AIM:To evaluate the effectiveness of 532,577,and 810 nm lasers as an initial treatment for non-resolving central serous chorioretinopathy(CSC).METHODS:Following the Cochrane Collaboration Handbook and Preferred Report...AIM:To evaluate the effectiveness of 532,577,and 810 nm lasers as an initial treatment for non-resolving central serous chorioretinopathy(CSC).METHODS:Following the Cochrane Collaboration Handbook and Preferred Reporting Items for Systematic Reviews and Meta-analysis(PRISMA)guidelines,randomized clinical trials(RCTs),non-randomized cohorts,observational studies,and case series(>10 cases)assessing these lasers for non-resolving CSC with≥3mo of follow-up were included.Non-resolving CSC was defined as persistent subretinal fluid(SRF)for>3-6mo.Searches were conducted in PubMed,the Cochrane Library,and Embase(January 17,2025).Two authors independently performed data extraction and assessed the risk of bias.The primary outcome was SRF resolution on optic cherence tomography(OCT)at 3-6mo.Central retinal thickness(CRT)and best-corrected visual acuity(BCVA)were secondary outcomes.A random-effects model was employed to calculate pooled proportions with 95%confidence intervals(CIs),and heterogeneity was assessed using I²and Q statistics.RESULTS:Twenty-four studies(3 RCTs,21 non-RCTs)involving 829 non-resolving CSC eyes(77.6%male,mean age 45.36y)were included.SRF resolution was 59%(95%CI:0.51-0.67;I2=72.6%),showing no significant difference between lasers.Trim-and-fill adjustment raised SRF resolution to 65%(95%CI:0.44-0.81).CRT significantly decreased by 126.32µm(95%CI:95.99-156.65;P<0.0001;I2=95.7%),with the largest reduction noted for the 810 nm laser.BCVA change was 0.10 logMAR(95%CI:-0.03 to 0.22;P=0.13;I2=96.6%),indicating no significant visual improvement.CONCLUSION:This Meta-analysis supports the use of 532,577,and 810 nm subthreshold micropulse lasers as equally effective in resolving SRF in non-resolving CSC.展开更多
BACKGROUND Serous carcinoma of the uterine cervix(USCC)represents a rare subtype of cervical adenocarcinoma,classified into human papillomavirus(HPV)-independent and HPV-associated types.It is characterized by high in...BACKGROUND Serous carcinoma of the uterine cervix(USCC)represents a rare subtype of cervical adenocarcinoma,classified into human papillomavirus(HPV)-independent and HPV-associated types.It is characterized by high invasiveness and poor prognosis,with limited global reports on this condition.CASE SUMMARY A 58-year-old Chinese woman presented with painless vaginal bleeding after sexual intercourse,which appeared as droplets.HPV testing and histopathological analysis confirmed the diagnosis of HPV-associated primary serous carcinoma of the USCC.The patient underwent radical hysterectomy and was diagnosed with primary serous carcinoma of the uterine cervix,stage III C2(FIGO 2018).A multimodal treatment approach,including surgery,radiotherapy,and chemotherapy,was administered.After additional concurrent chemoradiotherapy and three cycles of chemotherapy,the patient showed no evidence of disease progression and achieved long-term survival for 53 months.CONCLUSION USCC is a rare and aggressive malignancy.Upon diagnosis,multimodal treatment strategies,including surgery,radiotherapy,and chemotherapy,can effectively prolong patient survival and improve prognosis.展开更多
AIM:To describe the influence of adding topical nepafenac to both;oral eplerenone and intravitreal aflibercept on serous foveal detachment in eyes with central serous chorioretinopathy(CSCR).METHODS:This retrospective...AIM:To describe the influence of adding topical nepafenac to both;oral eplerenone and intravitreal aflibercept on serous foveal detachment in eyes with central serous chorioretinopathy(CSCR).METHODS:This retrospective cohort study included 31 eyes with non-resolving and recurrent CSCR that have been treated between 2015 and 2022 at Kasr Alainy Hospital.They were subdivided into Group A,which had been treated with a combination of systemic eplerenone,intravitreal aflibercept and topical nepafenac,and Group B,which had been treated with a combination of systemic eplerenone and intravitreal aflibercept(without topical nepafenac).Our outcome measures included changes in the best corrected visual acuity(BCVA),central subfield macular thickness(CMT)and serous detachment height(SDH)at baseline and at 2mo after treatment.RESULTS:Group A included 16 eyes.BCVA improved significantly from a logMAR of 0.62±0.44 to 0.42±0.47(P=0.03),CMT decreased significantly from 401±61 to 301±100μm,and SDH decreased significantly from 188±81 to 71±100μm.Group B included 15 eyes.BCVA improved significantly from a logMAR of 0.68±0.39 to 0.55±0.62(P=0.03),CMT decreased significantly from 411±39μm to 334±92μm,and SDH decreased significantly from 191±88 to 121±74μm.There was a significant difference between changes in BCVA,CMT,and SDH between the two groups.CONCLUSION:Using topical nepafenac in combination with both systemic eplerenone,and intravitreal aflibercept may provide better results in the treatment of CSCR.展开更多
AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy...AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.展开更多
BACKGROUND High-grade serous ovarian carcinoma(HGSOC)is among the most lethal gynecological malignancies,characterized by late-stage diagnosis,extensive peritoneal dissemination,and limited treatment options,resulting...BACKGROUND High-grade serous ovarian carcinoma(HGSOC)is among the most lethal gynecological malignancies,characterized by late-stage diagnosis,extensive peritoneal dissemination,and limited treatment options,resulting in poor survival outcomes.The tumor microenvironment plays a critical role in disease progression and therapy resistance,with CD4+T cells exhibiting significant plasticity and functional heterogeneity.Regulatory T cells(Tregs)are particularly implicated in immune suppression and tumor evasion.However,the spatial distribution,functional states,and prognostic significance of CD4+T cell subtypes in HGSOC remain poorly understood.AIM To characterize the functional heterogeneity and tissue-specific distributions of CD4+T cell subtypes in HGSOC and identify biomarkers for therapy.METHODS We analyzed single-cell RNA sequencing(scRNA-seq)data from 42 HGSOC patients,examining samples collected from adnexal tissues and ascites.CD4+T cells were identified and classified into subtypes using unsupervised clustering and marker gene analysis.Functional profiling was performed using pathway enrichment,differential expression analysis,and functional signature scoring.Kaplan-Meier survival and Cox proportional hazards modeling were conducted to evaluate the prognostic value of CD4+T cell subtypes.RESULTS Distinct distributions of CD4+T cell subtypes were identified between adnexal tissues and ascites.Naive CD4+T cells were predominant in ascites,while Tregs and CXCL13-expressing CD4+T cells were enriched in adnexal tissues.Tregs were further categorized into four subtypes(Treg1,Treg2,Treg3,and TISG),each exhibiting unique molecular signatures and tissue-specific adaptations.Treg3 cells,enriched in adnexal tissues,were characterized by high levels of activation and exhaustion markers,correlating with poor clinical outcomes in HGSOC patients.CONCLUSION Treg3 cells drive immune suppression and tumor progression in HGSOC,making them a key immunotherapy target.Their adnexal enrichment highlights the need for tissue-specific immune profiling in precision treatment.展开更多
Objective:The expression of programmed death 1(PD-1)on CD8^(+)T cells is associated with their activation and exhaustion,while CD57 serves as a senescence marker.The impact of PD-1^(+)and CD57^(+)CD8^(+)T cells on the...Objective:The expression of programmed death 1(PD-1)on CD8^(+)T cells is associated with their activation and exhaustion,while CD57 serves as a senescence marker.The impact of PD-1^(+)and CD57^(+)CD8^(+)T cells on the prognosis of patients with advanced high-grade serous ovarian cancer(HGSOC)remain unclear.Methods:We assessed the percentages of PD-1^(+)and CD57^(+)CD8^(+)T cells in tumor-infiltrating lymphocytes(TILs,n=85)and tumor ascites lymphocytes(TALs,n=87)using flow cytometry.The optimal cutoffs for these markers in TILs and TALs were determined through the log-rank maximization method.Gene expression analysis elucidated the tumor immune microenvironment(TIME,n=36).Results:Patients with higher PD-1^(+)CD8^(+)TILs(>87.8%)exhibited longer platinum-free interval(PFI)and overall survival(OS).In contrast,those with elevated CD57^(+)CD8^(+)TALs(>28.69%)were more likely to experience chemotherapy and had lower complete remission rates,shorter PFI and OS.PD-1^(+)CD8^(+)TILs are primarily displayed an effector memory state with strong proliferative and secretory capabilities.Approximately 50%of CD57^(+)CD8^(+)TALs were terminally differentiated,exhibiting significantly impaired proliferation.Based on the proportions of PD-1^(+)CD8^(+)TILs and CD57^(+)CD8^(+)TALs,patients were categorized into good,median and poor prognosis groups,with median PFI of 47.78,27.29 and 11.96 months,respectively(P<0.0001).Median OS for these groups was not reach,49.23 and 30.92 months,respectively(P<0.0001).Patients with poor prognosis exhibit significantly reduced CD8^(+)T cell proportion and increased M2 macrophage in the TIME,alongside downregulation of multiple T cell activation-related pathways.Conclusions:Lower levels of PD-1^(+)CD8^(+)TILs and higher CD57^(+)CD8^(+)TALs,assessed prior to treatment,correlated with poor prognosis and suppressive TIME in advanced HGSOC.展开更多
AIM: To examine eplerenone(Inspra, Pfizer), a mineralocorticoid receptor antagonist, as a treatment option for chronic central serous chorioretinopathy(CSCR).METHODS: A retrospective consecutive case series was conduc...AIM: To examine eplerenone(Inspra, Pfizer), a mineralocorticoid receptor antagonist, as a treatment option for chronic central serous chorioretinopathy(CSCR).METHODS: A retrospective consecutive case series was conducted for patients receiving oral eplerenone for chronic CSCR. At baseline and each follow-up visit,spectral domain optical coherence tomography(SD-OCT)imaging was performed, including manual measurements of the height and diameter size of subretinal fluid. The primary outcome measure was the reduction in subretinal fluid following initiation of therapy.RESULTS: A total of 17 eyes of 13 patients treated with25 and 50 mg of oral eplerenone per day were identified.Subretinal fluid(SRF) decreased over time following eplerenone therapy(P = 0.007 and P =0.002, diameter and height respectively). Maximum SRF height decreased from a mean of 131.5 μm at baseline to 15.3 μm at day181+. SRF diameter decreased from an average of 2174.4μm at baseline to 46.9 μm at day 181 +. Log MAR visual acuity improved from 0.42(Snellen equivalent: 20/53) at baseline to 0.29(Snellen equivalent: 20/39) at day 181 +(P = 0.024). Central subfield thickness(CST) decreased from 339.5 μm at baseline to 270.3 μm at day 181+(P = 0.029).CONCLUSION: Eplerenone therapy resulted in significant anatomic and visual improvements in eyes with chronic CSCR.展开更多
BACKGROUND Pancreatic mixed serous-neuroendocrine neoplasms(MSNNs)are mixed tumors containing two components with different pathologies,namely,pancreatic serous cystic neoplasm(PSCN)and pancreatic neuroendocrine tumor...BACKGROUND Pancreatic mixed serous-neuroendocrine neoplasms(MSNNs)are mixed tumors containing two components with different pathologies,namely,pancreatic serous cystic neoplasm(PSCN)and pancreatic neuroendocrine tumor(PanNET).For MSNNs,diffuse PSCN involving the whole pancreas is extremely rare,with only eight previous case reports.CASE SUMMARY A 45-year-old Chinese woman,with a free previous medical history and no obvious symptoms,was found to have a pancreatic neoplasm and admitted to our hospital for further diagnosis in March 2018.Abdominal palpation revealed a painless,mobile mass in the epigastrium,and no abnormalities were observed in an examination of the nervous system and ocular system.A computed tomography scan showed multiple cystic lesions involving the whole pancreas ranging in diameter from 0.4 to 2 cm and also revealed an enhanced mass,2.2 cm in diameter,in the head of the pancreas.Moreover,multiple cysts were found in the kidneys bilaterally,and the right lobe of the liver contained a small cyst.A Whipple operation with total pancreatectomy and splenectomy was performed.A diagnosis of pancreatic MSNN was established,consisting of diffuse serous microcystic cystadenoma with a concomitant grade 2 PanNET.Of note,the patient had no personal or family history of Von Hippel-Lindau syndrome or other disease.CONCLUSION We report the first case of MSNN with a diffuse PSCN component involving the entire pancreas in a Chinese woman.It is important to be aware of its relationship with VHL syndrome,and close clinical follow-up is recommended.展开更多
Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomat...Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomatic and found incidentally. Despite overall low risk of malignancy, these pancreatic cysts still generate anxiety, leading to intensive medical investigations with considerable financial cost to health care systems. This review discusses the general background of serous cystic neoplasms, including epidemiology and clinical characteristics, and provides an updated overview of diagnostic approaches based on clinical features, relevant imaging studies and new findings that are being discovered pertaining to diagnostic evaluation. We also concisely discuss and propose management strategies for better quality of life.展开更多
There is evidence to suggest that follicle-stimulating hormone （FSH） can facilitate the neovascularization of ovarian cancers by increasing vascular endothelial growth factor （VEGF） expression in cancer cells, alt...There is evidence to suggest that follicle-stimulating hormone （FSH） can facilitate the neovascularization of ovarian cancers by increasing vascular endothelial growth factor （VEGF） expression in cancer cells, although the underlying molecular mechanism of this process is not well known. Therefore, we investigated the effect of FSH on VEGF expression in the ovarian cancer cell lines SKOV-3 and ES-2. Treatment with FSH significantly increased VEGF expression in a dose- and time-dependent manner. In addition, FSH treatment enhanced the expression of survivin and hypoxlainducible factor-1 （HIF-1α）. Knockdown of survivin or HIF-1α suppressed VEGF expression, but only knockdown of survivin inhibited FSH-stimulated VEGF expression. Pretreatment with LY294002, a phosphoinositide 3-kinase （PI3K）/AKT inhibitor, neutralized the enhanced expression of survivin induced by FSH, but treatment with U0126, a mitogen-activated protein kinase/extracellular signal-regulated kinase inhibitor, had no such effect. We further showed that ovarian serous cystadenocarcinoma samples had much higher incidence of positive AKT and phosphorylated AKT （pAKT） protein staining than did benign ovarian cystadenoma samples （p 〈 0.01）. The 5-year survival rate was only about 15% in patients with ovarian serous cystadenocarcinoma who had AKT and pAKT expression, whereas it was about 80% in those who did not have AKT or pAKT expression. Taken together, these results indicate that FSH increases the expression of VEGF by upregulating the expression of survivin, which is activated by the PI3K/AKT signaling pathway. Understanding the role of the PI3K/AKT pathway in FSH-stimulated expression of survivin and VEGF will be beneficial for evaluating the prognosis for patients with ovarian serous cystadenocarcinoma and for pursulug effective treatment against this disease.展开更多
AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reade...AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reader performance. METHODS： The MDCT scans of 164 patients with surgically verified pancreatic cystic lesions were reviewed by two readers to study the predictive value of various morphological features for establishing a diagnosis of SCAs. Accuracy in lesion characterization and reader confidence were correlated with lesion size （≤3 cm or 〉≥3 cm） and scanning protocols （dedicated vs routine）. RESULTS： 28/164 cysts （mean size, 39 mm; range, 8-92 mm） were diagnosed as SCA on pathology. The MDCT features predictive of diagnosis of SCA were microcystic appearance （22/28, 78.6%）, surface Iobulations （25/28, 89.3%） and central scar （9/28, 32.4%）. Stepwise logistic regression analysis showed that only microcystic appearance was significant for CT diagnosis of SCA （P = 0.0001）. The sensitivity, specificity and PPV of central scar and of combined microcystic appearance and Iobulations were 32.4%/100%/100% and 68%/100%/100%, respectively. The reader confidence was higher for lesions 〉 3 cm （P = 0.02） and for MDCT scans performed using thin collimation （1.25-2.5 mm） compared to routine 5 mm collimation exams （P 〉 0.05）. CONCLUSION： Central scar on MDCT is diagnostic of SCA but is seen in only one third of SCAs. Microcystic morphology is the most significant CT feature in diagnosis of SCA. A combination of microcystic appearance and surface Iobulations offers accuracy comparable to central scar with higher sensitivity.展开更多
AIM: To summarize the clinical features, systemic associations, risk factors and choroidal thickness (CT) changing in posterior scleritis (PS) with serous retinal detachment.METHODS: This retrospective study included ...AIM: To summarize the clinical features, systemic associations, risk factors and choroidal thickness (CT) changing in posterior scleritis (PS) with serous retinal detachment.METHODS: This retrospective study included 23 patients diagnosed PS with retinal detachment from August 2012 to July 2017. All patients' medical history and clinical features were recorded. The examinations included best corrected visual acuity (BCVA), intraocular pressure (IOP), fundus examination, and routine eye examinations. Posterior coats thickness (PCT) was determined by B-scan ultrasound, the CT was measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and clinical data were compiled and analyzed.RESULTS: After application of extensive exclusion criteria, 23 patients with PS remained (13 females, 10 males). The average age at presentation was 29.5±9.24 years old. Ocular pain and blurred vision were the two most common complained symptoms by patients. Anterior scleritis occurred in 12 patients, which was confirmed by ultrasound biomicroscopy (UBM) examination. Despite all patients displaying serous retinal detachment in their macula, no fluorescein leakage was observed in the macular area. Optic disc swelling was documented in 10 of the 23 eyes. From B-scan ultrasound examination, the PCT in creased with fluid in Tenon's capsule demonstrated as a typical T-sign. The average PCT was 2.51±0.81 mm in the PS-affected eyes and only 1.09±0.29 mm in the unaffected eye (P<0.0001). The subfoveal CT was 442.61 ±55.61 μm, which correlated with axis length (r=-0.65, P=0.001) and PCT (r=0.783, P<0.001). The BCVA and IOP did not correlate with either CT or PCT.CONCLUSION: PS with serous retinal detachment presented a variety of symptoms, such as pain, visual loss, and physical indicators. Typical T-sign detected by B-scan ultrasound is a useful confirmatory sign for PS diagnosis. Pathological increases in CT might be a potential predictive factor for inflammation.展开更多
The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mim...The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts(honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm(IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.展开更多
and FA for identifying pathological abnormalities in CSC. The characteristics of IA AF in CSC were attributable to the modification of melanin in the RPE. IR- AIM: To evaluate the correlation among changes in fundus a...and FA for identifying pathological abnormalities in CSC. The characteristics of IA AF in CSC were attributable to the modification of melanin in the RPE. IR- AIM: To evaluate the correlation among changes in fundus autofluorescence (AF) measured using infrared fundus AF (IR -AF) and short-wave length fundus AF (SW -AF) with changes in spectral -domain optical coherence tomography (SD -OCT) and fluorescein angiography (FA) in central serous chorioretinopathy (CSC). METHODS: Two hundred and twenty consecutive patients with CSC were included. In addition to AF, patients were assessed by means of SD -OCT and FA. Abnormalities in images of IA -AF, SW -AF, FA were analyzed and correlated with the corresponding outer retinal alterations in SD-OCT findings. RESULTS: Eyes with abnormalities on either IR-AF or SW-AF were found in 256 eyes (58.18%), among them 256 eyes (100%) showed abnormal IR -AF, but SW-AF abnormalities were present only in 213 eyes (83.20%). The hypo-IR-AF corresponded to accumulation of subretinal liquid, collapse of retinal pigment epithelium (APE) or detachment of APE with or without RPE leakage point in the corresponding area. The hyper -IR -AF corresponded to the area with loss of the ellipsoid portion of the inner segments and sub -sensory retinal deposits or focal melanogenesis under sensory retina. The hypo-SW-AF corresponded to accumulation of subretinal liquid or atrophy of RPE. The hyper -SW -AF associated with sub -sensory retinal deposits, detachment of RPE and focal melanogenesis. CONCLUSION: IR-AF was more sensitive than SW-AF AF should be used as a common diagnostic tool for identifying pathological lesion in CSC.展开更多
·AIM:To analyze the efficacy and safety of subthreshold micropulse laser(SML)in the treatment of acute central serous chorioretinopathy(CSC).·METHODS:This is a retrospective case analysis study.Totally 58 ey...·AIM:To analyze the efficacy and safety of subthreshold micropulse laser(SML)in the treatment of acute central serous chorioretinopathy(CSC).·METHODS:This is a retrospective case analysis study.Totally 58 eyes of 58 patients were enrolled,and they were divided into different groups.And 39 patients were treated with SML(SML group)and 19 patients were only observed(observation group).The follow-up period was 3mo after diagnosis.The best corrected visual acuity(BCVA),central retinal thickness(CRT),superficial retinal vascular density(SRVD),deep retinal vascular density(DRVD),the superficial and deep foveal avascular zone(FAZ)area,retinal light sensitivity(RLS),perfusion area of choroidal capillary layer(CCL),subfoveal choroidal thickness(SFCT)and fundus autofluorescence(FAF)were investigated.·RESULTS:The BCVA,CRT,SRVD,DRVD,the superficial and deep FAZ area,RLS,SFCT of SML group were significantly improved at 3mo(all P<0.05).In the observation group,only CRT,DRVD and SFCT were improved(all P<0.05).Other research items in the observation group were not significantly different from baseline(all P>0.05).At the last follow-up,the BCVA and RLS in the SML group were better than those in the observation group,and CRT was lower,SRVD and DRVD,perfusion area of CCL were larger(all P<0.05).On FAF,no change of treatment spots was found after treatment.No structural laser damage was observed on optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),and no choroidal neovascularization was observed.·CONCLUSION:SML treatment of acute CSC can improve BCVA,RLS,and perfusion area of CCL,reduce CRT,increase SRVD and DRVD,and is safe.展开更多
Central serous chorioretinopathy （CSC） is characterized by a localized accumulation of subretinal fluid and an idiopathic focal leakage from choroidal vessels. The exact pathogenesis of CSC, however, still remains o...Central serous chorioretinopathy （CSC） is characterized by a localized accumulation of subretinal fluid and an idiopathic focal leakage from choroidal vessels. The exact pathogenesis of CSC, however, still remains obscure. In this paper, we hypothesized that CSC may result from a response of choroidal vessels to an acute increase in the environmental light intensity leading to a focal leakage from the choroidal vessels. High levels of glucocorticoids, in our proposed model, may cause persistence rather than initiation of the focal leakage, probably by suppressing the synthesis of collagen and extracellular matrix components and inhibiting fibroblastic activity.展开更多
AIM:To discuss and compare the fundus autofluorescence(FAF)and optical coherence tomography(OCT)in acute or chronic central serous chorioretinopathy(CSCR).METHODS:Medical records of 100 cases of CSCR were reviewed.Acu...AIM:To discuss and compare the fundus autofluorescence(FAF)and optical coherence tomography(OCT)in acute or chronic central serous chorioretinopathy(CSCR).METHODS:Medical records of 100 cases of CSCR were reviewed.Acute and chronic cases were evaluated according to the duration of decreased visual acuity,serous retinal detachment(RD)and focal leakage on fluorescein angiography(FA).Chi-square test was used for statistical analysis.RESULTS:Forty cases had acute and 60 cases had chronic CSCR.FAF showed focal hypo-autofluorescence in 34(85%)and iso-autofluorescence in 6(15%)of acute cases and hypo-autofluorescence in 51(85%),hyperautofluorescence in 6(10%)and iso-autofluorescence in3(5%)of chronic cases.OCT showed serous RD with distinct borders correlated with FAF findings(hypoautofluorescence)in all acute CSCR cases.In chronic CSCR group,OCT showed serous RD with indistinct borders correlated with FAF findings.The differences between the OCT and FAF findings of the two groups were significant(P=0.000).CONCLUSION:OCT and FAF findings can support the clinical observations in differential diagnosis of acute and chronic CSCR and help clinicians to evaluate retinal pigment epithelium,outer segments of photoreceptors and the components of serous RD.展开更多
AIM:To evaluate the efficacy and safety of subthreshold micropulse yellow laser(SMYL)in the treatment of chronic central serous chorioretinopathy(CCSC).METHODS:The medical records of 58 eyes of 58 patients with CCSC w...AIM:To evaluate the efficacy and safety of subthreshold micropulse yellow laser(SMYL)in the treatment of chronic central serous chorioretinopathy(CCSC).METHODS:The medical records of 58 eyes of 58 patients with CCSC were reviewed.A 577-nm SMYL system was used for the treatment.Fundus fluorescein angiography was used as the primary method of identifying CCSC,and resolution of subretinal fluid(SRF)evaluated by optical coherence tomography(OCT)and fundus autofluorescence.Central macular thickness(CMT),central macular volume(CMV),total macular volume(TMV),subfoveal choroidal thickness(SFCT),subretinal fluid height(SRFH),and subfoveal fluid basement diameter values were measured by spectral domain-OCT(SD-OCT)for all eyes.RESULTS:The mean age of the patients was 42.4±9.9(range:20-72)y.The mean follow-up was 11.4±8.5(range:6-37)mo.Median BCVA at at the final follow up after treatment was statistically significant from the baseline.Complete SRF resolution was 12.1%of the eyes in the 1^st month,67.2%of the eyes in the 3rd month and 67.2%of the eyes in the last follow up.The initial median CMT,CMV,TMV,and SFCT values before treatment was significantly higher than 3^rd month visit values(P<0.001).In the multivariate analysis performed,age and disease duration were found to be a risk factor for persistent SRF(P=0.017,P=0.016,respectively).CONCLUSION:SMYL treatment provides a significant anatomical and functional improvement and is effective in eliminating SRF in eyes with CCSC.展开更多
AIM: To evaluate chorioretinal responses to intravitreal aflibercept injection(IAI) in patients with acute central serous chorioretinopathy(CSC). METHODS: Seventy-one eyes from 71 patients with symptomatic CSC for les...AIM: To evaluate chorioretinal responses to intravitreal aflibercept injection(IAI) in patients with acute central serous chorioretinopathy(CSC). METHODS: Seventy-one eyes from 71 patients with symptomatic CSC for less than six months were included. Thirty-five eyes received a single IAI and 36 eyes were observed without treatment. Best-corrected visual acuity(BCVA), central subfield foveal thickness(CSFT), and subfoveal choroidal thickness(SFCT) were assessed at baseline and at 1, 2, and 3 mo. RESULTS: The mean SFCT in the IAI group decreased at 1 mo, rebounded at 2 mo and remained stable at 3 mo compared to the baseline, while significant change was not noted in the observation group. The mean CSFT decreased significantly during the 3-month study period in both groups, and was significantly lower in the IAI group at 1 mo(P<0.001). A rebound of CSFT between 1 and 2 mo was noted in 14 eyes(40.0%) in the IAI group and in 1 eye(2.8%) in the observation group(P<0.001). The significant visual improvement was achieved from 1 mo in the IAI group, and from 2 mo in the observation group. The rate of complete absorption of subretinal fluid at 3 mo did not differ between the two groups.(45.7% vs 41.7%, P=0.813). CONCLUSION: A single IAI for acute CSC induce a transient decrease in SFCT and CSFT, which implies that IAI may have a pharmacological effect on the underlying hyperpermeable choroid in acute CSC.展开更多
Helicobacter pylori(H. pylori), a Gram-negative bacterium, is one of the most frequent causes of gastrointestinal infections worldwide. It has been associated as a pathogen for the human body with many systemic diseas...Helicobacter pylori(H. pylori), a Gram-negative bacterium, is one of the most frequent causes of gastrointestinal infections worldwide. It has been associated as a pathogen for the human body with many systemic diseases, including different eye diseases. We will focus on a specific eye disease called idiopathic central serous chorioretinopathy(ICSCR). This disease is characterized by a serous detachment of the neurosensory retina in the macular region, which affects the vision to different degrees. Currently, the pathophysiology of ICSCR is not clear and there is no effective treatment. However, several potential risk factors have been elucidated. One of the factors that has more frequently been associated with ICSCR is stress. As H. pylori was identified as a possible etiological factor for occlusive arterial diseases in young people who were particularly stressed, it was thought that H. pylori might also be present in ICSCR. Therefore, some physicians started to test its presence in patents with ICSCR. If H. pylori happened to be associated with ICSCR, the treatment of gastrointestinal infection could also improve visual symptoms and help to remediate this eye disease. Although H. pylori is highly prevalent in the general population, a true cor-relation seems to exist. We present a review on the relationship between ICSCR and H. pylori.展开更多
文摘AIM:To evaluate the effectiveness of 532,577,and 810 nm lasers as an initial treatment for non-resolving central serous chorioretinopathy(CSC).METHODS:Following the Cochrane Collaboration Handbook and Preferred Reporting Items for Systematic Reviews and Meta-analysis(PRISMA)guidelines,randomized clinical trials(RCTs),non-randomized cohorts,observational studies,and case series(>10 cases)assessing these lasers for non-resolving CSC with≥3mo of follow-up were included.Non-resolving CSC was defined as persistent subretinal fluid(SRF)for>3-6mo.Searches were conducted in PubMed,the Cochrane Library,and Embase(January 17,2025).Two authors independently performed data extraction and assessed the risk of bias.The primary outcome was SRF resolution on optic cherence tomography(OCT)at 3-6mo.Central retinal thickness(CRT)and best-corrected visual acuity(BCVA)were secondary outcomes.A random-effects model was employed to calculate pooled proportions with 95%confidence intervals(CIs),and heterogeneity was assessed using I²and Q statistics.RESULTS:Twenty-four studies(3 RCTs,21 non-RCTs)involving 829 non-resolving CSC eyes(77.6%male,mean age 45.36y)were included.SRF resolution was 59%(95%CI:0.51-0.67;I2=72.6%),showing no significant difference between lasers.Trim-and-fill adjustment raised SRF resolution to 65%(95%CI:0.44-0.81).CRT significantly decreased by 126.32µm(95%CI:95.99-156.65;P<0.0001;I2=95.7%),with the largest reduction noted for the 810 nm laser.BCVA change was 0.10 logMAR(95%CI:-0.03 to 0.22;P=0.13;I2=96.6%),indicating no significant visual improvement.CONCLUSION:This Meta-analysis supports the use of 532,577,and 810 nm subthreshold micropulse lasers as equally effective in resolving SRF in non-resolving CSC.
基金Supported by the Sichuan Science and Technology Program,No.2022NSFSC0797.
文摘BACKGROUND Serous carcinoma of the uterine cervix(USCC)represents a rare subtype of cervical adenocarcinoma,classified into human papillomavirus(HPV)-independent and HPV-associated types.It is characterized by high invasiveness and poor prognosis,with limited global reports on this condition.CASE SUMMARY A 58-year-old Chinese woman presented with painless vaginal bleeding after sexual intercourse,which appeared as droplets.HPV testing and histopathological analysis confirmed the diagnosis of HPV-associated primary serous carcinoma of the USCC.The patient underwent radical hysterectomy and was diagnosed with primary serous carcinoma of the uterine cervix,stage III C2(FIGO 2018).A multimodal treatment approach,including surgery,radiotherapy,and chemotherapy,was administered.After additional concurrent chemoradiotherapy and three cycles of chemotherapy,the patient showed no evidence of disease progression and achieved long-term survival for 53 months.CONCLUSION USCC is a rare and aggressive malignancy.Upon diagnosis,multimodal treatment strategies,including surgery,radiotherapy,and chemotherapy,can effectively prolong patient survival and improve prognosis.
文摘AIM:To describe the influence of adding topical nepafenac to both;oral eplerenone and intravitreal aflibercept on serous foveal detachment in eyes with central serous chorioretinopathy(CSCR).METHODS:This retrospective cohort study included 31 eyes with non-resolving and recurrent CSCR that have been treated between 2015 and 2022 at Kasr Alainy Hospital.They were subdivided into Group A,which had been treated with a combination of systemic eplerenone,intravitreal aflibercept and topical nepafenac,and Group B,which had been treated with a combination of systemic eplerenone and intravitreal aflibercept(without topical nepafenac).Our outcome measures included changes in the best corrected visual acuity(BCVA),central subfield macular thickness(CMT)and serous detachment height(SDH)at baseline and at 2mo after treatment.RESULTS:Group A included 16 eyes.BCVA improved significantly from a logMAR of 0.62±0.44 to 0.42±0.47(P=0.03),CMT decreased significantly from 401±61 to 301±100μm,and SDH decreased significantly from 188±81 to 71±100μm.Group B included 15 eyes.BCVA improved significantly from a logMAR of 0.68±0.39 to 0.55±0.62(P=0.03),CMT decreased significantly from 411±39μm to 334±92μm,and SDH decreased significantly from 191±88 to 121±74μm.There was a significant difference between changes in BCVA,CMT,and SDH between the two groups.CONCLUSION:Using topical nepafenac in combination with both systemic eplerenone,and intravitreal aflibercept may provide better results in the treatment of CSCR.
基金Supported by General Program of National Natural Science Foundation of China(No.82471110)National Key Research and Development Program of China(No.2022YFC2502805)Postdoctoral Foundation of General Hospital of Central Theater Command(No.20210517KY04).
文摘AIM:To investigate the choroidal vascular index(CVI)and the choroidal structural changes beyond the subfoveal area(analyzed across a 20 mm×24 mm scanning area)in eyes with chronic central serous chorioretinopathy(cCSC)eyes with macular neovascularization(MNV)using ultra-widefield swept-source optical coherence tomography angiography(UWF SS-OCTA).METHODS:This retrospective comparative study included 46 cCSC with MNV eyes(With MNV group),52 cCSC without MNV eyes(Without MNV group),and 40 age-matched healthy controls.UWF SS-OCTA imaging with a 20 mm×24 mm protocol was used to quantify CVI across 9 subfields(superotemporal,superior,superonasal,temporal,central,nasal,inferotemporal,inferior,and inferonasal).The CVI was compared among the groups.RESULTS:With MNV group demonstrated significantly older mean age than Without MNV group(56.2±6.1 vs 47.5±8.6y,P<0.001).The CVI was significantly lower in the With MNV group than in the Without MNV group,except in the superotemporal,superior,and temporal regions(all P<0.05).Notably,despite MNV-associated CVI reductions,the With MNV group maintained a higher CVI than the control group in all 5 subfields(superior,temporal,central,inferior,and inferonasal;all P<0.05).In the central region,CONCLUSION:CVI decreases,and choroidal structural changes extend beyond the subfoveal area in cCSC with MNV eyes,providing with an imaging evidence for the important role of choroidal ischemia in the pathogenesis of MNV in cCSC.
基金Supported by The Natural Science Foundation of Hunan Province,China,No.2022JJ30329.
文摘BACKGROUND High-grade serous ovarian carcinoma(HGSOC)is among the most lethal gynecological malignancies,characterized by late-stage diagnosis,extensive peritoneal dissemination,and limited treatment options,resulting in poor survival outcomes.The tumor microenvironment plays a critical role in disease progression and therapy resistance,with CD4+T cells exhibiting significant plasticity and functional heterogeneity.Regulatory T cells(Tregs)are particularly implicated in immune suppression and tumor evasion.However,the spatial distribution,functional states,and prognostic significance of CD4+T cell subtypes in HGSOC remain poorly understood.AIM To characterize the functional heterogeneity and tissue-specific distributions of CD4+T cell subtypes in HGSOC and identify biomarkers for therapy.METHODS We analyzed single-cell RNA sequencing(scRNA-seq)data from 42 HGSOC patients,examining samples collected from adnexal tissues and ascites.CD4+T cells were identified and classified into subtypes using unsupervised clustering and marker gene analysis.Functional profiling was performed using pathway enrichment,differential expression analysis,and functional signature scoring.Kaplan-Meier survival and Cox proportional hazards modeling were conducted to evaluate the prognostic value of CD4+T cell subtypes.RESULTS Distinct distributions of CD4+T cell subtypes were identified between adnexal tissues and ascites.Naive CD4+T cells were predominant in ascites,while Tregs and CXCL13-expressing CD4+T cells were enriched in adnexal tissues.Tregs were further categorized into four subtypes(Treg1,Treg2,Treg3,and TISG),each exhibiting unique molecular signatures and tissue-specific adaptations.Treg3 cells,enriched in adnexal tissues,were characterized by high levels of activation and exhaustion markers,correlating with poor clinical outcomes in HGSOC patients.CONCLUSION Treg3 cells drive immune suppression and tumor progression in HGSOC,making them a key immunotherapy target.Their adnexal enrichment highlights the need for tissue-specific immune profiling in precision treatment.
基金supported by National Natural Science Foundation of China(No.82372888)National Key Research and Development Program of China(No.2022YFC2704000)+6 种基金National Natural Science Foundation of China(No.82273383)the Capital’s Funds for Health Improvement and Research(No.2020-2-4098)Youth program of Beijing Municipal Natural Science Foundation(No.7204328)Clinical Medicine Plus X-Young Scholars Project,Peking University(No.PKU2022LCXQ020)Key Clinical Project of Peking University Third Hospital(No.BYSY2022050)Key Clinical Projects of Peking University Third Hospital(No.BYSYZD2021006)Key Clinical Projects of Peking University Third Hospital(No.BYSYZD2019034).
文摘Objective:The expression of programmed death 1(PD-1)on CD8^(+)T cells is associated with their activation and exhaustion,while CD57 serves as a senescence marker.The impact of PD-1^(+)and CD57^(+)CD8^(+)T cells on the prognosis of patients with advanced high-grade serous ovarian cancer(HGSOC)remain unclear.Methods:We assessed the percentages of PD-1^(+)and CD57^(+)CD8^(+)T cells in tumor-infiltrating lymphocytes(TILs,n=85)and tumor ascites lymphocytes(TALs,n=87)using flow cytometry.The optimal cutoffs for these markers in TILs and TALs were determined through the log-rank maximization method.Gene expression analysis elucidated the tumor immune microenvironment(TIME,n=36).Results:Patients with higher PD-1^(+)CD8^(+)TILs(>87.8%)exhibited longer platinum-free interval(PFI)and overall survival(OS).In contrast,those with elevated CD57^(+)CD8^(+)TALs(>28.69%)were more likely to experience chemotherapy and had lower complete remission rates,shorter PFI and OS.PD-1^(+)CD8^(+)TILs are primarily displayed an effector memory state with strong proliferative and secretory capabilities.Approximately 50%of CD57^(+)CD8^(+)TALs were terminally differentiated,exhibiting significantly impaired proliferation.Based on the proportions of PD-1^(+)CD8^(+)TILs and CD57^(+)CD8^(+)TALs,patients were categorized into good,median and poor prognosis groups,with median PFI of 47.78,27.29 and 11.96 months,respectively(P<0.0001).Median OS for these groups was not reach,49.23 and 30.92 months,respectively(P<0.0001).Patients with poor prognosis exhibit significantly reduced CD8^(+)T cell proportion and increased M2 macrophage in the TIME,alongside downregulation of multiple T cell activation-related pathways.Conclusions:Lower levels of PD-1^(+)CD8^(+)TILs and higher CD57^(+)CD8^(+)TALs,assessed prior to treatment,correlated with poor prognosis and suppressive TIME in advanced HGSOC.
文摘AIM: To examine eplerenone(Inspra, Pfizer), a mineralocorticoid receptor antagonist, as a treatment option for chronic central serous chorioretinopathy(CSCR).METHODS: A retrospective consecutive case series was conducted for patients receiving oral eplerenone for chronic CSCR. At baseline and each follow-up visit,spectral domain optical coherence tomography(SD-OCT)imaging was performed, including manual measurements of the height and diameter size of subretinal fluid. The primary outcome measure was the reduction in subretinal fluid following initiation of therapy.RESULTS: A total of 17 eyes of 13 patients treated with25 and 50 mg of oral eplerenone per day were identified.Subretinal fluid(SRF) decreased over time following eplerenone therapy(P = 0.007 and P =0.002, diameter and height respectively). Maximum SRF height decreased from a mean of 131.5 μm at baseline to 15.3 μm at day181+. SRF diameter decreased from an average of 2174.4μm at baseline to 46.9 μm at day 181 +. Log MAR visual acuity improved from 0.42(Snellen equivalent: 20/53) at baseline to 0.29(Snellen equivalent: 20/39) at day 181 +(P = 0.024). Central subfield thickness(CST) decreased from 339.5 μm at baseline to 270.3 μm at day 181+(P = 0.029).CONCLUSION: Eplerenone therapy resulted in significant anatomic and visual improvements in eyes with chronic CSCR.
基金National Natural Science Foundation of China,No.81702596
文摘BACKGROUND Pancreatic mixed serous-neuroendocrine neoplasms(MSNNs)are mixed tumors containing two components with different pathologies,namely,pancreatic serous cystic neoplasm(PSCN)and pancreatic neuroendocrine tumor(PanNET).For MSNNs,diffuse PSCN involving the whole pancreas is extremely rare,with only eight previous case reports.CASE SUMMARY A 45-year-old Chinese woman,with a free previous medical history and no obvious symptoms,was found to have a pancreatic neoplasm and admitted to our hospital for further diagnosis in March 2018.Abdominal palpation revealed a painless,mobile mass in the epigastrium,and no abnormalities were observed in an examination of the nervous system and ocular system.A computed tomography scan showed multiple cystic lesions involving the whole pancreas ranging in diameter from 0.4 to 2 cm and also revealed an enhanced mass,2.2 cm in diameter,in the head of the pancreas.Moreover,multiple cysts were found in the kidneys bilaterally,and the right lobe of the liver contained a small cyst.A Whipple operation with total pancreatectomy and splenectomy was performed.A diagnosis of pancreatic MSNN was established,consisting of diffuse serous microcystic cystadenoma with a concomitant grade 2 PanNET.Of note,the patient had no personal or family history of Von Hippel-Lindau syndrome or other disease.CONCLUSION We report the first case of MSNN with a diffuse PSCN component involving the entire pancreas in a Chinese woman.It is important to be aware of its relationship with VHL syndrome,and close clinical follow-up is recommended.
文摘Pancreatic cystic neoplasms have been increasingly recognized recently. Comprising about 16% of all resected pancreatic cystic neoplasms, serous cystic neoplasms are uncommon benign lesions that are usually asymptomatic and found incidentally. Despite overall low risk of malignancy, these pancreatic cysts still generate anxiety, leading to intensive medical investigations with considerable financial cost to health care systems. This review discusses the general background of serous cystic neoplasms, including epidemiology and clinical characteristics, and provides an updated overview of diagnostic approaches based on clinical features, relevant imaging studies and new findings that are being discovered pertaining to diagnostic evaluation. We also concisely discuss and propose management strategies for better quality of life.
文摘There is evidence to suggest that follicle-stimulating hormone （FSH） can facilitate the neovascularization of ovarian cancers by increasing vascular endothelial growth factor （VEGF） expression in cancer cells, although the underlying molecular mechanism of this process is not well known. Therefore, we investigated the effect of FSH on VEGF expression in the ovarian cancer cell lines SKOV-3 and ES-2. Treatment with FSH significantly increased VEGF expression in a dose- and time-dependent manner. In addition, FSH treatment enhanced the expression of survivin and hypoxlainducible factor-1 （HIF-1α）. Knockdown of survivin or HIF-1α suppressed VEGF expression, but only knockdown of survivin inhibited FSH-stimulated VEGF expression. Pretreatment with LY294002, a phosphoinositide 3-kinase （PI3K）/AKT inhibitor, neutralized the enhanced expression of survivin induced by FSH, but treatment with U0126, a mitogen-activated protein kinase/extracellular signal-regulated kinase inhibitor, had no such effect. We further showed that ovarian serous cystadenocarcinoma samples had much higher incidence of positive AKT and phosphorylated AKT （pAKT） protein staining than did benign ovarian cystadenoma samples （p 〈 0.01）. The 5-year survival rate was only about 15% in patients with ovarian serous cystadenocarcinoma who had AKT and pAKT expression, whereas it was about 80% in those who did not have AKT or pAKT expression. Taken together, these results indicate that FSH increases the expression of VEGF by upregulating the expression of survivin, which is activated by the PI3K/AKT signaling pathway. Understanding the role of the PI3K/AKT pathway in FSH-stimulated expression of survivin and VEGF will be beneficial for evaluating the prognosis for patients with ovarian serous cystadenocarcinoma and for pursulug effective treatment against this disease.
文摘AIM： To identify multi-detector computed tomography （MDCT） features most predictive of serous cystadenomas （SCAs）, correlating with histopathology, and to study the impact of cyst size and MDCT technique on reader performance. METHODS： The MDCT scans of 164 patients with surgically verified pancreatic cystic lesions were reviewed by two readers to study the predictive value of various morphological features for establishing a diagnosis of SCAs. Accuracy in lesion characterization and reader confidence were correlated with lesion size （≤3 cm or 〉≥3 cm） and scanning protocols （dedicated vs routine）. RESULTS： 28/164 cysts （mean size, 39 mm; range, 8-92 mm） were diagnosed as SCA on pathology. The MDCT features predictive of diagnosis of SCA were microcystic appearance （22/28, 78.6%）, surface Iobulations （25/28, 89.3%） and central scar （9/28, 32.4%）. Stepwise logistic regression analysis showed that only microcystic appearance was significant for CT diagnosis of SCA （P = 0.0001）. The sensitivity, specificity and PPV of central scar and of combined microcystic appearance and Iobulations were 32.4%/100%/100% and 68%/100%/100%, respectively. The reader confidence was higher for lesions 〉 3 cm （P = 0.02） and for MDCT scans performed using thin collimation （1.25-2.5 mm） compared to routine 5 mm collimation exams （P 〉 0.05）. CONCLUSION： Central scar on MDCT is diagnostic of SCA but is seen in only one third of SCAs. Microcystic morphology is the most significant CT feature in diagnosis of SCA. A combination of microcystic appearance and surface Iobulations offers accuracy comparable to central scar with higher sensitivity.
基金Supported by the Fund of Natural Science Foundation of Zhejiang Province(No.LY18H120009)
文摘AIM: To summarize the clinical features, systemic associations, risk factors and choroidal thickness (CT) changing in posterior scleritis (PS) with serous retinal detachment.METHODS: This retrospective study included 23 patients diagnosed PS with retinal detachment from August 2012 to July 2017. All patients' medical history and clinical features were recorded. The examinations included best corrected visual acuity (BCVA), intraocular pressure (IOP), fundus examination, and routine eye examinations. Posterior coats thickness (PCT) was determined by B-scan ultrasound, the CT was measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and clinical data were compiled and analyzed.RESULTS: After application of extensive exclusion criteria, 23 patients with PS remained (13 females, 10 males). The average age at presentation was 29.5±9.24 years old. Ocular pain and blurred vision were the two most common complained symptoms by patients. Anterior scleritis occurred in 12 patients, which was confirmed by ultrasound biomicroscopy (UBM) examination. Despite all patients displaying serous retinal detachment in their macula, no fluorescein leakage was observed in the macular area. Optic disc swelling was documented in 10 of the 23 eyes. From B-scan ultrasound examination, the PCT in creased with fluid in Tenon's capsule demonstrated as a typical T-sign. The average PCT was 2.51±0.81 mm in the PS-affected eyes and only 1.09±0.29 mm in the unaffected eye (P<0.0001). The subfoveal CT was 442.61 ±55.61 μm, which correlated with axis length (r=-0.65, P=0.001) and PCT (r=0.783, P<0.001). The BCVA and IOP did not correlate with either CT or PCT.CONCLUSION: PS with serous retinal detachment presented a variety of symptoms, such as pain, visual loss, and physical indicators. Typical T-sign detected by B-scan ultrasound is a useful confirmatory sign for PS diagnosis. Pathological increases in CT might be a potential predictive factor for inflammation.
文摘The aim of this article is to clarify diagnostic pitfalls of pancreatic serous cystic neoplasm(SCN) that may result in erroneous characterization. Usual and unusual imaging findings of SCN as well as potential SCN mimickers are presented. The diagnostic key of SCN is to look for a cluster of microcysts(honeycomb pattern), which may not be always found in the center. Fibrosis in SCN may be mistaken for a mural nodule of intraductal papillary mucinous neoplasm(IPMN). The absence of cyst wall enhancement may be helpful to distinguish SCN from mucinous cystic neoplasm. However, oligocystic SCN and branch duct type IPMN may morphologically overlap. In addition, solid serous adenoma, an extremely rare variant of SCN, is difficult to distinguish from neuroendocrine tumor.
文摘and FA for identifying pathological abnormalities in CSC. The characteristics of IA AF in CSC were attributable to the modification of melanin in the RPE. IR- AIM: To evaluate the correlation among changes in fundus autofluorescence (AF) measured using infrared fundus AF (IR -AF) and short-wave length fundus AF (SW -AF) with changes in spectral -domain optical coherence tomography (SD -OCT) and fluorescein angiography (FA) in central serous chorioretinopathy (CSC). METHODS: Two hundred and twenty consecutive patients with CSC were included. In addition to AF, patients were assessed by means of SD -OCT and FA. Abnormalities in images of IA -AF, SW -AF, FA were analyzed and correlated with the corresponding outer retinal alterations in SD-OCT findings. RESULTS: Eyes with abnormalities on either IR-AF or SW-AF were found in 256 eyes (58.18%), among them 256 eyes (100%) showed abnormal IR -AF, but SW-AF abnormalities were present only in 213 eyes (83.20%). The hypo-IR-AF corresponded to accumulation of subretinal liquid, collapse of retinal pigment epithelium (APE) or detachment of APE with or without RPE leakage point in the corresponding area. The hyper -IR -AF corresponded to the area with loss of the ellipsoid portion of the inner segments and sub -sensory retinal deposits or focal melanogenesis under sensory retina. The hypo-SW-AF corresponded to accumulation of subretinal liquid or atrophy of RPE. The hyper -SW -AF associated with sub -sensory retinal deposits, detachment of RPE and focal melanogenesis. CONCLUSION: IR-AF was more sensitive than SW-AF AF should be used as a common diagnostic tool for identifying pathological lesion in CSC.
文摘·AIM:To analyze the efficacy and safety of subthreshold micropulse laser(SML)in the treatment of acute central serous chorioretinopathy(CSC).·METHODS:This is a retrospective case analysis study.Totally 58 eyes of 58 patients were enrolled,and they were divided into different groups.And 39 patients were treated with SML(SML group)and 19 patients were only observed(observation group).The follow-up period was 3mo after diagnosis.The best corrected visual acuity(BCVA),central retinal thickness(CRT),superficial retinal vascular density(SRVD),deep retinal vascular density(DRVD),the superficial and deep foveal avascular zone(FAZ)area,retinal light sensitivity(RLS),perfusion area of choroidal capillary layer(CCL),subfoveal choroidal thickness(SFCT)and fundus autofluorescence(FAF)were investigated.·RESULTS:The BCVA,CRT,SRVD,DRVD,the superficial and deep FAZ area,RLS,SFCT of SML group were significantly improved at 3mo(all P<0.05).In the observation group,only CRT,DRVD and SFCT were improved(all P<0.05).Other research items in the observation group were not significantly different from baseline(all P>0.05).At the last follow-up,the BCVA and RLS in the SML group were better than those in the observation group,and CRT was lower,SRVD and DRVD,perfusion area of CCL were larger(all P<0.05).On FAF,no change of treatment spots was found after treatment.No structural laser damage was observed on optical coherence tomography(OCT)and optical coherence tomography angiography(OCTA),and no choroidal neovascularization was observed.·CONCLUSION:SML treatment of acute CSC can improve BCVA,RLS,and perfusion area of CCL,reduce CRT,increase SRVD and DRVD,and is safe.
文摘Central serous chorioretinopathy （CSC） is characterized by a localized accumulation of subretinal fluid and an idiopathic focal leakage from choroidal vessels. The exact pathogenesis of CSC, however, still remains obscure. In this paper, we hypothesized that CSC may result from a response of choroidal vessels to an acute increase in the environmental light intensity leading to a focal leakage from the choroidal vessels. High levels of glucocorticoids, in our proposed model, may cause persistence rather than initiation of the focal leakage, probably by suppressing the synthesis of collagen and extracellular matrix components and inhibiting fibroblastic activity.
文摘AIM:To discuss and compare the fundus autofluorescence(FAF)and optical coherence tomography(OCT)in acute or chronic central serous chorioretinopathy(CSCR).METHODS:Medical records of 100 cases of CSCR were reviewed.Acute and chronic cases were evaluated according to the duration of decreased visual acuity,serous retinal detachment(RD)and focal leakage on fluorescein angiography(FA).Chi-square test was used for statistical analysis.RESULTS:Forty cases had acute and 60 cases had chronic CSCR.FAF showed focal hypo-autofluorescence in 34(85%)and iso-autofluorescence in 6(15%)of acute cases and hypo-autofluorescence in 51(85%),hyperautofluorescence in 6(10%)and iso-autofluorescence in3(5%)of chronic cases.OCT showed serous RD with distinct borders correlated with FAF findings(hypoautofluorescence)in all acute CSCR cases.In chronic CSCR group,OCT showed serous RD with indistinct borders correlated with FAF findings.The differences between the OCT and FAF findings of the two groups were significant(P=0.000).CONCLUSION:OCT and FAF findings can support the clinical observations in differential diagnosis of acute and chronic CSCR and help clinicians to evaluate retinal pigment epithelium,outer segments of photoreceptors and the components of serous RD.
文摘AIM:To evaluate the efficacy and safety of subthreshold micropulse yellow laser(SMYL)in the treatment of chronic central serous chorioretinopathy(CCSC).METHODS:The medical records of 58 eyes of 58 patients with CCSC were reviewed.A 577-nm SMYL system was used for the treatment.Fundus fluorescein angiography was used as the primary method of identifying CCSC,and resolution of subretinal fluid(SRF)evaluated by optical coherence tomography(OCT)and fundus autofluorescence.Central macular thickness(CMT),central macular volume(CMV),total macular volume(TMV),subfoveal choroidal thickness(SFCT),subretinal fluid height(SRFH),and subfoveal fluid basement diameter values were measured by spectral domain-OCT(SD-OCT)for all eyes.RESULTS:The mean age of the patients was 42.4±9.9(range:20-72)y.The mean follow-up was 11.4±8.5(range:6-37)mo.Median BCVA at at the final follow up after treatment was statistically significant from the baseline.Complete SRF resolution was 12.1%of the eyes in the 1^st month,67.2%of the eyes in the 3rd month and 67.2%of the eyes in the last follow up.The initial median CMT,CMV,TMV,and SFCT values before treatment was significantly higher than 3^rd month visit values(P<0.001).In the multivariate analysis performed,age and disease duration were found to be a risk factor for persistent SRF(P=0.017,P=0.016,respectively).CONCLUSION:SMYL treatment provides a significant anatomical and functional improvement and is effective in eliminating SRF in eyes with CCSC.
文摘AIM: To evaluate chorioretinal responses to intravitreal aflibercept injection(IAI) in patients with acute central serous chorioretinopathy(CSC). METHODS: Seventy-one eyes from 71 patients with symptomatic CSC for less than six months were included. Thirty-five eyes received a single IAI and 36 eyes were observed without treatment. Best-corrected visual acuity(BCVA), central subfield foveal thickness(CSFT), and subfoveal choroidal thickness(SFCT) were assessed at baseline and at 1, 2, and 3 mo. RESULTS: The mean SFCT in the IAI group decreased at 1 mo, rebounded at 2 mo and remained stable at 3 mo compared to the baseline, while significant change was not noted in the observation group. The mean CSFT decreased significantly during the 3-month study period in both groups, and was significantly lower in the IAI group at 1 mo(P<0.001). A rebound of CSFT between 1 and 2 mo was noted in 14 eyes(40.0%) in the IAI group and in 1 eye(2.8%) in the observation group(P<0.001). The significant visual improvement was achieved from 1 mo in the IAI group, and from 2 mo in the observation group. The rate of complete absorption of subretinal fluid at 3 mo did not differ between the two groups.(45.7% vs 41.7%, P=0.813). CONCLUSION: A single IAI for acute CSC induce a transient decrease in SFCT and CSFT, which implies that IAI may have a pharmacological effect on the underlying hyperpermeable choroid in acute CSC.
文摘Helicobacter pylori(H. pylori), a Gram-negative bacterium, is one of the most frequent causes of gastrointestinal infections worldwide. It has been associated as a pathogen for the human body with many systemic diseases, including different eye diseases. We will focus on a specific eye disease called idiopathic central serous chorioretinopathy(ICSCR). This disease is characterized by a serous detachment of the neurosensory retina in the macular region, which affects the vision to different degrees. Currently, the pathophysiology of ICSCR is not clear and there is no effective treatment. However, several potential risk factors have been elucidated. One of the factors that has more frequently been associated with ICSCR is stress. As H. pylori was identified as a possible etiological factor for occlusive arterial diseases in young people who were particularly stressed, it was thought that H. pylori might also be present in ICSCR. Therefore, some physicians started to test its presence in patents with ICSCR. If H. pylori happened to be associated with ICSCR, the treatment of gastrointestinal infection could also improve visual symptoms and help to remediate this eye disease. Although H. pylori is highly prevalent in the general population, a true cor-relation seems to exist. We present a review on the relationship between ICSCR and H. pylori.
