PURPOSE: To report the feasibility and safety profile of 2-mg and 6-mg fluoc inolone acetonide implants after longterm follow-up in eyes with choroidal neov ascularization (CNV)DESIGN: Prospective, noncomparative, int...PURPOSE: To report the feasibility and safety profile of 2-mg and 6-mg fluoc inolone acetonide implants after longterm follow-up in eyes with choroidal neov ascularization (CNV)DESIGN: Prospective, noncomparative, interventional case ser ies of patients with non-age-related subfoveal choroidal neovascularization en rolled in a compassionate use protocol METHODS: Sustained drug delivery devices containing either 2 mg (eight eyes) or 6 mg (six eyes) of fluocinolone acetonide were implanted through the pars plana into the vitreous cavity of 14 patients w ith predominantly classic, subfoveal CNV. The main outcome measures were complic ations related to the device. Secondary outcome measures were involution of esta blished CNV, inhibition of recurrent CNV, and visual acuity RESULTS: Patients ha d a diagnosis of ocular histoplasmosis (seven), myopic degeneration (four), angi oid streaks (two), and punctate inner choroidopathy (one). Patients were followe d for an average of 33 months (range, 16 to 40 months). All 14 eyes developed el evated intraocular pressure and cataract. Four eyes developed nonischemic centra l retinal vein occlusion. Complications required implant removal in 8 eyes. Ten of 14 eyes demonstrated involution of CNV or inhibition of recurrent CNV. Ten ey es had stable or improved visual acuity. Median initial visual acuity was 20/64. Median final visual acuity was 20/40 CONCLUSIONS: Longterm follow-up demonstra tes a significant complication rate with the sustained release of high-dose int raocular corticosteroids. The complications are treatable, and eyes can retain g ood vision. This therapeutic approach warrants further study to identify if lowe r doses of corticosteroids may reduce the complication rate yet still be effecti ve in treating ocular disease.展开更多
Objective: To evaluate the efficacy and the indication of basic fibroblast growth factor (bFGF) in the treatment of exposure of orbital implants. Design: Retrospective and observational case series. Methods: We review...Objective: To evaluate the efficacy and the indication of basic fibroblast growth factor (bFGF) in the treatment of exposure of orbital implants. Design: Retrospective and observational case series. Methods: We reviewed 41 patients (41 eyes) suffering exposure of orbital implants from Jan. 2000 to June 2006. The study group patients with mild exposure received com-bined treatment with bFGF and antibiotic drops, and while the control group patients with mild exposure were treated with anti-biotic drops only. The study group patients with moderate and severe exposure received combined treatment with bFGF and antibiotic drops, and after 2 months they were subjected to amniotic membrane transplantation, while the control group patients with moderate and severe exposure underwent amniotic membrane transplantation after using antibiotic drops. Observation of the growth of conjunctival epithelium and comparison of the healing rate of the two groups. Results: The healing rates of the mild, moderate and severe exposure study group were 100% and 92.3%. The healing rates of the mild, moderate and severe exposure control group were 55.6% and 66.7% respectively. The difference of the healing rates of the mild exposure study group and the control group was significant (P=0.033). And the difference of the healing rates of the moderate and severe exposure study group and the control group was not significant (P=0.167). Conclusion: bFGF may promote obviously the healing of orbital implant exposure, particularly it can be the first choice for the treatment of mild degree exposure. For the moderate and severe cases, it can be administered before surgical repair to enhance neovascularization and will tend to increase the success rate of surgical repair.展开更多
Objective To study the retinal tissue degeneration of intraocular hypertension experimentally induced in acute and chronic way. Methods In the acute model, pressure elevation was quickly induced by a needle in the ant...Objective To study the retinal tissue degeneration of intraocular hypertension experimentally induced in acute and chronic way. Methods In the acute model, pressure elevation was quickly induced by a needle in the anterior chamber and the retinal reaction was studied at 1,2,4,5,7,10 days after treatment. The tissue damage with chronic hypertension,induced by the cauterization of two episcleral veins,was studied at 1 and 2 month after the treatment. The TUNEL method and Caspade 3a immunochemical study evidenced the apoptosis mechanism. The NADPH-diaphorase reaction identified the Nitric Oxide, ( NO) producing cells. Results In the acute model,the immunohistochemical study evidenced that the apoptosis was an early death mechanism for ganglionar cells. The activity of Nitric Oxide Synthase ( NOS) didn' t show a significant activation toward the retinal tissue of control. The chronic hypertension model indicated an increase in the NOS signal, meaning an activation of this enzyme in particular bear the vascular vessels, showing the neuroprotective and not only cytotoxic effect of the NO. The TUNEL and Caspase 3a studies indicated that the apoptosic mechanism started in different times, the immunohistochemical reaction showed its immediately beginning or its later activation caused by the chronic damage. Conclusions The opportunity to have a clear vision of the beginning and causing factors of cell degeneration in hypertension damage could permit the study on different substances that act on apoptosis , on NOS mechanism and on synaptic transmission inhibiting or deviating the retinal tissue degeneration and particularly the ganglionar cells death in glaucoma.展开更多
文摘PURPOSE: To report the feasibility and safety profile of 2-mg and 6-mg fluoc inolone acetonide implants after longterm follow-up in eyes with choroidal neov ascularization (CNV)DESIGN: Prospective, noncomparative, interventional case ser ies of patients with non-age-related subfoveal choroidal neovascularization en rolled in a compassionate use protocol METHODS: Sustained drug delivery devices containing either 2 mg (eight eyes) or 6 mg (six eyes) of fluocinolone acetonide were implanted through the pars plana into the vitreous cavity of 14 patients w ith predominantly classic, subfoveal CNV. The main outcome measures were complic ations related to the device. Secondary outcome measures were involution of esta blished CNV, inhibition of recurrent CNV, and visual acuity RESULTS: Patients ha d a diagnosis of ocular histoplasmosis (seven), myopic degeneration (four), angi oid streaks (two), and punctate inner choroidopathy (one). Patients were followe d for an average of 33 months (range, 16 to 40 months). All 14 eyes developed el evated intraocular pressure and cataract. Four eyes developed nonischemic centra l retinal vein occlusion. Complications required implant removal in 8 eyes. Ten of 14 eyes demonstrated involution of CNV or inhibition of recurrent CNV. Ten ey es had stable or improved visual acuity. Median initial visual acuity was 20/64. Median final visual acuity was 20/40 CONCLUSIONS: Longterm follow-up demonstra tes a significant complication rate with the sustained release of high-dose int raocular corticosteroids. The complications are treatable, and eyes can retain g ood vision. This therapeutic approach warrants further study to identify if lowe r doses of corticosteroids may reduce the complication rate yet still be effecti ve in treating ocular disease.
文摘Objective: To evaluate the efficacy and the indication of basic fibroblast growth factor (bFGF) in the treatment of exposure of orbital implants. Design: Retrospective and observational case series. Methods: We reviewed 41 patients (41 eyes) suffering exposure of orbital implants from Jan. 2000 to June 2006. The study group patients with mild exposure received com-bined treatment with bFGF and antibiotic drops, and while the control group patients with mild exposure were treated with anti-biotic drops only. The study group patients with moderate and severe exposure received combined treatment with bFGF and antibiotic drops, and after 2 months they were subjected to amniotic membrane transplantation, while the control group patients with moderate and severe exposure underwent amniotic membrane transplantation after using antibiotic drops. Observation of the growth of conjunctival epithelium and comparison of the healing rate of the two groups. Results: The healing rates of the mild, moderate and severe exposure study group were 100% and 92.3%. The healing rates of the mild, moderate and severe exposure control group were 55.6% and 66.7% respectively. The difference of the healing rates of the mild exposure study group and the control group was significant (P=0.033). And the difference of the healing rates of the moderate and severe exposure study group and the control group was not significant (P=0.167). Conclusion: bFGF may promote obviously the healing of orbital implant exposure, particularly it can be the first choice for the treatment of mild degree exposure. For the moderate and severe cases, it can be administered before surgical repair to enhance neovascularization and will tend to increase the success rate of surgical repair.
文摘Objective To study the retinal tissue degeneration of intraocular hypertension experimentally induced in acute and chronic way. Methods In the acute model, pressure elevation was quickly induced by a needle in the anterior chamber and the retinal reaction was studied at 1,2,4,5,7,10 days after treatment. The tissue damage with chronic hypertension,induced by the cauterization of two episcleral veins,was studied at 1 and 2 month after the treatment. The TUNEL method and Caspade 3a immunochemical study evidenced the apoptosis mechanism. The NADPH-diaphorase reaction identified the Nitric Oxide, ( NO) producing cells. Results In the acute model,the immunohistochemical study evidenced that the apoptosis was an early death mechanism for ganglionar cells. The activity of Nitric Oxide Synthase ( NOS) didn' t show a significant activation toward the retinal tissue of control. The chronic hypertension model indicated an increase in the NOS signal, meaning an activation of this enzyme in particular bear the vascular vessels, showing the neuroprotective and not only cytotoxic effect of the NO. The TUNEL and Caspase 3a studies indicated that the apoptosic mechanism started in different times, the immunohistochemical reaction showed its immediately beginning or its later activation caused by the chronic damage. Conclusions The opportunity to have a clear vision of the beginning and causing factors of cell degeneration in hypertension damage could permit the study on different substances that act on apoptosis , on NOS mechanism and on synaptic transmission inhibiting or deviating the retinal tissue degeneration and particularly the ganglionar cells death in glaucoma.
