AIM:To present the outcome of modified grid laser photocoagulation(GLP)in diffuse diabetic macular edema(DDME)in eyes without extrafoveal and/or vitreofoveal traction.METHODS:Inclusion criteria for the retrospective s...AIM:To present the outcome of modified grid laser photocoagulation(GLP)in diffuse diabetic macular edema(DDME)in eyes without extrafoveal and/or vitreofoveal traction.METHODS:Inclusion criteria for the retrospective study were DDME eyes of patients with typeⅡdiabetes mellitus that had≥4 months of follow-up following GLP.Only one eye per patient was analyzed.Using 3-D spectral-domain optical coherence tomography(3-D SDOCT),eyes that had either extrafoveal or vitreofoveal traction,or had been previously treated by an intravitreal medication(s)were excluded.Treated DDME eyes were divided into 4 groups:A)"Classic"DDME that involved the central macula;B)edema did not involve the macular center;C)eyes associated with central epiretinal membrane(ERM);D)DDME that was associated with macular capillary dropout≥2 disc-diameter(DD).RESULTS:GLP outcome in 35 DDME eyes after 4-24(mean,13.1±6.9)months was as follows:Group A)18eyes with"classic"DDME.Following one or 2(mean,1.2)GLP treatments,best-corrected visual acuity(BCVA)improved by 1-2 Snellen lines in 44.4%(8/18)of eyes,and worsened by 1 line in 11.1%(2/18).Central macular thickness(CMT)improved by 7%-49%(mean,26.6%)in77.8%(14/18)of eyes.Causes of CMT worsening(n=4)were commonly explainable,predominantly(n=3)associated with emergence of extrafoveal traction,5-9months post-GLP.Group B)GLP(s)in DDME that did not involve the macular center(n=6)resulted in improved BCVA by 1-2 lines in 2 eyes.However,the central macula became involved in the edema process after the GLP in 3(50%)eyes,associated with an emergence of extrafoveal traction in one of these eyes 4months following the GLP.Group C)GLP failed in all 5eyes associated with central ERM.Group D)GLP was of partial benefit in 2 of 6 treated eyes with macular capillary dropout≥2DD.CONCLUSION:Eyes with DDME that involved the macular center were found to achieve favourable outcomes after GLP(s)during mid-term follow-up,unless complicated pre-GLP or post-GLP by vltreoretinal interface abnormalities,often extrafoveal traction or ERM,or by capillary dropout≥2DD.Prospective studies with larger cohorts are required.展开更多
AIM:To compare changes in visual acuity and macular edema in patients with central retinal vein occlusion(CRVO)treated with intravitreal injections of bevacizumab,macular grid photocoagulation combined with pan ret...AIM:To compare changes in visual acuity and macular edema in patients with central retinal vein occlusion(CRVO)treated with intravitreal injections of bevacizumab,macular grid photocoagulation combined with pan retinal photocoagulation(PRP),or both(bevacizumab+grid+PRP).· METHODS:Our study is a retrospective cohort clinical study that examined patients that suffered from ischemic CRVO with macular edema.Study inclusion criteria were ischemic CRVO with macula edema and the availability of complete medical records for at least 12 mo after treatment.Excluded were patients with diabetes or any other retinal disease.We reviewed the medical records of patients treated in one ophthalmology departmentcomparing changes in visual acuity and macular edema in patients treated with intravitreal injections of bevacizumab vs those that were treated with macular grid photocoagulation and PRP or both.The main outcome measures were the differences in best corrected visual acuity(BCVA) and in macular thickness,as assessed by optical coherence tomography,between the enrollment and the final follow up visits.· RESULTS:Sixty-five patients met inclusion criteria.There were no statistically significant differences among the three groups in the mean changes in macular thickness as measured by ocular coherence tomography(131.5±41.2,108.6±29.2,and 121.1±121.1,P=0.110),or in visual acuity(0.128±0.077,0.088±0.057,and 0.095±0.065),for intravitreal injections,macular grid photocoagulation+PRP and a combination of the treatments,respectively,P =0.111.The proportions of patients with macular edema after treatment were:26.1%,28.6%,and 14.3%,respectively,P=0.499.· CONCLUSION:Similar benefit was observed for intravitreal injections,laser photocoagulation,or a combined regimen in the treatment of CRVO.A nonstatistically significant trend for reduction in macular edema was observed following combined treatment.展开更多
AIM: To find out the outcome of laser photocoagulation in clinically significant macular edema (CSME) by optical coherence tomography (OCT). · METHODS: It was a prospective, non-controlled, case series study enro...AIM: To find out the outcome of laser photocoagulation in clinically significant macular edema (CSME) by optical coherence tomography (OCT). · METHODS: It was a prospective, non-controlled, case series study enrolling 81 eyes of 64 patients with CSME between August 2008 and January 2010. All patients received modified grid photocoagulation with frequency doubled Nd: YAG laser. Each patient was evaluated in terms of best-corrected visual acuity (BCVA) and regression or progression of maculopathy after laser therapy at 1, 3 and 6 months. Spearman’s correlation test was used to show the correlation between BCVA and total macular volume (TMV). Analysis of variance (ANOVA) was used to compare among groups and independent t-test was used to compare in each group. · RESULTS: There is high correlation between BCVA and TMV (P ≤0.001). BCVA improved in 50.6%, remained static in 39.5 % and deteriorated in 9.9% patients after 6 month of treatment. The Baseline TMV (mean and SD) were 9.26±1.83, 10.4±2.38, 11.5±3.05, 8.89±0.75 and 9.47±1.98 mm3 for different OCT patterns, ST (sponge like thickening), CMO (cystoid macular edema), SFD (subfoveal detachment), VMIA (Vitreo macular interface abnormality) and average TMV respectively (P =0.04). After 6 months of laser treatment, the mean TMV decreased from 9.47±1.98mm3 to 8.77±1.31mm3(P =0.01). In ST there was significant decrease in TMV, P =0.01, Further within these groups at 6 months, they were significantly different, P =0.01. · CONCLUSION: OCT showed the different morphological variant of CSME while the response of treatment is different. TMV decreased the most and hence showed the improvement in vision after 6 months of laser treatment. In the era of Anti vascular endothelial growth factors (VEGFs), efficacy of laser seems to be in shadow but it is still first line of treatment in developing nation like Nepal where antiVEGFs may not be easily available and affordable.展开更多
Purpose: To assess the efficacy of intravitreal bevacizumab (IVB) combined with grid photocoagulation in the management of recurrent macular edema secondary to retinal vein occlusion (RVO). Methods: This is a prospect...Purpose: To assess the efficacy of intravitreal bevacizumab (IVB) combined with grid photocoagulation in the management of recurrent macular edema secondary to retinal vein occlusion (RVO). Methods: This is a prospective, non-randomized, interventional study. Thirty five eyes with branch retinal vein occlusion (BRVO) and 15 eyes with central retinal vein occlusion (CRVO) were treated with grid photocoagulation combined with IVB for recurrent macular edema. The visual acuity, central macular thickness and intraocular pressure were outcome measures. The mean duration of follow-up was 18.1 ± 3.6 months. Results: One month after treatment, 45 of the 50 eyes showed complete resolution of the cystoid space. Compared with initial values, final central macular thickness was reduced significantly in both BRVO and CRVO groups (P < 0.001), but improvement in VA was significant only for eyes with BRVO (P = 0.012). The total number of IVB was 1.8 ± 0.3 for eyes with either BRVO or CRVO. Conclusion: IVB combined with grid photocoagulation is an effective treatment for reducing recurrent macular edema associated with RVO.展开更多
A commercially available laser marking system based on diode-pumped Nd:YVO<sub>4</sub> laser was used for creating grid patterns for forming strain analysis of a dual-phase steel. The aim was to determine ...A commercially available laser marking system based on diode-pumped Nd:YVO<sub>4</sub> laser was used for creating grid patterns for forming strain analysis of a dual-phase steel. The aim was to determine and analyze the influence of laser working parameters on the formability of sheet material by means of an in-depth characterization of this induced microstructural and geometric inhomogeneity. The electrochemical etching served as the reference method without the negative effect of generating inhomogeneity. The formability was evaluated using the cupping test according to Erichsen. While the quantification of geometric inhomogeneity was based on the determination of the notch factor, light microscopy and microhardness measurement were used for the evaluation of microstructural inhomogeneity. Furthermore, on the basis of the results an empirical regression model was established which described in terms of quantity the relationship between the examined factors such as laser power, pulse frequency and scanning speed as well as the command variable and the mark depth. The results showed that microstructural inhomogeneity in the used marking parameters due to their locally very limited formation did not have an appreciable influence on the mechanical properties. In contrast to this, the induced geometric inhomogeneity had a marked influence on the material formability.展开更多
Using the laser controlled thermocracking method, research results for the new technology of optical grids and scales manufacturing are given in this paper. The opportunity of grids and scales manufacturing is shown f...Using the laser controlled thermocracking method, research results for the new technology of optical grids and scales manufacturing are given in this paper. The opportunity of grids and scales manufacturing is shown for a wide range of the sizes, scale’s pitches and its width: from 10 nanometers up to 10 microns with a backlight in various optical ranges.展开更多
文摘AIM:To present the outcome of modified grid laser photocoagulation(GLP)in diffuse diabetic macular edema(DDME)in eyes without extrafoveal and/or vitreofoveal traction.METHODS:Inclusion criteria for the retrospective study were DDME eyes of patients with typeⅡdiabetes mellitus that had≥4 months of follow-up following GLP.Only one eye per patient was analyzed.Using 3-D spectral-domain optical coherence tomography(3-D SDOCT),eyes that had either extrafoveal or vitreofoveal traction,or had been previously treated by an intravitreal medication(s)were excluded.Treated DDME eyes were divided into 4 groups:A)"Classic"DDME that involved the central macula;B)edema did not involve the macular center;C)eyes associated with central epiretinal membrane(ERM);D)DDME that was associated with macular capillary dropout≥2 disc-diameter(DD).RESULTS:GLP outcome in 35 DDME eyes after 4-24(mean,13.1±6.9)months was as follows:Group A)18eyes with"classic"DDME.Following one or 2(mean,1.2)GLP treatments,best-corrected visual acuity(BCVA)improved by 1-2 Snellen lines in 44.4%(8/18)of eyes,and worsened by 1 line in 11.1%(2/18).Central macular thickness(CMT)improved by 7%-49%(mean,26.6%)in77.8%(14/18)of eyes.Causes of CMT worsening(n=4)were commonly explainable,predominantly(n=3)associated with emergence of extrafoveal traction,5-9months post-GLP.Group B)GLP(s)in DDME that did not involve the macular center(n=6)resulted in improved BCVA by 1-2 lines in 2 eyes.However,the central macula became involved in the edema process after the GLP in 3(50%)eyes,associated with an emergence of extrafoveal traction in one of these eyes 4months following the GLP.Group C)GLP failed in all 5eyes associated with central ERM.Group D)GLP was of partial benefit in 2 of 6 treated eyes with macular capillary dropout≥2DD.CONCLUSION:Eyes with DDME that involved the macular center were found to achieve favourable outcomes after GLP(s)during mid-term follow-up,unless complicated pre-GLP or post-GLP by vltreoretinal interface abnormalities,often extrafoveal traction or ERM,or by capillary dropout≥2DD.Prospective studies with larger cohorts are required.
文摘AIM:To compare changes in visual acuity and macular edema in patients with central retinal vein occlusion(CRVO)treated with intravitreal injections of bevacizumab,macular grid photocoagulation combined with pan retinal photocoagulation(PRP),or both(bevacizumab+grid+PRP).· METHODS:Our study is a retrospective cohort clinical study that examined patients that suffered from ischemic CRVO with macular edema.Study inclusion criteria were ischemic CRVO with macula edema and the availability of complete medical records for at least 12 mo after treatment.Excluded were patients with diabetes or any other retinal disease.We reviewed the medical records of patients treated in one ophthalmology departmentcomparing changes in visual acuity and macular edema in patients treated with intravitreal injections of bevacizumab vs those that were treated with macular grid photocoagulation and PRP or both.The main outcome measures were the differences in best corrected visual acuity(BCVA) and in macular thickness,as assessed by optical coherence tomography,between the enrollment and the final follow up visits.· RESULTS:Sixty-five patients met inclusion criteria.There were no statistically significant differences among the three groups in the mean changes in macular thickness as measured by ocular coherence tomography(131.5±41.2,108.6±29.2,and 121.1±121.1,P=0.110),or in visual acuity(0.128±0.077,0.088±0.057,and 0.095±0.065),for intravitreal injections,macular grid photocoagulation+PRP and a combination of the treatments,respectively,P =0.111.The proportions of patients with macular edema after treatment were:26.1%,28.6%,and 14.3%,respectively,P=0.499.· CONCLUSION:Similar benefit was observed for intravitreal injections,laser photocoagulation,or a combined regimen in the treatment of CRVO.A nonstatistically significant trend for reduction in macular edema was observed following combined treatment.
基金Supported by Natinoal Academy of Medical Sciences, Bir Hospital, Nepal
文摘AIM: To find out the outcome of laser photocoagulation in clinically significant macular edema (CSME) by optical coherence tomography (OCT). · METHODS: It was a prospective, non-controlled, case series study enrolling 81 eyes of 64 patients with CSME between August 2008 and January 2010. All patients received modified grid photocoagulation with frequency doubled Nd: YAG laser. Each patient was evaluated in terms of best-corrected visual acuity (BCVA) and regression or progression of maculopathy after laser therapy at 1, 3 and 6 months. Spearman’s correlation test was used to show the correlation between BCVA and total macular volume (TMV). Analysis of variance (ANOVA) was used to compare among groups and independent t-test was used to compare in each group. · RESULTS: There is high correlation between BCVA and TMV (P ≤0.001). BCVA improved in 50.6%, remained static in 39.5 % and deteriorated in 9.9% patients after 6 month of treatment. The Baseline TMV (mean and SD) were 9.26±1.83, 10.4±2.38, 11.5±3.05, 8.89±0.75 and 9.47±1.98 mm3 for different OCT patterns, ST (sponge like thickening), CMO (cystoid macular edema), SFD (subfoveal detachment), VMIA (Vitreo macular interface abnormality) and average TMV respectively (P =0.04). After 6 months of laser treatment, the mean TMV decreased from 9.47±1.98mm3 to 8.77±1.31mm3(P =0.01). In ST there was significant decrease in TMV, P =0.01, Further within these groups at 6 months, they were significantly different, P =0.01. · CONCLUSION: OCT showed the different morphological variant of CSME while the response of treatment is different. TMV decreased the most and hence showed the improvement in vision after 6 months of laser treatment. In the era of Anti vascular endothelial growth factors (VEGFs), efficacy of laser seems to be in shadow but it is still first line of treatment in developing nation like Nepal where antiVEGFs may not be easily available and affordable.
文摘Purpose: To assess the efficacy of intravitreal bevacizumab (IVB) combined with grid photocoagulation in the management of recurrent macular edema secondary to retinal vein occlusion (RVO). Methods: This is a prospective, non-randomized, interventional study. Thirty five eyes with branch retinal vein occlusion (BRVO) and 15 eyes with central retinal vein occlusion (CRVO) were treated with grid photocoagulation combined with IVB for recurrent macular edema. The visual acuity, central macular thickness and intraocular pressure were outcome measures. The mean duration of follow-up was 18.1 ± 3.6 months. Results: One month after treatment, 45 of the 50 eyes showed complete resolution of the cystoid space. Compared with initial values, final central macular thickness was reduced significantly in both BRVO and CRVO groups (P < 0.001), but improvement in VA was significant only for eyes with BRVO (P = 0.012). The total number of IVB was 1.8 ± 0.3 for eyes with either BRVO or CRVO. Conclusion: IVB combined with grid photocoagulation is an effective treatment for reducing recurrent macular edema associated with RVO.
文摘A commercially available laser marking system based on diode-pumped Nd:YVO<sub>4</sub> laser was used for creating grid patterns for forming strain analysis of a dual-phase steel. The aim was to determine and analyze the influence of laser working parameters on the formability of sheet material by means of an in-depth characterization of this induced microstructural and geometric inhomogeneity. The electrochemical etching served as the reference method without the negative effect of generating inhomogeneity. The formability was evaluated using the cupping test according to Erichsen. While the quantification of geometric inhomogeneity was based on the determination of the notch factor, light microscopy and microhardness measurement were used for the evaluation of microstructural inhomogeneity. Furthermore, on the basis of the results an empirical regression model was established which described in terms of quantity the relationship between the examined factors such as laser power, pulse frequency and scanning speed as well as the command variable and the mark depth. The results showed that microstructural inhomogeneity in the used marking parameters due to their locally very limited formation did not have an appreciable influence on the mechanical properties. In contrast to this, the induced geometric inhomogeneity had a marked influence on the material formability.
文摘Using the laser controlled thermocracking method, research results for the new technology of optical grids and scales manufacturing are given in this paper. The opportunity of grids and scales manufacturing is shown for a wide range of the sizes, scale’s pitches and its width: from 10 nanometers up to 10 microns with a backlight in various optical ranges.