Objective To observe the fundus lesions in the unilateral rhegmatogenous retinal detachment (RRD) eyes and contralateral eyes in non-traumatic emmetropia patients, and explore the risks of lateral eyes. Methods This is a retrospective case analysis. A total of 426 patients of unilateral RRD diagnosed by clinical examination were enrolled in this study. There were 273 males and 74 females. The average age of onset was 54.7 years. 81.46% of them (347 patients) were 51 - 70 years old. The average detachment time was 2.12 months. They were divided into two groups, equal or lesser than 50 years old group and more than 50 years old group. A total of 100 patients (200 eyes) with ocular surface disorders were randomly selected as control. The lattice-like degeneration, cystic degeneration and dry retinal holes were treated with prophylactic laser photocoagulation. Follow-up period was 6 to 24 months. The age, gender, proliferative vitreous retinopathy (PVR) grading, best corrected visual acuity (BCVA), distribution and quantity of retinal holes, and posterior vitreous detachment (PVD) were retrospectively analyzed. The incidence of PVD among different age groups was compared with Chi square. Results Among 426 RRD eyes, there were 239 eyes (56.10%) with PVD. Among them, there were 30 eyes with age equal or lesser than 50 years old (12.55%) and 209 eyes with age more than 50 years old (84.75%). There were 187 eyes (43.90%) without PVD, which including 38 eyes with age equal or lesser than 50 years old (20.32%) and 149 eyes with age more than 50 years old (79.68%). The incidence of PVD among different age groups was statistically significant (χ2=4.72, P＜0.05). There were 10, 254, 40 and 5 eyes in class A, B, C and D of PVR, respectively; 117 eyes without PVR. The retinal hole was located in superior temporal, inferior temporal, superior nasal, inferior nasal and macular in 305, 91, 22, 4 and 4 eyes, respectively. The number of holes was 1, 2, and more than 3 in 297, 89 and 40 eyes, respectively. The retinal detachment range of 1, 2, 3 quadrants and total dissociation were 92, 230, 71, 33 eyes, respectively. The fundus lesion was found in 47 eyes (11.03%) in the lateral eyes. There were 20 RRD eyes in class B of PVR, and 27 RRD eyes in class C of PVR. Retinal degenerated area was found. Among them, the degeneration of 41 eyes was located in the temporal retina, 45 eyes involved in a quadrant. There were 16 eyes with peripheral retinal dry holes; the holes diameter was less than 1, 1 - 2, greater than 2 optic-discs in 6, 11 and 5 retinal holes. At the end of the follow-up, there were 47 eyes with almost normal visual field, 16 eyes with decreased visual acuity, no eyes with retinal detachment. In the control group, 4 patients (5 eyes, 2.50%) had fundus lesions. Conclusion The unilateral RRD in non-traumatic emmetropia mostly occurs in elderly patients; 11.03% of patients had fundus lesions in the contralateral eyes, higher than the general population.
Objective Mendelian randomization (MR) was used to analyze the potential relationship between blood pressure and proliferative diabetic retinopathy (PDR). MethodsTwo-sample MR analysis was performed using summary statistics from genome-wide association studies. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were selected as the exposure, PDR as the outcome. The instrumental variable of SBP and DBP came from the publicly available data of the the UK Medical Research Council Comprehensive Epidemiology Unit and Neale Laboratory; the outcome data (8 681 cases in the case group, 204 208 cases in the control group, European population) are from the FinnGen database. Inverse variance weighting (IVW) and weighted median (WM) were used to analyze the potential relationships between SBP, DBP and PDR. ResultsMR analysis showed that IVW [SBP: odds ratio (OR)=1.36, 95% confidence interval (CI) 1.17-1.57, P=4.22E-05; DBP: OR=1.29, 95%CI 1.11-1.51, P=8.6E-04], WM (SBP: OR=1.33, 95%CI 1.07-1.66, P=0.009; DBP: OR=1.28, 95%CI=1.03-1.59, P=0.002). The results showed that elevated SBP and DBP increased the risk of PDR. ConclusionBlood pressure (SBP, DBP) change is positively correlated with the risk of PDR.
ObjectiveTo examine the postoperative morphological changes in outer retinal wave-like changes (ORC) in eyes with rhegmatogenous retinal detachment (RRD). MethodsA retrospective clinical study. From March 2020 to March 2024, 64 eyes of 64 RRD patients diagnosed at The Second Affiliated Hospital of Zunyi Medical University were included. The cohort included 39 males (39 eyes) and 25 females (25 eyes), with a mean age of (45.3±15.7) years and a mean retinal detachment duration of (16.6±13.5) days. Macular involvement was observed in 51 eyes. Scleral buckling surgery (SB), pars plana vitrectomy (PPV), and SB+PPV were performed in 17, 44, and 3 eyes respectively. Best corrected visual acuity (BCVA) and spectral domain optical coherence tomography examinations were performed in all affected eyes. BCVA examination was performed using the standard logarithmic visual acuity chart, and the visual acuity was converted to logarithm of the minimum angle of resolution (logMAR) during statistics. Combined with the ORC situation before the operation, the morphological repositioning of outer retinal folds (ORF) after the operation was classified into types Ⅰ, Ⅱ and Ⅲ. One week and one and three months after the operation, relevant examinations were performed using the same equipment and methods as before the operation. The structural characteristics of ORC and the morphology of ORF after surgery were observed. The comparison between groups was conducted using the independent sample t test or the Mann-Whitney U test. ResultsAmong the 64 eyes, preoperative ORC was present in 46 eyes (71.9%, 46/64) and absent in 18 eyes (28.1%, 18/64). The 18 eyes without ORC had retinal detachment durations of either ≤4 days or ≥42 days. Postoperatively, ORF was observed in 51 eyes (79.7%, 51/64) and absent in 13 eyes (20.3%, 13/64). Among the 51 eyes with macular holes involved, 24 eyes (24/51, 47.1%) had ORF after the operation and 27 eyes (27/51, 52.9%) had no ORF. Among the 46 and 18 eyes with and without ORC, the ORF after surgery was 28 (60.9%, 28/46) and 1 (5.6%, 1/18) eyes, respectively. There was a statistically significant difference in the reduction rate of ORF after surgery between eyes with and without ORC (χ2=15.974, P＜0.001). Among the 46 eyes with ORC, the proportions of ORF to types Ⅰ, Ⅱ and Ⅲ after surgery were 24 (52.2%, 24/46), 20 (43.5%, 20/46), and 2 (4.3%, 2/46) eyes, respectively. There was no statistically significant difference in the incidence of ORF after different surgical methods in eyes with ORC (P＞0.05). One week and one month after the surgery, the logMAR BCVA of the affected eyes with and without ORF was 0.97±0.47, 0.69±0.34 and 0.85±0.32, 0.54±0.21, respectively. The BCVA of those without ORF was better than that of those with ORF, but the differences were not statistically significant (t=0.237, 0.408; P＞0.05). ConclusionsThe occurrence of ORC in RRD eyes has a certain relationship with the time of retinal detachment. For RRD eyes with ORC before the operation, the repositioning morphology after the operation is more likely to show changes in ORF. The transformation from ORC to ORF after ORC surgery has no correlation with the surgical method.
ObjectiveTo investigate the causes of secondary glaucoma after vitrectomy for familial vitreous amyloidosis associated with transthyretin (TTR) gene Gly83Arg mutation.MethodsA retrospective case study. From January 2008 to January 2020, 13 cases (23 eyes) with hereditary vitreous amyloidosis and treated by vitrectomy in the Affiliated Hospital of Zunyi Medical University were collected. Among them, there were 7 males with 12 eyes and 6 females with 11 eyes. The average age was 43.0±4.8 years. All the affected eyes underwent standard three-channel vitrectomy through the flat part of the ciliary body. According to whether complete vitreous detachment (PVD) was formed during the operation, it was divided into complete PVD group and incomplete PVD group; according to the occurrence time of secondary glaucoma and vitreous amyloidosis after surgery, it was divided into 1-12 months group and 13-36 months group, ＞37 months group. The average follow-up time after surgery was 36.7±6.0 months. The incidence of secondary glaucoma and the recurrence rate of vitreous amyloidosis between groups were compared by χ2 test; the correlation between recurrence of vitreous amyloidosis and secondary glaucoma after surgery was analyzed by Spearman rank correlation analysis.ResultsAmong the 23 eyes, there were 8 eyes in the complete PVD group and 15 eyes in the incomplete PVD group, respectively. Vitreous amyloidosis recurred in 15 eyes (65.22%, 15/23) after surgery. There were 14 (93.30%, 14/15) and 1 (6.70%, 1/15) eyes in the incomplete PVD group and the complete PVD group, respectively; the comparison of the recurrence rate of vitreous amyloidosis between the two groups was statistically significant (χ2=11.676, P＜0.01). 1-12 months group, 13-36 months group, ＞37 months group included 1 (4.35%, 1/23), 12 (52.17%, 12/23), 2 (8.70%, 2/23) Only eye. The recurrence rate in the 13-36 months group was significantly higher than that in the 1-12 months group and ＞37 month group. Secondary glaucoma occurred in 11 eyes (47.80%, 11/23) after surgery. 1-12 months group, 13-36 months group, above 37 months group were 1 (4.35%, 1/23), 8 (34.78%, 8/23), 2 (8.70%, 2/23) eyes. The incidence of secondary glaucoma in the 13-36 months group was higher than that in the 1-12 months group and ＞37 months group. Among 11 eyes with secondary glaucoma, 10 eyes had recurrence of vitreous amyloidosis after surgery, and 1 eye had no recurrence. The results of Spearman rank correlation analysis showed that there was a positive correlation between the recurrence of vitreous amyloidosis and the occurrence of secondary glaucoma (rs=0.516, P=0.012).ConclusionThe incidence of secondary glaucoma after vitrectomy in a family with vitreous amyloidosis caused by the Gly83Arg mutation of TTR gene is higher, and its occurrence is significantly positively correlated with the recurrence of vitreous amyloidosis.