ObjectiveTo observe the retinal reattachment of suprachoroidal injection with sodium hyaluronate in the treatment of rhegmatogenous retinal detachment (RRD).MethodsTwelve eyes of 12 patients with RRD diagnosed by the examinations of B-mode ultrasound, binocular indirect ophthalmoscope, OCT and scanning laser ophthalmoscope in West China Hospital of Sichuan University from October 2018 to February 2019 were included in this study. There were 7 males and 5 females, aged from 15 to 66 years, with the mean age of 32.40±14.81 years. There were 4 eyes with BCVA＜0.1, 4 eyes with BCVA 0.1-0.4, 4 eyes with BCVA＞0.4. The extent of retinal detachment involves 1 to 4 quadrants. All eyes were injected with sodium hyaluronate via suprachoroidal space under non-contact wide-angle system. Surgery was performed by the same ophthalmologist with extensive surgical experience. During the operation, the retinal hole was handled with scleral freezing and laser photocoagulation. The follow-up was 2 months. The retinal reattachment was observed.ResultsOf the 12 eyes, 6 eyes (50.00%) were anatomically reattached, 4 eyes (33.33%) ere partly anatomically reattached with subretinal fluid, 2 eyes (16.67%) were not reattached. The holes in 4 eyes of partly anatomically reattached with subretinal fluid were located on the choroidal pad and the holes were closed, in addition, the subretinal fluid gradually absorbed over time. Two eyes failed in retinal reattachment received vitrectomy with silicone oil tamponade or sclera buckling surgery. No severe complications such as endophthalmitis and choroidal hemorrhage were found at follow-up visits.ConclusionSuprachoroidal injection of sodium hyaluronate is an effective and safe treatment for RRD, which can promote retinal reattachment.
Gene therapy is designed to introduce genetic material into the cells of a patient via virus to enhance, inhibit, edit or add a genetic sequence, results in a therapeutic or prophylactic effect. Gene therapy has brought positive influence and great potential for the treatment of retinal diseases including genetic retinal diseases and acquired retinal diseases. In addition to the constant optimization of gene vectors, the exploration of different drug delivery techniques has brought different therapeutic effects for gene therapy of retinal diseases. The main delivery methods include subretinal injection, intravitreal injection, suprachoroidal injection. Considering the transfection efficiency and safety of delivery methods, emerging sub-inner limiting membrane injection and noninvasive gene delivery are under investigation. The selection of gene delivery method is very important for the safety and effectiveness of gene therapy for retinal diseases. It is not only related to the development of equipment and technology, but also related to the modification of adeno-associated virus, the selection of promoter and the specific retinal cells that the target gene wants to be transfected. Therefore, the most appropriate method of gene delivery should be selected according to the final gene therapy agent and the specific transfected cells after taking all these factors into consideration.
Objective To observe the efficacy of intravitreal injection of conbercept (IVC) combined with suprachoroidal injection of triamcinolone acetonide (SCTA) in the treatment of macular edema secondary to retinal vein occlusion (RVO-ME). MethodsA prospective clinical study. Twenty-eight eyes of 28 patients with RVO-ME diagnosed at Tianjin Eye Hospital from January to October 2025 were included in the study. Among them, there were 13 eyes of 13 males and 15 eyes of 15 females; all were monocular. The age was (62.9±9.4) years. All affected eyes underwent best corrected visual acuity (BCVA), eye pressure, optical coherence tomography (OCT), and fundus fluorescein angiography (FFA) examinations. BCVA was examined using the international standard visual acuity chart, and the results were converted to logarithm of the minimum angle of resolution visual acuity for statistical analysis. The OCT instrument was used to measure central macular thickness (CMT) and subfoveal choroidal thickness (SFCT). The patients were randomly divided into an experimental group and a control group using a random number table, with 14 eyes in each group. The control group received IVC 0.05 ml (containing conbercept 0.5 mg); the experimental group received suprachoroidal injection of triamcinolone acetonide 0.1 ml (containing triamcinolone acetonide 4.0 mg) combined with IVC, with the same dose as the control group. Relevant examinations were performed using the same equipment and methods as before treatment at 1-3 and 6 months after treatment. Changes in BCVA, eye pressure, CMT, and SFCT were compared between the two groups; the occurrence of complications such as cataract progression, endophthalmitis, vitreous hemorrhage, and retinal detachment was also observed. Intergroup comparisons were performed using the two independent samples t test, and intragroup comparisons before and after treatment were performed using the paired t test. ResultsCompared with baseline, BCVA was significantly improved, and CMT and SFCT were significantly decreased in both the control and experimental groups at 1, 2, 3, and 6 months after treatment, with statistically significant differences (P＜0.05). Intergroup comparison showed that at 1 month after treatment, the improvement in BCVA (Z=?2.262) and the reduction in CMT (Z=?2.482) in the experimental group were significantly better than those in the control group, with statistically significant differences (P＜0.05); at 2 months after treatment, the reduction in SFCT in the experimental group was significantly better than that in the control group, with a statistically significant difference (Z=?1.977, P＜0.05). At 3 and 6 months after treatment, there were no statistically significant differences in the increase in BCVA and the decreases in CMT and SFCT between the two groups (P＞0.05). The number of injections in the control group was (3.36±0.63) times, which was significantly higher than that in the experimental group, with a statistically significant difference (t=2.110, P＜0.05). At 1 month after treatment, one eye in the experimental group showed a transient mild increase in eye pressure; no significant cataract progression was observed in any affected eye, and no complications such as vitreous hemorrhage, retinal detachment, or endophthalmitis occurred. ConclusionIVC combined with SCTA can rapidly improve visual acuity and anatomical structure in eyes with RVO-ME, reduce the need for anti-vascular endothelial growth factor injections, and has no significant adverse reactions.
