AIM： To evaluate the efficacy and safety of anti-vascular endothelial growth factor （VEGF） combined with photodynamic therapy （PDT） versus anti-VEGF monotherapy for polypoidal choroidal vasculopathy （PCV）. MET...AIM： To evaluate the efficacy and safety of anti-vascular endothelial growth factor （VEGF） combined with photodynamic therapy （PDT） versus anti-VEGF monotherapy for polypoidal choroidal vasculopathy （PCV）. METHODS： We conducted a Meta-analysis of 9 studies to compare the efficacy and safety between combined therapy and anti-VEGF monotherapy for PCV. The programs of RevMan 5.3 and Stata 12.0 were used to analyze data. RESULTS： The best corrected visual acuity （BCVA） in combined therapy group were significantly better than those of anti-VEGF monotherapy group at 6, 24 and 36mo, with pooled weighted means differences （WMDs） of 0.12 （0.06, 0.18）, 0.25 （0.12, 0.38） and 0.28 （0.13, 0.43）, respectively. The central retinal thickness （CRT） reductions in combined therapy group were higher than that in anti- VEGF monotherapy group at 1, 3, 6 and 9mo, with pooled WMDs of 63.90 （20.41, 107.38）, 33.47 （4.69, 62.24）, 30.57 （0.12, 60.01） and 28.00 （2.51, 53.49）, respectively. The regression rate of polyps in combined therapy group was much higher than that in anti-VEGF monotherapy group [RD： 0.47 （0.26, 0.68）; P〈0.0001]. The adverse event retinal hemorrhage did not differ significantly between the two groups. CONCLUSION： Our findings clearly document that anti- VEGF combined with PDT is a more effective therapy for PCV compared with anti-VEGF monotherapy. Furthermore, combined therapy does not increase the incidence of retinal hemorrhage.展开更多
A gastric neuroendocrine tumor(NET)is generated from deep within the tissue mucosal layers.In many cases,NETs are discovered as submucosal tumor(SMT)-like structures by forming a tumor mass.This case has a clear mucos...A gastric neuroendocrine tumor(NET)is generated from deep within the tissue mucosal layers.In many cases,NETs are discovered as submucosal tumor(SMT)-like structures by forming a tumor mass.This case has a clear mucosal demarcation line and developed like a polyp.A dilated blood vessel was found on the surface.The mass lacked the yellow color characteristic of NETs,and a SMT-like form was evident.Therefore,a nonspecific epithelial lesion was suspected and we performed endoscopy with magnifying narrowband imaging(M-NBI).However,this approach did not lead to the diagnosis,as we diagnosed the lesion as a NET by biopsy examination.The lesion was excised by endoscopic submucosal dissection.The histopathological examination proved that the lesion was a polypoid lesion although it was also a NET because the tumorcells extended upward through the normal gland ducts scatteredly.To our knowledge,there is no previous report of NET G1 with such unique histopathological growth progress and macroscopic appearance shown by detailed examination using endoscopy with M-NBI.展开更多
AIM: To evaluate the real-life clinical outcomes of intravitreal injection of conbercept combined rescue therapy for polypoidal choroidal vasculopathy(PCV). METHODS: This was an open label, single center, and interven...AIM: To evaluate the real-life clinical outcomes of intravitreal injection of conbercept combined rescue therapy for polypoidal choroidal vasculopathy(PCV). METHODS: This was an open label, single center, and interventional study. All enrolled patients were treated initially with three consecutive monthly intravitreal conbercept injections(0.5 mg). Additional conbercept injections were administered upon substantial polyp regression with improved visual acuity(VA). Eyes with partial or no polyp regression and poor VA were rescue treated with photodynamic therapy(PDT) for subfoveal polyps or thermal laser photocoagulation for extrafoveal polyps. Best-corrected visual acuity(BCVA), central foveal thickness(CFT) and polyp regression were observed as primary outcomes. Side effects were also collected during the follow-up period. RESULTS: A total of 56 eyes(56 patients) with PCV were included. BCVA increased significantly from the baseline of 43.52±24.21 letters to 55.88±21.94 letters(P<0.001) at 12 mo, while CFT decreased significantly from 457.41±207.86 μm to 247.98±127.08 μm(P<0.001). All patients showed polyp regression. Twenty-three eyes achieved complete polyp regression after the three initial injections, which increased to 44 eyes at 12 mo. Seventeen eyes underwent rescue therapy, among which 2 eyes treated with PDT and 15 eyes treated with laser photocoagulation. A mean of 4.30±1.43 injections were given per eye. No intraocular inflammation, retinal or vitreous hemorrhage, or systemic complication occurred. CONCLUSION: Conbercept is an effective and safe option for the treatment of PCV in Chinese population. The treatment regimen of three initial conbercept injections followed by additional injections or rescue therapies is efficacious for treating PCV.展开更多
Background：Polypoidal choroidal vasculopathy （PCV） is characterized by the presence of polyps with or without a branching vascular network and more prevalent among Asians.The aim of this study was to compare the ou...Background：Polypoidal choroidal vasculopathy （PCV） is characterized by the presence of polyps with or without a branching vascular network and more prevalent among Asians.The aim of this study was to compare the outcomes of conbercept therapy between two different angiographic subtypes of PCV.Methods：Fifty-eight patients of PCV were classified into two phenotypes according to indocyanine green angiography （ICGA）.In Type 1,both feeder and draining vessels are visible on ICGA and network vessels are numerous.In Type 2,neither feeder nor draining vessels are detectable,and the number of network vessels is small.The patients were treated with intravitreal conbercept （IVC） for 3 months.Additional 1VC was given at subsequent monthly visits,if needed.The patients were followed up for 12 months,and changes in mean best-corrected visual acuity （BCVA）,central retinal thickness （CRT）,subretinal fluid （SRF） thickness,pigmented epithelial detachment （PED）,hemorrhage,and number of polypoidal lesions were evaluated.Results：The mean BCVA in Type 2 PCV （15.92 ± 9.76 letters） achieved a significantly greater improvement than that in the Type 1 （14.10± 9.07 letters） at month 12 （t=2.37,P〈 0.01）.Moreover,the mean CRTdecrease was numerically greater in Type 2 （120.44± 73.81μm） compared with Type 1 （106.48 ± 72.33 μm） at month 6 （t =4.31,P 〈 0.01）,and greater in Type 2 （130.21 ± 76.28 μm） compared with Type 1 （111.67 ± 79.57μm） at month 9 （t =1.87,P 〈 0.0l）.There was no significant difference between the two types for the decrease in SRF thickness,PED height,and regression of polyps from month 3 to 12 （t =2.97,P〉 0.05）.Conclusion：Classification systems for PCV will show differences in presentation,natural history,or response to anti-vascular endothelial growth factor treatment and might,therefore,provide a new key to the choice of treatment for the disease.展开更多
文摘AIM： To evaluate the efficacy and safety of anti-vascular endothelial growth factor （VEGF） combined with photodynamic therapy （PDT） versus anti-VEGF monotherapy for polypoidal choroidal vasculopathy （PCV）. METHODS： We conducted a Meta-analysis of 9 studies to compare the efficacy and safety between combined therapy and anti-VEGF monotherapy for PCV. The programs of RevMan 5.3 and Stata 12.0 were used to analyze data. RESULTS： The best corrected visual acuity （BCVA） in combined therapy group were significantly better than those of anti-VEGF monotherapy group at 6, 24 and 36mo, with pooled weighted means differences （WMDs） of 0.12 （0.06, 0.18）, 0.25 （0.12, 0.38） and 0.28 （0.13, 0.43）, respectively. The central retinal thickness （CRT） reductions in combined therapy group were higher than that in anti- VEGF monotherapy group at 1, 3, 6 and 9mo, with pooled WMDs of 63.90 （20.41, 107.38）, 33.47 （4.69, 62.24）, 30.57 （0.12, 60.01） and 28.00 （2.51, 53.49）, respectively. The regression rate of polyps in combined therapy group was much higher than that in anti-VEGF monotherapy group [RD： 0.47 （0.26, 0.68）; P〈0.0001]. The adverse event retinal hemorrhage did not differ significantly between the two groups. CONCLUSION： Our findings clearly document that anti- VEGF combined with PDT is a more effective therapy for PCV compared with anti-VEGF monotherapy. Furthermore, combined therapy does not increase the incidence of retinal hemorrhage.
文摘A gastric neuroendocrine tumor(NET)is generated from deep within the tissue mucosal layers.In many cases,NETs are discovered as submucosal tumor(SMT)-like structures by forming a tumor mass.This case has a clear mucosal demarcation line and developed like a polyp.A dilated blood vessel was found on the surface.The mass lacked the yellow color characteristic of NETs,and a SMT-like form was evident.Therefore,a nonspecific epithelial lesion was suspected and we performed endoscopy with magnifying narrowband imaging(M-NBI).However,this approach did not lead to the diagnosis,as we diagnosed the lesion as a NET by biopsy examination.The lesion was excised by endoscopic submucosal dissection.The histopathological examination proved that the lesion was a polypoid lesion although it was also a NET because the tumorcells extended upward through the normal gland ducts scatteredly.To our knowledge,there is no previous report of NET G1 with such unique histopathological growth progress and macroscopic appearance shown by detailed examination using endoscopy with M-NBI.
文摘AIM: To evaluate the real-life clinical outcomes of intravitreal injection of conbercept combined rescue therapy for polypoidal choroidal vasculopathy(PCV). METHODS: This was an open label, single center, and interventional study. All enrolled patients were treated initially with three consecutive monthly intravitreal conbercept injections(0.5 mg). Additional conbercept injections were administered upon substantial polyp regression with improved visual acuity(VA). Eyes with partial or no polyp regression and poor VA were rescue treated with photodynamic therapy(PDT) for subfoveal polyps or thermal laser photocoagulation for extrafoveal polyps. Best-corrected visual acuity(BCVA), central foveal thickness(CFT) and polyp regression were observed as primary outcomes. Side effects were also collected during the follow-up period. RESULTS: A total of 56 eyes(56 patients) with PCV were included. BCVA increased significantly from the baseline of 43.52±24.21 letters to 55.88±21.94 letters(P<0.001) at 12 mo, while CFT decreased significantly from 457.41±207.86 μm to 247.98±127.08 μm(P<0.001). All patients showed polyp regression. Twenty-three eyes achieved complete polyp regression after the three initial injections, which increased to 44 eyes at 12 mo. Seventeen eyes underwent rescue therapy, among which 2 eyes treated with PDT and 15 eyes treated with laser photocoagulation. A mean of 4.30±1.43 injections were given per eye. No intraocular inflammation, retinal or vitreous hemorrhage, or systemic complication occurred. CONCLUSION: Conbercept is an effective and safe option for the treatment of PCV in Chinese population. The treatment regimen of three initial conbercept injections followed by additional injections or rescue therapies is efficacious for treating PCV.
文摘Background：Polypoidal choroidal vasculopathy （PCV） is characterized by the presence of polyps with or without a branching vascular network and more prevalent among Asians.The aim of this study was to compare the outcomes of conbercept therapy between two different angiographic subtypes of PCV.Methods：Fifty-eight patients of PCV were classified into two phenotypes according to indocyanine green angiography （ICGA）.In Type 1,both feeder and draining vessels are visible on ICGA and network vessels are numerous.In Type 2,neither feeder nor draining vessels are detectable,and the number of network vessels is small.The patients were treated with intravitreal conbercept （IVC） for 3 months.Additional 1VC was given at subsequent monthly visits,if needed.The patients were followed up for 12 months,and changes in mean best-corrected visual acuity （BCVA）,central retinal thickness （CRT）,subretinal fluid （SRF） thickness,pigmented epithelial detachment （PED）,hemorrhage,and number of polypoidal lesions were evaluated.Results：The mean BCVA in Type 2 PCV （15.92 ± 9.76 letters） achieved a significantly greater improvement than that in the Type 1 （14.10± 9.07 letters） at month 12 （t=2.37,P〈 0.01）.Moreover,the mean CRTdecrease was numerically greater in Type 2 （120.44± 73.81μm） compared with Type 1 （106.48 ± 72.33 μm） at month 6 （t =4.31,P 〈 0.01）,and greater in Type 2 （130.21 ± 76.28 μm） compared with Type 1 （111.67 ± 79.57μm） at month 9 （t =1.87,P 〈 0.0l）.There was no significant difference between the two types for the decrease in SRF thickness,PED height,and regression of polyps from month 3 to 12 （t =2.97,P〉 0.05）.Conclusion：Classification systems for PCV will show differences in presentation,natural history,or response to anti-vascular endothelial growth factor treatment and might,therefore,provide a new key to the choice of treatment for the disease.
