ObjectiveTo evaluate the macular visual function of patients with myopic choroidal neovascularization (MCNV) before and after intravitreal injection of conbercept.MethodsA prospective, uncontrolled and non-randomized study. From April 2017 to April 2018, 21 eyes of 21 patients diagnosed as MCNV in Shanxi Eye Hospital and treated with intravitreal injection of conbercept were included in this study. There were 9 males (9 eyes, 42.86%) and 12 females (12 eyes, 57.14%), with the mean age of 35.1±13.2 years. The mean diopter was ?11.30±2.35 D and the mean axial length was 28.93±5.68 mm. All patients were treated with intravitreal injection of conbercept 0.05 ml (1+PRN). Regular follow-up was performed before and after treatment, and BCVA and MAIA micro-field examination were performed at each follow-up. BCVA, macular integrity index (MI), mean sensitivity (MS) and fixation status changes before and after treatment were comparatively analyzed. The fixation status was divided into three types: stable fixation, relatively unstable fixation, and unstable fixation. The paired-sample t-test was used to compare BCVA, MI and MS before and after treatment. The x2 test was used to compare the fixation status before and after treatment.ResultsDuring the observation period, the average number of injections was 3.5. The logMAR BCVA of the eyes before treatment and at 1, 3, and 6 months after treatment were 0.87±0.32, 0.68±0.23, 0.52±0.17, and 0.61±0.57, respectively; MI were 89.38±21.34, 88.87±17.91, 70.59±30.02, and 86.76±15.09, respectively; MS were 15.32±7.19, 21.35±8.89, 23.98±11.12, 22.32±9.04 dB, respectively. Compared with before treatment, BCVA (t=15.32, 18.65, 17.38; P＜0.01) and MS (t=4.08, 3.50, 4.26; P＜0.01) were significantly increased in the eyes 1, 3, and 6 months after treatment. There was no significant difference in the MI of the eyes before treatment and at 1, 3, and 6 months after treatment (t=0.60, 2.42, 2.58; P＞0.05). Before treatment and at 1, 3, and 6 months after treatment, the proportion of stable fixation were 28.57%, 38.10%, 38.10%, 33.33%;the proportion of relatively unstable fixation were 47.62%, 47.62%, 52.38%, 57.14% and the proportion of unstable fixation were 23.81%, 14.28%, 9.52%, 9.52%, respectively. The proportion of stable fixation and relatively unstable fixation at 1, 3 and 6 months after treatment were higher than that before treatment, but the difference was not statistically significant (x2=1.82, 1.24, 1.69; P＞0.05).ConclusionBCVA and MS are significantly increased in patients with MCNV after intravitreal injection of conbercept.
Objective
To observe the characteristics of fundus autofluorescence (FAF) in patients with polypoidal choroidal vasculopathy (PCV) before and after intravitreal ranibizumab injections.
Methods
A retrospective case series. Seventeen patients (17 eyes) including 11 males and 6 females were enrolled in this study. Best corrected visual acuity (BCVA), FAF and indocyanine green angiography examination were performed on all eyes. The eyes were divided into hypo-autofluorescence group (8 eyes) and mixed autofluorescence group (9 eyes) according to the fluorescence degree. There was no differences of BCVA between two groups (t=2.403, P=0.072).All eyes received monthly intravitreal ranibizumab injections for 3 months followed by an as-needed reinjection schedule. All eyes were followed up for 12 months. FAF was performed at the 3rd, 6th and 12th month after first treatment. The changes of FAF characteristics and BCVA before and after treatment were observed.
Results
Before the treatment, the PCV lesions showed two distinct FAF patterns: the confluent hypo-autofluorescence at the polypoidal lesions and the granular hypo-autofluorescence at branching choroidal vascular networks (BVN). During the treatment, the abnormal FAF area of the whole lesions in all eyes reduced and gradually returned to normal. At the 3rd month after treatment, the central hypo-autofluorescence of polyps was surrounded by a hyper-autofluorescence ring, and with time, the ring was weakened or eliminated. However, all the hypo-autofluorescence findings in BVN at baseline were unchanged during the follow-up period. There was no significant differences in BCVA between hypo-autofluorescence group and hyper-autofluorescence group at different follow-up times (t=2.674, 2.862, 2.250; P=0.058, 0.052, 0.081). At final follow-up, 5 eyes (62.5%) in hypo-autofluorescence group and 3 eyes (33.3%) in hyper-autofluorescence group had increased BCVA, the different was not significant (P=0.347).
Conclusions
Before the treatment, there were the central hypo-autofluorescence of polyps and circumferential hypo-autofluorescence ring or confluent hypo-autofluorescence. After the treatment, the autofluorescence of polyps increased and then gradually returned to normal.
ObjectiveTo investigate the characteristics of microcirculation parameter changes in the deep capillary plexus (DCP) of the macular region in patients with type 2 diabetes mellitus (T2DM) and to analyze their correlation with diabetic kidney disease (DKD). MethodsThis cross-sectional study included 133 eyes of 133 T2DM patients who visited Shanxi Eye Hospital from March 2022 to May 2024. According to the presence of DKD, the patients were divided into a DKD group (49 eyes of 49 patients) and a non-DKD group (84 eyes of 84 patients). All eyes underwent swept-source optical coherence tomography angiography examination, and 6 mm × 6 mm macular images were acquired. Microcirculation parameters of the superficial capillary plexus (SCP) and DCP were quantitatively analyzed, including vessel diameter (VD), vessel area density (VAD), vessel skeleton density (VSD), and non-perfusion area (NPA). The area of the foveal avascular zone (FAZ) was also measured. Intergroup comparisons were performed using the independent samples t-test or Mann-Whitney U test. Multivariate logistic regression was employed to analyze the independent association between microcirculation parameters of SCP and DCP and DKD after adjusting for diabetic retinopathy (DR) status. ResultsCompared with the non-DKD group, the DKD group showed significantly increased VD (Z=?3.885) and NPA (Z=?4.268), and significantly decreased VAD (t=2.883) and VSD (t=3.866) in the DCP layer (P＜0.05). No statistically significant differences were observed between the two groups in VD, VAD, VSD, NPA of the SCP layer, or the FAZ area (P＞0.05). After adjusting for DR, multivariate logistic regression analysis indicated that VD [odds ratio (OR)=2.513, 95% confidence interval (CI) 1.445-4.370] and NPA (OR=2.079, 95%CI 1.375-3.143) of the DCP were independent risk factors for DKD in T2DM patients (P＜0.05), whereas VAD (OR=0.810, 95%CI 0.696-0.943) and VSD (OR=0.433, 95%CI 0.271-0.691) of the DCP were protective factors (P＜0.05). ConclusionsIn T2DM patients, those with DKD exhibit characteristic microcirculatory alterations in the macular DCP, specifically increased VD and NPA, along with decreased VAD and VSD. These abnormalities in DCP microcirculation parameters are independently associated with the occurrence of DKD, suggesting their potential as imaging biomarkers for assessing renal complications in T2DM.
