Intravitreal injection of bevacizumab alone or with triamcinolone acetonide for treatment of macular edema caused by central retinal vein occlusion

AIM: To compare the efficacy and safety of intravitreal bevacizumab alone versus bevacizumab combined with triamcinolone acetonide in eyes with macular edema caused by central retinal vein occlusion (CRVO) in Chinese patients. METHODS: Seventy-five eyes of 75 patients were enrolled in this prospective, randomized, consecutive study. Thirty-six patients in group 1 were treated with an intravitreal injection of bevacizumab (1.25mg/0.05mL), and 39 patients in group 2 were treated with intravitreal bevacizumab (1.25mg/0.05mL) combined with triamcinolone acetonide (2mg/0.05mL). The main outcomes of the mean best corrected visual acuity (BCVA), central retinal thickness (CRT), and intraocular pressure (IOP) were measured. RESULTS: In group 1, the mean BCVA improved from 37.78 +/- 6.14 (baseline) to 48.06 +/- 3.86, 46.48 +/- 4.77 and 44.18 +/- 5.78 at four, six and twelve weeks post-injection, respectively (P<0.01, P=0.03, P=0.04). In group 2, the mean BCVA improved from 35.92 +/- 6.20 (baseline) to 50.69 +/- 4.22, 48.76 +/- 5.59 and 45.70 +/- 6.56 at the same time points (P<0.01 each). However, there was no significant differences in the mean BCVA (F=0.043, P=0.836) and CRT (F=0.374, P=0.544) between these two groups. During the follow-up, five patients in group 1 and six patients in group 2 with high IOP were controlled with anti-glaucoma drugs. CONCLUSION: Intravitreal injection of bevacizumab alone or combined with triamcinolone acetonide has a short beneficial effect in Chinese patients with macular edema caused by CRVO, but there is no significant difference between the two groups.

两种抗VEGF药物治疗1型早产儿视网膜病变的疗效比较

目的:比较玻璃体腔注射康柏西普和雷珠单抗治疗1型早产儿视网膜病变(ROP)的有效性和安全性。方法:回顾性收集2018-08/2020-01于西京医院眼科确诊为1型ROP,并进行玻璃体腔注射康柏西普(IVC组,46例91眼)或雷珠单抗(IVR组,55例109眼)治疗的患儿临床资料,比较治疗后两组患儿ROP病变消退、复发及再治疗情况,不良预后及眼部和全身并发症情况。结果:纳入患儿101例200眼中急进型后极部ROP(AP-ROP)20眼,阈值期ROP 86眼,阈值前期1型ROP 94眼。两组患儿基线资料及治疗前ROP严重程度均无差异(P>0.05)。IVC组和IVR组一次治愈率无差异(93.4%vs 87.2%,P>0.05)。一次治疗后IVC组复发6眼(6.6%),平均复发时间为11.7±4.13wk,其中2眼再次行IVC治疗,4眼行视网膜激光光凝治疗,治疗后病变均消退;IVR组复发11眼(10.1%),平均复发时间9.82±4.02wk,其中4眼再次行IVR治疗,7眼行视网膜激光光凝治疗,治疗后病变均退行;两组复发率及复发时间均无显著差异(P>0.05)。IVC组一次治疗后未见病变进展;IVR组一次治疗后3眼病情进展,其中2眼视网膜增殖加重伴出血,行视网膜激光光凝治疗,1眼进展为牵拉性视网膜脱离,行玻璃体切除术治疗。两组患儿治疗后均未出现与药物或玻璃体腔注射相关的眼部及全身并发症,IVR组3眼出现颞侧视网膜皱褶,视网膜血管牵拉致血管弓夹角变小等不良预后。结论:IVC和IVR均为1型ROP治疗的有效手段,两者一次治愈率、复发率无显著差异,但IVR治疗的部分病情严重患儿有出现病变进展或不良预后的可能,需长期严密观察随访。

Fundus autofluorescence in central serous chorioretinopathy: association with spectral-domain optical coherence tomography and fluorescein angiography

and FA for identifying pathological abnormalities in CSC. The characteristics of IA AF in CSC were attributable to the modification of melanin in the RPE. IR- AIM: To evaluate the correlation among changes in fundus autofluorescence (AF) measured using infrared fundus AF (IR -AF) and short-wave length fundus AF (SW -AF) with changes in spectral -domain optical coherence tomography (SD -OCT) and fluorescein angiography (FA) in central serous chorioretinopathy (CSC). METHODS: Two hundred and twenty consecutive patients with CSC were included. In addition to AF, patients were assessed by means of SD -OCT and FA. Abnormalities in images of IA -AF, SW -AF, FA were analyzed and correlated with the corresponding outer retinal alterations in SD-OCT findings. RESULTS: Eyes with abnormalities on either IR-AF or SW-AF were found in 256 eyes (58.18%), among them 256 eyes (100%) showed abnormal IR -AF, but SW-AF abnormalities were present only in 213 eyes (83.20%). The hypo-IR-AF corresponded to accumulation of subretinal liquid, collapse of retinal pigment epithelium (APE) or detachment of APE with or without RPE leakage point in the corresponding area. The hyper -IR -AF corresponded to the area with loss of the ellipsoid portion of the inner segments and sub -sensory retinal deposits or focal melanogenesis under sensory retina. The hypo-SW-AF corresponded to accumulation of subretinal liquid or atrophy of RPE. The hyper -SW -AF associated with sub -sensory retinal deposits, detachment of RPE and focal melanogenesis. CONCLUSION: IR-AF was more sensitive than SW-AF AF should be used as a common diagnostic tool for identifying pathological lesion in CSC.

Infrared autofluorescence, short-wave autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytomas

AIM： To investigate the findings of infrared fundus autofluorescence（IR-AF） and spectral-domain optical coherence tomography（SD-OCT） in eyes with optic disc melanocytoma（ODM）.· METHODS： IR-AF findings and those of other ophthalmologic imaging examinations, including short-wave autofluorescence（SW-AF）, fluorescein angiography（FA）, fundus color photography, and SD-OCT of 8 eyes of 8 consecutive cases with ODM were assessed.·RESULTS： The ODMs in all cases（100%） presented similar IR-AF, SW-AF, and FA findings. On IR-AF images, ODMs showed outstanding hyper-AF with well-defined outline. On SW-AF images, the area of ODMs presented as hypo-AF. FA images revealed the leaking retinal telangiectasia on the surface of the ODMs. On SDOCT images in 8 cases（100%）, the ODMs were sloped with highly reflective surface, which were disorganized retina and optic nerve layers. In 7 cases（87.5%）, peripapillary choroids were involved. The melanocytomas of 8 cases（100%） presented as optically empty spaces. Vitreous seeds were found in one case（12.5%）.· CONCLUSION： IR-AF imaging may provide a new modality to evaluate the pathologic features of ODMs,and together with SW-AF imaging, offers a new tool to study biological characteristics associated with ODMs.SD-OCT is a valuable tool in delimitating the tumor extension and providing morphological information about the adjacent retinal tissue.

Twelve-year profile of screening results of retinopathy of prematurity at a tertiary care institute in Northwest China

AIM:To report the changes in detection rate and characteristics of retinopathy of prematurity(ROP)in infants,during a 12-year period in Northwest China.METHODS:The medical records of infants were retrospectively collected and reviewed using an established clinical database.The detection rate and severity of ROP were compared between two consecutive periods(P1:2008-2013,P2:2014-2019).Gender,gestational age(GA),birth weight(BW),multiple births,delivery pattern,and postmenstrual age of the first fundus screen were analyzed in all visiting infants.RESULTS:During the 12-year study period,7832 infants were initially included;among them,1266(16.16%)were diagnosed with ROP,441 of whom(5.63%)developed severe ROP.Throughout the study period,the total number of infants being screened showed a trend of slight fluctuation after a rapid increase;however,an annual increase was observed in the number of infants diagnosed with ROP and severe ROP.The proportion of each stage at the first screening of infants with ROP was stable.The detection rate of ROP increased from 2.33%in 2008 to 16.18%in 2010,decreased to 10.73%in 2014,and then increased to 27.47%in 2019.For severe ROP,the detection rate gradually increased from 0 in 2008 to 12.49%in 2019.Among the infants with ROP,96(7.58%)did not meet the screening criteria set by the Chinese Medical Association in 2014(GA<32wk,or BW<2000 g);among them,14(1.11%)needed treatment because of severe ROP.CONCLUSION:From 2008 to 2019,the detection rates of ROP and severe ROP in infants screened in Northwest China were 16.16%and 5.63%,respectively.The characteristics of the ROP infants were similar to those in other middle-income regions.The"tertiary prevention network of ROP"is a potentially effective screening approach.

Persistent organic pollutants in global surface soils:Distributions and fractionations

The distribution and fractionation of persistent organic pollutants(POPs)in different matrices refer to how these pollutants are dispersed and separated within various environmental compartments.This is a significant study area as it helps us understand the transport efficiencies and long-range transport potentials of POPs to enter remote areas,particularly polar regions.This study provides a comprehensive review of the progress in understanding the distribution and fractionation of POPs.We focus on the contributions of four intermedia processes(dry and wet depositions for gaseous and particulate POPs)and determine their transfer between air and soil.These processes are controlled by their partitioning between gaseous and particulate phases in the atmosphere.The distribution patterns and fractionations can be categorized into primary and secondary types.Equations are developed to quantificationally study the primary and secondary distributions and fractionations of POPs.The analysis results suggest that the transfer of low molecular weight(LMW)POPs from air to soil is mainly through gas diffusion and particle deposition,whereas high molecular weight(HMW)POPs are mainly via particle deposition.HMW-POPs tend to be trapped near the source,whereas LMW-POPs are more prone to undergo long-range atmospheric transport.This crucial distinction elucidates the primary reason behind their temperatureindependent primary fractionation.However,the secondary distribution and fractionation can only be observed along a temperature gradient,such as latitudinal or altitudinal transects.An animation is produced by a one-dimensional transport model to simulate conceptively the transport of CB-28 and CB-180,revealing the similarities and differences between the primary and secondary distributions and fractionations.We suggest that the decreasing temperature trend along latitudes is not the major reason for POPs to be fractionated into the polar ecosystems,but drives the longer-term accumulation of POPs in cold climates or polar cold trapping.

Differential Occupational Health Risks between Methylated PAHs and PAHs:Monitoring 126 PAHs and 6 Oxidative Stress Markers in Paired Serum−Urine Samples

The hazards of polycyclic aromatic hydrocarbons(PAHs)on occupationally exposed population have been widely acknowledged.However,the occupational exposure risks associated their derivatives,methylated PAHs,remain poorly understood.This study conducted a screen of 126 PAHs and 6 oxidative stress biomarkers(OSBs)in paired serum−urine samples from 110 petrochemical workers to assess the risk associated with different PAHs exposure.The results showed that the median concentrations of unmetabolized 16 priority PAHs(p-PAHs),16 regular PAHs(R-PAHs),50 methyl-PAHs(Me-PAHs),and 30 nitro-PAHs(N-PAHs)in serum(urine)were 97.98(66.46),11.02(0.00),77.76(31.77),and 1.93(0.10)ng/mL,respectively.The median concentration of metabolized hydroxy PAHs(OH-PAHs)in urine was 12.00 ng/mL(9.49 ng/mg creatinine).OSBs indicate that the hazards of Me-PAHs on exposed populations manifest as protein damage,while the hazards of p-PAHs mainly result in lipid and DNA damage.Results from common diseases and PAH exposure demonstrate a correlation between liver damage and PAH exposure,and Me-PAHs are more difficult to metabolize through urine due to their stronger lipophilicity.This study suggests that traditional health screenings targeting p-PAHs may be insufficient and likely underestimate the exposure risks for occupational populations.