Objective To study the ultrastructure of macular puck er (MP) from the patients with rhegmatogenous retinal detachment (RRD) and the mechanism associated with its development． Methods Twenty specimens of MP surgically removed by vitrectomy from 13 patients were dissected into two layers in each of them．The ultrastructure of two layers,i,e,near the vitreous and near the retina,was studied with electron microscopy． Results Seven sections of the near vitreous ones appeared prodominant collagen deposits and a few of epithelial like cells,and pigment particles might be present in the cytoplasm．While cells with foot processes were found in 13 membrane sections near the retina and increasing number of various types of cells rich in collagen around were observed including fibroblast like cells and glial cells． Conclusion The findings suggest that the MP after surgery of retinal detachment may possess a characteristic lamination,and posterior hyaloid cortex was involved in the developmetn of MP． The adhesion between posterior hyaloid cortex and macular area might be a key factor for forming MP． (Chin J Ocul Fundus Dis, 2001,17:52-54)
Objective To measure the changes of eye shape and axial length of the eyeball before and after removing the scleral encircling buckles.Methods This is a prospective and controlled study. Twenty eyes (20 patients) with rhegmatogenous retinal detachment and the fellow eyes were enrolled in this study. All patients underwent scleral encircling buckling, and the buckles were removed 2.0-3.5 years after the surgery. The eye shape and axial length of both eyes were measured by three-dimensional computed tomography (3D-CT) before and one,three,six months after the removing surgery. The axial length was also measured by intraocular lens (IOL) Master.Results 3D-CT showed that buckled eyeball depressed at the equator, resulting in a gourd-shaped eyeball. One month after removing the encircling buckle the depression disappeared. By 3D-CT scanning, the axial lengths of buckled eyes were (27.65plusmn;1.22), (27.3plusmn;1.56), (27.29plusmn;1.46) and (27.12plusmn;1.49) mm before and one, three, six months after the removing surgery respectively. The difference between before and after removing surgery was not statistically significant (t=2.89,P=0.723). By IOLMaster, the axial length of operated eyes were (28.32plusmn;1.94), (28.17plusmn;1.87), (28.21plusmn;1.94), (28.25plusmn;1.93） mm respectively. The difference between before and after removing the encircling band was not statistically significant (t=3.304, P=0.93). There was no significant difference in these two measuring modes (t=3.705,P=0.847).Conclusions Encircling buckling can cause eyeball indentation, removing the encircling band can rescue the indentation. There are no changes in the axial length before and after removing the encircling buckles.
ObjectiveTo assess the clinical efficacy of vitrectomy with intravitreal ranibizumab (IVR) at different injection time for proliferative diabeticretinopathy (PDR). MethodsThis was a prospective, comparative, and randomized study. Ninety-seven eyes of 97 patients were enrolled and randomly assigned to three different treatment groups: 30 eyes (30 patients) in the preoperative IVR group, 32 eyes (32 patients) in the intraoperative IVR group and 35 eyes (35 patients) in the no IVR injection group. The best corrected visual acuity (BCVA) (F=0.18) and the grading of vitreous hemorrhage (χ2=1.39) before surgery did not differ significantly among the 3 groups, respectively (P > 0.05). All eyes enrolled underwent conventional 23-gauge pars plana vitrectomy (PPV). The preoperative IVR group received intravitreal 0.5 mg/0.05 ml ranibizumab injection 3 to 7 days before PPV, intraoperative IVR group received intravitreal 0.5 mg/0.05 ml ranibizumab injection at the end of PPV and non-drug injection group received PPV only. Postoperative BCVA, fundus color photography, optical coherence tomography examination was performed in all eyes at 1 week and 1, 3, 6, 9, 12 months after surgery. Early RVH was defined as RVH occurred within 1 week to 1 month postoperatively; while late RVH was defined as RVH occurred 1 month later after the operation. ResultsThe mean BCVA were all improved among the 3 groups compared with the preoperative vision at 1 month after operation. At the beginning of 3 months after surgery, the average BCVA of the preoperative injection group and the intraoperative injection group tended to stable; while 3 eyes in the non-drug injection group began to decreased. There was no significant difference in average BCVA at 1, 3 and 12 months of follow-up periods among the 3 groups (F=1.42, 1.17, 0.26; P > 0.05). The incidences of early RVH were 16.7%, 9.4%, 28.6% in the preoperative injection group, intraoperative injection group, and non-drug injection group, respectively (χ2=5.12, P < 0.05). The incidence of early RVH in the intraoperative injection group reduced compared to preoperative injection group and non-drug injection group (χ2=4.04, 4.93; P < 0.05). The incidences of late RVH were 13.3%, 9.4%, 14.3% in preoperative injection group, intraoperative injection group, and non-drug injection group, respectively (χ2=0.47, P > 0.05). The average centeral foveal thickness (CFT) decreased among the 3 groups in different degrees at 1 month when compared with that of 1 week after operation and the decreasing was statistically significant (F=59.50, P < 0.05). A subgroup pairwise analysis showed no significant difference of decreasing CFT in preoperative injection group compared with that of intraoperative injection group (t=0.23, P > 0.05). The average CFT of the 3 groups had different degrees of thickening at 3, 6, 9, 12 months after surgery, and the increasingof CFT among the 3 groups were not differ significantly (F=2.92, 2.86, 3.07, 3.12; P > 0.05). ConclusionsThe adjunctive use of IVR can reduce the incidence of early postoperative RVH in vitrectomy for PDR, decrease in macular thickness and obtain favorable visual recovery. The effect of preoperative IVR injection was slightly better than that of the intraoperative IVR injection.
ObjectiveTo evaluate the effects of intravitreal ranibizumab therapy for serous pigment epithelial detachment (sPED) secondary to exudative age-related macular degeneration(eAMD). MethodsTwenty-three eyes from 23 patients of eAMD with sPED were enrolled in this study. The best corrected visual acuity, ocular coherence tomography (OCT), maximum PED height from baseline, volume of PED and central fovea thickness(CFT)were collected monthly for these patients. And the patients were receiced intravitreal injection with ranibizumab of 0.5 mg of three consecutive monthly injections. ResultsNo complications were observed during the study period. After 6 months follow-up, 17 eyes improved, 4 eyes unchanged and only 2 eye decreased. The best corrected visual acuity was from 0.77±0.39 up to 0.61±0.27(t=2.601, P < 0.05). It was observed by OCT that the PED height was decreased from (357.2±171.9)μm (before treatment) to (247.7±171.7)μm (after treatment) (t=3.192, P < 0.05) and the volume of PED was decreased from(0.741±1.012) mm3 to (0.337±0.498) mm3 (t=2.502, P < 0.05). The central foveal thickness was decreased from (317.9±73.8)μm to (302.5±89.3)μm, but the difference were no statistically significantly (t=0.887, P > 0.05). ConclusionRanibizumab may be an effective treatment for improving vision and reducing the degree of PED in eAMD patients.