After an injury of the peripheral nerve, therewould be naturally occurring the reduction oreven disappearance of FRAP from the substantiagelatinase in the corresponding part of the dorsalhorn of the spinal cord, The enzymhistochemical method was used to show the changesof FRAP activity before and after the nerveinjury. Aftcr the injury of the sciatic nerve,FRAP would be decreased in the correspondingpart of the spinal cord and gave a sharp contrastto that of the control rats and the uni...
ObjectiveTo evaluate the efficacy and safety of 41G ultramicroneedle subretinal injection of balanced salt solution (BSS) in the treatment of large diameter macular holes (MH). MethodsA prospective clinical intervention study. A total of 22 eyes of 22 large-diameter full-layer MH patients diagnosed by examination in Tianjin Eye Hospital from March to June 2024 were included in the study. The minimum diameter of MH in the affected eyes was all greater than 400 μm. The affected eyes received 25G pars plana vitrectomy combined with internal limiting membrane peeling and 41G ultramicroneedle subretinal injection of BSS. The affected eyes underwent best-corrected visual acuity (BCVA), microperimetry, fundus autofluorescence, and optical coherence tomography (OCT) examinations before and 1 and 3 months after surgery. BCVA was measured using the standard logarithmic visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical analysis. The minimum and base diameter of MH were measured using OCT. Microperimetry was performed using a macular integrity assessment device, recording the macular integrity index (MII) and macular threshold (MT) within 10° of the macular. The changes in BCVA, MII, MT, and the closure of MH and the occurrence of complications were compared and analyzed before and after surgery. For the comparison of the same continuous indicators before and after surgery, Student's t-test was used if the data were normally distributed and had equal variances, and the Mann-Whitney U test was used if the data were not normally distributed; the correlation between different indicators was analyzed using Pearson correlation analysis. ResultsAmong the 22 cases (22 eyes), there were 4 males and 18 females; all were unilaterally affected. The age was 66 (60, 71) years. The duration of the disease was 5 (2.5, 12.0) months. The logMAR BCVA of the affected eyes was 1.24±0.57, and the MII and MT were 100.0 (99.53, 100.00) and 19.0 (13.23, 21.78) dB, respectively. One month after surgery, all MH were closed, with 20 (90.91%, 20/22) and 2 (9.09%, 2/22) eyes classified as typeⅠand Ⅱ closure, respectively. At the last follow-up, the logMAR BCVA was 0.62±0.58, and the MII and MT were 99.9 (59.45, 100.00) and 23.6 (19.33, 26.25) dB, respectively; compared with before surgery, the BCVA (t=3.579), MII (Z=－2.374), and MT (Z=－2.997) were significantly improved, and the differences were all statistically significant (P＜0.05). Correlation analysis showed that postoperative BCVA was significantly positively correlated with preoperative BCVA (r=0.41), the minimum and base diameter of MH (r=0.64, 0.58), disease duration (r=0.63), and age (r=0.50) (P＜0.05). No surgery-related complications occurred in all affected eyes during the follow-up period. Conclusion41G ultramicroneedle subretinal injection of BSS can effectively improve the hole closure rate of large diameter MH-affected eyes in the short term, improve visual function, and has good safety.
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.