Objective To observe the hemodynamic changes in the retina and choroid after scleral buckling surgery in eyes with rhegmatogenous retinal detachment (RRD). MethodsA prospective clinical observational study. A total of 25 eyes of 25 patients with RRD who underwent scleral buckling surgery in Tianjin Eye Hospital from February to April 2024 were included in the study. Among them, 10 were male and 15 were female. Age was 17-68 years old. All cases were monocular. The surgical eye and the contralateral healthy eye were divided into the affected eye group and the contralateral healthy eye group respectively. Best corrected visual acuity (BCVA), scanning source optical coherence tomography angiography (SS-OCTA), and axial length (AL) measurements were performed 3 months after surgery. SS-OCTA examination of macular area was performed by VG200 of Visual Microimaging (Henan) Technology Co., LTD. Scanning range 21 mm×26 mm. According to the partitioning method of the early treatment group of glycosuria retinopathy, the retina within 21 mm of the macular fovea was divided into concentric circles with the macular fovea as the center and diameters of 1-3, 3-6, 6-12, 12-21 mm, respectively. The built-in software of the device was used to record the central area (12 mm×12 mm in the fovea of the macula) and the peripheral area (12-21 mm range) retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), radial peripapillary capillaries (RPC) blood density and choroidal vascular index (CVI), choroidal vascular volume (CVV), and 1-3, 3-6, 6-12, 12-21 mm above concentric circles (S), nasal side (N), temporal side (T), and lower side (I) SCP, DCP, and RPC blood flow density. Quantitative data between the two groups were compared by independent sample t test or Wilcoxon signed rank test. The correlation between retinal and choroid blood flow parameters and postoperative BCVA was analyzed by Spearman correlation analysis. ResultsCompared with the opposite healthy eye group, SCP blood density in the central area (Z=?4.372), DCP blood density in the central area (Z=?2.829), and CVI in the peripheral area (Z=?2.138) were decreased in the affected eye group, and the differences were statistically significant (P＜0.05). SCP: in the affected eye group, the blood flow density in T3-6 mm, T6-12 mm, N6-12 mm and T12-21 mm regions decreased, while the blood flow density in I6-12 mm regions increased, with statistical significance (P＜0.05). DCP: blood flow density in S6-12 mm, I6-12 mm, S12-21 mm and I12-21 mm regions decreased significantly, and the differences were statistically significant (P＜0.05). RPC: blood flow density decreased significantly in T6-12 mm and I12-21 mm, and the differences were statistically significant (P＜0.05). CVI: T6-12 mm, S12-21 mm, T12-21 mm, I12-21 mm significantly decreased, and T1-3 mm, S12-21 mm significantly increased, the differences were statistically significant (P＜0.05). Correlation analysis showed that AL growth was positively correlated with CVV in central region (r=0.408, P=0.040) . The number of pad pressure was negatively correlated with the blood density of central DCP (r=?0.422, P=0.030). ConclusionsAfter scleral buckling operation, the blood flow density and choroidal blood flow parameters in RRD affected eyes are lower than those in contralateral healthy eyes in some areas. The increase of AL is positively correlated with CVV in the central region, and the wider the range of pad pressure, the worse the recovery of DCP blood density.
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.