Endophthalmitis caused by intravitreal injection is a rare disease which impair patients’s vision. In recent years, with the increase of the diseases and frequency of intravitreal injections, the incidence of endophthalmitis has increased. Standardizing each step of intravitreal injections is an important method to reduce postoperative endophthalmitis. Despite the current availability of prevention strategies providing by a lot of clinical trials, there are considerable variations and a lack of consensus and inconsistencies in clinical practice. Understanding the existing key measures, standardizing the operation of intravitreal injection in my country, and minimizing the incidence of infective endophthalmitis are of positive significance for improving the treatment of ophthalmology, especially fundus diseases.
ObjectiveTo observe and analyze the influencing factors for the prognosis of anti-vascular endothelial growth factor (VEGF) drug treatment in patients with macular neovascularization (MNV) under 45 years old. MethodsA retrospective clinical case study. A total of 89 MNV patients with 96 eyes who were diagnosed and treated with anti-VEGF drugs in Department of Ophthalmology of The Second Hospital of Lanzhou University from January 2020 to January 2024 were included in the study. The ages of all patients were ＜45 years old. All patients underwent best corrected visual acuity (BCVA) and optical coherence tomography (OCT) examinations; 49 eyes underwent OCT angiography (OCTA) examination. The BCVA examination was carried out using the international standard visual acuity chart and was converted into the logarithm of the minimum angle of resolution (logMAR) visual acuity for statistics. The macular foveal thickness (CMT) was measured using an OCT instrument. The size of the MNV lesion was measured using the software of the OCTA self-contained device. The affected eyes were given intravitreal injection of anti-VEGF drugs once, and then the drugs were administered as needed after evaluation. The follow-up time after treatment was ≥6 months. During the follow-up, relevant examinations were performed using the same equipment and methods as before treatment. The last follow-up was taken as the time point for efficacy evaluation. According to the OCT image characteristics of the MNV lesions, the affected eyes were divided into the fibrous scar group and the non-fibrous scar group, with 52 (54.16%, 52/96) and 44 (45.83%, 44/96) eyes respectively. Comparing the CMT and BCVA at the last follow-up with those at the baseline, the affected eyes were divided into the CMT reduction group, the CMT increase group, the BCVA improvement group and the BCVA reduction group, with 66 (68.75%, 66/96), 30 (31.25%, 30/96) eyes and 74 (77.08%, 74/96), 22 (22.92%, 22/96) eyes respectively. The Mann-Whitney U test was used for the comparison of non-normally distributed measurement data between groups. Logistic regression analysis was used to analyze the independent factors affecting the prognosis of MNV patients. ResultsThere were no statistically significant differences in the age (Z=?0.928) and gender composition ratio (χ2= 0.123) between the fibrous scar group and the non-fibrous scar group (P＞0.05); there were statistically significant differences in the number of eyes with a follow-up time of ≥36 months and ＜36 months (χ2= 3.906, P=0.048); there were statistically significant differences in the size of the MNV lesions (Z=?2.385, P=0.017); there were statistically significant differences in the number of eyes with different vascular network morphologies (χ2=12.936, P=0.001). Before treatment and at the last follow-up, the CMT of the affected eyes was 267.50 (237.25, 311.75) μm and 242.00 (217.25, 275.75) μm respectively; logMAR BCVA was 0.20 (0.10, 0.50) and 0.35 (0.16, 0.60) logMAR respectively. There were statistically significant differences in the CMT and logMAR BCVA before treatment and at the last follow-up (Z=?3.311,?1.984; P=0.001, 0.047). There were statistically significant differences in different ages (Z=?2.284), myopic diopter (χ2=7.437), etiology (χ2=6.956), and disease course (Z=?1.687) between the CMT reduction group and the CMT increase group (P＜0.05). There were statistically significant differences in the number of eyes with different subjective feelings between the BCVA improvement group and the BCVA reduction group (χ2=10.133, P＜0.05). The results of logistic regression analysis showed that the etiology was an independent risk factor for CMT thickening. ConclusionsAge, etiology, myopic diopter, disease course, follow-up time, lesion size and the morphology of the neovascular network are the influencing factors for the prognosis of anti-VEGF drug treatment in MNV patients under 45 years old. The etiology is an independent risk factor for CMT increase.
Obstructive sleep apnea hypopnea syndrome (OSAHS) is a disease in which apnea and hypopnea occur during sleep, and the main symptoms are sleep snoring. OSAHS is not only closely related to the occurrence of various eye diseases, but also the severity of OSAHS can affect the progression of related eye diseases. At present, continuous positive airway pressure (CPAP) is an effective means to treat OSAHS, and the progression of related eye diseases has been improved correspondingly after CPAP treatment. In the future, it is necessary to further study the pathogenesis of OSAHS and enrich the research evidence of the association between OSAHS and eye diseases, so as to provide more comprehensive theoretical evidence for the prevention and treatment of OSAHS-related eye diseases.
ObjectiveTo observe and evaluate the functional-structural correlations of quick contrast sensitivity function (qCSF), quantitative color vision, best-corrected visual acuity (BCVA), and peripapillary retinal nerve fiber layer (pRNFL) thickness among different stages of diabetic retinopathy (DR). MethodsA prospective cross-sectional observational study. From November 2023 to August 2025, 135 eyes of 79 patients with type 2 diabetes diagnosed at the Endocrinology Department of Lanzhou University Second Hospital were enrolled. According to the presence and severity of DR, the eyes were divided into no DR (NDR) group (53 patients, 99 eyes), non-proliferative DR (NPDR) group (18 patients, 27 eyes), and proliferative DR (PDR) group (8 patients, 9 eyes). Forty healthy volunteers (80 eyes) were selected as the control group during the same period. All subjects underwent BCVA, qCSF, color vision, and optical coherence tomography (OCT) examinations. BCVA was measured using the international standard visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Contrast sensitivity (CS) was measured at spatial frequencies of 3, 6, 12, and 18 cpd using a CS test instrument; the complete qCSF was plotted using Bayesian adaptive psychophysical algorithms, and the area under the log CS function (AULCSF) was exported. The average, superior, nasal, temporal, and inferior pRNFL thicknesses were measured using OCT. Binary logistic regression analysis was performed to identify risk factors affecting different stages of DR progression; receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic efficacy. ResultsSignificant differences were found among the control, NDR, NPDR, and PDR groups in logMAR BCVA (H=41.077), AULCSF (F=48.893), CS at different spatial frequencies (F=27.528, 35.194, 49.427, 39.689), color vision (H=41.165), and inferior and temporal pRNFL thicknesses (F=6.518, 3.177; P＜0.005). No significant differences were observed in superior, nasal, or average pRNFL thicknesses (F=1.828, 1.832, 0.934; P＞0.05). Multivariate binary logistic regression analysis showed that AULCSF and CS at 3 and 6 cpd were independent protective factors for DR progression (P＜0.05); color vision was an independent protective factor for DR progression (P＜0.05); BCVA was an independent risk factor for NPDR and PDR (P＜0.05), and pRNFL thickness was an independent protective factor for NPDR and PDR (P＜0.05). ROC curve analysis showed that the AUC values of AULCSF and color vision in distinguishing NDR (AUC=0.701?0.850) and NPDR (AUC=0.642?0.838) were higher than those of BCVA (AUC=0.610?0.726) and pRNFL thickness (AUC=0.501?0.560). ConclusionsDuring the progression of DR, qCSF and quantitative color vision can identify neural functional abnormalities earlier than visual acuity decline and structural damage during DR progression.