简介:目的:研究视网膜血管疾病在印度喜马偕尔邦丘陵地带(海拔500~4500m)的患病模式/分布。方法:对西姆拉三级医院眼科自2008-08/2013-04期间的视网膜疾病患者进行回顾/前瞻性研究。选取5600位中的4323名患者作为研究对象。该数据均来自于医院记录,随后根据患者的年龄,性别分布情况和诊断结果进行分析。所有患者都进行了视力,屈光,裂隙灯和眼底检查。以眼底临床记录和眼底照相记录来确定诊断。应用眼底照像机(KowaFundusCameraVX-10)进行照相,必要时进行眼底荧光素血管造影。结果:在4323例患者中,男性视网膜疾病患者有2563例(59.29%),多于女性1760例(40.71%)。在525例(12.14%)糖尿病视网膜病变患者中,轻度非增殖性糖尿病视网膜病变133例(3.08%),中度156例(3.60%),重度120例(2.78%),增殖性糖尿病视网膜病变116例(2.68%)。在393例(9.10%)高血压性视网膜病变患者中,I级高血压性视网膜病变患者130例(3.01%),II级111例(2.57%),III级131例(3.03%),IV级21例(0.49%)。在660例(15.27%)其他视网膜血管疾病中,视网膜分支静脉阻塞229例(5.30%),视网膜中央静脉阻塞55例(1.27%),半视网膜中央静脉阻塞8例(0.19%),视网膜中央动脉阻塞20例(0.46%),视网膜分支动脉阻塞4例(0.09%),眼部缺血综合征1例(0.02%),早产儿视网膜病变9例(0.21%),视网膜大动脉瘤5例(0.12%),近中心凹毛细血管扩张6例(0.14%),贫血性视网膜病变16例(0.37%),白血病视网膜病变10例(0.23%),视网膜前出血52例(1.20%),Coats病8例(0.19%),睫状视网膜动脉阻塞1例(0.02%)例,Eales病10例(0.23%),血管炎17例(0.39%)以及有临床意义的黄斑水肿209例(4.83%)。结论:糖尿病视网膜病变是最常见的视网膜血管疾病。视网膜疾病已经成为印度一个主要公共卫生问题。此研究将有利于对喜�
简介:AIM:Tocharacterizetemporalpatternofresolutionandrecurrenceofnaivechoroidalneovascularization(CNV)secondarytowetage-relatedmaculardegeneration(AMD)treatedwithintravitrealbevacizumabonasneededregimen,andtoanalyzebaselineriskfactorsforCNVresolutionorrecurrence.METHODS:Ninety-oneeyesof80patientswithnewlydiagnosedwetAMDwereretrospectivelystudied.Alleyesweretreatedwitharoundofthreemonthlyintravitrealbevacizumabinjections,followedbyoneadditional’bonus’injectionafterresolutionofCNVactivity.Duringfollow-up,eyesweremonitoredwithfluoresceinangiography,opticalcoherencetomography,andbest-correctedvisualacuity(BCVA).IncaseofrecurrencesofCNVactivity,eyeswereretreatedwithotherroundsofbevacizumabinjectionsfollowingthesametreatmentprotocol.RESULTS:Overamedianfollow-upof532d,themedianresolutiontimeofCNVactivityinthefirst,second,andthirdtreatmentroundwas98d,126d,and111d,respectively.Themedianrecurrencetimeforthethreeroundswas154d,126d,and151d,respectively.Nosignificantdifferenceinresolutiontime(P=0.09)orinrecurrencetime(P=0.11)wasdetectedamongtreatmentrounds.Age(P=0.0082)andlensstatus(P=0.035)werefoundtobeassociatedwithCNVresolution;forevery1-yearincreaseinagetherewas4%greaterchanceofCNVresolution;Phakiceyesdemonstrateda33%betterchancetoexperienceCNVresolutionthanpseudophakiceyes.ForCNVrecurrence,lensstatus(P=0.0009)andgender(P=0.0446)werefoundtobepredictive;pseudophakiceyeshada3.69-foldgreaterrisktoexperiencerecurrenceofCNVactivitycomparedtophakiceyes;maleshada2.19-foldgreaterrisktoexperiencerecurrenceofCNVactivitythanfemales.NosignificantBCVAchangesamongthreetreatmentroundswerenoted(P=0.56).CONCLUSION:ResolutiontimeandrecurrencetimeofCNVactivitywerenotsignificantlydifferentamongtreatmentrounds,suggestingabsenceoftachyphylaxistobevacizumab.Acautiousdecisionshouldbemadeupondisco
简介:AIM:Toinvestigatethelevelsofserumsolubleintercellularadhesionmolecules-1(sICAM-1)andneutrophilicexpressionofCD18inpatientswithvariousstagesofdiabeticretinopathyandtodeterminetheirdifferentexpressionpatterninthedevelopmentofdiabeticretinopathy(DR).·METHODS:LevelsofserumsICAM-1andCD18onthesurfaceofneutrophileweremeasuredin41DRpatients,theywereclassifiedinthreesubgroupsaccordingtothestageofretinopathyasdeterminedbyfund’sophthalmoscopy;10controlsubjectswerealsostudied.sICAM-1weremeasuredbyenzyme-linkedimmunosorbentassayandCD18byflowcytometry.·RESULTS:TheneutrophilicCD18expressionandserumsICAM-1levelwereallsignificantlyelevatedinalldiabeticsubgroupscomparedtocontrolsubjects(P<0.01).ThedifferencesofCD18andsICAM-1amongthediabeticsubgroupsweresignificantinCD18butnotinsICAM-1.TheprogressionofretinopathywasassociatedwithanincreasebothinCD18andinsICAM-1levelsbysimplecorrelationanalysis(β=0.74,P<0.001;β=0.38,P<0.01,respectively).ButstepwisemultipleregressionanalysisrevealedthatonlyCD18wasindependentdeterminantofretinopathy(β=1.04,P<0.01).·CONCLUSION:OurresultsconfirmthecontributionofendothelialandneutrophilicactivationinthedevelopmentofDRasindicatedbyincreasedlevelsofCD18andsICAM-1.However,adirectimplicationofCD18andICAM-1intheprogressionofDRcanbesupportedonlyintheCD18butnotICAM-1.CD18andICAM-1mayplaydifferentroleinthedevelopmentofdiabeticretinopathy.