目的:探讨玻璃体腔内注射雷珠单抗(IVR)联合577 nm阈值下微脉冲激光(STML)治疗病理性近视继发脉络膜新生血管(PM-CNV)的临床疗效。方法:选取2021年12月至2023年12月于包头市眼科医院就诊的PM-CNV患者52例52眼作为研究对象。采用数字抽...目的:探讨玻璃体腔内注射雷珠单抗(IVR)联合577 nm阈值下微脉冲激光(STML)治疗病理性近视继发脉络膜新生血管(PM-CNV)的临床疗效。方法:选取2021年12月至2023年12月于包头市眼科医院就诊的PM-CNV患者52例52眼作为研究对象。采用数字抽签方式将患者按1:1随机分为两组:对照组(26眼)仅接受IVR治疗;试验组(26眼)接受IVR-STML联合治疗。对比两组治疗前及治疗后3、6、9、12 mo最佳矫正视力(BCVA)、中心凹黄斑厚度(CMT)值和脉络膜新生血管(CNV)面积及IVR总次数的差异。结果:两组患者治疗前一般资料具有可比性。与治疗前相比,治疗后3、6、9、12 mo,两组患者视力均改善,CMT均降低、CNV面积均减小(均P<0.05);试验组治疗3、6 mo CMT及治疗6、9、12 mo CNV面积明显低于对照组(均P<0.05)。治疗12 mo内,试验组平均IVR总次数明显低于对照组(P<0.05)。结论:IVR单药治疗与IVR-STML联合治疗PM-CNV均能改善患者BCVA,且两组视力改善效果相当。IVRSTML联合治疗能更持久稳定地维持黄斑区解剖结构,有效抑制CNV病灶进展,并显著减少抗VEGF药物注射次数。该方案有助于减轻治疗负担、改善远期预后,具有显著临床优势。展开更多
目的:探究病理性近视脉络膜新生血管(PM-CNV)患者玻璃体内注射抗血管内皮生长因子(VEGF)药物的远期疗效及其影响因素。方法:回顾性病例对照研究。分析2020年1月至2023年2月在南阳南石医院接受玻璃体内注射抗VEGF药物治疗的145例PM-CNV...目的:探究病理性近视脉络膜新生血管(PM-CNV)患者玻璃体内注射抗血管内皮生长因子(VEGF)药物的远期疗效及其影响因素。方法:回顾性病例对照研究。分析2020年1月至2023年2月在南阳南石医院接受玻璃体内注射抗VEGF药物治疗的145例PM-CNV患者的临床资料,观察患者治疗前后不同时间点的最佳矫正视力(BCVA)及黄斑中心视网膜厚度(CMT)情况;根据随访2 a预后情况将患者分为疗效良好组和疗效不良组,比较两组患者一般资料,多因素Logistic回归分析患者疗效不良的影响因素;基于影响因素构建PM-CNV患者疗效不良的风险预测模型,采用受试者工作特征(ROC)曲线评估该模型的预测价值。结果:与治疗前相比,治疗后1、3、6、12、24 mo CMT显著降低、BCVA显著改善(均P<0.05)。与治疗后1 mo相比,治疗后3、6、12、24 mo CMT显著降低、BCVA显著改善(均P<0.05)。与治疗后3 mo相比,治疗后6、12、24 mo CMT显著降低、BCVA显著改善(均P<0.05)。与治疗后6 mo相比,治疗后24 mo BCVA显著改善(P<0.05)。相较于疗效良好组,疗效不良组患者年龄≥50岁占比更高,病程更长、注射次数更多、治疗前BCVA较差、治疗前CMT更厚(均P<0.05)。病程长、注射次数较多、治疗前BCVA较差、治疗前CMT厚是PM-CNV患者玻璃体内注射抗VEGF药物疗效不良的影响因素(均P<0.05)。基于影响因素构建联合预测模型,ROC结果显示,该联合模型预测PM-CNV患者疗效不良的曲线下面积(AUC)为0.756(95%CI:0.678-0.824),灵敏度86.27%、特异度62.77%、约登指数0.490,该联合模型预测效能良好。结论:抗VEGF药物能改善PM-CNV患者视力,降低CMT,其中病程长、注射次数较多、治疗前BCVA较差、治疗前CMT较厚是PM-CNV患者疗效不良的影响因素。展开更多
AIM:To evaluate the agreement of axial length(AL),anterior chamber parameters,and total cornea power obtained by swept-source optical coherence tomography(SS-OCT)-based and Scheimpflug-based optical biometers in myopi...AIM:To evaluate the agreement of axial length(AL),anterior chamber parameters,and total cornea power obtained by swept-source optical coherence tomography(SS-OCT)-based and Scheimpflug-based optical biometers in myopic children.METHODS:AL,steep keratometry(K),flat K,posterior corneal keratometry(PK),total keratometry(TK),anterior chamber depth(ACD),horizontal corneal diameter(CD),and central corneal thickness(CCT)were obtained using IOL Master 700 and Pentacam AXL.The agreement between the devices was evaluated using intraclass correlation coefficients(ICC),Bland-Altman plots,and astigmatism vector analysis.RESULTS:Totally 175 myopic children(48.5%male)with a mean age of 10.29±2.14y were enrolled.The ICC and Bland-Altman plots indicated a satisfactory agreement for AL,ACD,and CCT.The mean difference in CD of-0.31±0.30 mm was considered clinically significant(>0.2 mm).Additionally,measurements of K and TK obtained from the IOL Master 700 showed good agreement.Nevertheless,there were clinically significant differences observed in PK,simulated keratometry(simK),total cornea power,and astigmatism(at least 10%of the cases with a difference of>10 degrees in meridian)between the two devices.CONCLUSION:The study findings demonstrate a significant difference in K,PK,astigmatism,and CD,indicating that the two optical biometers cannot be considered interchangeable.Therefore,it is recommended to utilize one kind device for follow-up examinations in myopic children.展开更多
AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supple...AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.展开更多
文摘目的:探讨玻璃体腔内注射雷珠单抗(IVR)联合577 nm阈值下微脉冲激光(STML)治疗病理性近视继发脉络膜新生血管(PM-CNV)的临床疗效。方法:选取2021年12月至2023年12月于包头市眼科医院就诊的PM-CNV患者52例52眼作为研究对象。采用数字抽签方式将患者按1:1随机分为两组:对照组(26眼)仅接受IVR治疗;试验组(26眼)接受IVR-STML联合治疗。对比两组治疗前及治疗后3、6、9、12 mo最佳矫正视力(BCVA)、中心凹黄斑厚度(CMT)值和脉络膜新生血管(CNV)面积及IVR总次数的差异。结果:两组患者治疗前一般资料具有可比性。与治疗前相比,治疗后3、6、9、12 mo,两组患者视力均改善,CMT均降低、CNV面积均减小(均P<0.05);试验组治疗3、6 mo CMT及治疗6、9、12 mo CNV面积明显低于对照组(均P<0.05)。治疗12 mo内,试验组平均IVR总次数明显低于对照组(P<0.05)。结论:IVR单药治疗与IVR-STML联合治疗PM-CNV均能改善患者BCVA,且两组视力改善效果相当。IVRSTML联合治疗能更持久稳定地维持黄斑区解剖结构,有效抑制CNV病灶进展,并显著减少抗VEGF药物注射次数。该方案有助于减轻治疗负担、改善远期预后,具有显著临床优势。
文摘目的:探究病理性近视脉络膜新生血管(PM-CNV)患者玻璃体内注射抗血管内皮生长因子(VEGF)药物的远期疗效及其影响因素。方法:回顾性病例对照研究。分析2020年1月至2023年2月在南阳南石医院接受玻璃体内注射抗VEGF药物治疗的145例PM-CNV患者的临床资料,观察患者治疗前后不同时间点的最佳矫正视力(BCVA)及黄斑中心视网膜厚度(CMT)情况;根据随访2 a预后情况将患者分为疗效良好组和疗效不良组,比较两组患者一般资料,多因素Logistic回归分析患者疗效不良的影响因素;基于影响因素构建PM-CNV患者疗效不良的风险预测模型,采用受试者工作特征(ROC)曲线评估该模型的预测价值。结果:与治疗前相比,治疗后1、3、6、12、24 mo CMT显著降低、BCVA显著改善(均P<0.05)。与治疗后1 mo相比,治疗后3、6、12、24 mo CMT显著降低、BCVA显著改善(均P<0.05)。与治疗后3 mo相比,治疗后6、12、24 mo CMT显著降低、BCVA显著改善(均P<0.05)。与治疗后6 mo相比,治疗后24 mo BCVA显著改善(P<0.05)。相较于疗效良好组,疗效不良组患者年龄≥50岁占比更高,病程更长、注射次数更多、治疗前BCVA较差、治疗前CMT更厚(均P<0.05)。病程长、注射次数较多、治疗前BCVA较差、治疗前CMT厚是PM-CNV患者玻璃体内注射抗VEGF药物疗效不良的影响因素(均P<0.05)。基于影响因素构建联合预测模型,ROC结果显示,该联合模型预测PM-CNV患者疗效不良的曲线下面积(AUC)为0.756(95%CI:0.678-0.824),灵敏度86.27%、特异度62.77%、约登指数0.490,该联合模型预测效能良好。结论:抗VEGF药物能改善PM-CNV患者视力,降低CMT,其中病程长、注射次数较多、治疗前BCVA较差、治疗前CMT较厚是PM-CNV患者疗效不良的影响因素。
基金Supported by National Natural Science Foundation of Guangdong,China(No.2020A1515010829,No.2023A1515011652,No.2025A1515012389)Science and Technology Program of Guangzhou,China(No.2025A03J4033).
文摘AIM:To evaluate the agreement of axial length(AL),anterior chamber parameters,and total cornea power obtained by swept-source optical coherence tomography(SS-OCT)-based and Scheimpflug-based optical biometers in myopic children.METHODS:AL,steep keratometry(K),flat K,posterior corneal keratometry(PK),total keratometry(TK),anterior chamber depth(ACD),horizontal corneal diameter(CD),and central corneal thickness(CCT)were obtained using IOL Master 700 and Pentacam AXL.The agreement between the devices was evaluated using intraclass correlation coefficients(ICC),Bland-Altman plots,and astigmatism vector analysis.RESULTS:Totally 175 myopic children(48.5%male)with a mean age of 10.29±2.14y were enrolled.The ICC and Bland-Altman plots indicated a satisfactory agreement for AL,ACD,and CCT.The mean difference in CD of-0.31±0.30 mm was considered clinically significant(>0.2 mm).Additionally,measurements of K and TK obtained from the IOL Master 700 showed good agreement.Nevertheless,there were clinically significant differences observed in PK,simulated keratometry(simK),total cornea power,and astigmatism(at least 10%of the cases with a difference of>10 degrees in meridian)between the two devices.CONCLUSION:The study findings demonstrate a significant difference in K,PK,astigmatism,and CD,indicating that the two optical biometers cannot be considered interchangeable.Therefore,it is recommended to utilize one kind device for follow-up examinations in myopic children.
文摘AIM:To conduct a systematic review and Meta-analysis to determine the differential effects of combined lutein and zeaxanthin supplementation on myopia prevention in teenagers.It also investigates the effects of supplements dosage,intervention duration,and geographical variation on intervention results.METHODS:A systematic search and screening of randomized controlled trials(RCTs)completed between 2014 and 2023 was undertaken using the PubMed,EMBASE,Cochrane Library,and Web of Science databases,in accordance with the PRISMA recommendations.The Cochrane risk of bias method was used to assess the quality of the studies.A Meta-analysis was performed using Stata 17.0 to calculate standardized mean differences(SMDs)and 95%confidence intervals(CIs).Subgroup analyses were performed to look at the effects of different doses,intervention periods,and geographic areas.Additionally,publication bias was assessed using Egger’s test.RESULTS:Ten studies including 1035 participants with myopia were analyzed.Supplementation with lutein and zeaxanthin resulted in a significant reduction in axial length elongation among adolescents in the intervention group(SMD=-0.40,P=0.001),an increase in macular pigment optical density(SMD=0.50,P=0.010),and an enhancement in visual sensitivity(SMD=0.53,P=0.008).Subgroup analyses revealed that participants receiving high doses and those undergoing intervention for more than 12mo exhibited significantly improved outcomes compared to those in the low-dose and short-term groups(high-dose vs low-dose:SMD=-0.41 vs-0.22,P=0.003;>12mo vs 6-12mo:SMD=-0.43 vs-0.23,P=0.004,respectively).Furthermore,Egger’s test indicated no significant publication bias(P=0.094).CONCLUSION:Combined lutein and zeaxanthin supplementation has a significant effect on myopia prevention in adolescents,with more pronounced benefits observed in high-dose and long-term interventions.The findings provide scientific evidence for its use as an adjunctive approach in myopia control.
