatment of massive subretinal hemorrhage and vitreous hemorrhage associated with age-related macular degeneration. Methods A retrospective study of 14 consecutive patients underwent a complete pars plana vitrectomy. Retinotomy was carried out for removing subretinal hemorrhage by using balanced salt solution. Complete air-fluid exchange and gas or silicone oil tamponade were performed in all patients. The follow-up period was within 3～7 months. Results Atrophy of eyeball in 2 eyes (14.3%) postoperatively. Improvement of corrected final visual acuity and anatomical retinal reattachment were achieved in 12 (85.7%) of the 14 eyes postoperatively. Seven days after operation, muddy-sand-hemorrhage in anterior chamber occurred in 4(28.6%)of the eyes and paracenteses of anterior chamber were performed for these eyes. Conclusion Surgical intervention should be applied in the eyes with the massive subretinal hemorrhage associated with age-related macular degeneration in order to avoid the affected eyes becoming atrophic due to the subsequent complication of vitreous hemorrhage, anterior chamber muddy sand hemorrhage,ghost cell-glaucoma or retinal detachment. (Chin J Ocul Fundus Dis,2000,16:217-219)
Objective To describe cultured human retinal pigment epithelial (RPE) cells transdifferentiation and investigate the effects of human vitreous fluid on the morphologic and cytoskeleton changes of RPE cells in vitro. Methods Cytoskeleton characteristics in the 2nd, 5th, 8th passage of RPE cells in normal culture, which included cytokeratin 18 (CK18) and α-smooth muscle actin (α-SMA) were analyzed by Western blot. RPE cells were cultured in human vitreous-conditioned medium (VCM) at the concentration of 1∶4 for 6 days, morphologic changes were examined by light and electron microscopy, and cytoskeleton characteristics were analyzed by imunocytochemistry and Western blot. Results During culture in vitro, RPE cells lost epithelial characteristics and aquired fibroblast-like phenotype. The expression of CK18 was the highest at the 5th passage, and it decreased in the following passage, but α-SMA increased gradually. The morphologic transdifferentiation from epithelial to fibroblast-like cells of RPE was accelerated by VCM. Ultrastructural changes such as decreased microvilli and gradually increased rough endoplasmic reticulum and Golgi complex were found during the cultivation. CK18 produced by RPE cells decreased in VMC (P＜0.05), and α-SMA increased (P＜0.01). Conclusion Morphologic changes in epithelialmesenchymal transdifferenetiation of RPE cells are stimulated by VCM and accomplied by the shift of cytoskeleton proteins, The results imply that cells migration may be decreased and contraction may be enhanced in VCM. It may suggest that vitreous accelerates the pathogenesis of PVR and RPE cells play an important role. (Chin J Ocul Fundus Dis, 2002, 18: 289-292)
Objective To analyze the reasons, methods of treatment, and effects on prognosis of vitreous hemorrhage after vitrectomy in patients with diabetic retinopathy. Methods The clinical data of 98 patients (122 eyes) with diabetic retinopathy (VI stage) who had undergone vitrectomy were retrospectively analyzed. Results Post-vitrectomy vitreous hemorrhage (gt;grade 2) was found in 25 eyes with the occurrence of 20.5%, in which the hemorrhage occurred 1 week after the surgery in 8 eyes, 1 week to 1 month in 6 eyes, and more than 1 month in 11 eyes. In the 25 eyes, C3F8 tamponade eyes occupied 31.1%, silicone oil tamponade eyes occupied 6.1%, air tamponade eyes occupied 33.3%, and infusion solution tamponade eyes occupied 26.3%. Peripheral fibrovascular proliferation was found in 9 eyes. In the 3 eyes with silicone oil tamponade, the hemorrhage was absorbed in 2, and epiretinal membrane was found in 1 which was moved when the silicon oil was taken out. In the 22 eyes without silicone oil tamponade, the hemorrhage was absorbed in 6 and aggravated in 2 without any timely treatment, neovascular glaucoma occurred in 1, and wide vitreo-retinal proliferation and retinal detachment was observed in 1 with the visual acuity of no light perception. Operations such as fluid-air exchange, vitrectomy were performed on 14 eyes 2 weeks after the hemorrhage absorption stopped. Recurrent vitreous hemorrhage was not found in 12 eyes after single operation. At the end of the follow up period, the visual acuity was no light perception in 3 eyes, hand moving in 2 eyes, counting finger-0.1 in 10 eyes, under 0.3 in 4 eyes, and over 0.3 in 6 eyes. Conclusion Most of the patients with vitreous hemorrhage after vitrectomy due to DR had peripheral fibrovascular proliferation. The visual prognosis after re-operation is good. (Chin J Ocul Fundus Dis,2007,23:241-243)
Objective To evaluate the therapeutic effects of vitrectomy on chronic and refractory Behcet′s diseases. Methods The clinical data of 8 patients (10 eyes) with Behcet′s diseases from 0.5 to 3 years after vitrectomy were retrospectively analyzed. Pre-and post-operative visual acuity, control of inflammation after the surgery, and the recurrence were observed and analyzed. Both of the eyes were involved in all of the patients, including complete Behcet′s diseases in 5 and incomplete in 3. Results Vitreous opacity and liquefaction were found in all of the involved eyes, dark retina and thin retinal vessels were seen in most of the eyes, and vascular obstruction or sheath-like changes in different degrees were detected in some eyes. Improvement of visual acuity was observed in all of the eyes which had undergone the treatment after the operation. There was significant difference between the visual acuity before the surgery and at the 1st and 2nd week and the 1st and 6th month after the surgery. During the follow-up period, recurrence of the inflammation was found in 3 eyes within 1 month and in 6 eyes within 6 months; no recurrence was found in 4 eyes after the operation. No acute recurrence of inflammation was found after operation in the involved eyes. Conclusion Vitrectomy for chronic and refractory Behcet′s diseases may improve the visual acuity of the involved eyes, and the surgery is safe and effective. (Chin J Ocul Fundus Dis, 2005, 21: 357-359)
Objective To observe and analyze the causes and prognosis of postoperative vitreous hemorrhage (PVH) after vitrectomy for proliferative diabetic retinopathy (PDR). Methods A total of 160 PDR patients (171 eyes) were enrolled in this retrospective study. There were 85 males and 75 females. The patients aged from 33 to 73 years, with the mean age of (56.40±8.97) years. All the patients were performed 25G pars plana vitrectomy by the same doctor. Fibrovascular membrane peeling and panretinal photocoagulation were performed during the operation. Combined phacoemulsification was performed in one hundred and five patients. Vitreous tamponade was used at the end of surgery, including silicone oil (43 eyes), C3F8 (63 eyes), air or fluid (65 eyes). The follow-up ranged from 6 to 22 months, with the mean follow-up of (9.34±6.97) months. The features of PVH were observed. The difference of age, HbA1c, creatinine level, the severity of the fundus lesions, whether received treatment of anti-vascular endothelial growth factor (VEGF), whether received combined cataract phacoemulsification were analyzed to find out the cause and prognosis of PVH. Results The corrected vision of all the patients after the primary PPV at the latest follow up was finger counting/1 meter. PVH occurred in 15 eyes of 15 patients, the incidence was 8.77%. The PVH occurred 2 weeks to 6 months after surgery. There were significant difference in age (t=2.551), proportion with tractional retinal detachment (χ2=7.431), progressive fibrovascular proliferation (χ2=4.987) and using anti-VEGF (χ2=9.742) between the patients with and without PVH (P＜0.05). There was no significant difference in HbA1c (t=0.501), creatinine level (t=1.529), and the proportion of cataract phacoemulsification (χ2=0.452) between the patients with and without PVH (P＞0.05). During follow-up, neovascularization of iris (NVI) occurred in 1 eye and neovascular glaucoma (NVG) occurred in 4 eyes. Seven eyes underwent reoperation, 7 eyes were spontaneous recovered, 1 eye with NVG give up treatment. Fibrovascular membrane was the major cause of recurrent hemorrhage. At the end of follow-up, hemorrhage was absorbed in all the 14 eyes which were treated, 12 eyes had same visual acuity compared to that before postoperative hemorrhage, 2 eyes with NVG had decreased vision. There was significant difference in the corrected vision between the patients with and without NVI or NVG (P=0.022). Conclusions PVH after PPV for PDR is closely related to the severity of diabetic retinopathy, fibrovascular membrane is the major cause of recurrent hemorrhage. NVG is an important factor related to vision acuity prognosis.
Purpose To investigate the effects of human vitreous fluid on proliferation of cultured human retinal pigment epithelial (RPE) cells and vascular endothelial cell lines(VEC304). Methods Human RPE cells and VEC304 were cultured and treated in different human vitreous-conditioned medium (VCM) with or without serum, vitreous volume concentrations of VCM were 1∶8, 1∶4 and 1∶2. Cells proliferation was assayed by tetrazolium (MTT) colorimetry at the 2nd, 4th and 6th day respectively. Results In the presence of serum, 1∶4, 1∶2 VCM had a significantly stimulative effect on RPE cells proliferation compared with control group at the 2nd, 4th, and 6th day retrospectively (P＜0.01), but exerted a bly inhibitory effect on VEC304 proliferation compared with control group at the 2nd, 4th, and 6th day retrospectively (Plt;0.05). In the absence of serum, only 1∶2 VCM had a stimulative effect on RPE cells growth compared with control group at the 2nd day (P＜0.05) and obviously at the 4th and 6th day respectively (P＜0.01). Conclusion Human vitreous fluid influences human RPE cells and VEC304 growth in vitro. This result suggests that vitreous may play different role in proliferative vitreoretinopathy and intraocular neovascular disease. (Chin J Ocul Fundus Dis, 2002, 18: 140-142)