Retina-The Journal of Retinal and Vitreous Diseases最新文献

{"title":"Preretinal Hyperreflective Dots: A novel OCT Sign Associated With The Development Of Epiretinal Membrane After Vitrectomy For Rhegmatogenous Retinal Detachment.","authors":"Bayram Mhibik, Federico Bernabei, Marco Pellegrini, Antoine Constant, Cassem Azri, Pauline Eymard, Maria Angela Romeo, Frederic Azan, Giuseppe Giannaccare, Pierre-Raphael Rothschild","doi":"10.1097/IAE.0000000000004540","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004540","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between preretinal hyperreflective dots (PHD) with the occurrence of epiretinal membrane (ERM) following pars plana vitrectomy (PPV) for rhegmatogenous retinal detachment (RRD).</p><p><strong>Methods: </strong>This retrospective study included patients who underwent PPV for RRD at Ophtalmopôle de Paris. Optical coherence tomography (OCT) scans were acquired at 1, 3, 6 months and 1 year post-surgery. PHD were defined as point-like hyperreflective deposits on the inner retinal surface on the first postoperative OCT. The association between PHD and ERM was evaluated using logistic regression and Kaplan-Meier analysis.</p><p><strong>Results: </strong>Of 894 patients who underwent vitrectomy for RRD, 417 were included in the analysis. Univariate analysis showed significant associations between ERM occurrence and macula-off RRD (P=0.043), number of retinal tears (P=0.002), use of cryopexy (P=0.012), C2F6 tamponade (P=0.045), and presence of PHD on OCT (P<0.001). On multivariate analysis, presence of PHD (P<0.001) and use of cryopexy (P=0.013) were significant predictors of ERM. Kaplan-Meier analysis indicated that the cumulative probability of developing an ERM at 6 months was 4% in patients without PHD and 26% in patients with PHD (P<0.001).</p><p><strong>Conclusion: </strong>PHD are associated with the occurrence of ERM following vitrectomy for RRD.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship of Deep Capillary Plexus Nonperfusion to Visual Acuity and Low Light Vision in Diabetic Retinopathy through OCTA Analysis.","authors":"Daniela Castellanos-Canales, Brandon V Duffy, Nicole L Decker, Taffeta Chingning Yamaguchi, Elizabeth Pearce, Amani A Fawzi","doi":"10.1097/IAE.0000000000004517","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004517","url":null,"abstract":"<p><strong>Purpose: </strong>Considering its proximity to photoreceptors, we evaluated the relationship of nonperfusion at the deep capillary plexus (DCP) to visual acuity (VA) in eyes with diabetic retinopathy (DR).</p><p><strong>Methods: </strong>Our study included 313 eyes with no retinopathy (DMnoDR) to proliferative DR (PDR). Optical coherence tomography angiography (OCTA) scans of the DCP and superficial capillary plexus (SCP) were averaged to measure vessel density (VD), vessel length density (VLD), and geometric perfusion deficit (GPD). Best corrected VA (BCVA) and low-luminance VA (LLVA) were measured per the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol.</p><p><strong>Results: </strong>We found a significant correlation between BCVA and DCP-VD, DCP-VLD and DCP-GPD (r=.270, r= .352 and r= -.362, p<0.001, respectively). These relationships were also significant for LLVA: DCP-VD, DCP-VLD and DCP-GPD (r=.335, r= .421 and r= -.396, p<0.001, respectively).At the SCP level we found relationships between VD and VLD metrics with BCVA (r=.303 and r=.300, p<0.001, respectively) as well as with LLVA (r=.315 and r=.314, p<0.001, respectively). GPD exhibited a negative correlation with BCVA and LLVA (r=-.265 and r= -.279, p<0.001).</p><p><strong>Conclusion: </strong>Nonperfusion in the DCP and SCP correlate to vision loss, suggesting that capillary loss affects both BCVA and LLVA. Interestingly, the ischemic changes in the DCP have a stronger relationship to vision.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal vascularization from a new angle: A systematic review of temporal retinal vessel angles in familial exudative vitreoretinopathy.","authors":"Alexander George Maloof, Nicholas Vlado Pavic, Shane Zhang, Weng Onn Chan, Stephen Bacchi, Christopher Ze Qian Go","doi":"10.1097/IAE.0000000000004533","DOIUrl":"10.1097/IAE.0000000000004533","url":null,"abstract":"<p><strong>Purpose: </strong>Retinal temporal vessel angles (TVA) could function as a clinical marker to reflect the structural and functional integrity of the macular region. We aimed to systematically search and appraise all literature investigating the association between temporal vessel angles (TVA) and familial exudative vitreoretinopathy (FEVR).</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines. We identified articles examining the association between TVA and FEVR by systematically searching PubMed, Medline, EMBASE and SCOPUS, on January 15, 2024. Additional studies were located through hand searching and content area expert contributions. The methodological quality of the included studies was evaluated using the Newcastle Ottawa Scale.</p><p><strong>Results: </strong>We identified 767 papers in the initial search. After screening 333 papers, three papers were included in the review. In all three studies, the FEVR group had a significantly smaller temporal retinal vessel angle compared to healthy full-term infants or infants with retinopathy of prematurity. Narrower temporal vessel angles have been found to be associated with the presence and progression of FEVR as compared to normal controls. No consensus about the normal threshold angle has been reached.</p><p><strong>Conclusion: </strong>These data suggest that TVA measurement may serve as a clinical biomarker for the progression of FEVR. Thus, this correlation underscores the importance of TVA as a diagnostic and prognostic tool, potentially facilitating earlier intervention and more tailored treatment strategies. A standardized method of measuring TVA will enable a better understanding of its association with FEVR severity.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Outcomes and Clinical Features of Extensive Macular Atrophy with Pseudodrusen (EMAP).","authors":"Letícia de Oliveira Audi, Ricardo A P de Carvalho, Antônio M Casella, Lourdes Aiko H Maniero, Claudio Zett, André M V Messias, Fabrício T Borges, Francyne Veiga R Cyrino, Theodomiro Garrido, Thais M A Bastos, Maria Inêz C Costa, Juliana L Orefice, João Vítor T Marques, Raul N G Vianna, Arnaldo P Cialdini, Érika P M Diniz, Carlos A Moreira-Neto, Carlos A Moreira, Marcos P Ávila, Sérgio Pimentel, Michel E Farah, Rodrigo Jorge, Luiz H Lima","doi":"10.1097/IAE.0000000000004534","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004534","url":null,"abstract":"<p><strong>Purpose: </strong>To describe extensive macular atrophy with pseudodrusen (EMAP) using multimodal imaging and analyze factors associated with visual loss.</p><p><strong>Methods: </strong>This observational case seriesretrospectively reviewed the clinical and multimodal imaging (color fundus photography [CFP], fluorescein angiography, fundus autofluorescence (FAF), and optical coherence tomography [OCT]) of patients between January and December 2023. The EMAP diagnosis was based on early-onset macular atrophy, pseudodrusen, and bilateral disease. Univariate and multivariate Tobit regression models identified and ranked imaging findings and risk factors (P<0.05) for visual loss.</p><p><strong>Results: </strong>Seventy-four patients (52.7% women) were diagnosed with EMAP; 86.5% had a history of rheumatic fever (RF), and nearly 17% had heart valve disease. Mean age at onset was 58.7 years (range, 43 -73 years), and the mean best-corrected visual acuity (VA) was 20/60 (range, 20/800-20/20). CFP or FAF identified pseudodrusen in 91.7% and 93.0% of eyes, respectively, and OCT did so in all evaluable patients. FAF revealed a hyperautofluorescent edge around the hypoautofluorescent central lesion in 86.6% of eyes. OCT showed a diffuse pseudodrusen pattern in 88.9%, outer retinal loss/thinning in 80.8% and macular neovascularization in 9.4% of eyes. Subfoveal choroidal thickness (P=0.004), outer retinal loss/thinning (P<0.01), and preserved fovea (P<0.01) were associated significantly with VA. Visual loss was associated with younger age at diagnosis (P=0.04) and co-existence of RF and heart valve disease (P=0.006).</p><p><strong>Conclusions: </strong>Early diagnosis and treatment of RF complications may be related to EMAP progression and outcomes. Longitudinal studies should characterize the natural history of EMAP.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Anisometropia on Diabetic Retinopathy Progression: The Role of Optical Coherence Tomography Biomarkers.","authors":"Shenghai Huang, Haisi Chen, Weiwei Zheng, Bing Lin","doi":"10.1097/IAE.0000000000004532","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004532","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the impact of myopic changes on diabetic retinopathy (DR) progression by comparing ETDRS grading scores and optical coherence tomography (OCT) biomarkers between the eyes with anisometropia.</p><p><strong>Method: </strong>This observational cross-sectional study retrospectively reviewed clinical records of anisometropia patients with DR. ETDRS grading scores and OCT biomarkers, including central subfield thickness (CST), subfoveal choroidal thickness (SFCT), presence of subretinal fluid (SRF), cystoid changes in the outer nuclear layer (ONL) and inner nuclear layer (INL), hyperreflective foci (HRF), ellipsoid zone (EZ) continuity, the continuity of the external limiting membrane (ELM), disorganization of retinal inner layers (DRIL) and vitreomacular interface changes, were analyzed between the lower and higher diopter eyes. Correlations among binocular differences in spherical equivalent refraction (SER), SFCT, and ETDRS grading scores were examined.</p><p><strong>Results: </strong>Lower diopter eyes had significantly lower ETDRS scores (35.3 ± 14.5 vs. 54.4 ± 21.3, P < 0.001) and thinner SFCT (153.0 ± 109.4 μm vs. 235.6 ± 107.2 μm, P < 0.001) compared to higher diopter eyes. Lower diopter eyes exhibited fewer cystoid spaces in the ONL, reduced HRF, less DRIL and less disruption of the EZ. Significant positive correlations were found between binocular differences in SER and ETDRS scores (ρ = 0. 789, P < 0.001), SFCT and ETDRS scores (ρ = 0. 726, P < 0.001), and SER and SFCT (ρ = 0. 719, P < 0.001).</p><p><strong>Conclusion: </strong>Myopia appears to have a protective effect against DR progression in anisometropia, as indicated by lower ETDRS scores and favorable OCT biomarkers.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Response: Sparing versus Removal of Epiretinal Proliferation in the Surgical Repair of Full-Thickness Macular Holes.","authors":"Kotaro Tsuboi, Masaki Fukushima","doi":"10.1097/IAE.0000000000004530","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004530","url":null,"abstract":"","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foveal Configuration After Amniotic Membrane Transplantation in Complex Macular Holes.","authors":"Mihyun Choi, Seung Heon Lee, Seong-Woo Kim, Joo Yong Lee, Sang Joon Lee","doi":"10.1097/IAE.0000000000004528","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004528","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated outcomes and foveal morphological changes following human amniotic membrane transplantation (hAMT) in complex macular holes.</p><p><strong>Methods: </strong>A multicenter, retrospective analysis was conducted on 30 eyes that underwent vitrectomy with hAMT for indications including failed prior macular hole closure, macular hole-associated retinal detachment in high myopia (axial length >28mm), giant macular holes (>1000µm), and large macular holes (≥400µm) unsuitable for internal limiting membrane flaps (ILM). Postoperative assessments included closure rates, visual outcomes, and foveal structural changes on optical coherence tomography (OCT) at 1, 3, and 6 months.</p><p><strong>Results: </strong>Macular hole closure with retinal tissue reconstitution was observed in 73.3% of eyes at 1 month, whereas 23.3% showed foveolar dehiscence with exposed hAM in the subretinal space. Visual acuity improved from logMAR 1.22 (20/320) to 0.99 (20/200) at 1 month (P= 0.026), 0.98 at 3 months (P=0.013), and 0.97 at 6 months (P=0.013). The bare hAM area decreased over time in eyes with foveolar dehiscence (P=0.016), and retinal tissue reconstitution was observed in three of these cases. A larger preoperative minimal linear diameter was significantly associated with this pattern (P=0.033).</p><p><strong>Conclusion: </strong>hAMT demonstrated favorable outcomes in complex macular holes, supporting its potential role in the anatomical restoration.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Hepatic Steatosis and Age-Related Macular Degeneration: A Cross-Sectional Study.","authors":"Patrick Wang, Zoe Hu, Maera Haider, Wilma Hopman, Evan Sharma, Sanjay Sharma","doi":"10.1097/IAE.0000000000004526","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004526","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study is to estimate the association of hepatic steatosis in patients diagnosed with Age-Related Macular Degeneration (AMD).</p><p><strong>Methods: </strong>Patients with AMD and without secondary causes of chronic liver disease, alongside age- and sex-matched controls were recruited. Hepatic steatosis was determined via ultrasound imaging, and metabolic risk factors were collected using standardized surveys.</p><p><strong>Results: </strong>A total of 98 patients were recruited (49 cases, 49 controls). Hepatic steatosis was observed in 51.0% of the AMD group compared to 30.6% in controls, a statistically significant difference (χ2(1) = 4.224, p = 0.040). In multivariable models, dyslipidemia and diabetes were the strongest predictors, with association of steatosis attenuated but still significant (OR 2.36, 95% CI 1.03-5.40, p = 0.049).</p><p><strong>Conclusion: </strong>This study suggests an association between AMD and the prevalence of hepatic steatosis, after controlling for metabolic risk factors.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of immunosuppressive therapy for immune-mediated inflammatory disease on the risk of age-related macular degeneration.","authors":"Natan Lishinsky-Fischer, Itay Chowers, Jaime Levy","doi":"10.1097/IAE.0000000000004531","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004531","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of immunosuppressive therapy on the development and progression of age-related macular degeneration (AMD) in patients with an immune-mediated inflammatory disease (IMID).</p><p><strong>Methods: </strong>This is a retrospective cohort study. Data were obtained from TriNetX, a global database of electronic medical records. The analysis utilized the largest network in TriNetX, comprised of 171,583,261 patients from 18 countries. Kaplan-Meier analysis was used to estimate the probability of predefined AMD subcategories between patients with IMID who were prescribed an immunosuppressants and patients who were not.</p><p><strong>Results: </strong>After 1:1 propensity score matching, equal-sized cohorts of patients in each group were generated for predefined IMIDs. We found that AMD was more prevalent in patients who received an immunosuppressant for systemic lupus erythematosus (SLE), Crohn's disease, rheumatoid arthritis, sarcoidosis, Sjogren's syndrome, giant cell arteritis and all IMIDs combined.</p><p><strong>Conclusions: </strong>The use of immunosuppressants in patients with some IMIDs appears to be associated with an increased risk of AMD. Further research is warranted in order to fully understand the complex relationship between immunosuppressive therapy and AMD.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Feasible and Reproducible Surgical Approach for Subfoveal Hard Exudates Removal via Intentional Macular Hole Creation in Diabetic Retinopathy.","authors":"Tomoyuki Ishibashi, Yuko Morimoto, Shunichi Fukuyama, Hiroshi Nakashima, Ryo Inoue, Kazuyuki Emi","doi":"10.1097/IAE.0000000000004525","DOIUrl":"https://doi.org/10.1097/IAE.0000000000004525","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a modified surgical technique for removing subfoveal hard exudates (SFHE) in diabetic retinopathy through controlled macular hole (MH) creation.</p><p><strong>Methods: </strong>Eyes with visual impairment due to SFHE underwent 25-gauge vitrectomy. At the site where internal limiting membrane (ILM) was locally peeled, subretinal injection of balanced salt solution was performed using a 41-gauge needle and Viscous Fluid Control (VFC) system to create an intentional MH. SFHE was removed from the hole, and the MH was closed using an inverted ILM flap technique. Anatomical findings and best-corrected visual acuity (BCVA) were evaluated over a 24-month postoperative period.</p><p><strong>Results: </strong>Five eyes of four patients with BCVA less than 20/100 were evaluated. Intentional MHs were created in all eyes by progressively increasing the injection pressure to a maximum of 14 psi. MH closure and SFHE reduction were achieved in all eyes at 1 month postoperatively. At 24 months, all eyes achieved SFHE resolution and sustained BCVA improvement of 5 or more ETDRS lines. One patient with preoperative SFHE accumulation lasting over 6 months developed macular atrophic changes.</p><p><strong>Conclusions: </strong>VFC-assisted intentional MH creation and inverted ILM flap technique for MH closure provide a technically accessible and reproducible approach for removing vision-threatening SFHE.</p>","PeriodicalId":54486,"journal":{"name":"Retina-The Journal of Retinal and Vitreous Diseases","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}