Retinal vein occlusion(RVO) is the second vascular retinal cause of visual loss and defined by the occlusion of a retinal vein. It is divided into branch retinal vein occlusion or central retinal vein occlusion, depen...Retinal vein occlusion(RVO) is the second vascular retinal cause of visual loss and defined by the occlusion of a retinal vein. It is divided into branch retinal vein occlusion or central retinal vein occlusion, depending on the location of occlusion. RVO has severe medical, financial and social implications on the patients. The diagnosis of the disease is easier nowadays with the use of spectral domain optical coherence tomography and fluorescein angiography. The treatment options for RVO have changed dramatically over the past few years with the introduction of the intravitreal injections of dexamethasone(Ozurdex), bevacizumab(Avastin), ranibizumab(Lucentis) and aflibercept(EYLEA), along with the panretinal laser photocoagulation, abandoning former treatment modalities and surgical solution. This manuscript is a review of current literature about RVO with emphasize on the pathophysiology, risk factors and prevention, diagnosis and sub-group categorization and treatments including medical and surgical. Since no official guidelines are available for the treatment of RVO patients, and considering the latest developments in the treatment options, and the variety of follow-up and treatment modalities, this manuscript aims to provide tools and knowledge to guide the physician in treating RVO patients, based on the latest publications from the literature and on several of the patients characteristics.展开更多
We have treated thirty-two cases (52 eyes) of retinal vein obstruction by acupuncture and oral administration of Huo Xue Ming Mu Decoction. The total effective rate of 90.38% demonstrated that the treatment was defini...We have treated thirty-two cases (52 eyes) of retinal vein obstruction by acupuncture and oral administration of Huo Xue Ming Mu Decoction. The total effective rate of 90.38% demonstrated that the treatment was definitely effective.展开更多
To investigate the possible correlation between obstructive sleep apnea(OSA) and central retinal vein occlusion(CRVO). Thirty consecutive patients with a recent(<3 mo)CRVO and an age-and sex-matched group of 30 con...To investigate the possible correlation between obstructive sleep apnea(OSA) and central retinal vein occlusion(CRVO). Thirty consecutive patients with a recent(<3 mo)CRVO and an age-and sex-matched group of 30 control subjects were recruited. All subjects underwent full-night polysomnography to measure apnea-hypopnea index(AHI)and oxygen desaturation index(ODI). The average AHI and ODI were significantly higher in CRVO patients(AHI:13.86±8.63, ODI: 9.21±4.47) than in control subjects(AHI:8.51±6.36, ODI: 5.87±3.18;P=0.008 and 0.001 respectively).Additionally, the AHI was positively correlated with body mass index(BMI;r=0.476, P=0.017) and ODI(r=0.921,P<0.01) in both CRVO and control subjects. According to AHI scores, twenty-two(73.33%) CRVO patients had OSA and 12(40.00%) control subjects had OSA, a difference that was statistically significant(P=0.019). OSA may be a risk factor for or a trigger of CRVO development.展开更多
AIM: To investigate and compare the efficacy of two machine-learning technologies with deep-learning(DL) and support vector machine(SVM) for the detection of branch retinal vein occlusion(BRVO) using ultrawide-field f...AIM: To investigate and compare the efficacy of two machine-learning technologies with deep-learning(DL) and support vector machine(SVM) for the detection of branch retinal vein occlusion(BRVO) using ultrawide-field fundus images. METHODS: This study included 237 images from 236 patients with BRVO with a mean±standard deviation of age 66.3±10.6 y and 229 images from 176 non-BRVO healthy subjects with a mean age of 64.9±9.4 y. Training was conducted using a deep convolutional neural network using ultrawide-field fundus images to construct the DL model. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and area under the curve(AUC) were calculated to compare the diagnostic abilities of the DL and SVM models. RESULTS: For the DL model, the sensitivity, specificity, PPV, NPV and AUC for diagnosing BRVO was 94.0%(95%CI: 93.8%-98.8%), 97.0%(95%CI: 89.7%-96.4%), 96.5%(95%CI: 94.3%-98.7%), 93.2%(95%CI: 90.5%-96.0%) and 0.976(95%CI: 0.960-0.993), respectively. In contrast, for the SVM model, these values were 80.5%(95%CI: 77.8%-87.9%), 84.3%(95%CI: 75.8%-86.1%), 83.5%(95%CI: 78.4%-88.6%), 75.2%(95%CI: 72.1%-78.3%) and 0.857(95%CI: 0.811-0.903), respectively. The DL model outperformed the SVM model in all the aforementioned parameters(P<0.001). CONCLUSION: These results indicate that the combination of the DL model and ultrawide-field fundus ophthalmoscopy may distinguish between healthy and BRVO eyes with a high level of accuracy. The proposed combination may be used for automatically diagnosing BRVO in patients residing in remote areas lacking access to an ophthalmic medical center.展开更多
Background: Portal biliopathy producing intrahepa- tic and extrahepatic biliary ductai abnormalities from portal hypertension, particularly with extrahepatic portal vein obstruction (EHPVO) is common. A majority of th...Background: Portal biliopathy producing intrahepa- tic and extrahepatic biliary ductai abnormalities from portal hypertension, particularly with extrahepatic portal vein obstruction (EHPVO) is common. A majority of these patients are asymptomatic, but oc- casionally there is symptomatic biliary obstruction, and cholangitis and choledocholithiasis. Objective: To explore the principles of diagnosis and treatment of portal biliopathy. Data sources: To review the literature of portal bili- opathy. Conclusions: Endoscopic sphincterotomy, stone ex- traction and supportive drainage could effectively re- lieve cholangitis when jaundice is associated with common bile duct stones. Definitive decompressive portal-system vein shunting operation and choledo- cho-jejunostomy are sometimes required when biliary obstruction is recurrent and progressive.展开更多
目的:系统评价复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞的有效性。方法:计算机检索PubMed、Embase、Web of Science、CNKI、万方和维普数据库等,搜集关于复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞的随机对照试验(RC...目的:系统评价复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞的有效性。方法:计算机检索PubMed、Embase、Web of Science、CNKI、万方和维普数据库等,搜集关于复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞的随机对照试验(RCT),检索时限均从建库至2023年5月25日。采用RoB2.0对纳入研究进行偏倚风险评估,采用RevMan5.4软件进行Meta分析。结果:共纳入8研究,包括702名患者。结果显示,与对照组相比,联合治疗组可以提高患者综合疗效有效率[OR=1.23,CI(1.16,1.32),P<0.00001],在血液流变学指标方面,全血粘度[MD=-0.76,95%CI(-1.32,-0.20),P=0.008]、血浆粘度[MD=-0.37,95%CI(-0.47,-0.27),P<0.00001]、红细胞聚集指数[MD=-0.96,95%CI(-1.09,-0.84),P<0.00001]、红细胞比容[MD=-0.09,95%CI(-0.11,-0.07),P<0.00001]、纤维蛋白原[MD=-0.62,95%CI(-0.90,-0.33),P<0.00001]。结论:Meta分析结果表明,复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞可能改善血液流变学指标,能明显提升综合疗效有效率。但由于原始文献质量较低,分析结果具有一定限制性,故上述结论尚待更多高质量研究予以验证。展开更多
视网膜静脉阻塞(retinal vein occlusion,RVO)是继糖尿病视网膜病变后常见的眼底血管性疾病。2011年发表的《视网膜静脉阻塞管理专家共识》对RVO的诊疗进行了全面的阐述。2019年8月,欧洲视网膜专家协会(European Society of Retina Spec...视网膜静脉阻塞(retinal vein occlusion,RVO)是继糖尿病视网膜病变后常见的眼底血管性疾病。2011年发表的《视网膜静脉阻塞管理专家共识》对RVO的诊疗进行了全面的阐述。2019年8月,欧洲视网膜专家协会(European Society of Retina Specialists,EURETINA)则在2011年专家共识基础上更新了RVO诊疗指南,总结了大型临床试验结果,采纳更强证据等级的数据资料对RVO的诊疗进行了规范。2019年指南形式上采用了"基本原理-证据-推荐"的结构,对RVO进行全面总结。本文对该指南内容进行解读。展开更多
文摘Retinal vein occlusion(RVO) is the second vascular retinal cause of visual loss and defined by the occlusion of a retinal vein. It is divided into branch retinal vein occlusion or central retinal vein occlusion, depending on the location of occlusion. RVO has severe medical, financial and social implications on the patients. The diagnosis of the disease is easier nowadays with the use of spectral domain optical coherence tomography and fluorescein angiography. The treatment options for RVO have changed dramatically over the past few years with the introduction of the intravitreal injections of dexamethasone(Ozurdex), bevacizumab(Avastin), ranibizumab(Lucentis) and aflibercept(EYLEA), along with the panretinal laser photocoagulation, abandoning former treatment modalities and surgical solution. This manuscript is a review of current literature about RVO with emphasize on the pathophysiology, risk factors and prevention, diagnosis and sub-group categorization and treatments including medical and surgical. Since no official guidelines are available for the treatment of RVO patients, and considering the latest developments in the treatment options, and the variety of follow-up and treatment modalities, this manuscript aims to provide tools and knowledge to guide the physician in treating RVO patients, based on the latest publications from the literature and on several of the patients characteristics.
文摘We have treated thirty-two cases (52 eyes) of retinal vein obstruction by acupuncture and oral administration of Huo Xue Ming Mu Decoction. The total effective rate of 90.38% demonstrated that the treatment was definitely effective.
基金Supported by Planned Science and Technology Project of Xi’an City, China [No.2017116SF/YX010(9)]
文摘To investigate the possible correlation between obstructive sleep apnea(OSA) and central retinal vein occlusion(CRVO). Thirty consecutive patients with a recent(<3 mo)CRVO and an age-and sex-matched group of 30 control subjects were recruited. All subjects underwent full-night polysomnography to measure apnea-hypopnea index(AHI)and oxygen desaturation index(ODI). The average AHI and ODI were significantly higher in CRVO patients(AHI:13.86±8.63, ODI: 9.21±4.47) than in control subjects(AHI:8.51±6.36, ODI: 5.87±3.18;P=0.008 and 0.001 respectively).Additionally, the AHI was positively correlated with body mass index(BMI;r=0.476, P=0.017) and ODI(r=0.921,P<0.01) in both CRVO and control subjects. According to AHI scores, twenty-two(73.33%) CRVO patients had OSA and 12(40.00%) control subjects had OSA, a difference that was statistically significant(P=0.019). OSA may be a risk factor for or a trigger of CRVO development.
文摘AIM: To investigate and compare the efficacy of two machine-learning technologies with deep-learning(DL) and support vector machine(SVM) for the detection of branch retinal vein occlusion(BRVO) using ultrawide-field fundus images. METHODS: This study included 237 images from 236 patients with BRVO with a mean±standard deviation of age 66.3±10.6 y and 229 images from 176 non-BRVO healthy subjects with a mean age of 64.9±9.4 y. Training was conducted using a deep convolutional neural network using ultrawide-field fundus images to construct the DL model. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and area under the curve(AUC) were calculated to compare the diagnostic abilities of the DL and SVM models. RESULTS: For the DL model, the sensitivity, specificity, PPV, NPV and AUC for diagnosing BRVO was 94.0%(95%CI: 93.8%-98.8%), 97.0%(95%CI: 89.7%-96.4%), 96.5%(95%CI: 94.3%-98.7%), 93.2%(95%CI: 90.5%-96.0%) and 0.976(95%CI: 0.960-0.993), respectively. In contrast, for the SVM model, these values were 80.5%(95%CI: 77.8%-87.9%), 84.3%(95%CI: 75.8%-86.1%), 83.5%(95%CI: 78.4%-88.6%), 75.2%(95%CI: 72.1%-78.3%) and 0.857(95%CI: 0.811-0.903), respectively. The DL model outperformed the SVM model in all the aforementioned parameters(P<0.001). CONCLUSION: These results indicate that the combination of the DL model and ultrawide-field fundus ophthalmoscopy may distinguish between healthy and BRVO eyes with a high level of accuracy. The proposed combination may be used for automatically diagnosing BRVO in patients residing in remote areas lacking access to an ophthalmic medical center.
文摘Background: Portal biliopathy producing intrahepa- tic and extrahepatic biliary ductai abnormalities from portal hypertension, particularly with extrahepatic portal vein obstruction (EHPVO) is common. A majority of these patients are asymptomatic, but oc- casionally there is symptomatic biliary obstruction, and cholangitis and choledocholithiasis. Objective: To explore the principles of diagnosis and treatment of portal biliopathy. Data sources: To review the literature of portal bili- opathy. Conclusions: Endoscopic sphincterotomy, stone ex- traction and supportive drainage could effectively re- lieve cholangitis when jaundice is associated with common bile duct stones. Definitive decompressive portal-system vein shunting operation and choledo- cho-jejunostomy are sometimes required when biliary obstruction is recurrent and progressive.
文摘目的:系统评价复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞的有效性。方法:计算机检索PubMed、Embase、Web of Science、CNKI、万方和维普数据库等,搜集关于复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞的随机对照试验(RCT),检索时限均从建库至2023年5月25日。采用RoB2.0对纳入研究进行偏倚风险评估,采用RevMan5.4软件进行Meta分析。结果:共纳入8研究,包括702名患者。结果显示,与对照组相比,联合治疗组可以提高患者综合疗效有效率[OR=1.23,CI(1.16,1.32),P<0.00001],在血液流变学指标方面,全血粘度[MD=-0.76,95%CI(-1.32,-0.20),P=0.008]、血浆粘度[MD=-0.37,95%CI(-0.47,-0.27),P<0.00001]、红细胞聚集指数[MD=-0.96,95%CI(-1.09,-0.84),P<0.00001]、红细胞比容[MD=-0.09,95%CI(-0.11,-0.07),P<0.00001]、纤维蛋白原[MD=-0.62,95%CI(-0.90,-0.33),P<0.00001]。结论:Meta分析结果表明,复方血栓通联合复方樟柳碱注射液治疗视网膜静脉阻塞可能改善血液流变学指标,能明显提升综合疗效有效率。但由于原始文献质量较低,分析结果具有一定限制性,故上述结论尚待更多高质量研究予以验证。
文摘视网膜静脉阻塞(retinal vein occlusion,RVO)是继糖尿病视网膜病变后常见的眼底血管性疾病。2011年发表的《视网膜静脉阻塞管理专家共识》对RVO的诊疗进行了全面的阐述。2019年8月,欧洲视网膜专家协会(European Society of Retina Specialists,EURETINA)则在2011年专家共识基础上更新了RVO诊疗指南,总结了大型临床试验结果,采纳更强证据等级的数据资料对RVO的诊疗进行了规范。2019年指南形式上采用了"基本原理-证据-推荐"的结构,对RVO进行全面总结。本文对该指南内容进行解读。
