Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography (FFA) for familial exudative vitreoretinopathy (FEVR). Methods 34 children (68 eyes) with FEVR and 64 parents (128 eyes) were included. All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy. Meanwhile the children were examined by RetcamⅡ,the best corrected visual acuity of parents were recorded. The children and their parents were classified according to the ocular findings. Among 68 eyes of children, 3 eyes (4.41%) were normal, 4 eyes (5.88%) were in stage 1, 7 eyes (10.29%) were in stage 2, 2 eyes (2.94%) were in stage 3, 8 eyes (11.76%) were in stage 4 and 44 eyes (64.71%) were in stage 5. Among 128 eyes of parents, 74 eyes (57.81%) were normal, 51 eyes (39.84%) were in stage 1, 1 eyes (0.78%) were in stage 2 and 2 eyes (1.56%) were in stage 5. FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage. Results FFA characteristics in children included uncompleted vascularization of the periphery, peripheral avascular zone (stage 1); neovascularization and/or peripheral subretinal and intraretinal exudation (stage 2); subtotal retinal detachment with attached fovea (stage 3); subtotal retinal detachment with detached fovea (stage 4) and total retinal detachment (stage 5). FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone (stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation (stage 2) and atrophia bulbi (stage 5). Conclusions FEVR in different stage has different FFA characteristics. FFA plays an important role in early diagnosis of FEVR.
Objective To observe the expression of erythropoietin (EPO) and its receptor (EPOR) mRNA and protein levels in retinae of mice with oxygen-induced retinopathy, and to evaluate the effect of EPO and EPOR in retinal vascular develo pment and in the occurrence and development of oxygen-induced retinopathy. Methods One hundred and thirty-two 7-day-old C57BL/6J mice were divided into two g rou ps: normal control group (control group) and oxygen-induced retinopathy group (experimental group). The proliferative neovascular response was estimated by obse rving the vascular pattern in adenosine diphosphatease (ADPase) stained retina flat-mounts by executing 6 mice in each group at the 12th, 15th, and 17th day, respectively. The expression of EPO, EPOR mRNA was determined by reverse transcription-polym erase chain reaction (RT-PCR), and the protein levels of EPO and E PO R were determined by immunohistochemistry. RT-PCR and immunohistochemistry were done every other day from the 7th to the 21st day. Results In the control group, retinal vascularization was found. In the experimental group, the large vesse ls were constricted straight, the branches decreased, and alarge nonperfusion area was observed at the 12th day; the large vessels were dilated and tortuous and neovascularization occurred at the 15th day; a mass of neovascularization was found and the vascular net structure of the deep and shallow layer was destroye d at the 17th day. The expression of EPO mRNA decreased from the 7th day and kee p decreasing in the whole oxygen-breathing duration in the experimental group. A fter the mice were returned to room air, the expression increased obviously from the 15th day and kept the high level until the 21st day. The expression of EPO mRNA increased at the 7th day and reached the peak at the 11th day, and kept the high level until the 21st day. The changes of protein levels of these three fac tors were later than that of their mRNA, but had the same trend. The difference of the expression between the two groups at the different time point was signifi cant except for the 7thday point (Plt;0.05). Conclusion It 's suggested that EPO and EPOR played important roles on the development of normal retina vascularizati on and the pathogenesis of ROP, which may provide new conception and method for the prevention and treatment of the oxygen-induced retinopathy.
Early detection and timely treatment hold the key to cure retinopathy of prematurity (ROP). ROP screening is carried out unevenly in China. Examination equipments and personnel experiences are the major factors to constraint ROP screening. In addition to strengthening personnel training, it is necessary to establish a standard guideline and pipeline for ROP consultation and referral. Laser photocoagulation and cryotherapy are the first options for the threshold ROP and Type 1 prethreshold ROP. Scleral buckling or vitrectomy is needed for advanced ROP when retinal detachment occurs. The clinical efficacy of intravitreal injection of bevacizumab (an anti-vascular endothelial growth factor monoclonal antibody) for severe ROP is encouraging, but needs further verification. Genetic interference and stem cell therapy will be the prosperous futures in the treatment of ROP. The screening and treatment of ROP in China is becoming more common and improved, but it is still a long way to go considering the huge population of China.
Refractory macular holes typically represent macular holes larger than 400 μm, macular holes in pathological myopic eyes or complicated with myopic schisis, chronic holes longer than 6 months, persistent macular holes after surgeries, and some subtypes of secondary macular holes. A routine pars plana vitrectomy combined with internal limiting membrane peeling yielded a lower closure rate and unsatisfying visual rehabilitation in patients with refractory macular holes, which raised concerns among vitreoretinal surgeons. This editorial reviewed the new upcoming surgical techniques which were reportedly to improve the anatomical and visual prognosis of major subtypes of refractory macular holes. Although with a great variability, these surgical techniques are based the following surgical strategies: firstly, to sufficiently unravel the epi-macular tractional force; secondly, to bridge the defect of neurosensory retina by tissue insertion or implantation and stimulate wound healing process; thirdly, proper tamponade of gas or silicone oil so that the surface tension can stabilize the inserted or implanted tissue and encourage closure of the holes. In conclusion, surgical strategies for refractory macular holes should be made after a comprehensive consideration and a customized design.