The therapeutic effect of anti-vascular endothelial growth factor (VEGF) for neovascular age-related macular degeneration (nAMD) was determined by a number of factors. Comprehensive thorough analysis of clinical features, imaging results and treatment response can predict the potential efficacy and possible vision recovery for the patient, and also can optimize the treatment regime to make a personalized therapy plan. Precise medicine with data from genomics, proteomics and metabolomics study will provide more objective and accurate biology basis for individual precise treatment. The future research should focus on comprehensive assessment of factors affecting the efficacy of anti-VEGF therapy, to achieve individualized precise diagnosis and treatment, to improve the therapeutic outcome of nAMD.
PURPOSE:To investigale the influence of orally administered aldose reduetace inhibitor(ARI) and myo-inositol (MI)for contents of gluecose,sorbitol and myo-inositol in experimental diabetic retinal tissue in rat. METHODS :The STZ-induced diabetic rats were administered ARI or MI by oral. The glucose sorbitol and myo-inositol in retinal tissues were analysed by high performance liquid chromatography after experimental period of 6 montbs. RESULTS:It was found that the contents of glucose and sorhitol were increased and myo inosltol was decreased in diabetic group. In diabetes with ARI group.the content of sorbitol was increased although the glucose was in high level. In diabetes wilb MI group,the sorbitol accumulaled and coment of myo-inositol was close to the normal control group. CONCLUSIONS:The ARI can effectively obstruct sorbitol accumulation in retina. MI increase myo-inositol level but fail to reduce sorbitol contenl of retina. （Chin J Ocul Fundus Dis,1997,13: 75-77 ）
The activities of tissue- type plasminogen activator (t-PA) and plasminogen activator inhibitor(PAl) in plasm from 61 patients with retinal vein occlusion (RVO) were measured by using chromatogenous substrate s-2390 assay.The results showed that the t-PA activity in the patients with RVO were decreased (1.69plusmn;0. 56IU/ml, P＜0.01) and PAI activity increased (8.80plusmn;1.60AU/ml, P＜0. 01) comparing with health subjects 2.07plusmn;0.40IU/ml and 7.33plusmn;0.67AU/ml respectively. Among the patients, t-PA activity in the patients with ischemic retinopathy was more obviously decreased (1.35plusmn;0.43IU/ml, P＜0.01) and the activity of PAI was increased (9.35plusmn;1.37AU/mi) comparing with those patients suffering from nonischemic retinopathy (the activities of t-PA and PAI were 1.92 + 0.53IU/ml and 8.42plusmn;1.29AU/ml respectively, Plt;0.01). In addition, these changes were getting more obvious with the degree of severity of the disease. These results indicated that there was disorder in the balance between t-PA and PAI in patients with RVO,which my play an important role in the course of occurrence and development of RVO, especially in ischemic type. （Chin J Ocul Fundus Dis,1994,10:71-73）
For choroidal neovascularization (CNV) secondary to pathological myopia, intravitreal injection of anti-VEGF has been widely used in clinic and achieved good outcome. However, due to the differences in the demographic characteristics, stages of disease progression and treatment procedure of CNV, the prognosis of the disease is variable. Complete ellipsoid band, smaller baseline choroidal neovascularization and better baseline vision are important predictors of good outcome of anti-vascular endothelial growth factor treatment. Chorioretinal atrophy or complications related to pathologic myopia indicate a poor prognosis. The influence of age, race, previous photodynamic therapy and early treatment on the prognosis of treatment need to be further studied.
ObjectiveTo investigate the efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to branch retinal vein occlusion (BRVO) during one year period. MethodsThe data of 31 eyes from 31 consecutive patients with macular edema secondary to BRVO during one year follow-up visit were retrospectively analyzed. Mean best corrected visual acuity (BCVA) logMAR was (0.74±0.36) and mean central retinal thickness (CRT) was (484.48±164.81)μm at baseline. All patients received standardized clinical comprehensive examinations including vision, intraocular pressure and optical coherence tomography for diagnosis before treatment. All patients received intravitreal injections of 0.5 mg ranibizumab (0.05 ml) at first visit. The continue PRN treatment were based on the visual acuity changes and the optical coherence tomography findings. Eyes received combined triamcinolone acetonide 0.05 ml (40 mg/ml) and ranibizumab for macular edema recurrence after two injections of ranibizumab and received laser photocoagulation during 10-14 days after third injections of ranibizumab. Mean injection of ranibizumab was 3.52±2.01, 15 eyes with triamcinolone acetonide (0.84±1.21), 21 eyes with laser photocoagulation (0.97±0.95) and 12 eyes with three treatment. Compared the visual acuities and CRTs of the first and the last visits by statistical analysis. ResultsMean visual acuity improved significantly to 0.42±0.33 logMAR (t=6.611, P=0.000). Mean improvement of visual acuity was 2.90±3.07 lines. A gain of three or more logarithmic lines was evaluated in 20/31 eyes (64.52%) at the last visit. Mean CRT was (326.19±117.80)μm (t=4.514, P=0.000).Mean reduction of CRT was (333.58±134.17)μm. A decrease of 100μm of CRT was evaluated in 17/31 eyes (54.84%). No severe ocular and systematic side effect was found. ConclusionThe efficacy and safety of intravitreal ranibizumab and (or) triamcinolone combined with laser photocoagulation for macular edema secondary to BRVO were assured.
ObjectiveTo systematically review the association between 5α-reductase inhibitors (5ARIs) and risk of sexual dysfunction in subjects with benign prostatic hyperplasia (BPH).MethodsPubMed, Web of Science, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on the association between 5ARIs and risk of sexual dysfunction in subjects with BPH from inception to October 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed by using Stata 12.0 software.ResultsA total of 15 studies involving 17 774 subjects were included. The results of the meta-analysis showed that compared with the placebo group, 5ARIs could significantly increase risk of erectile dysfunction (RR=1.52, 95%CI 1.36 to 1.69, P<0.000 1), while decrease libido (RR=1.79, 95%CI 1.37 to 2.32, P<0.000 1) and ejaculation disorder (RR=2.97, 95%CI 1.82 to 4.83, P<0.000 1) in subjects with BPH. Subgroup analysis of the type of 5ARIs, intervention period, publication year and sample size showed that the 5ARIs had a higher risk of sexual dysfunction than the placebo group.ConclusionsCurrent evidence shows that 5ARIs can increase risk of erectile dysfunction, decrease libido and ejaculation disorder in subjects with BPH. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.