OBJECTIVE:To verify the safe dose of cephradine in intravitreal injection.
METHODS:After injecting different doses of cephradine(100mu;g,200mu;g,250mu;g,300mu;g,400mu;g)into vitreous cavity of different group of rabbits the activities of the retinal enzymes (SDH,LDH )on different time (Id,3d, 7d ) were determined respectively, and the histological and ultrastructural changes of retinas were also observed simuhaneously.
RESULTS:The activity of rellnal SDH and LDH was found to be decreased gradually with tbe icreasing of the dosage of intravitreal cephradine. The activities of SDH and LDH were found in the lowest level on tile 3rd and lsl day,but they recover to normal levels on tile 7th day after intravitreal in}eetion in 100mu;g,200mu;g groups,and still lower tban normal in the other groups. Histologically,retinal edema was found both in 100mu;g and 200mu;g groups,but degradation of retinal cells,and loss of cones and rods were round in the 250mu;g, 300mu;g and 400mu;g groups.
CONCLUSION: The safe dose of intravitreal injection of cepbradlnc is 200mu;g.
（Chin J Ocul Fundus Dis,1997,13:139-142 ）
Objective To observe the regulation effect of transforming growth factor alpha (TGFalpha;) on expression of glutamate transporter（GLAST）and ingestion activity of retinal Muuml;ller cells in mice. Methods To take the retinal tissue of Kunming mouse at postnatal 7～10 day, and then cultured Muuml;ller cells according to literature. The 3～4 generation cultured cells of the same primary cell were divided into two groups at random: ① TGFalpha; group: maintained in different concentrations of TGFalpha; as 50, 75, 125 and 150 ng/ml, 3 holes in each concentration;② Control group: cultured by Eagle culture medium which improved from Dulbeccon and contained 20% fetal calf serum. The influence of different concentrations TGFalpha; on GLAST activity in Muuml;ller cells were observed by L-3H-glutamate uptake detection; the expression of GLAST mRNA in Muuml;ller cells was determined by RT-PCR; the expression of GLAST protein was detected with immunocytochemical staining. Results With the increase of TGFalpha; concentration, both L3H glutamate uptake and GLAST mRNA expression were increased. The L-3H-glutamate accumulation had got to the maximum uptake at concentration of 125 ng/ml, which was 266% of that in control group, meanwhile, the expressions of GLAST mRNA also got to the maximum as 4 times of control group. Immunocytochemical staining indicated that the effect of 125ng/ml TGFalpha; on expression of GLAST protein was higher than that in the control group, the differences between two groups were statistically significant (Plt;0.05). Conclusion TGF-alpha; can increase GLAST activity through up-regulating the expression of GLAST mRNA and protein.
ObjectiveTo investigate the therapeutic effects of thrombolysis infusion via microcatheter on the treatment of central retinal artery occlusion(CRAO). MethodsUrokinase (UK) was directly infused via ophthalmic artery (OA) by microcatheter (6 patients) or via intravenous (7 patients) to dissolve the thrombus. The patency of the artery was evaluated by fundus fluorescein angiography (FFA), and the effect of fibrinolytic activity on the systemic changes was observed by blood biochemical examination simultaneously.
ResultsIn 6 patients in the microcatheter group, 5 had completely and 1 had partly reopened OA on the morrow of UK infusion with the patency rate of 83.33%, while in 7 patients in vein group, 3 completely reopened, 2 partly reopened and 2 obstructed OA were found with the patency rate of 42.86%. The difference between the two groups was significant. No obvious change of index of blood coagulation system was found in catheter group, which had great disparity compared with the vein group.ConclusionUrokinase infusion via microcatheter in CRAO has better therapeutic impact and smaller effect on systemic action. (Chin J Ocul Fundus Dis, 2005,21:16-19)
Continuous renal replacement therapy (CRRT) is an important therapy for patients with severe acute kidney injury. With the development of blood purification, the application of CRRT has been beyond the scope of kidney disease and developed into a comprehensive and integrated organ support platform, providing a hybrid treatment of different blood purification techniques. With the advancement of informatization, it is possible to improve the quality of CRRT treatment to formulate individualized and precise treatment based on the specific information of patients. This article will discuss the precise prescription and development prospective of CRRT from three dimensions: anticoagulation, dosage and volume management.
ObjectiveTo evaluate the efficacy of 30% and 50% dose photodynamic therapy (PDT) for acute central serous chorioretinopathy (CSC).
MethodsA retrospective cohort study. Ninety-two eyes of 88 patients with CSC, diagnosed by best corrected visual acuity (BCVA) of logarithm of the minimum angle of resolution (logMAR), indirect ophthalmoscope, fundus colorized photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA)and optical coherence tomography (SD-OCT) treated with 30% and 50% doses of verteporfin respectively between March 2007 and August 2013, were enrolled. The eyes were divided into 50% dose group (49 eyes) and 30% dose group (43 eyes). The differences of age (t=-1.45), gender (χ2=0.011), eyes (χ2=2.140), mean logMAR BCVA (t=-0.40), mean central retinal thickness (CRT) and the maximum thickness of serous retinal detachment (SRD) between two groups were not significant (P > 0.05). The difference of spot size between two groups was significant (t=-2.84, P < 0.05). The follow-up time was ranged from 6 to 68 months, with a mean of (17.16 ±11.30) months. The difference of follow-up between two groups was significant (P > 0.05). The BCVA, cure rate, recurrence rate and the changes of CRT and maximum SRT were observed by SD-OCT.
ResultsThe subretinal fluid (SRF) of 31 eyes (72.09%) in the 30% dose group and that of 47 eyes (95.92%) in the 50% dose PDT group was absorbed completely respectively. The cure rates in the 30% dose PDT group was significantly less than that in the 50% dose group (χ2=10.077, P=0.020). There was a significant negative association between the cure rate and spot size by Logistic regression (odds ratio > 1, P=0.040). The difference of changes in the BCVA of logMAR in 50% dose group was better than that in 30% dose group after more than 12 months after PDT (P=0.036). On 3, 6, 12 and more than 12 months after PDT, the difference in CRT in 50% dose group and 30% dose group were not statistically significant (P=0.068, 0.060, 0.082, 0.067). The difference in maximum thickness of SRD was not statically significant (P > 0.05). SRF was appeared in 8 eyes (25.81%) of 31 eyes in the 30% dose group, while SRF was appeared in 1 eye (2.13%) of 47 eyes in the 50% dose group. The recurrence rate of 30% dose group was much higher than that of 50% dose group (P < 0.05).
ConclusionsFor acute CSC treated by PDT, the curative effect of 50% dose group is better than the 30% dose group.
Objective To observe the effect of medicineinduced posterior vitreous detachment (PVD) on proliferative vitreoretinopathy (PVR). Methods PVR was induced in the left eyes of 24 pigmented rabbits by intravitreal injection with platelet rich plasma. The rabbits were randomly divided into two experimental groups (group A and B) and one control group with 8 eyes in each group. Three hours later, the eyes in group A and B and the control group underwent intravireal injection with 1 U plasmin 0.05 ml+20 U hyaluronidase 0.05 ml, plasmin 0.1 ml, and balance salt solution 0.1 ml, respectively. The grade of PVR was recorded 1, 7, and 28 days after the intravitreal injection, and the eyes were examined by flash electroretinogram (FERG), B-scan, and retinal histopathological examination. Results The PVR models of rabbit eyes were induced successfully. On the 7th day after injection, complete and partial PVD was found in 5 and 3 eyes respectively in group A; partial PVD in 5 eyes and no complete PVD was observed in group B; there was no PVD in the other 3 eyes in group B and also in the eyes in the control group. On the 28th day after intravitreal injection, PVR grade of group A and B were both obviously lower than that of the control group（D=75.6, 98.9；P=0.003，P=0.011）; On the 7th and 28th day after injection, the b-wave amplitude in group A and B was significantly higher than that in the control group; PVR grade of the PVD eyes was lower than that of nonPVD eyes; PVR grade of the complete PVD eyes was only 0～1. Conclusions Three hours after the PVR models of rabbit eyes were induced, complete PVD induced by intravitreal injection of plasmin combined with hyaluronidase could prevent the development of PVR of rabbit eyes in some degree; partial PVD induced by plasmin alone or combined with hyaluronidase could relieve the development of PVR.
Objective：To observe the protective effect of ginkgo bilo ba extrac t (EGb 761), a free radical scavenger, on the photoreceptor cells after lighti nduced retinal damage.
Methods：Seventytwo female SpragueDa wley (SD) rats we re randomly divided into 4 groups: normal control group, lightinduced retinal da m age model group, model+physiological saline group, and model+EGb 761 group, with 18 rats in each group. All of the rats except the ones in the control group were exposed to white light at (2740plusmn;120) lx for 6 hours after the dark adap tation for 24 hours to set up the lightinduced retinal damage model. Rats in m o del + physiological saline group and model+EGb 761 group were intraperitoneall y injected daily with physiological saline and 0.35% EGb 761 (100 mg/kg), respec tively 7 days before and 14 days after the light exposure. Apoptosis of photorec eptor cells was detected 4 days after light exposure; 7 and 14 days after light exposure, histopathological examination was performed and the layer number of ou ter nuclear layers (ONL) on the superior and inferior retina was counted.
Results：Four days after light exposure, the apoptosis of photorecep tor cells was fou nd on ONL in model, model+ physiological saline and model+EGb 761 group, and w as obviously less in model + EGb 761 group than in model and model+physiologic al saline group. Seven days after light exposure, the layers of ONL on the super ior retina were 3 to 4 in model and model+physiological saline group, and 7 to 8 in model+EGb 761 group; the mean of the layer number of ONL in model+EGb 761 group (6.92plusmn;0.82) was less than that in normal control group (8.40plusmn;0.95) (t=-1.416, P＜0.05), but significantly more than that in model (5.96 plusmn;1.36 ) and model+physiological saline group (5.90plusmn;1.40）（t=1.024, 1.084; P＜0.05). Fourteen days after light exposure, the layers of ONL on the superior retina were 0 to 1 in model and model+physiological saline group, and 3 to 4 i n model+EGb 761 group. The mean of the layer number of ONL in model+EGb 761 group (5.5 2plusmn;1.06) was significantly more than that in model (3.44plusmn;2.15) and model + physiological saline group (3.37plusmn;1.91) (t=2.082, 2.146, P＜0.05).
Conclusion：EGb 761 can partially inhibit the apoptosis of pho toreceptor cells, thus exert protective effect on photoreceptor cells.
Objective To evaluate the safety repeated intravitreal injection of bevacizumab (Avastin) with different dosage in rabbitsprime;eyes. Methods Fourteen chinchilla rabbits were randomly divided into 3 groups, including both eyes of 2 rabbits in the control group,the right eyes of the other 12 rabbits in the experimental group,and the left eyes of the 12 rabbits in the experimental control group. The eyes in the experimental group underwent intravitreal injection of bevacizumab with the dosage of 2.5 mg/0.1 ml and 5.0 mg/0.2 ml of bevacizumab; the eyes in the experimental control group underwent intravitreal injection of normal saline with the same dosage as in the experimental group. Injections were performed every two weeks and lasted six weeks. Clinical observation and retinal function tests were performed before and two days after every injection. The eyes were sacrificed 1 week and 4 weeks after last intravitreal injection respectively.Electron and optical microscope and TUNEL were performed.Results After intravitreal injection,no obvious anterior chamber flare, abnormal change of the ocular fundus, or vitreous opacity and hemorrhage was observed in all of the eyes.No change was found by indirect ophthalmoscope,Bultrasonic inspection, ultrasound biomicroscopy and optical coherence tomography. The number of anterior chamber flare before and after the injection with the dosage of 2.5 and 5.0 mg, the difference among the 3 groups didnprime;t differ much from each other (Pgt;0.05).Amplitude and pattern of ERG responses and flash VEP were similar between the control and experimental groups (Pgt;0.05). Some inflammatory cells were found in the some bevacizumabinjected eyes 1 week after injection, and vanished 3 weeks later. The histological configuration of the retina didnprime;t change in both experimental control and the control group. Electron microscopy showed that plasma cells were presented and vacuolelike change was observed in part of the photoreceptor cells in 5.0 mg experimental group 1 week after injections.Cellular apoptosis was observed in the photoreceptor cell layer. The number of apoptotic cells was more in 5.0 mg experimental group than that in the control and experimental control group 1 week after injections (Plt;0.01). Conclusion Multiintravitreal injection with 5.0 mg bevacizumab may have mild toxicity to the retina in the rabbits.
PURPOSE: To investigate the treatment of severe bacterial endophthalmitis. METHODS:The curative effects of vitrectomy after intravitreal antibiotics and steroids (IVAS)for the treatment of 23 patients with bacterial endophthalmitis
(group I)and vitrectomy and IVA at the same time for the treatment of 28 patients with bacterial endopbthalmitis (group I)were analyzed retrospectively. RESULTS: The rate of curative effects of two groups were similar,while the marked curative effects in group I (47.8% )was significantly higher than that of the group I (17.9%). The average period of eliminating infiamation of group I was longer than that of group I , and the incidence of postoperative retinal detachment of group Ⅱ was 3 times more than that of group I . CONCLUSION :It was indicated that vitrectomy after IVAS may increase the security of vitrectomy and the curative effects of severe bacterial ndophthalmitis.
What drug dosage range is appropriate for treatment? What drug dosage range can maximally reduce the incidence of adverse drug reaction (ADR)? The gold zone method as a new method of evidence-based medical research was proposed to study those two blind areas of drug dosage in this article. Studying the dose-effect relationship, taking gold zone as the middle range and dividing empirical range into 3 sections were the key to study design. The evidence-based survey with extremely large sample showed a U-shaped rule existing between the antibiotics’ dosage and the incidence of ADR; and the dosage in gold zone appeared at the bottom of U-shaped curve. The gold zone method for determining dosage is a special breakthrough currently for solving those two blind areas of drug dosage
