Diabetic retinopathy(DR)is the leading cause of vision loss of working-age adults,and diabetic macular edema(DME)is the most frequent cause of vision loss related to diabetes.The Wisconsin Epidemiologic Study of Diabe...Diabetic retinopathy(DR)is the leading cause of vision loss of working-age adults,and diabetic macular edema(DME)is the most frequent cause of vision loss related to diabetes.The Wisconsin Epidemiologic Study of Diabetic Retinopathy found the 14-year incidence of DME in type 1 diabetics to be 26%.Similarly the Diabetes Control and Complications Trial reported that 27% of type 1 diabetic patients develop DME within9 years of onset.The most common type of diabetes,type 2,is strongly associated with obesity and a sedentary lifestyle.An even higher incidence of macular edema has been reported in older patients with type 2diabetes.Within the last 5 years,the use of intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor(VEGF)agents have come into clinical practice for the management of DME and several recent randomized clinical trials have shown improved effectiveness of ranibizumab compared to focal/grid laser.In this theme issue,we discuss the classification of DR and the treatment options currently available for the treatment of DME including corticosteroids,anti-VEGF agents,combined therapy,enzymatic vitrectomy(vitreolysis),and new therapies.展开更多
Neovascular glaucoma (NVG) is a severe secondary and refractory *severe secondary conditio, that accounts for a varying prevalence between 0.01% to 5.1% of all glaucoma those studied in different regions of the world....Neovascular glaucoma (NVG) is a severe secondary and refractory *severe secondary conditio, that accounts for a varying prevalence between 0.01% to 5.1% of all glaucoma those studied in different regions of the world. **This is a pathological condition, which is caused by the new vessels over iris surface and followed by fibrovascular membrane formation over the trabecular meshwork, secondary to a local angiogenic stimulus. The fibrovascular membrane over trabecular meshwork obstructs the aqueous outflow at an angle of the anterior chamber. ***The obstruction in outflow of the aqueous results increase of intraocular pressure (IOP), within the eyeball. NVG results from a number of ocular and systemic conditions with retinal ischemia leading to anoxia as a mediator in over 95% of cases. Most of them are affected with proliferative diabetic retinopathy (PDR) followed by central retinal venous occlusion (CRVO), and ocular ischemic syndrome (OIS) along with other uncommon causes or all those causes that causes retinal anoxia which led to angiogenic activity in retina and iris of eye. Although NVG overall prevalence is low, but it is a dreadful condition led to blindness. The objective of this review is to provide detailed information on its basic and clinical aspects, to enable us to manage it logically. Here its etiopathogenesis, methods of early diagnosis and management are discussed. It was concluded that if NVG is detected earlier and managed systematically (both medical and surgical) along with an eye on alleviation of different aggravating factors of the retinal hypoxia, it could be a sight-saving measure to the affected person.展开更多
目的:评估2002-10/2006-10在巴西de Clinicasde Porto Alegre医院出生的所有早产儿的早产儿视网膜病变(ROP)的发生率,其治疗和预后的比率。方法:对323例出生体质量低于或等于1500g或者出生时孕龄等于或者少于32wk的早产儿进行前瞻性队...目的:评估2002-10/2006-10在巴西de Clinicasde Porto Alegre医院出生的所有早产儿的早产儿视网膜病变(ROP)的发生率,其治疗和预后的比率。方法:对323例出生体质量低于或等于1500g或者出生时孕龄等于或者少于32wk的早产儿进行前瞻性队列研究。所有的新生儿都在出生后6wk内进行开睑器开睑,瞳孔散大,间接检眼镜及28D透镜眼底检查,根据疾病的分类进行复查。结果由均数表示,发病率为于95%的可信区间,主要的临床结果为任何分期的ROP发生。结果:新生儿82例发生了ROP,发生率为25.7%。患者中只有17例((5.3%)发生了阈病变,他们的病变都累及后部第II区,需要激光治疗。除了3例经治疗的患儿需要两次激光治疗外,没有一个经过治疗的患儿有I区病变或者严重的后部病变。重复治疗组的1例患儿因发展成为4期ROP而需要行赤道部硅胶带巩膜环扎术。结论:ROP的发生率和阈病变同国际其它的研究结果类似。本研究显示了孕期28wk以内或出生后体重1000g的新生儿高生存率(70.1%)、高视网膜病变发病率和激光治疗的高度必要性。这组患儿需要眼科专家和新生儿专家为发现ROP进行仔细筛查和随访。本组患儿中没有确诊1例有I区后部病变,此点是本研究值得引起注意之处。展开更多
文摘Diabetic retinopathy(DR)is the leading cause of vision loss of working-age adults,and diabetic macular edema(DME)is the most frequent cause of vision loss related to diabetes.The Wisconsin Epidemiologic Study of Diabetic Retinopathy found the 14-year incidence of DME in type 1 diabetics to be 26%.Similarly the Diabetes Control and Complications Trial reported that 27% of type 1 diabetic patients develop DME within9 years of onset.The most common type of diabetes,type 2,is strongly associated with obesity and a sedentary lifestyle.An even higher incidence of macular edema has been reported in older patients with type 2diabetes.Within the last 5 years,the use of intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor(VEGF)agents have come into clinical practice for the management of DME and several recent randomized clinical trials have shown improved effectiveness of ranibizumab compared to focal/grid laser.In this theme issue,we discuss the classification of DR and the treatment options currently available for the treatment of DME including corticosteroids,anti-VEGF agents,combined therapy,enzymatic vitrectomy(vitreolysis),and new therapies.
文摘Neovascular glaucoma (NVG) is a severe secondary and refractory *severe secondary conditio, that accounts for a varying prevalence between 0.01% to 5.1% of all glaucoma those studied in different regions of the world. **This is a pathological condition, which is caused by the new vessels over iris surface and followed by fibrovascular membrane formation over the trabecular meshwork, secondary to a local angiogenic stimulus. The fibrovascular membrane over trabecular meshwork obstructs the aqueous outflow at an angle of the anterior chamber. ***The obstruction in outflow of the aqueous results increase of intraocular pressure (IOP), within the eyeball. NVG results from a number of ocular and systemic conditions with retinal ischemia leading to anoxia as a mediator in over 95% of cases. Most of them are affected with proliferative diabetic retinopathy (PDR) followed by central retinal venous occlusion (CRVO), and ocular ischemic syndrome (OIS) along with other uncommon causes or all those causes that causes retinal anoxia which led to angiogenic activity in retina and iris of eye. Although NVG overall prevalence is low, but it is a dreadful condition led to blindness. The objective of this review is to provide detailed information on its basic and clinical aspects, to enable us to manage it logically. Here its etiopathogenesis, methods of early diagnosis and management are discussed. It was concluded that if NVG is detected earlier and managed systematically (both medical and surgical) along with an eye on alleviation of different aggravating factors of the retinal hypoxia, it could be a sight-saving measure to the affected person.
文摘目的:评估2002-10/2006-10在巴西de Clinicasde Porto Alegre医院出生的所有早产儿的早产儿视网膜病变(ROP)的发生率,其治疗和预后的比率。方法:对323例出生体质量低于或等于1500g或者出生时孕龄等于或者少于32wk的早产儿进行前瞻性队列研究。所有的新生儿都在出生后6wk内进行开睑器开睑,瞳孔散大,间接检眼镜及28D透镜眼底检查,根据疾病的分类进行复查。结果由均数表示,发病率为于95%的可信区间,主要的临床结果为任何分期的ROP发生。结果:新生儿82例发生了ROP,发生率为25.7%。患者中只有17例((5.3%)发生了阈病变,他们的病变都累及后部第II区,需要激光治疗。除了3例经治疗的患儿需要两次激光治疗外,没有一个经过治疗的患儿有I区病变或者严重的后部病变。重复治疗组的1例患儿因发展成为4期ROP而需要行赤道部硅胶带巩膜环扎术。结论:ROP的发生率和阈病变同国际其它的研究结果类似。本研究显示了孕期28wk以内或出生后体重1000g的新生儿高生存率(70.1%)、高视网膜病变发病率和激光治疗的高度必要性。这组患儿需要眼科专家和新生儿专家为发现ROP进行仔细筛查和随访。本组患儿中没有确诊1例有I区后部病变,此点是本研究值得引起注意之处。