Central Macular Retinal Thickness Research Articles

Application of optical coherence tomography angiography in the assessment of diabetic macular edema staging and laser photocoagulation efficacy

ObjectiveThis study aimed to analyze the effect of optical coherence tomography angiography (OCTA) on diabetic macular edema (DME) staging and assess the efficacy of laser photocoagulation. MethodsEighty-six patients (141 eyes) with suspected DME who visited our hospital from August 2019 to March 2022 were selected and underwent fundus angiography and OCTA. The two examination methods were compared in terms of their efficacy in macular edema staging. Subsequently, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of OCTA in diagnosing DME were assessed using fundus angiography as the gold standard. In patients with clinically significant macular edema (CSME) treated with laser photocoagulation, the central concave non-perfused zone (FAZ), vascular density (VD), central macular retinal thickness (CRT), whole retinal blood flow density (FD-300), superficial capillary plexus (SCP), and deep capillary plexus (DCP) were measured using the OCTA 3 mm × 3 mm mode before treatment, at 3 months after treatment, and at 6 months after treatment. SCP, deep capillary plexus (DCP), blood flow density (VD), best corrected visual acuity (BCVA), and central retinal thickness (CRT) were recorded before treatment, 3 months after treatment, and 6 months after treatment. The correlation between BCVA and pre-treatment OCTA parameters at 6 months after treatment was analyzed using Pearson's correlation. ResultsFundus angiography was performed in 86 patients (141 eyes) with suspected DME. Of the 141 eyes, 44 had no leakage, 52 had diffuse edema, 40 had focal macular edema, and 5 had eyes ischemia. A total of 97 eyes showed CSME on fundus angiography. Using fundus angiography as the gold standard, OCTA exhibited a sensitivity of 97.94 %, a specificity of 63.64 %, and an accuracy of 87.23 % in diagnosing CSME. The Kappa value between OCTA and fundus angiography was 0.674. The receiver operating characteristic curve revealed that the area under the curve (AUC) of OCTA in diagnosing CSME was 0.808 (95 % confidence interval: 0.717–0.899). The BCVA was higher, while the CRT was lower in CSME patients at 3 and 6 months after treatment (P<0.05). No significant difference was observed in the OCTA parameters in CSME patients at 3 months after treatment compared with that before treatment (P>0.05). Similarly, no significant difference was found in the FD300 of CSME patients at 6 months after treatment compared with that before treatment (P>0.05). However, the FAZ area, DCP-VD (overall, central concave, and paracentral concave), and SCP-VD (overall, central concave, and paracentral concave) were higher in CSME patients at 6 months after treatment compared with that before treatment (P<0.05). Pearson's correlation showed that BCVA was positively correlated with pre-treatment FAZ area, DCP-VD, and SCP-VD (r>0, P<0.05), and negatively associated with CRT (r<0, P<0.05). ConclusionOCTA exhibited high sensitivity and specificity in diagnosis and staging DME. It adeptly captures the microvascular and visual changes in the central macular recess before and after laser photocoagulation therapy, which can quantitatively guide the follow-up treatment of DME.

Efficacy and safety of intravitreal injections of conbercept for the treatment of idiopathic choroidal neovascularization.

To determine the efficacy and safety of intravitreally injected conbercept, a vascular endothelial growth factor receptor fusion protein, for the treatment of idiopathic choroidal neovascularization (ICNV). This retrospective study analyzed outcomes in 40 patients (40 eyes) with ICNV who received intravitreal injections of conbercept 0.5 mg (0.05 ml) and were followed up for at least 12 months. All patients underwent full ophthalmic examinations, including best-corrected vision acuity (BCVA), intraocular pressure (IOP), slit-lamp examination, color fundus photography, optical coherence tomography angiography, multifocal electroretinogram, and fundus fluorescence angiography, if necessary, at baseline and after 1, 3, 6, and 12 months. BCVA, macular central retinal thickness (CRT), IOP, CNV blood flow area, thickness of the CNV-pigment epithelial detachment complex, thickness of the retinal nerve fiber layer (RNFL), and the first positive peak (P1) amplitude density in ring 1 before and after treatment were compared. Mean baseline BCVA (logMAR), CRT, CNV blood flow area, and CNV-pigment epithelial detachment complex thickness were significantly lower 1, 3, 6, and 12 months after than before conbercept treatment (P < 0.05 each). IOP and baseline RNFL thickness were unaffected by conbercept treatment. P1 amplitude density was significantly higher 1, 3, 6, and 12 months after than before conbercept treatment (P < 0.05 each). None of the 40 eyes showed obvious ocular adverse reactions, such as endophthalmitis, glaucoma, cataract progression, and retinal detachment, and none of the patients experienced systemic adverse events, such as cardiovascular and cerebrovascular accidents. Intravitreal injection of conbercept is beneficial to eyes with ICNV, inducing the recovery of macular structure and function and improving BCVA, while not damaging the neuroretina. Intravitreal conbercept is safe and effective for the treatment of ICNV.

Thinning of the retinal nerve fiber and choroidal layers in adolescents with anorexia nervosa: A controlled study.

We aimed to evaluate retinal nerve fiber and choroidal layer alterations in adolescents with anorexia nervosa using spectral-domain optical coherence tomography. Thirty patients with anorexia nervosa and 30 healthy adolescents aged 12-18 years were included in this study. Their age, sex, body mass index, anorexia nervosa type, disease duration, and spectral-domain optical coherence tomography data were recorded. Central macular thickness and retinal nerve fiber layer thickness in the temporal and inferior regions were significantly lesser in patients with anorexia than in healthy controls (p<0.05). Moreover, significant choroidal thinning around the foveal and subfoveal regions in patients with anorexia was observed (p<0.05). In addition, a statistically significant relation between the increase in disease duration and the thinning of the inferior retinal nerve fiber layer was detected (p<0.05). The retinal nerve fiber layer and choroidal layer thicknesses were lesser in patients with anorexia than in healthy controls. Screening for retinal indices might prevent the development of irreversible retinal pathologies in adolescents with anorexia nervosa. In addition, thinning of the retinal nerve fiber and choroidal layers could reflect structural or functional changes in the brain of adolescents with anorexia nervosa.

Clinical Features, Treatment, and Visual Outcomes of Posterior Scleritis from Tertiary Eye Care Center

ABSTRACT Purpose To describe the epidemiological and clinical features and course of patients with posterior scleritis (PS). Methods This retrospective, cross-sectional consecutive case series analyzed the medical records of 16 patients diagnosed with PS. Results Female gender and unilateral involvement were dominant. Blurred vision (84.21%) and ocular pain (78.95%) were the most common presenting complaints. Serous retinal detachment was the most common ocular finding (84.21%), followed by optic disc swelling (42.11%). Increased scleral thickness was observed in all patients, although a T-sign was detected 8 of 19 eyes (42.1%). Recurrence occured in 5 of 19 eyes in mean 30.2 ± 34.7 months. Central macular thickness, choroidal thickness, and retinal nerve fiber layer thickness were reduced with treatment at final examination significantly (p = .005, .002, and .002, respectively). Conclusions PS should be considered in patients presenting with unilateral ocular pain and decreased vision. Not only USG findings but also OCT findings are very useful in the follow-up of treatment response.

Towards a population pharmacokinetic/pharmacodynamic model of anti-VEGF therapy in patients with age-related macular degeneration

PurposeTo develop a population pharmacokinetic/pharmacodynamic model (popPKPD) of intravitreal bevacizumab treatment for neovascular age-related macular degeneration (nAMD) patients to learn about the PK/PD relationship and utilise it for dosing regimen decisions on future nAMD patients. MethodsThe Greater Manchester Avastin for Neovascularisation (GMAN) randomised clinical trial data was retrospectively utilised, and the best-corrected visual acuity (BCVA) and central macular retinal thickness (CRT, measured by optical coherence tomography) were the PD inputs to the model. Using the nonlinear mixed-effects method, the best PKPD structural model was investigated, and the clinical significance of the two different dosing treatment regimens (as-needed versus routine) was evaluated. ResultsA structural model to describe the change of BCVA from the baseline of nAMD patients was successfully obtained based on the turnover PD model concept (drug stimulates the “visual acuity response production”). The popPKPD model and simulation indicate that the routine regimen protocol improves patient visual outcome compared to the as–needed protocol.For the change in CRT, the turnover structural PKPD model was too demanding to fit to the given clinical data. ConclusionsThis is the first popPKPD attempt in nAMD treatment that shows the potential of this strategy to understand/inform the dosing regimen. Clinical trials with richer PD data will provide the means to build more robust models.

Treatment Outcomes of Suprachoroidal Triamcinolone Injection in Refractory Diabetic Macular Edema

Purpose: To find out the outcomes of suprachoroidal Triamcinolone injection in refractory diabetic macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Al-Ehsan Eye Hospital, Lahore from Jan 2020 to 31st Dec 2020. Methods: Sixty-five patients with refractory diabetic macular edema were included. Patients underwent complete ocular history and examination. To document baseline macular edema, SD-OCT was done. The recruited patients received 0.1ml of suprachoroidal Triamcinolone injection (40mg/ml) using a 30 gauge syringe. Follow up was performed at one week, one month and third month after injection. At each follow up, best corrected visual acuity, central macular thickness and retinal nerve fiber thickness were documented. Data was analysed using SPSS version 36.0. Comparison of BCVA, central macular thickness and retinal nerve fibre layer thickness (RNFL) before and after injection was analyzed by paired sample t-test with p value of ≤ 0.05 as significant. Results: Out of 65 patients, 29 (44.62%) were females. Mean age of patients was 54 ± 8.4 years (range 40 to 80 years). Central macular thickness after suprachoroidal Triamcinolone injection changed from 556.2 ± 10.9 to 313.6 ± 7.2 ųm. Change in visual acuity was 0.9 ± 0.01 to 0.6 ± 0.02. Pre-treatment and post-treatment visual acuities demonstrated a substantial change after undergoing treatment along with decrease in central macular thickness with p value ˂ 0.001. Conclusion: Suprachoroidal Triamcinolone injection results in anatomical as well as functional improvement in diabetic patients with refractory macular edema.

Retinal Changes in Panic Disorder Patients

AimOptical coherence tomography (OCT) is a novel method that allows high resolution cross-sectional imaging of biological tissues. It was suggested that changes in the cranial structure or functions would be reflected in the retina. OCT has been an important method in the diagnosis and follow-up of diseases via morphometric or quantitative retinal measurements. Panic disorder (PD) is an anxiety disorder, where free radicals, inflammatory processes and neurotransmitter transmission disorders play a role in the etiology. The present study aimed to demonstrate neurodegeneration in PD by the comparison of PD patient and control OCT data. Material and MethodThe study group included 21 PD patients who met the study criteria. The control group included 21 healthy individuals without any known psychiatric or organic disease, including eye disease, and gender-matched to the patient group. All participants underwent detailed psychiatric and eye examinations. Central macular thickness (CMT), macular volume (MV), mean and retinal nerve fiber layer thickness (RNFL), ganglion cell layer thickness (GCLT), and central choroidal thickness (CCT) were measured in both eyes of all participants with OCT. A sociodemographic data form, Clinical Global Impression Scale (CGIS), and Panic Disorder Severity Scale (PDSS) were administered to the participants. ResultsIn the study, it was determined that the CMT values of the PD patients were lower when compared to the controls in the OCT examination. There was a statistically significant difference between the CMT of the PD patient group and the control group; the CMT was lower in the patient group. There were no significant differences between the groups based on GCLT, RNFL superior, RNFL inferior, RNFL nasal, RNFL temporal, and CCT. There was no significant correlation between CGIS, PDSS scores and OCT measurements. ConclusionThis is the first study in the literature where patients with a PD diagnosis were analyzed based on the OCT method. OCT, which is a simple, noninvasive and relatively inexpensive method that the patient could easily adapt to during imaging, could be employed as a supplementary method in the diagnosis and follow-up of PD patients.

Changes in optical coherence tomography angiography in patients with vitamin D deficiency.

25-hydroxyvitamin D [25(OH)D] sufficiency has critical biological importance for the human body. Although there are several studies on the association between serum 25(OH)D levels and macular structure, the data in this regard are limited. This study mainly aimed to investigate macular microvascular structure using optical coherence tomography angiography (OCTA) in 25(OH)D deficiency. Prospective, single-center, clinical study. The study included 82 eyes of 82 patients with 25(OH)D deficiency (Group I) and 50 eyes of 50 healthy subjects (Group II). All participants underwent OCTA examinations. The foveal avascular zone (FAZ) and superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density (VD) measurements of the participants were statistically compared between the patients and healthy subjects. The mean 25(OH)D levels measured from the venous blood samples of the participants were 7.61 ± 3.27 ng/mL in Group I and 25.39 ± 4.16 ng/mL in Group II, and the difference between these values was statistically significant (p < 0.0001). The FAZ measurement was significantly higher in Group I. The VDs of the SCP and DCP measurements were significantly higher in Group II. When the central macular thickness values of the participants were compared, Group II had a significantly higher value, but there was no significant difference in the central macular volume and retinal nerve fiber layer thickness analyses. The results showed that the FAZ area was significantly higher and the VDs of SCP and DCP were significantly lower in the patients with 25(OH)D deficiency. We found that 25(OH)D deficiency affected macular microvascular architecture.

Study on BCVA, CMT, CME, Curative Effect, and Prognostic Value of DR Sufferers Based on Surgical Therapy Combined with VEGF Therapy at Different Times.

In order to explore the efficacy and prognostic value of best corrected visual acuity (BCVA), central macular retinal thickness (CMT), and cystoid macular edema (CME) in diabetic retinopathy (DR) sufferers based on surgical therapy combined with vascular endothelial growth factor (VEGF) therapy at different times, a total of 170 cases of DR sufferers who visited our hospital from March 2019 to March 2021 are analyzed. All patients are randomly divided into control group and study group, with 85 cases and 85 eyes in each group. In addition, the contrast set received 2 therapies for 1.5 months/time, and the study set received 3 therapies for 1 month/time. The experimental results show that the BCVA of the two sets is notoriously enhanced. Besides, CMT and CME in the study set decrease more than those in the contrast set, and the blood vessel density of retinal capillaries in the contrast set and the examination set is notoriously enhanced. For DR sufferers, 1 month/time of anti-VEGF therapy can effectively enhance the sufferers' visual acuity, CMT and CME. It is suggested that the clinical application of 1 month/time of anti-VEGF to DR sufferers can enhance the clinical therapeutic effect of sufferers and reduce the prognosis and recurrence.

Effect of Duration of Silicone Oil Tamponade on Retinal Structure after Rhegmatogenous Retinal Detachment Surgery

Purpose: The aim of the study was to investigate the effect of tamponade duration on retinal changes induced by silicone oil (SO) in patients who underwent successful rhegmatogenous retinal detachment (RRD) surgery. Methods: Retrospective comparative case series of 68 patients who underwent SO tamponade for RRD. Patients were divided into 2 groups based on timing of SO removal: <6 months (group 1, n = 34) versus ≥6 months (group 2, n = 34). The main outcome measure was the change in central macular, inner, and outer retinal layer thickness (CMT, IRLT, and ORLT) before and after SO removal (SOR). Results: The median tamponade duration was 4 [Clin Ophthalmol. 2016;10:471–6, Zhonghua Yan Ke Za Zhi. 1997 Jan;33(1):39–41] months in group 1 and 8 [Arch Ophthalmol. 1994 Jun;112(6):778–85, Retina. 2004 Dec;24(6):871–7] months in group 2 (p < 0.001). The mean CMT significantly increased from 245.3 ± 22.2 μm and 238.8 ± 41.6 μm under SO to 281.3 ± 60.2 μm and 259.0 ± 43.5 μm after SOR in group 1 (p = 0.009) and in group 2 (p = 0.007), respectively. Automated segmentation measurement revealed a significant increase in mean IRLT (p = 0.014 and p = 0.013) but no change in mean ORLT (p = 0.080 and p = 0.257) in both groups. After adjustment, there was no difference between the 2 groups in terms of mean final CMT, IRLT, and ORLT and mean retinal thickness changes after SOR. There was also no correlation between the tamponade duration and macular microstructural changes or visual recovery. Conclusion: SO tamponade causes a thinning of all retinal layers, mainly affecting the inner retinal layer. However, these changes resolved following SO extraction and were not affected by longer tamponade duration.

Changes of retinal thickness in macular area of myopia children

Objective: To study the changes of macular retinal thickness in children with moderate and low myopia by frequency domain OCT. Methods: 108 school-age children aged 7-12 years were selected and enrolled into the group. Among them, 58 cases (116 eyes) with simple moderate and low myopia in the myopia group and 50 cases (100 eyes) with straight eyes in the emmetropia group. The retinal thickness in different parts of macular area was compared between the two groups, and the correlation between retinal thickness in different parts of macular area and diopter and axial length was analyzed by Pearson correlation analysis. Results: The length of eye axis in moderate and low myopia group was longer than that in emmetropia group, and the difference was statistically significant (P &lt; 0.05). There was no significant difference in CMT(Central Macular Thickness) and I-AMT(average macular thickness of inner circle) between the two groups (P &gt; 0.05). The AMT(Average Macular Thickness) and O-AMT(average macular thickness of outer circle) in moderate and low myopia group were lower than those in emmetropia group, and the differences were all statistically significant (P &lt; 0.05). The thickness of the retina below the macula and the nasal side was positively correlated with the refractive power in patients with moderate to low-grade myopia (r=0.201, 0.302, P＜0.05), and the thickness of the retina around the macula was negatively correlated with the refractive power (r=-0.326, P＜0.05). Conclusion: There is no significant difference in macular central retinal thickness between children with moderate and low myopia and normal children, and the thickness of paracentral retina tends to become thinner with the deepening of myopia.

Angiogenin, FGF-\u03b1, and IL-36\u03b2 have higher expression levels in aqueous humor of nAMD patients in comparison to cataract patients

BackgroundNumerous cytokines have been proven to participate in the pathogenesis of neovascular age-related macular degeneration (nAMD). The present study aimed to investigate the aqueous humor cytokine expression profile in nAMD patients before and after ranibizumab treatments in comparison to cataract patients.MethodsThis prospective study included 20 treatment-naïve nAMD eyes of 20 patients who received three consecutive monthly injections of ranibizumab. Aqueous humor samples were collected before the first (baseline), second (1 month later), and third (2 months later) injections. Controls were 20 age- and gender-matched cataract patients without any other ocular disease. The aqueous concentrations of 28 cytokines were measured using a multiplex bead assay. Central macular thickness (CMT) and maximum retinal thickness (MRT)-3 mm were measured by spectral domain optical coherence tomography (SD-OCT). The greatest linear diameter (GLD) was measured by fundus fluorescein angiography (FA).ResultsThree cytokines in aqueous humor, including angiogenin, interleukin-36β (IL-36β), and fibroblast growth factor-acidic (FGF-α) were significantly higher in nAMD patients in comparison to cataract patients, both before and after two consecutive monthly ranibizumab injections. Compared with the nAMD patients’ basal levels, two consecutive monthly ranibizumab injections effectively reduced the aqueous concentrations of VEGF-A and placental growth factor (PlGF), as well as the values of CMT, MRT-3 mm, and GLD.ConclusionsAngiogenin, IL-36β, and FGF-α have higher expression levels in nAMD patients in comparison to cataract patients, both before and after 2 months of ranibizumab therapy. These cytokines may have correlations with the pathogenesis of nAMD.

The effects of nasal septum deviation on eye posterior segment finding

Aim: Deviation of the nasal septum, which can cause upper respiratory tract obstruction and systemic hypoxia, may also affect the eye. The aim of this study was to detect changes in posterior segment parameters of the eye in patients with nasal septal deviation. Material and Methods: The study included 50 patients with nasal septal deviation, and a control group of 30 healthy subjects with no nasal septal deviation. Choroidal thickness, central macular thickness and retinal nerve fiber layer thickness were measured with Optical Coherence Tomography.Results: Choroidal thickness was significantly lower in patients with severe nasal septal deviation compared to the control group. (p=0.001) There is no statistically significant change in other measurements.Conclusion: The study results suggest that marked nasal septal deviation may lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.

Clinical observation on the efficacy of intravitreal injection of conbercept in the treatment of macular edema

Objective To observe the efficacy of intravitreal injection of conbercept in the treatment of macular edema secondary to branch retinal vein occlusion. Methods The data of 33 eyes of 33 patients with macular edema secondary to retinal branch vein occlusion (BRVO-ME) from Jan.2018 to Dec.2018 were retrospectively analysed. The followed-up time was 3 months. Results BCVA(logMAR) were improved at 1, 2, and 3 months after injection, and the difference were statistically significant between before and each time after injection(Z=4.948, 4.642, 4.305, P=0.000, 0.000, 0.000). Central macular retinal thickness (CMT) decreased at 1, 2, and 3 months after injection, and the difference were statistically significant(Z=4.315, 4.404, 4.387, P=0.000, 0.000, 0.000). Conclusion Intravitreal injection of conbercept can improve vision and reduce macular edema in the treatment of retinal branch vein occlusion secondary to macular edema in a short period of time. Key words: Occlusion, vein, retinal; Edema, macular; Conbercept, injection, intravitreal

Assessment of retinal thickness as a marker of brain masculinization in children with congenital adrenal hyperplasia: a pilot study.

Objective To investigate the relationship between brain masculinization and retinal thickness in children with congenital adrenal hyperplasia (CAH). Methods Forty-five patients with CAH aged between 4 and 18 years and 30 age-matched healthy controls were included in this prospective study. Macular area was examined with optical coherence tomography (OCT); central subfield thickness (CST), cube volume (CV) and macular retinal thickness (MT) were measured in each subject. A gender identity questionnaire (GIQ) was used for the evaluation of gender happiness index. Results Girls with CAH had a higher CV (p = 0.002) and MT (p = 0.003) than healthy girls. No significant difference was found between boys with CAH and healthy boys regarding the retinal thickness measurements. Mean CST, CV and MT were significantly higher in boys than in girls in the control group (p = 0.013, p < 0.001, respectively), but there was no significant difference in those parameters between girls and boys with CAH. The gender happiness index was not different between healthy boys and boys with CAH, but was significantly lower in girls with CAH than healthy girls (p = 0.01). Conclusions As retina is part of the brain, our finding appears to be a morphological evidence of the excess androgen exposure on brain structures in girls with CAH. In addition, we suggest using retinal thickness measurements as a marker of prenatal excess androgen exposure in future studies.

Observation of Conbercept combined with laser photocoagulation for macular edema caused by branch retinal vein occlusion

Objective To observe the clinical efficacy of intravitreal injection of Conbercept combined with laser photocoagulation for the treatment of macular edema caused by ischemic type of branch retinal vein occlusion. Methods The data of 48 eyes of 48 patients with macular edema caused by ischemic type of branch retinal vein occlusion from Jun.2014 to Apr.2018 were analyzed retrospectively. All cases were divided into observation group and control group according to hospital sequence, 24 eyes of 24 cases in each group. Observation group was treated with intravitreal injection of Conbercept combined with laser photocoagulation, and the control group was treated with laser photocoagulation. The best corrected visual acuity (BCVA), central macular retinal thickness(CMT) and complications of two groups were observed before and 1 week, 1, 3 months after treatment. Results The difference of BCVA and CMT was significant between the two groups during the follow-up (P<0.05). The visual acuity was improved and the CMT was reduced. Conclusion Intravitreal injection of Conbercept combined with laser photocoagulation in the treatment of macular edema caused by ischemic type of branch retinal vein occlusion can improve the visual acuity, reduce macular edema and prevent complications. Key words: Occlusion, vein, branch, retinal; Edema, macular; Conbercept, intravitreal injection; Photocoagulation, laser

Intravitreal Ranibizumab injection combined with Atorvastatin in the treatment of hyperlipidemic diabetic macular edema

Objective To observe the clinical efficacy of intravitreal injection of Ranibizumab combined with oral Atorvastatin in the treatment of hyperlipidemic diabetic macular edema (DME). Methods The data of 40 eyes of 40 patients with hyperlipidemic DME were analyzed retrospectively. All cases were randomly divided into treatment group and control group, in 20 eyes each group. The control group was treated with intravitreal injection of Ranibizumab, 1 time per month for 3 months. The treatment group was treated with intravitreal injection of Ranibizumab combined with oral Atorvastatin, 1 time a day, each time 10 mg, for 3 months.The efficacy was evaluated between the two groups. Results The BCVA and central macular retinal thickness (CMT) of the two groups were significantly improved at 1, 3 and 6 months after treatment(P 0.05). The difference of CMT was statistically significant between the two groups at 6 months after treatment (P=0.049). The hard exudates reducing rate was 70.00% in treatment group at 6 months after treatment and 25.00% in control group. The difference was statistically significant(P=0.004). Conclusion Intravitreal injection of Ranibizumab combined with oral Atorvastatin can effectively reduce the leakage of retina and macular edema, improve visual acuity and promote the absorption of hard exudates. Key words: Atorvastatin, oral; Ranibizumab, intralitreal injection; Macular edema, diabetic, hyperlipidemic

Relationship between erythrocyte sedimentation rate and choroidal and retinal thickness in Behçet's disease.

To compare retinal and choroidal thickness in patients with Behçet's disease with and without ocular involvement as well as to evaluate the correlation between erythrocyte sedimentation rate and choroidal thickness among patients with Behçet's disease. This was a prospective interventional study investigating erythrocyte sedimentation as well as choroidal and retinal thickness among patients with Behçet's disease. Patients who were diagnosed based on The International Criteria for Behçet's Disease with (Group A) or without (Group B) ocular involvement and a matched control group (Group C) participated in the study. Optical coherence tomography measurements and blood tests were performed on the same day. Retinal and choroidal thickness were measured using spectral-domain optical coherence tomography (Spectralis, Heidelberg Engineering, Heidelberg, Germany), and central macular thickness, central subfoveal choroidal thickness, and retinal nerve fiber layer thickness were measured using optical coherence tomography. Average erythrocyte sedimenta-tion values were 9.89 mm/h in Group A, 16.21 mm/h in Group B, and 3.89 mm/h in Group C; average central subfoveal choroidal thickness values were 350.66, 331.74, and 325.95 mm, respectively. Average central macular thickness and retinal nerve fiber layer thickness values of patients in Groups A, B and C were 226.39 and 225.97mm; 234.11 and 92.00 mm; and 97.58 and 99.84 mm, respectively. No significant difference was seen between Group A and B patients in central subfoveal choroidal thickness, central macular thickness, or retinal nerve fiber layer thickness values. Central macular thickness was statistically significantly thinner in Groups A and B than in Group C (p=0.016). Group A had thinning in the nasal quadrant of the retinal and general retinal nerve fiber layers when compared with those in Group C (p=0.010 and 0.041, respectively). A connection could not be established between the erythrocyte sedimentation, central subfoveal cho-roidal thickness, central macular thickness, and retinal nerve fiber layer thickness in the patients with Behçet's disease. The erythrocyte sedimentation rate is typically used to test for activation of Behçet's disease and assess treatment response. In our study, we could not establish a connection between the erythrocyte sedimentation rate and central subfoveal choroidal thickness, central macular thickness, and retinal nerve fiber layer thickness in patients with systematically active Behçet's disease without ocular involvement.

Panretinal photocoagulation combined with calcium dobesilate in the treatment of proliferative diabetic retinopathy

Objective To evaluate the efficacy of panretinal photocoagulation (PRP) combined with oral calcium dobesilate in the treatment of proliferative diabetic retinopathy (PDR). Methods The data of 160 eyes of 80 patients with PDR were selected and analyzed retrospectively. All cases were divided into two groups randomly.Eighty eyes of 40 patients in combination group were treated with PRP combined with calcium dobesilate, and 80 eyes of 40 patients in control group were treated with PRP only.The follow-up time was 6 months. Results The total efficacy rate of the combination group(95.0%) was better than that of the control group(83.8%) (P=0.040). The difference in BCVA was not statistically significant between 2 groups before surgery (P=0.649). The BCVA in the combination group was better than that of the control group in 1 month after operation (P=0.014). The difference in central macular thickness and macular retinal thickness were not significant between the 2 groups before and after operation(P=0.920, 0.896). The neovascularization and fluorescein leakage area value of the combination group was less than that of the control group(P=0.043). Conclusion PRP combined with oral calcium dobesilate in treatment of PDR is effective. Key words: Photocoagulation, panretinal; Retinopathy, diabetic, proliferative; Calcium dobesilate, oral; Function, visual

Efficacy of intravitreal injection of Ranibizumab for macular edema secondary to retinal vein occlusion

Objective To evaluate the efficacy of intravitreal injection of Ranibizumab for the treatment of macular edema secondary to retinal vein occlusion(RVO). Methods Forty-four eyes of 44 cases with macular edema secondary to RVO from Mar. 2016 to Jul. 2017 were collected and they received intravitreal injection of Ranibizumab. The subfoveal choroidal thickness and central macular retinal thickness were examined by SD-OCT before injection and 1, 3, 6 month after injection. The change of subfoveal choroidal thickness and central macular retinal thickness after injection were evaluated, and the factors related to thickness change: age, history of hypertension, smoking, drinking, site of occlusion, time of onset and preoperative conditions were evaluated. Results The subfoveal choroidal thickness and the central retinal thickness 1, 3, 6 months after injection were less than that before surgery (all P<0.05). The change of the subfoveal choroidal thickness was related to the subfoveal choroidal thickness preoperative.The change of the central retinal thickness was related to the central retinal preoperative, site of occlusion and the disease time. Conclusion The intravitreal injection of Ranibizumab is effective for the macular edema secondary to RVO. Key words: Ranibizumab, intravitreal injection; Macular edema, retinal vein occlusion; Choroidal thickness, subfoveal; Retinal thickness, macular