Panretinal photocoagulation (PRP) and macular photocoagulation (MPC) are the gold standard treatments for proliferative diabetic retinopathy (DR) and diabetic macular edema. With the development of equipment and technology advancement, photocoagulation has been gradually applied in many Eye Centers all over China. However, there are still several problems such as no standardized guideline and undesirable therapeutic effects. In this article we will summarize the indications and techniques of photocoagulation, and when and how to apply drug treatments for retinal diseases; aim at improving the criterion and clinical effects of photocoagulation.
目的:观察外伤性肾损伤出血行肾动脉栓塞术及护理效果。方法:本组26例,其中12例有失血性休克。均采用Seldinger技术,经股动脉穿刺选择性肾动脉造影,超选择性插管后注入栓塞剂。术前重点监测生命体征,及时补液、止血、输血防治休克。术中顺应医师的操作,观察生命体征、小便量、色的变化。术后:重点预防穿刺点出血,观察下肢血液循环,处理疼痛,发热等并发症。结果:26例患者临床症状很快缓解,血压均在12h内恢复正常,血尿在1~2天消失,有效率达100%。结论:外伤性肾损伤出血,采用肾动脉栓塞术即可立刻止血,又可为患者保全功能正常的肾脏。
Objective To observe the effect of laser photocoagulation of the peripheral retinal holes and/or degeneration in high myopia. Methods Full fundus examination for high myopic patients was made before keratorefractive surgery with binocular indirect ophthalmoscopy.Peripheral holes,degeneration and vitreous traction were found in 206 eyes of 135 patients,and all of them were treated with laser photocoagulation. Results No retinal detachment occurred after keratorefrative operation within 1 year follows up. Conclusions Retinal laser photocoagulation is an effective and safety method before keratorefractive operation for prevention of the retinal detachment in high myopia at least in short-term observation. (Chin J Ocul Fundus Dis, 1999, 15: 135-136)
Diabetic retinopathy (DR) is a major and irreversible blinding eye disease in working aged adults. Diabetic macular edema (DME) is a complication of the further development of DR, and it is one of the main causes of vision loss in DR patients. The emergence of anti-VEGF drugs has changed the treatment model of DR and DME. Firstly, for the treatment of DME, the previous focal/grid-like laser photocoagulation is converted to anti-VEGF drugs as the first-line treatment. Secondly, for the treatment of proliferative DR (PDR), panretinal photocoagulation (PRP) was the gold standard in the past, and now anti-VEGF drugs have become an alternative treatment for some PDR patients. In varying degrees of DR and DME, the option of treatment, anti-VEGF drug therapy replacing PRP, and the era of anti-VEGF drug therapy on DR treatment modes are worthy questions for consideration by clinicians. In-depth study of the clinical study of PRP and anti-VEGF drugs in the treatment of DR, the changes attention in clinical guidelines and expert consensus, the gradual establishment of treatment of DR and DME suitable, and the personalized treatment of DR patients may help improve the level of DR treatment in China.
Objective To investigate the characteristics of indocyanine green angiography(ICGA) in central serous chorioretinopathy(CSC) Methods The simultanous fundus fluorescein angiography(FFA) and ICGA were performed on 79 eyes of 70 consecutive patients with Heidelberg Retina Angiography. Results Seventy-nine eyes in FFA revealed RPE leakages.The changes of ICGA showed a small localized delay of filling of choroid vessels during the early phase of angiography in 23 eyes,choroidal capillary congestion in 79 eyes,the choriodal capillary hyperpermeability in the area of RPE leakage in 78 eyes,pigment epithelial detachment in 25 eyes and RPE atrophy in 21 eyes. Conclusion The findings in this research indicate that the choroidal abnormalities are the basic characteristics of ICGA in CSC. (Chin J Ocul Fundus Dis,20000,16:14-16)
Objective To evaluate the correlation between retinal thickness (RT) at the macular area and the axial length (AL) in myopia. Mehtods Optical coherence tomography (OCT) was used to detect the RT at the macular fovea, and at the superior, nasal, inferior, and temporal side of the fovea and parafovea area. The AL of the examined eye was measured by IOL master measuring machine, and the correlation between RT at the macular area and the Al was evaluated. Results The minimum RT in the macular area in the eyes with myopia was (150.90plusmn;22.10)mu;m.The retina at the temporal side of parafovea was the thinnest. The average RT in the areas around the fovea was negatively correlated with the AL, and there was no correlation among the minimum RT, the mean RT at the fovea, and the AL of eye. Conclusions As the AL of eye increases, the RT at the parafovea decreases, while the minimum and the average RT at the fovea remain unchanged. (Chin J Ocul Fundus Dis, 2006, 22: 397-399)
ObjectiveTo investigate the value of pattern reversal visual evoked potential (PRVEP) and sweep pattern visual evoked potential (SPVEP) in evaluating the visual function of patients with central serous chorioretinopathy (CSC).MethodsA retrospective clinical trial. A total of 38 monocular CSC patients were enrolled from March 2016 to December2018 in Heping Hospital Affiliated Changzhi Medical College. There were 34 males and 4 females with the mean age of 40.0±5.2 years. All patients undergo PRVEP detection in both the acute phase (disease course ≤ 3 months) and the clinical cure phase (disease course ≤ 6 months) using the German Roland electrophysiological RETIport system.The stimulation pattern adopted a checkerboard with 1.00° and 0.25° stimulation angles. The P100 peak amplitude and peak time were observed. SPVEP inspection equipment and methods were the same as PRVEP, and the spatial frequency was 1, 2, 4, 6, 8, 12, 16, 22 cpd. The difference between SPVEP vision and subjective vision were compared. The PRVEP peak amplitude, peak time and SPVEP amplitude and phase of the affected eye and the contralateral eye were compared by paired t test; the subjective vision and SPVEP visual acuity of the affected eye and the contralateral eye were compared by Wilcoxon paired rank test; Pearson product-moment correlation analysis was performed on SPVEP vision.ResultsIn the acute phase, the peak amplitude of P100 in the affected eye was lower than that in the contralateral eye (t=30.26, 13.59), and the peak time was prolonged (t=-19.89, -29.41). The difference was statistically significant (P<0.01); in clinically cured period, the P100 peak amplitude (t=1.49, -0.57) and peak time (t=-1.22, -1.84) of the affected eye and the contralateral eye showed no significant difference (P>0.05). In the acute phase, the difference in SPVEP amplitude between the affected eye and the contralateral eye with different spatial frequencies was statistically significant (P<0.01); the phase of the affected eye and the contralateral eye were compared about the spatial frequency 1, 2, 4, 6, 8, 12 cpd, the difference was statistically significant (P<0.01). During the clinical cure period, the spatial frequency of 6, 8, 12, 16 cpd, the SPVEP amplitude of the affected eye and the contralateral eye, the difference was statistically significant (P<0.01); on the spatial frequency of 6, 8, 12 cpd, the phase of SPVEP was compared between the affected eye and the contralateral eye, the difference was statistically significant (P<0.01). During the acute phase and the clinical cure phase, the SPVEP visual acuity of the affected eye was lower than that of the contralateral eye, and the difference was statistically significant (P<0.01); during the acute phase and clinical cure phase, the SPVEP visual acuity of the affected eye and the contralateral eye were lower than the subjective vision. The difference was statistically significant (acute phase: Z =-5.38, -3.00; P<0.001, 0.003; clinical cure phase: Z=-5.36, -5.38; P<0.001,<0.001). In the acute phase, the subjective visual acuity of the affected eye was positively correlated with SPVEP visual acuity (r=0.847, P<0.001).ConclusionsPRVEP and SPVEP are useful for objectively assessing the visual function of the patients with CSC. Especially, the slight and potential visual impairment in CSC can been detected by SPVEP.