Aims: Analysis of highly myopic eyes (mean myopia-11 D)with post-LASIK vitre oretinal complications (breaks, retinal detachment) that also had pre-LASIK vit reoretinal pathology (lattice, breaks). Methods: Retrospecti...Aims: Analysis of highly myopic eyes (mean myopia-11 D)with post-LASIK vitre oretinal complications (breaks, retinal detachment) that also had pre-LASIK vit reoretinal pathology (lattice, breaks). Methods: Retrospective case series. Resu lts: 67 eyes in 56 patients with pre-LASIK retinal examination developed post- LASIK vitreoretinal complications. 17 of the 67 eyes (25.4%) had pre-LASIK vit reoretinal pathology. 10 of the 17 eyes that underwent pre-LASIK prophylactic r etinal treatment still developed post-LASIK lesions. They developed adjacent to pre-LASIK lesions for 15 of 17 eyes (88.2%), and outside of quadrant(s) of pr e-LASIK lesions for five eyes (29.4%). Conclusion: Pre-LASIK retinal examinat ion may predict locations of certain post-LASIK retinal lesions that may develo p in highly myopic eyes with pre-LASIK vitreoretinal pathology, but prophylacti c treatment may not prevent all posfLASIK vitreoretinal complications.展开更多
目的比较不同眼底成像方式对增生性糖尿病视网膜病变(PDR)患眼视网膜及视盘新生血管的检出率和检测时间。方法采用横断面研究方法,纳入2019年10月至2021年2月于河南省立眼科医院确诊的PDR患者38例48眼,其中男22例28眼,女16例20眼;平均(5...目的比较不同眼底成像方式对增生性糖尿病视网膜病变(PDR)患眼视网膜及视盘新生血管的检出率和检测时间。方法采用横断面研究方法,纳入2019年10月至2021年2月于河南省立眼科医院确诊的PDR患者38例48眼,其中男22例28眼,女16例20眼;平均(51.08±13.35)岁。所有患者均行超广角眼底成像(UWFI)、荧光素眼底血管造影(FFA)、光学相干断层扫描血管成像(OCTA)、en face OCT、近红外眼底成像(IR)联合频域OCT(SD-OCT),因相关原因无法行FFA的患者接受超广角扫频源OCTA(WF-SS-OCTA)检查。记录单眼每项检查所需的时间、各种检查方法对视盘新生血管(NVD)及视网膜其他部位新生血管(NVE)的检出率。结果 UWFI的单眼检查时间平均为(0.51±0.13)min,NVE检出率为52.1%(25/48),NVD检出率为12.5%(6/48);IR联合SD-OCT的单眼平均检查时间为(2.08±0.57)min,NVE检出率为81.3%(39/48),NVD检出率为20.8%(10/48);OCTA和en face OCT的单眼平均检查时间为(5.79±0.68)min,NVD检出率为83.3%(40/48),NVE检出率为27.1%(13/48);FFA平均检查时间为(17.66±1.83)min,WF-SS-OCT为(13.38±1.23)min,FFA联合WF-SS-OCT的NVE检出率为93.8%(45/48),NVD检出率为29.2%(14/48)。5种不同影像模式单眼检查花费时间总体比较,差异有统计学意义(F=2 077.960,P<0.001)。各不同影像模式间NVE检出率比较差异有统计学意义(χ2=26.460,P<0.001),NVD检出率差异无统计学意义(χ2=4.645,P=0.200)。OCTA在3例患眼中检出新生血管芽5处,而该新生血管芽未在FFA检测出。结论 UWFI和IR联合SD-OCT筛查PDR患眼NVD及NVE用时短且无创。OCTA和en face OCT较FFA可清晰显示新生血管形态。FFA检查范围较大,但用时较长且有创。WF-SS-OCTA检查扩大了OCTA的扫描范围、无创且检查时间较FFA短。展开更多
Purpose To investigate the intraocular pressure (IOP) variations occurring aft er indirect diode laser photocoagulation for threshold retinopathy of prematurit y. Design Prospective, nonrandomized, comparative study. ...Purpose To investigate the intraocular pressure (IOP) variations occurring aft er indirect diode laser photocoagulation for threshold retinopathy of prematurit y. Design Prospective, nonrandomized, comparative study. Participants A study gr oup 21 consecutive premature babies (42 eyes) undergoing diode laser photocoagul ation for retinopathy of prematurity and control groups 32 premature babies (64 eyes) undergoing retinal examination with or without scleral indentation. Interv ention Intraocular pressure was measured with a portable electronic tonometer be fore, immediately after, and 1, 2, and 3 days after diode laser photocoagulation in the study group; before retinal examination in control group 1; and before a nd after retinal examination with scleral indentation in control group 2. Main o utcome measure Intraocular pressure after diode laser photocoagulation for thres hold retinopathy of prematurity. Results Mean IOP in the study group rose from 1 5 mmHg (standard deviation SD=4.1) before coagulation to 33.2 mmHg (SD = 7.8; range, 20-50) immediately after, and then dropped to 22.2 (SD=5.2), 16.5 (SD=3) , and 14.5 mmHg (SD=2.1) 1, 2, and 3 days later, respectively. All the changes w ere statistically significant at P < 0.0001, except for the difference between d ays 2 and 3(P=0.096). Mean baseline IOPs were 16.3 mmHg (SD=3.7) in control grou p 1 and 15.7 mmHg (SD=2.3) in control group 2 (P=0.84 between control group 1 an d study group, and P=0.32 between control group 2 and the study group). At termi nation of the retinal examination with scleral indentation (control group 2), IO P measured 15.1 mmHg (SD=2.2) (P=0.49 compared with baseline). Conclusions Intra ocular pressure may be significantly elevated after diode laser photocoagulation for retinopathy of prematurity. The mechanism and long-term clinical implicati ons of this observation should be investigated.展开更多
Purpose: The aim of this study was to clarify whether the clinical, laboratory and genetic aspects of sickle cell disease (SCD) influence the occurrence of vessel alterations in the conjunctiva and retina. Methods: A ...Purpose: The aim of this study was to clarify whether the clinical, laboratory and genetic aspects of sickle cell disease (SCD) influence the occurrence of vessel alterations in the conjunctiva and retina. Methods: A total of 102 SCD patients underwent biomicroscopical and retinal examination, in addition to evaluations of haemoglobin (Hb) and haematocrit (Ht) levels, fetal haemoglobin (HbF) estimations, serum creatinine and albuminuria levels, glomerular filtration rate (GFR) values, phenotypes, β -globin gene haplotypes and α -thalassaemia. The relationship between ocular vessel alterations and clinical, laboratory and genetic features were evaluated using chisquared or Fisher tests and logistic regression analysis. In 13 patients on enalapril treatment, a second ophthalmological evaluation was performed after a 12- month period to evaluate the longitudinal effect of the drug on ocular vessels. Results: Conjunctival vessel alteration (CVA) was not influenced by age, gender, HbF estimation, serum creatinine and albuminuria levels, GFR values, β -globin gene haplotypes or α -thalassaemia. However, increased frequencies of CVA were found in patients with Hb ≤ 9.0 g/dl, Ht ≤ 26.7% and sickle cell anaemia (SS) phenotype. Retinal vessel alteration (RVA) was identi-fied only in patients aged 17 years or older. Enalapril did not demonstrate ocular vessel amelioration after 12- months of daily use. Conclusion: The results indicate that lower Hb and Ht levels and SS phenotype are risk factors for CVA, and age over 17 years may be risk factors for RVA in SCD patients.展开更多
Background: Cerebral and retinal vessels behave similarly under the influence of vascular risk factors. Several groups have shown that retinal microvascular abnormalities represent an independent risk factor with rega...Background: Cerebral and retinal vessels behave similarly under the influence of vascular risk factors. Several groups have shown that retinal microvascular abnormalities represent an independent risk factor with regard to strokes and heart attacks. Aim of the Study: The aim of this study was to perform a prospective screening examinationwith regard to retinalmicrovascular abnormalities as well as an extended vessel diagnosis in a subgroup of patients with lower arteriovenous risk values. Methods: In the course of a prospective cross-sectional study (“Talking Eyes”) between 1.9.2001 and 1.8.2002 a telemedical-supported screening of the retina (study 1) was carried out in 7,163 subjects. The patients were selected without any inclusion or exclusion criteria. The mean age was 48.2±8 years (18-83 years) with a sex distribution of 39.2%females to 60.8%males. Digital fundus photos of the right and left eyes were taken for all patients. The pictures were taken without pupil dilation using a CANON-NM camera. The pictures and case histories were stored in a central server using web-based software (MedStage, Siemens). In a central reading centre, the arteriovenous ratio of both eyes was determined telemedically using the Parr-Hubbard formula and the retinas subjected to a standardised examination by an ophthalmologist. The retinal risk factor was calculated on the basis of the arteriovenous ration, the presence of microvascular abnormalities and the case history. The reproducibility of measurement of the arteriovenous ratio (Kronbach alpha coefficient) was evaluated by double measurements on 1,332 images. In a subgroup of study 1 with arteriovenous ratio values < 0.76 (N=107), an extended vessel diagnosis with measurement of 24-h blood pressure and vessel-relevant blood values (homocysteine, cholesterol, LDL, HDL, CRP, TG, HbA1c) was carried out (study II). Results: Study 1: The Kronbach alpha coefficient as a measure of reproducibility amounted to 0.77. The mean arteriovenous ratio of the retinal vessels was 0.83±0.09 and showed a pronounced age dependence (R=0.9, p< 0.0001). On multivariate testing the arteriovenous ratio correlated significantly (R=0.33, p< 0.001) with the factors age, systolic blood pressure, diastolic blood pressure and body mass index. Diastolic blood pressure followed by age had the largest influence. The prevalence of microvascular abnormalities in the right (RE) and left (LE)-eyes, respectively were: cotton wool foci RE 0.0015%, LE 0.003%, retinal haemorrhage RE 0.1%, LE 0.1%, focal stenoses RE 3.4%, LE 3.4%, tortuositas vasorumRE 4.1%, LE 4.0%, arteriovenous crossing signs RE 11.2%, LE 11.2%. On multivariate testing the occurrence of microvascular abnormalities correlated significantly (R=0.38, p < 0.001) with the factors high blood pressure known from case history, body mass index, and gender. Arterial hypertension had the strongest influence followed by diastolic blood pressure. The calculated retinal risk factor correlated with the prevalence of angina pectoris. Study 11: 2/3 of the subjects with arteriovenous risk factor values < 0.76 exhibited pathologically high 24-h blood pressure values. For these patients there were significant correlations between the arteriovenous ratio and the low-density lipoprotein concentration as well as the Framingham risk score. Conclusion: In the course of a prospective, telemedical-supported screening examination of the retinal vessels of more than 7,000 subjects the arteriovenous ratio exhibited a strong dependence on age and blood pressure. Among the subjects with lowered arteriovenous ratio values, 2/3 exhibited arterial hypertension in the 24-h blood pressure determination.展开更多
文摘Aims: Analysis of highly myopic eyes (mean myopia-11 D)with post-LASIK vitre oretinal complications (breaks, retinal detachment) that also had pre-LASIK vit reoretinal pathology (lattice, breaks). Methods: Retrospective case series. Resu lts: 67 eyes in 56 patients with pre-LASIK retinal examination developed post- LASIK vitreoretinal complications. 17 of the 67 eyes (25.4%) had pre-LASIK vit reoretinal pathology. 10 of the 17 eyes that underwent pre-LASIK prophylactic r etinal treatment still developed post-LASIK lesions. They developed adjacent to pre-LASIK lesions for 15 of 17 eyes (88.2%), and outside of quadrant(s) of pr e-LASIK lesions for five eyes (29.4%). Conclusion: Pre-LASIK retinal examinat ion may predict locations of certain post-LASIK retinal lesions that may develo p in highly myopic eyes with pre-LASIK vitreoretinal pathology, but prophylacti c treatment may not prevent all posfLASIK vitreoretinal complications.
文摘目的比较不同眼底成像方式对增生性糖尿病视网膜病变(PDR)患眼视网膜及视盘新生血管的检出率和检测时间。方法采用横断面研究方法,纳入2019年10月至2021年2月于河南省立眼科医院确诊的PDR患者38例48眼,其中男22例28眼,女16例20眼;平均(51.08±13.35)岁。所有患者均行超广角眼底成像(UWFI)、荧光素眼底血管造影(FFA)、光学相干断层扫描血管成像(OCTA)、en face OCT、近红外眼底成像(IR)联合频域OCT(SD-OCT),因相关原因无法行FFA的患者接受超广角扫频源OCTA(WF-SS-OCTA)检查。记录单眼每项检查所需的时间、各种检查方法对视盘新生血管(NVD)及视网膜其他部位新生血管(NVE)的检出率。结果 UWFI的单眼检查时间平均为(0.51±0.13)min,NVE检出率为52.1%(25/48),NVD检出率为12.5%(6/48);IR联合SD-OCT的单眼平均检查时间为(2.08±0.57)min,NVE检出率为81.3%(39/48),NVD检出率为20.8%(10/48);OCTA和en face OCT的单眼平均检查时间为(5.79±0.68)min,NVD检出率为83.3%(40/48),NVE检出率为27.1%(13/48);FFA平均检查时间为(17.66±1.83)min,WF-SS-OCT为(13.38±1.23)min,FFA联合WF-SS-OCT的NVE检出率为93.8%(45/48),NVD检出率为29.2%(14/48)。5种不同影像模式单眼检查花费时间总体比较,差异有统计学意义(F=2 077.960,P<0.001)。各不同影像模式间NVE检出率比较差异有统计学意义(χ2=26.460,P<0.001),NVD检出率差异无统计学意义(χ2=4.645,P=0.200)。OCTA在3例患眼中检出新生血管芽5处,而该新生血管芽未在FFA检测出。结论 UWFI和IR联合SD-OCT筛查PDR患眼NVD及NVE用时短且无创。OCTA和en face OCT较FFA可清晰显示新生血管形态。FFA检查范围较大,但用时较长且有创。WF-SS-OCTA检查扩大了OCTA的扫描范围、无创且检查时间较FFA短。
文摘Purpose To investigate the intraocular pressure (IOP) variations occurring aft er indirect diode laser photocoagulation for threshold retinopathy of prematurit y. Design Prospective, nonrandomized, comparative study. Participants A study gr oup 21 consecutive premature babies (42 eyes) undergoing diode laser photocoagul ation for retinopathy of prematurity and control groups 32 premature babies (64 eyes) undergoing retinal examination with or without scleral indentation. Interv ention Intraocular pressure was measured with a portable electronic tonometer be fore, immediately after, and 1, 2, and 3 days after diode laser photocoagulation in the study group; before retinal examination in control group 1; and before a nd after retinal examination with scleral indentation in control group 2. Main o utcome measure Intraocular pressure after diode laser photocoagulation for thres hold retinopathy of prematurity. Results Mean IOP in the study group rose from 1 5 mmHg (standard deviation SD=4.1) before coagulation to 33.2 mmHg (SD = 7.8; range, 20-50) immediately after, and then dropped to 22.2 (SD=5.2), 16.5 (SD=3) , and 14.5 mmHg (SD=2.1) 1, 2, and 3 days later, respectively. All the changes w ere statistically significant at P < 0.0001, except for the difference between d ays 2 and 3(P=0.096). Mean baseline IOPs were 16.3 mmHg (SD=3.7) in control grou p 1 and 15.7 mmHg (SD=2.3) in control group 2 (P=0.84 between control group 1 an d study group, and P=0.32 between control group 2 and the study group). At termi nation of the retinal examination with scleral indentation (control group 2), IO P measured 15.1 mmHg (SD=2.2) (P=0.49 compared with baseline). Conclusions Intra ocular pressure may be significantly elevated after diode laser photocoagulation for retinopathy of prematurity. The mechanism and long-term clinical implicati ons of this observation should be investigated.
文摘Purpose: The aim of this study was to clarify whether the clinical, laboratory and genetic aspects of sickle cell disease (SCD) influence the occurrence of vessel alterations in the conjunctiva and retina. Methods: A total of 102 SCD patients underwent biomicroscopical and retinal examination, in addition to evaluations of haemoglobin (Hb) and haematocrit (Ht) levels, fetal haemoglobin (HbF) estimations, serum creatinine and albuminuria levels, glomerular filtration rate (GFR) values, phenotypes, β -globin gene haplotypes and α -thalassaemia. The relationship between ocular vessel alterations and clinical, laboratory and genetic features were evaluated using chisquared or Fisher tests and logistic regression analysis. In 13 patients on enalapril treatment, a second ophthalmological evaluation was performed after a 12- month period to evaluate the longitudinal effect of the drug on ocular vessels. Results: Conjunctival vessel alteration (CVA) was not influenced by age, gender, HbF estimation, serum creatinine and albuminuria levels, GFR values, β -globin gene haplotypes or α -thalassaemia. However, increased frequencies of CVA were found in patients with Hb ≤ 9.0 g/dl, Ht ≤ 26.7% and sickle cell anaemia (SS) phenotype. Retinal vessel alteration (RVA) was identi-fied only in patients aged 17 years or older. Enalapril did not demonstrate ocular vessel amelioration after 12- months of daily use. Conclusion: The results indicate that lower Hb and Ht levels and SS phenotype are risk factors for CVA, and age over 17 years may be risk factors for RVA in SCD patients.
文摘Background: Cerebral and retinal vessels behave similarly under the influence of vascular risk factors. Several groups have shown that retinal microvascular abnormalities represent an independent risk factor with regard to strokes and heart attacks. Aim of the Study: The aim of this study was to perform a prospective screening examinationwith regard to retinalmicrovascular abnormalities as well as an extended vessel diagnosis in a subgroup of patients with lower arteriovenous risk values. Methods: In the course of a prospective cross-sectional study (“Talking Eyes”) between 1.9.2001 and 1.8.2002 a telemedical-supported screening of the retina (study 1) was carried out in 7,163 subjects. The patients were selected without any inclusion or exclusion criteria. The mean age was 48.2±8 years (18-83 years) with a sex distribution of 39.2%females to 60.8%males. Digital fundus photos of the right and left eyes were taken for all patients. The pictures were taken without pupil dilation using a CANON-NM camera. The pictures and case histories were stored in a central server using web-based software (MedStage, Siemens). In a central reading centre, the arteriovenous ratio of both eyes was determined telemedically using the Parr-Hubbard formula and the retinas subjected to a standardised examination by an ophthalmologist. The retinal risk factor was calculated on the basis of the arteriovenous ration, the presence of microvascular abnormalities and the case history. The reproducibility of measurement of the arteriovenous ratio (Kronbach alpha coefficient) was evaluated by double measurements on 1,332 images. In a subgroup of study 1 with arteriovenous ratio values < 0.76 (N=107), an extended vessel diagnosis with measurement of 24-h blood pressure and vessel-relevant blood values (homocysteine, cholesterol, LDL, HDL, CRP, TG, HbA1c) was carried out (study II). Results: Study 1: The Kronbach alpha coefficient as a measure of reproducibility amounted to 0.77. The mean arteriovenous ratio of the retinal vessels was 0.83±0.09 and showed a pronounced age dependence (R=0.9, p< 0.0001). On multivariate testing the arteriovenous ratio correlated significantly (R=0.33, p< 0.001) with the factors age, systolic blood pressure, diastolic blood pressure and body mass index. Diastolic blood pressure followed by age had the largest influence. The prevalence of microvascular abnormalities in the right (RE) and left (LE)-eyes, respectively were: cotton wool foci RE 0.0015%, LE 0.003%, retinal haemorrhage RE 0.1%, LE 0.1%, focal stenoses RE 3.4%, LE 3.4%, tortuositas vasorumRE 4.1%, LE 4.0%, arteriovenous crossing signs RE 11.2%, LE 11.2%. On multivariate testing the occurrence of microvascular abnormalities correlated significantly (R=0.38, p < 0.001) with the factors high blood pressure known from case history, body mass index, and gender. Arterial hypertension had the strongest influence followed by diastolic blood pressure. The calculated retinal risk factor correlated with the prevalence of angina pectoris. Study 11: 2/3 of the subjects with arteriovenous risk factor values < 0.76 exhibited pathologically high 24-h blood pressure values. For these patients there were significant correlations between the arteriovenous ratio and the low-density lipoprotein concentration as well as the Framingham risk score. Conclusion: In the course of a prospective, telemedical-supported screening examination of the retinal vessels of more than 7,000 subjects the arteriovenous ratio exhibited a strong dependence on age and blood pressure. Among the subjects with lowered arteriovenous ratio values, 2/3 exhibited arterial hypertension in the 24-h blood pressure determination.
