中华眼科杂志最新文献

{"title":"[Clinical effect of XEN gel stent implantation or combined with phacoemusification and intraocular lens implantation on glaucoma].","authors":"B Zhang, X L Shen, X P Wang, D Gong, J H Guo, J T Wang","doi":"10.3760/cma.j.cn112142-20231223-00304","DOIUrl":"https://doi.org/10.3760/cma.j.cn112142-20231223-00304","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of internal XEN gel stent implantation or combined with phacoemusification and intraocular lens (IOL) implantation in the treatment of glaucoma. <b>Methods:</b> It was a retrospective case series study. Forty-five patients (28 males and 17 females; 52 eyes) who had different types of glaucoma treated at the Shenzhen Eye Hospital from December 2021 to June 2023 were included. XEN gel stent implantation (the XEN group) or XEN implantation combined with phacoemusification and IOL implantation (the combined group) were performed in these patients. The postoperative follow-up was 18 months. The observational indexes included the best corrected visual acuity (recorded as the logarithm of the minimum angle of resolution), intraocular pressure (IOP), XEN implantation quadrant, number of IOP-lowering medications, corneal endothelial cell count, operation success rate and surgical complications. The one-way repeated measures of variance, LSD-<i>t</i> test, and rank sum test were used for statistical analysis. <b>Results:</b> There were 28 patients (33 eyes) in the XEN group and 17 patients (19 eyes) in the combined group. The postoperative best corrected visual acuity had no significant change in the XEN group, but improved significantly (0.21±0.30 at 6 months; <i>P</i><0.05) in the combined group, compared with the preoperative value. The IOP of the two groups at 18 months after surgery [(12.2±3.1) and (11.9±3.9) mmHg (1 mmHg=0.133 kPa)] was significantly lower than that before surgery [(22.1±8.5) and (19.4±10.2) mmHg; <i>P</i><0.05]. The average number of IOP-lowering medications in all patients was 3 (2, 3) before surgery and 0 (0, 0) at 18 months after surgery. The difference was statistically significant (<i>P</i><0.05). In the XEN group, the corneal endothelial cell count was (2 387.37±478.22) cells/mm² preoperatively and (2 193.89±311.96) cells/mm² at 12 months. The decrease showed no statistical significance. The XEN gel stent was implanted in the supranasal quadrant in 8 eyes (15.4%), in the inferonasal quadrant in 36 eyes (69.2%), and in the infratemporal quadrant in 8 eyes (15.4%). The operation success rate [complete success rate, 86.5% (45/52); conditional success rate, 9.6% (5/52)] was 96.2% (50/52). The filtering bleb scarring occurred in 9.6% (5/52) of eyes. A small amount of hyphema, postoperative shallow anterior chamber, transient hypertension, and intraoperative drain breakage were found in 7.7% (4/52) of eyes, respectively. A small amount of subconjunctival bleeding was observed in 5.8%(3/52) of eyes. Re-implantation of an XEN gel stent was performed in 5.8% (3/52) of eyes. The intraoperative conjunctival tissue rupture, hypotony macular edema, and drain exposure were observed in 1.9% (1/52) of eyes, respectively. <b>Conclusion:</b> The XEN gel stent implantation or combined with phacoemusification and IOL implantation was effective and safe in treating different types of glau","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"746-756"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pharmacokinetics of intravitreal anti-VEGF drugs in vitrectomized eyes].","authors":"J Zhu, J Liu, R R Zhu","doi":"10.3760/cma.j.cn112142-20231018-00153","DOIUrl":"10.3760/cma.j.cn112142-20231018-00153","url":null,"abstract":"<p><p>Neovascular retinal diseases pose a significant burden, often resulting in visual impairment. Intravitreal injection of anti-vascular endothelial growth factor (VEGF) drugs serves as the primary therapeutic approach. Nonetheless, certain patients necessitate continued anti-VEGF treatment post-vitrectomy or other ocular surgeries. Emerging evidence suggests that variations in surgical techniques and postoperative vitreous cavity management may induce distinct intraocular pharmacokinetics (PK) of anti-VEGF agents following vitrectomy, prompting potential adjustments in therapeutic strategies. This review offers a thorough examination of the pharmacokinetic determinants impacting anti-VEGF drugs and their intraocular dynamics post-vitrectomy.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"787-792"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Fully recognizing selective laser trabeculoplasty].","authors":"L L Wu","doi":"10.3760/cma.j.cn112142-20240521-00229","DOIUrl":"https://doi.org/10.3760/cma.j.cn112142-20240521-00229","url":null,"abstract":"<p><p>Selective laser trabeculoplasty (SLT), as one of the main methods for the treatment of open-angle glaucoma, has again aroused wide concern in recent years. Although SLT has a clear effect on reducing intraocular pressure, its role needs to be fully recognized. In order to provide guidance for the clinical SLT practice, this article summarizes and discusses the current status of SLT treatment for glaucoma, its therapeutic effects on primary open-angle glaucoma, ocular hypertension, and other types of glaucoma, surgical details, and application prospects.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"723-727"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Focusing on issues about phacoemulsification lens extraction combined with goniosynechialysis].","authors":"X H Sun, Y Dai","doi":"10.3760/cma.j.cn112142-20240609-00259","DOIUrl":"10.3760/cma.j.cn112142-20240609-00259","url":null,"abstract":"<p><p>Angle closure is a basic pathological process in primary angle-closure glaucoma. Unlike filtration anti-glaucoma surgery, goniosynechialysis is a treatment for the cause of primary angle-closure glaucoma by reconstructing the physiological aqueous outflow pathway. In the past 10 years, phacoemulsification lens extraction with posterior chamber intraocular lens implantation in combination with goniosynechialysis for the treatment of primary angle-closure glaucoma has become a hot topic of clinical research and discussion. This article points out the issues that need to be paid attention to in the clinical practice of the combined surgery, including the relationship between phacoemulsification surgery and goniosynechialysis, the effectiveness and influencing factors of the combined surgery, and how to avoid the postoperative re-adhesion of the angle, in order to provide reference and guidance for better goniosynechialysis.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"719-722"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Electrophysiological properties of neurons in the visual sensory layers of the superior colliculus in early postnatal mice].","authors":"J F Wang, Y J Yan, X Cui, M H Yu, X Jin, X F Shi","doi":"10.3760/cma.j.issn.cn112142-20231104-00208","DOIUrl":"https://doi.org/10.3760/cma.j.issn.cn112142-20231104-00208","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the action potential firing patterns of neurons in the visual sensory layers of the superior colliculus in early postnatal mice and the electrophysiological characteristics of neurons with different firing patterns. <b>Methods:</b> This experimental study utilized whole-cell patch-clamp recordings performed on neurons in the visual sensory layers of the superior colliculus using brain slices from 57 healthy male C57BL/6J mice aged 14 to 20 days (weighing 5.0 to 8.9 g) using brain slices. In current-clamp mode, action potential characteristics were analyzed based on the first action potential generated by depolarizing current, and the firing patterns of neurons were recorded using step depolarizing currents. Neuronal firing patterns were analyzed using hierarchical clustering, and the active electrical properties of neurons with different firing patterns were compared. <b>Results:</b> A total of 135 neurons from the visual sensory layers of the superior colliculus were successfully recorded. Cluster analysis of the neuronal firing patterns identified three types of firing patterns: tonic firing (97, 72%), phasic firing (26, 19%), and single firing (12, 9%). The number of action potentials for each firing pattern was 13.30±7.38, 3.73±3.61, and 0.83±0.39, respectively, with significant differences (<i>P</i><0.001). There was no significant difference in the membrane potential response to step currents among the three firing pattern types (<i>P</i>>0.05). The action potential amplitudes were (60.45±12.22), (53.67±13.20), and (44.04± 12.92) mV, and the afterhyperpolarization amplitudes were (13.45±13.79), (12.02±13.11), and (20.75±2.85) mV, respectively. The maximum rising slopes were (171.29±77.46), (130.14±61.83), and (78.89±37.08) V/s, and the maximum falling slopes were (-76.33±33.61), (-68.17±31.65), and (-47.97±13.92) V/s, respectively, with all differences being statistically significant (all <i>P</i><0.05). There were no significant differences in the resting membrane potential, action potential threshold, half-width, and afterhyperpolarization duration among the three firing pattern types (all <i>P</i>>0.05). <b>Conclusions:</b> In the early postnatal mice, neurons in the visual sensory layers of the superior colliculus exhibit three distinct firing patterns: tonic, phasic, and single firing. These firing pattern types show significant differences in action potential amplitude, afterhyperpolarization amplitude, maximum rising slopes, and maximum falling slopes.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"766-772"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of factors affecting the progression of visual field defects in patients with myopia and primary open-angle glaucoma].","authors":"J Huang, L T Ye, N Luo, L Cheng, Y Z Xiang, J J Huang","doi":"10.3760/cma.j.cn112142-20240424-00191","DOIUrl":"https://doi.org/10.3760/cma.j.cn112142-20240424-00191","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the factors affecting the progression of visual field defects in patients with myopia and primary open-angle glaucoma (POAG), and to clarify whether the factors vary in patients with different degrees of myopia. &lt;b&gt;Method:&lt;/b&gt; An ambispective cohort study was conducted among patients diagnosed with myopia and POAG from the glaucoma outpatient department at the Zhongshan Ophthalmic Center of Sun Yat-sen University between January 2006 and January 2024. Based on the criteria of functional visual field progression, patients were divided into the progression group and non-progression group, and further divided into the low to moderate myopia subgroup and high myopia subgroup according to the degree of myopia. The patient age, gender, type of glaucoma (high tension glaucoma and normal tension glaucoma), spherical equivalent refraction, best corrected visual acuity (BCVA, recorded as the logarithm of the minimum angle of resolution), intraocular pressure (IOP), central corneal thickness, baseline visual field, history of ophthalmic surgery (corneal refractive surgery and glaucoma surgery), and number of anti-glaucoma medications were summarized. The generalized estimation equation was used for comparison between groups, and the Cox proportional hazards model was used to analyze the factors affecting the progression of visual field defects. &lt;b&gt;Results:&lt;/b&gt; A total of 182 eyes from 106 patients were included in this study. There were 57 eyes in the progression group and 125 eyes in the non-progression group. Compared with the non-progression group, the progression group had the older age [43 (29, 53) years old], worse BCVA [0.05 (0.00, 0.17)], greater IOP fluctuation [1.8 (1.3, 2.9)mmHg(1 mmHg=0.133 kPa)], more common baseline central defects [52.6%(30/57)], higher visual field pattern standard deviations [8.92 (5.32, 12.00)dB], lower visual field index [77% (67%, 88%)], and more anti-glaucoma medications [35.1% (20/57) patients used three medications] (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). The Cox proportional hazards models showed that the baseline moderate visual field defects [hazard ratio (&lt;i&gt;HR&lt;/i&gt;)=2.33, 95% confidence interval (&lt;i&gt;CI&lt;/i&gt;): 1.25 to 4.36, &lt;i&gt;P&lt;/i&gt;=0.008], baseline central defects (&lt;i&gt;HR&lt;/i&gt;=2.09, 95%&lt;i&gt;CI&lt;/i&gt;: 1.11 to 3.93, &lt;i&gt;P&lt;/i&gt;=0.022), older age (Model A, &lt;i&gt;HR&lt;/i&gt;=1.03, 95%&lt;i&gt;CI&lt;/i&gt;: 1.00 to 1.05, &lt;i&gt;P&lt;/i&gt;=0.017; Model B, &lt;i&gt;HR&lt;/i&gt;=1.02, 95%&lt;i&gt;CI&lt;/i&gt;: 1.00 to 1.05, &lt;i&gt;P&lt;/i&gt;=0.019), and greater IOP fluctuation (Model A, &lt;i&gt;HR&lt;/i&gt;=1.54, 95%&lt;i&gt;CI&lt;/i&gt;: 1.32 to 1.81, &lt;i&gt;P&lt;/i&gt;&lt;0.001; Model B, &lt;i&gt;HR&lt;/i&gt;=1.49, 95%&lt;i&gt;CI&lt;/i&gt;: 1.26 to 1.75, &lt;i&gt;P&lt;/i&gt;&lt;0.001) were risk factors for visual field progression. In the low to moderate myopia subgroup, the increased risk of progression was associated with baseline central defects (&lt;i&gt;HR&lt;/i&gt;=5.74, 95%&lt;i&gt;CI&lt;/i&gt;: 1.72 to 19.20, &lt;i&gt;P&lt;/i&gt;=0.005), worse BCVA (Model A, &lt;i&gt;HR&lt;/i&gt;=15.80, 95%&lt;i&gt;CI&lt;/i&gt;: 2.07 to 121.00, &lt;i&gt;P&lt;/i&gt;=0.008; Model B, &lt;i&gt;HR&lt;/i&gt;=12.50, 95%&lt;i&gt;CI&lt;/i&gt;: 2.65 to 58.7","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"736-745"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Differences in anterior segment structure and pupillary diastolic characteristics of eyes with primary angle closure suspects under light and shade environments].","authors":"M L Ma, J B Sun, H P Yuan","doi":"10.3760/cma.j.cn112142-20231228-00318","DOIUrl":"https://doi.org/10.3760/cma.j.cn112142-20231228-00318","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the anatomical structure changes of the anterior segment and dynamic pupil changes in eyes with suspected primary angle-closure (PACS) under light and dark conditions, and their correlation with the occurrence of acute primary angle-closure (APAC). <b>Methods:</b> This cross-sectional study collected data from 37 PACS patients (66 eyes) who visited the ophthalmology clinic of the Second Affiliated Hospital of Harbin Medical University between September 2019 and March 2021. The patients included 12 males and 25 females, with an average age of (61.27±7.35) years. Of the 66 eyes, 58 had no history of APAC in the contralateral eye, while 8 had a history of APAC in the contralateral eye. Patients without a history of APAC in both eyes underwent the dark room prone provocative test (DRPPT), and the eyes were divided into three groups: DRPPT- (44 eyes), DRPPT+ (14 eyes), and APAC (8 eyes). The DRPPT+ and APAC groups were combined into the APAC+ group. All patients underwent ultrasound biomicroscopy (UBM) to measure the changes in various parameters under light and dark conditions, including anterior chamber angle 500 (ACA_500Δ) and 1000 (ACA_1000Δ), angle opening distance 500 (AOD_500Δ) and 1000 (AOD_1000Δ), and iris thickness 500 (IT_500Δ) and 1000 (IT_1000Δ). Anterior segment analysis was performed to capture the pupil changes under light and dark conditions, recording pupil diameter, maximum dilation speed (V_max), maximum constriction speed (V_min), and average speed (V_m). <b>Results:</b> There was no significant difference in the parameters between DRPPT+ group and APAC group (<i>P></i>0.05). In the difference analysis, it was found that the V_m value of DRPPT- group [(0.17±0.07) mm/s] was higher than that of APAC+ group [(0.13±0.06)mm/s], and the difference was statistically significant (<i>P</i><0.05). There was no significant difference in other parameters (<i>P</i>>0.05). V_max was positively correlated with temporal ACA_1000Δ and temporal AOD_1000Δ in all patients with PACS (<i>r</i>=0.302, 0.260; <i>P</i><0.05), V_min was negatively correlated with temporal ACA_1000Δ and temporal AOD_1000Δ (<i>r</i>=-0.338, -0.330; <i>P</i><0.05). <b>Conclusions:</b> The dynamic changes in the anterior segment and pupil under different lighting conditions provide insights into the risk factors and potential predictive indicators for the occurrence of APAC in PACS patients.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 9","pages":"728-735"},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Conjunctival fungal infection mimicking a recurrent conjunctival mass: a case report].","authors":"Q R Wu, X Z Zhang, S Li, Y Zhang, S J Deng, L Tian, Y Jie","doi":"10.3760/cma.j.cn112142-20231113-00229","DOIUrl":"10.3760/cma.j.cn112142-20231113-00229","url":null,"abstract":"<p><p>A 40-year-old man presented with recurrent ocular surface masses in his left eye persisting for over a year. Despite undergoing resection of the conjunctival mass and receiving anti-inflammatory treatment at another hospital, the mass reappeared within a week post-surgery. Over the past 6 months, the mass gradually increased in size, accompanied by a decline in vision. Following conjunctival mass excision combined with amniotic membrane transplantation at Beijing Tongren Hospital, Capital Medical University, histopathological examination revealed a fungal infection of the conjunctiva, resulting in a diagnosis of fungal conjunctivitis and conjunctival granuloma in the left eye. The patient received systemic antifungal medications and local therapy, resulting in a stable condition with no recurrence of the mass.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 8","pages":"695-699"},"PeriodicalIF":0.0,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Bilateral acute regional occult outer retinopathy: a case report].","authors":"Z X Deng, S Y Peng, Y J Peng, Q L Zhang, Y C Wei","doi":"10.3760/cma.j.cn112142-20231024-00178","DOIUrl":"10.3760/cma.j.cn112142-20231024-00178","url":null,"abstract":"<p><p>A 63-year-old female patient presented with \"flashes of light in both eyes accompanied by decreased visual acuity for one year.\" Visual field examination revealed partial defects in the central 30° of the visual field in both eyes. Scanning laser ophthalmoscopy showed extensive atrophic lesions across the entire posterior pole of the retina in both eyes. Optical coherence tomography revealed atrophy and thinning of the retina in the macular regions, with significant atrophy of the photoreceptor inner segment and outer segment layer in the areas corresponding to the visual field defects. Fluorescein fundus angiography demonstrated thinning of the retinal arterioles. Early-phase imaging showed large window-like defects in the posterior retina with background fluorescence from choroidal macrovessels. In the late phase, patchy fluorescence staining with a circumferential hyperfluorescent area was observed. Pattern visual evoked potential and pattern electroretinography tests revealed a significant decrease in the P100 amplitude in both eyes. The patient was diagnosed with acute regional occult outer layer retinopathy in both eyes.</p>","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 8","pages":"700-703"},"PeriodicalIF":0.0,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141861224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical observation of the subthreshold micropulse laser combined with ranibizumab for treatment of diabetic macular edema].","authors":"X Y Gu, S Song, H Dai, X B Yu","doi":"10.3760/cma.j.cn112142-20231227-00314","DOIUrl":"10.3760/cma.j.cn112142-20231227-00314","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of the subthreshold micropulse laser (SMPL) combined with ranibizumab in treating diabetic macular edema (DME). <b>Methods:</b> This was a prospective randomized controlled study. Patients diagnosed with DME in the Ophthalmology Department of Beijing Hospital were enrolled from January 2020 to December 2022. Patients were randomized in a ratio of 1∶1 using a table of random numbers into the ranibizumab monotherapy group and the SMPL combined with ranibizumab therapy group. We compared the changes of best-corrected visual acuity, central macular thickness measured by optical coherence tomography and optical coherence tomography angiography parameters, including the vessel density of the superficial and deep capillary plexus (DCP), foveal avascular zone size and peripapillary vessel density, at baseline, 6 and 12 months after the treatment. After 12 months of follow-up, fundus fluorescein angiography results, adverse events, and the number of injections or laser therapies were recorded. The Fisher's exact test and group <i>t</i>-test were used for statistical analysis. <b>Results:</b> Seventy-two patients (72 eyes) were enrolled, with a mean age of (61.1±8.2) years. Patients in the combination therapy group included 19 males and 17 females, while patients in the ranibizumab monotherapy group were 17 males and 19 females. There was no statistically significant difference in baseline characteristics between the two groups (<i>P</i>>0.05). A significant improvement in best-corrected visual acuity was shown in both groups at 6 and 12 months [(58.5±12.9) and (58.2±12.2) ETDRS letters in the combination therapy group, and (63.3±13.1) and (63.8±12.5) ETDRS letters in the ranibizumab monotherapy group]. A significant reduction in central macular thickness was shown in both groups at 6 and 12 months [(451.0±185.5) and (380.4±159.3)μm in the combination therapy group, and (387.5±135.5) and (372.8±146.1)μm in the ranibizumab monotherapy group]. However, there was no significant difference between groups at each timepoint (all <i>P</i>>0.05). At 12 months, the vessel density of the superficial capillary plexus showed no statistical difference compared to the baseline value in each group or between groups (42.6%±5.9% in the ranibizumab monotherapy group and 42.2%±5.5% in the combination therapy group, <i>P</i>>0.05). The vessel density of the DCP in the combination therapy group significantly increased to 47.5%±5.6% at 12 months, significantly different from that in the ranibizumab group (43.4%±5.1%; <i>P</i><0.05). The foveal avascular zone size in the ranibizumab monotherapy group reduced to (0.32±0.13) mm², significantly different from that in the combination therapy group [(0.34±0.16) mm²] at 12 months (<i>P</i><0.05). Patients in the ranibizumab monotherapy group received (7.3±2.5) intravitreal injections, while patients in the combination therapy group received 3 injections.","PeriodicalId":39688,"journal":{"name":"中华眼科杂志","volume":"60 7","pages":"570-579"},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}