Retinal Functional Changes Measured by Microperimetry after Intravitreal Ranibizumab Injection and Sulfotanshinone Sodium Injection for Macular Edema Secondary to Retinal Vein Occlusion

Objectives: To study the visual field changes after intravitreal ranibizumab (IVR) injection and sulfotanshinone sodium (SS) injection for macular edema (ME) secondary to retinal vein occlusion (RVO), and discuss the value of microperimetry as a routine diagnostic test in the follow-up of RVO patients. Methods: This was a retrospective, interventional, case-series study. Twelve eyes of 12 RVO patients, including 6 eyes with central RVO (CRVO) and 6 eyes with branch RVO (BRVO) were included. The eyes were treated with IVR (0.5 mg) injections and SS injections (20 mg per day, one week consecutively in one month). The outcomes measured included best corrected visual acuity (BCVA), central retinal thickness (CRT), mean defect (MD), pattern standard deviation (PSD), macular light sensitivity of the central 16 points in CRVO group and the central 8 points in BRVO group before and after the treatment. Statistical analyses were then performed on the main outcome measures. Results: An improvement of BCVA was found in all patients after treatment with significant difference (t = 7.74, p p p p > 0.05). All RVO patients had their macular light sensitivity of the involved part improved significantly (t = 5.03, p p p < 0.01). The Pearson’s correlation was calculated among BCVA, MD, macular light sensitivity and CRT. No obvious significance was found between CRT and BCVA outcomes, whereas MD and mean macular light sensitivity outcomes were closely related to BCVA results in the BRVO group and the latter showed a more intimate correlation. No similar correlation was found in RVO and CRVO group. Conclusion: IVR injection and SS injection together could effectively improve the therapeutic effect in RVO patients with ME. Microperimetry could be used as a routine diagnostic test and a possible valuable tool in the follow-up of patients with RVO, especially in BRVO.

Clinical Study of Sulfotanshinone Sodium Injection in Treating Non-Ischemic Retinal Vein Occlusion

Objectives: To study the effect of sulfotanshinone sodium (SS) injection in the treatment of non-ischemic retinal vein occlusion (RVO). Methods: Sixty-two RVO patients treated in our hospital between Jan. 2013 and Oct. 2014 were randomly divided into Control Group (30 patients;Bendazol tablets) and Treatment Group (32 patients, Bendazol tablets + SS injections), each with a follow-up period of 6 months. Statistical analysis was then performed on changes in visual acuity, central retinal thickness (CRT) and retinal circulation time (RCT) before and after the treatment. Results: After treatment, both Control Group and Treatment Group witnessed an improvement on visual acuity (Control Group: t = 2.103, p = 0.044;Treatment Group: t = 8.021, p = 0.000). Visual acuity could be greatly improved in Treatment Group when compared with Control Group, with significant differences (p < 0.01). Macular edema could be greatly relieved in Treatment Group measured by CRT (t = 2.571, p = 0.007) while the difference was of no statistical significance in Control Group (t = 1.016, p = 0.070). RCT were remarkably shortened in both groups (Control Group: t = 43.83, p = 0.000;Treatment Group: t = 27.34, p = 0.000), and when compared with Control group, the changes in Treatment Group were more significant (p < 0.05). Conclusion: SS injection could effectively improve the therapeutic effect in patients with non-ischemic retinal vein occlusion.

Clinical Study of “Lingqi Huangban Granule” in Treating Choroidal Neovascularisation in Pathologic Myopia

Objectives: To study the therapeutic effects of “Lingqi Huangban Granule” (LQHB) combined with intravitreal ranibizumab injection (IVR) for choroidal neovascularisation (CNV) in pathologic myopia (PM). Methods: This was a prospective, comparative, interventional study. Eighty eyes of eighty consecutive patients with myopic CNV were randomized into control group (IVR, 40 eyes) and integrative therapy group (IVR + LQHB, 40 eyes), each with a follow-up period of 12 months. IVR was given with an “on demand” regimen (Pro re nata, PRN). Final best corrected visual acuity (BCVA) and its change from baseline were the main outcome measures. Changes in optical coherence tomography (OCT) and central retinal thickness (CRT) were the secondary outcome measures. Results: BCVA of patients in the integrative group improved significantly (from 47.10 ± 13.51 letters to 90.72 ± 12.98 letter, P 0.05), more than in the control group (from 42.90 ± 13.18 letters to 69.18±13.21 letters, P 0.05) since the third month after the initial treatment to the end of the follow-up. Mean OCT CRT reduced from 364.75 ± 69.31 to 278.93 ± 33.05 um (P 0.05) in the control group and from 370.73 ± 65.31 to 271.73 ± 46.44 um (P 0.05) in the integrative group, respectively. The mean number of intravitreal injections in the 1-year follow-up was also reduced. No ocular or systemic side effects were observed. Conclusion: LQHB combined with IVR therapy was an effective treatment for stabilizing and improving vision with fewer intravitreal injections. It appears to be an interesting option for this type of patient.

23-Gauge Pars Plana Vitrectomy Alone by a Bimanual Technique for the Removal of Dense Posteriorly Dislocated Crystalline Lens

Background: We sought to verify the efficacy and safety of transconjunctival 23-gauge pars plana vitrectomy (PPV) alone by our bimanual technique for the removal of dense posteriorly dislocated crystalline lens. Methods: A retrospective, noncomparative, interventional study of 31 consecutive cases of patients who underwent 23-gauge PPV alone for the removal of dense posteriorly dislocated crystalline lens following complicated cataract surgeries using our bimanual technique was conducted. The main outcomes measured included best-corrected visual acuity (BCVA), preoperative intraocular pressure (IOP), postoperative IOP and postoperative complications. Results: In all 31 cases included in this study, those dense posteriorly dislocated crystalline lenses were successfully removed. The enrolled patients consisted of 17 males and 14 females with a mean age of (75.84 ± 6.17) years (range 59 - 90). The mean follow-up length was (7.61 ± 1.87) months with a range of 6 months to 1 year. The mean preoperative BCVA was 0.22 ± 0.11 logMAR system, and the postoperative BCVA was 0.33 ± 0.07 logMAR system after 6 months of follow-up. The mean operative time was 46.32 ± 4.80 minutes with a range of 38.00 to 57.00 minutes. All of the conjunctival incisions self-closed within the first week with no wound leakage or hemorrhage. The postoperative complications were relatively rare. Conclusions: The removal of dense posteriorly dislocated crystalline lens might be a challenge for micro-incision vitrectomy. Our bimanual technique was proved to be an effective and safe method for those particular dense lenses using 23-gauge alone.

Intravitreal Ranibizumab Combined with Sulfotanshinone Sodium Injection in Treating Type II Optic Disc Vasculitis

Objectives: To present the effect of intravitreal ranibizumab (IVR) therapy combined with sulfotanshinone sodium (SS) injection in a patient suffering from type II optic disc vasculitis (ODV). Methods: A 26-year-old female patient was diagnosed with type II ODV with macular edema (ME). The information was obtained by complete medical and ophthalmic history taking and a detailed ophthalmic examination at the initial and follow-up visits. Functional and morphological outcomes at baseline, 1 week and 1 month following IVR+SS injections, are presented. Results: Best-corrected visual acuity (BCVA) improved from 78 letters (ETDRS) at baseline to 90 letters at 1-week follow-up and maintained stable through 1-month follow-up. Central retinal thickness (CRT) measured by optical coherence tomography (OCT) decreased from 465 μm at baseline to 240 μm at 1-week follow-up and to 226 μm at 1-month follow-up. Mean deviation (MD) measured by perimetry increased from ?5.17 dB to ?4.59 dB and to ?4.29 dB, respectively. Fluorescein angiography (FFA) showed that the initial macular edema at baseline disappeared while the arm-retina circulation time (ART) was also greatly shortened when compared to the baseline. Electroretinogram (ERG) measured at 1-month follow-up demonstrated an overall improvement of the retinal function after the injection. No ocular or systemic side effects were detected. Conclusions: IVR+SS injection may lead to resolution of the associated ME and improve the retina morphologically as well as functionally. To our knowledge, this is the first case of a type II ODV benefiting from treatment with IVR+SS injection. The observed results warrant further investigation.

The Protective Effect of Compound Danshen Dripping Pills on Oxidative Stress after Retinal Ischemia/Reperfusion Injury in Rats

Objective: To investigate the effect of Compound Danshen Dripping Pills (CDDP) on oxidative stress after ischemia/reperfusion (I/R) injury in the rat retina. Methods: Adult male SD rats were randomly divided into 3 groups: sham (group A), I/R (group B), and I/R plus CDDP (group C). Retinal ischemia/reperfusion injury (RIRI) was introduced by increasing the intraocular pressure (IOP) to 110 mmHg for 60 min via cannulation into the anterior chamber. Right after the insult, CDDP was administered intragastrically (450 mg/kg/d) for 7 days. The levels of malondialdehyde (MDA), the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) in the retinal tissues were determined on d1 and d7 after the ischemic insult. Results: Following ischemia, the MDA levels in group B and group C were significantly higher than those in group A (p < 0.01). CDDP significantly lowered MDA levels in group C when compared with group B (p < 0.01). The activities of SOD, GSH-Px and CAT were higher in group A than in group B and group C (p < 0.01). CDDP could increase the activities of SOD, GSH-Px and CAT remarkably in group C when compared with group B (p < 0.01). Conclusion: CDDP can protect the retina from I/R injury through reducing oxidative stress, and thus may be a promising method for the treatment of ischemic retinal disorders.

Finished surface morphology, microstructure and magnetic properties of selective laser melted Fe-50wt% Ni permalloy

This work focuses on the structure and magnetic properties of Fe-50wt% Ni permalloy manufactured from the pre-alloyed powder by selective laser melting (SLM). The selective laser melted (SLMed) alloys were characterized by a 3D profilometer,optical microscope, scanning electron microscope, X-ray diffraction, etc. The effects of the volume energy density of laser(LVED) on structure, and magnetic properties with coercivity ( H), remanence ( B), and power losses ( P), were evaluated and discussed systematically. The results show that the relative porosity rate and the surface roughness of the SLMed specimens decreased with the increase in LVED. Only the γ-(FeNi) phase was detected in the X-ray diffraction patterns of the SLMed permalloys fabricated from the different LVEDs. Statistical analysis of optical microscopy images indicated that the grain coarsened at higher LVED. Furthermore, the microstructure of the SLMed parts was a typical columnar structure with an oriented growth of building direction. The highest microhardness reached 198 HV. Besides, the magnetic properties including B, H, and Pof SLMed samples decreased when the LVED ranged from 33.3 to 60.0 J/mm ~3 firstly and then increased while LVED further up to 93.3 J/mm, which is related to the decrease in porosity and the increase in grain size, while the higher residual stress and microcracks presented in the samples manufactured using very high LVED. The observed evolution of magnetic properties and LVED provides a good compromise in terms of reduced porosity and crack formation for the fabrication of SLMed Fe-50 wt% Ni permalloy. The theoretical mechanism in this study can offer guidance to further investigate SLMed soft magnetic alloys.