Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography (FFA) for familial exudative vitreoretinopathy (FEVR). Methods 34 children (68 eyes) with FEVR and 64 parents (128 eyes) were included. All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy. Meanwhile the children were examined by RetcamⅡ,the best corrected visual acuity of parents were recorded. The children and their parents were classified according to the ocular findings. Among 68 eyes of children, 3 eyes (4.41%) were normal, 4 eyes (5.88%) were in stage 1, 7 eyes (10.29%) were in stage 2, 2 eyes (2.94%) were in stage 3, 8 eyes (11.76%) were in stage 4 and 44 eyes (64.71%) were in stage 5. Among 128 eyes of parents, 74 eyes (57.81%) were normal, 51 eyes (39.84%) were in stage 1, 1 eyes (0.78%) were in stage 2 and 2 eyes (1.56%) were in stage 5. FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage. Results FFA characteristics in children included uncompleted vascularization of the periphery, peripheral avascular zone (stage 1); neovascularization and/or peripheral subretinal and intraretinal exudation (stage 2); subtotal retinal detachment with attached fovea (stage 3); subtotal retinal detachment with detached fovea (stage 4) and total retinal detachment (stage 5). FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone (stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation (stage 2) and atrophia bulbi (stage 5). Conclusions FEVR in different stage has different FFA characteristics. FFA plays an important role in early diagnosis of FEVR.
Objective To observe the clinical effects of vitrectomy for advanced retinopathy of prematurity (ROP) and evaluate influence factors of anatomical recovery for stage 5 ROP. Methods Fifty-eight eyes of 40 infants with advanced ROP who underwent vitrectomy were retrospectively analyzed. There were 16 eyes of stage 4a, 7 eyes of stage 4b, and 35 eyes of stage 5 ROP. Eighteen eyes received laser photocoagulation, 2 eyes received cryotherapy, and 11 eyes received intravitreous injection of Bevacizumab (IVB) before surgery. The average follow-up time was 17.01 months. Anatomical outcome of retina after surgery was recorded by indirect ophthalmoscope and RetCamⅡ digital camera system. Visual outcome was measured by grating acuity test（lea gratingTM）, and was converted to Snellen acuity values for analysis. For those who cannot cooperate to accomplish the test, we use hand move, light perception and non-light perception to record visual outcome. ResultsAll 16 eyes of stage 4a were anatomically recovered (100.00%). 5/7 eyes of stage 4b were anatomically recovered (71.43%) and 2/7 eyes were anatomically failed(28.57%). 12/35 eyes of stage 5 were anatomically recovered (34.29%); 10/35 eyes were partial anatomically recovered (28.57%); 13 eyes were anatomically failed (37.14%). Anatomical outcome of stage 4a or 4b was better than stage 5 statistically（χ2=22.55，P＜0.05）. Of 16 eyes of stage 4a, 3 eyes were absent for visual function test. In the rest 13 eyes of stage 4a, VA of 6 eyes (46.15%) was between 0.03 and 0.07; 5 eyes (38.46%) were hand move; 2 eyes (15.39%) were light perception. Of 7 eyes of stage 4b, 2 eyes (28.57%) accomplished grating acuity test with VA of 0.008 and 0.017 respectively; 1 eye (14.29%) was hand move; 2 eyes (28.57%) were light perception; 2 eyes (28.57%) were nonlight perception. Of 35 eyes of stage 5, 5 eyes were absent for visual function test. In the rest 30 eyes of stage 5, VA of 2 eyes (6.67%) was 0.004; 4 eyes (13.33%) were hand move; 12 eyes (40.00%) were light perception; 12 eyes (40.00%) were non-light perception. Visual outcome of stage 5 was worse than stage 4a or 4b statistically（χ2=15.734，P＜0.05）.There was no statistically significant relationship between anatomical outcome and birth weight, gestational weeks, age at surgery, IVB therapy, laser or cryotherapy before surgery. ConclusionsVitrectomy can effectively control the lesions progress of stage 4a ROP, and achieve partially anatomically recovery of some stage 4b/5 patients. There was no statistically significant relationship between anatomical outcome and birth weight, gestational weeks, age at surgery, IVB, laser or cryotherapy before surgery.
Objective To observe the expression of erythropoietin (EPO) and its receptor (EPOR) mRNA and protein levels in retinae of mice with oxygen-induced retinopathy, and to evaluate the effect of EPO and EPOR in retinal vascular develo pment and in the occurrence and development of oxygen-induced retinopathy. Methods One hundred and thirty-two 7-day-old C57BL/6J mice were divided into two g rou ps: normal control group (control group) and oxygen-induced retinopathy group (experimental group). The proliferative neovascular response was estimated by obse rving the vascular pattern in adenosine diphosphatease (ADPase) stained retina flat-mounts by executing 6 mice in each group at the 12th, 15th, and 17th day, respectively. The expression of EPO, EPOR mRNA was determined by reverse transcription-polym erase chain reaction (RT-PCR), and the protein levels of EPO and E PO R were determined by immunohistochemistry. RT-PCR and immunohistochemistry were done every other day from the 7th to the 21st day. Results In the control group, retinal vascularization was found. In the experimental group, the large vesse ls were constricted straight, the branches decreased, and alarge nonperfusion area was observed at the 12th day; the large vessels were dilated and tortuous and neovascularization occurred at the 15th day; a mass of neovascularization was found and the vascular net structure of the deep and shallow layer was destroye d at the 17th day. The expression of EPO mRNA decreased from the 7th day and kee p decreasing in the whole oxygen-breathing duration in the experimental group. A fter the mice were returned to room air, the expression increased obviously from the 15th day and kept the high level until the 21st day. The expression of EPO mRNA increased at the 7th day and reached the peak at the 11th day, and kept the high level until the 21st day. The changes of protein levels of these three fac tors were later than that of their mRNA, but had the same trend. The difference of the expression between the two groups at the different time point was signifi cant except for the 7thday point (Plt;0.05). Conclusion It 's suggested that EPO and EPOR played important roles on the development of normal retina vascularizati on and the pathogenesis of ROP, which may provide new conception and method for the prevention and treatment of the oxygen-induced retinopathy.
“The international classification of retinopathy of prematurity (ROP)(The 3rd edition)”, retains current definitions such as zone, stage, and circumferential extent of disease, however, there are also many updates. Major updates include: (1) increase of the definition of posterior pole Ⅱ; (2) introduction of a new concept "notch"; (3) definition of stage 5's subcategorization; (4) recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease. Updates also include the definition of “aggressive ROP” to replace “aggressive-posterior ROP”. ROP regression and reactivation are described in detail, with additional description of long-term sequelae.