macular edema (ME)

  • 文章类型: Editorial
    暂无摘要。
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    UNASSIGNED:为了确定早期反应评估是否可以预测抗血管内皮生长因子(VEGF)治疗视网膜静脉阻塞(RVO-ME)继发黄斑水肿的长期疗效。
    UNASSIGNED:对诊断为RVO-ME和玻璃体内抗VEGF治疗的患者进行回顾性研究。临床特征包括年龄,性别,基线时记录疾病亚型和病程.最佳矫正视力(BCVA和logMAR),眼内压(IOP),和中央黄斑厚度(CMT)记录在基线,2周,和注射后的每个月(1-6个月)。Further,我们比较了治愈组(6个月CMT≤250μm)和未治愈组(6个月CMT>250μm)的早期反应评估.
    UNASSIGNED:共164眼(男性77例,女性87例)。在每个注射后时间点,BCVA和CMT均较基线显著降低(均P<0.001).Spearman检验显示,首次注射后2周CMT降低率与6个月时BCVA呈负相关(r=-0.359,P<0.001)。与未治愈组(47例)相比,治愈组(117例)年轻(59.53±11.68vs.65.19±13.10岁,P<0.01),有更多的BRVO患者(76.1%vs.44.7%,P<0.01),疾病持续时间较短(1.92±2.43vs.5.05±4.32个月,P<0.01),较低基线CMT(527.09±154.95vs.768.96±287.75μm,P<0.01),和较低的基线BCVA(0.86±0.44vs.1.31±0.51,P<0.01)。在每个注射后时间点,与未治愈组相比,治愈组的CMT和BCVA值均较低(均P<0.01),2周CMT降低率被确定为预测长期治疗疗效的最早缓解时间。此外,ROC曲线分析表明,2周CMT降低率>37%是预测抗VEGF治疗6个月长期治愈的最佳临界点(P<0.001)。多因素logistic回归分析证实2周CMT降低率>37%与6个月治愈率独立相关(OR=9.639,95%Cl=1.030~90.227,P=0.047)。
    未经批准:年龄,疾病持续时间,基线CMT,和基线BCVA与RVO-ME抗VEGF治疗6个月时的视力结果相关。首次注射后的“2周CMT降低率>37%”是预测更好的长期结果的独立因素。
    UNASSIGNED: To determine if the early response assessments can predict the long-term efficacy of anti-vascular endothelial growth factor (VEGF) treatment for macular edema secondary to retinal vein occlusion (RVO-ME).
    UNASSIGNED: A retrospective study of patients with diagnosis of RVO-ME and intravitreal anti-VEGF treatment was conducted. Clinical characteristics including age, gender, disease subtype and disease duration were recorded at baseline. The best corrected visual acuity (BCVA and logMAR), intraocular pressure (IOP), and central macular thickness (CMT) were recorded at baseline, 2 weeks, and every month (months 1-6) after injection. Further, we compared the early response assessments between the cured group (6-month CMT ≤ 250 μm) and the uncured group (6-month CMT > 250 μm).
    UNASSIGNED: A total of 164 eyes in 164 patients (77 male and 87 female) were included. At each post-injection time point, both BCVA and CMT are significantly decreased from baseline (all P < 0.001). Spearman\'s test showed that 2-week CMT reduction rate after the first injection was negatively correlated with BCVA at 6 months (r = -0.359, P < 0.001). Compared with the uncured group (47 cases), the cured group (117 cases) was younger (59.53 ± 11.68 vs. 65.19 ± 13.10 years old, P < 0.01), had more BRVO patients (76.1% vs. 44.7%, P < 0.01), a shorter disease duration (1.92 ± 2.43 vs. 5.05 ± 4.32 months, P < 0.01), lower baseline CMT (527.09 ± 154.95 vs. 768.96 ± 287.75 μm, P < 0.01), and lower baseline BCVA (0.86 ± 0.44 vs. 1.31 ± 0.51, P < 0.01). At each post-injection time point, the cured group had lower CMT and BCVA values when compared to the uncured group (all P < 0.01), and the 2-week CMT reduction rate was identified as the earliest response time to predict the long-term treatment efficacy. Moreover, ROC curve analysis indicated that a 2-week CMT reduction rate >37% yielded the best cut-off point for predicting the long-term cure of anti-VEGF treatment at 6 months (P < 0.001). Multivariable logistic regression confirmed that the 2-week CMT reduction rate >37% was independently associated with the 6-month cured rate (OR = 9.639, 95% Cl = 1.030-90.227, P = 0.047).
    UNASSIGNED: Age, disease duration, baseline CMT, and baseline BCVA are associated with visual outcomes at 6-month of anti-VEGF treatment for RVO-ME. The \"2-week CMT reduction rate >37%\" after the first injection is an independent factor to predict better long-term outcomes.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    目的:通过总结所有现有证据,进行网络荟萃分析,以获得不同药物治疗视网膜静脉阻塞(RVO)继发黄斑水肿的相对有效性。方法:PubMed,Embase,在Cochrane图书馆数据库中搜索所有相关的随机对照试验.结果是通过网络荟萃分析估计的,包括最佳矫正视力(BCVA)从基线的平均变化,从基线获得BCVA≥15个字母的患者比例,中央视网膜厚度(CRT)的平均变化。结果:在我们的研究中,我们确定了15项随机对照试验(RCTs),涉及3,431例RVO患者。比较了不同的治疗方案,包括三种抗血管内皮生长因子(VEGF)药物(雷珠单抗,贝伐单抗,和aflibercept),雷珠单抗激光,地塞米松玻璃体内植入物,和激光。对于分支RVO,雷珠单抗每月0.5mg[加权平均差(WMD)=11,95%置信区间(CrI)3.6至19],雷珠单抗0.5mg3+prorenata(WMD=9.4,95%CrI0.43-18)在BCVA变化和15个字母或更多的BCVA改善方面最有效.对于中央RVO,三种抗VEGF方案均可提高视力,雷珠单抗的疗效无显著差异,贝伐单抗和阿柏西普(p>0.05)。每月0.5mg的雷珠单抗可以在具有分支RVO或中央RVO的眼睛中实现CRT减少的额外疗效(WMD=-130,95%CrI-400至140或WMD=-280,95%CrI-590至16)。地塞米松玻璃体内植入物(WMD=1.7,95%CrI-4.2至7.1或WMD=0.38,95%CrI-9.8至8.8)在6个月随访结束时,视力没有显着改善分支RVO或中央RVO。结论:总之,这项网络荟萃分析显示,在分支型或中央型RVO患者的6个月内,几种抗VEGF药物对平均视力变化和解剖恢复具有同等效果.仅在6个月内注射一次地塞米松玻璃体内植入物不能维持视觉益处。患者和临床医生可以选择药物疗法,并进一步考虑个人因素。
    Purpose: This network meta-analysis was conducted to obtain the relative effectiveness of different pharmacotherapy of macular edema secondary to retinal vein occlusion (RVO) by summarizing all available evidences. Methods: PubMed, Embase, and Cochrane Library databases were searched for all relevant randomized controlled trials. The outcomes were estimated through a network meta-analysis, including the mean change in best-corrected visual acuity (BCVA) from baseline, the proportion of patients who gained ≥15 letters in BCVA from baseline, the mean change in central retinal thickness (CRT). Results: We identified 15 randomized controlled trials (RCTs) involving 3,431 patients with RVO in our study. Different therapeutic regimens were compared including three anti-vascular endothelial growth factor (VEGF) agents (ranibizumab, bevacizumab, and aflibercept), ranibizumab with laser, dexamethasone intravitreal implant, and laser. For branch RVO, ranibizumab 0.5 mg monthly [weighted mean difference (WMD) = 11, 95% confidence intervals (CrI) 3.6 to 19], ranibizumab 0.5 mg 3 + pro re nata (WMD = 9.4, 95% CrI 0.43-18) is most effective in terms of changes of BCVA and 15 letters or more of BCVA improvement. For central RVO, three anti-VEGF regimens can improve visual acuity and there is no significant difference of efficacy among ranibizumab, bevacizumab and aflibercept (p > 0.05). Ranibizumab 0.5 mg monthly could achieve additional efficacy in CRT reduction in eyes with branch RVO or central RVO (WMD = -130, 95% CrI -400 to 140 or WMD = -280, 95% CrI -590 to 16)). Dexamethasone intravitreal implant (WMD = 1.7, 95% CrI -4.2 to 7.1 or WMD = 0.38, 95% CrI -9.8 to 8.8)) did not show a significant improvement in visual acuity at the end of 6 months follow-up in eyes with branch RVO or central RVO. Conclusion: In summary, this network meta-analysis demonstrated several anti-VEGF agents had equivalent effects on mean visual acuity changes and anatomical recovery in 6 months in eyes with branch or central RVO. Only one injection of dexamethasone intravitreal implant in 6 months could not maintain the visual benefit. Patients and clinicians could choose pharmacotherapies with further consideration toward personal factors.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    Accurate detection of diabetic retinopathy (DR) mainly depends on identification of retinal landmarks such as optic disc and fovea. Present methods suffer from challenges like less accuracy and high computational complexity. To address this issue, this paper presents a novel approach for fast and accurate localization of optic disc (OD) and fovea using one-dimensional scanned intensity profile analysis. The proposed method utilizes both time and frequency domain information effectively for localization of OD. The final OD center is located using signal peak-valley detection in time domain and discontinuity detection in frequency domain analysis. However, with the help of detected OD location, the fovea center is located using signal valley analysis. Experiments were conducted on MESSIDOR dataset, where OD was successfully located in 1197 out of 1200 images (99.75%) and fovea in 1196 out of 1200 images (99.66%) with an average computation time of 0.52s. The large scale evaluation has been carried out extensively on nine publicly available databases. The proposed method is highly efficient in terms of quickly and accurately localizing OD and fovea structure together compared with the other state-of-the-art methods.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    OBJECTIVE: Macular diseases tend to damage macula within human retina due to which the central vision of a person is affected. Macular edema (ME) and central serous retinopathy (CSR) are two of the most common macular diseases. Many researchers worked on automated detection of ME from optical coherence tomography (OCT) and fundus images, whereas few researchers have worked on diagnosing central serous retinopathy. But this paper proposes a fully automated method for the classification of ME and CSR through robust reconstruction of 3D OCT retinal surfaces.
    METHODS: The proposed system uses structure tensors to extract retinal layers from OCT images. The 3D retinal surface is then reconstructed by extracting the brightness scan (B-scan) thickness profile from each coherent tensor. The proposed system extracts 8 distinct features (3 based on retinal thickness profile of right side, 3 based on thickness profile of left side and 2 based on top surface and cyst spaces within retinal layers) from 30 labeled volumes (10 healthy, 10 CSR and 10 ME) which are used to train the supervised support vector machines (SVM) classifier.
    RESULTS: In this research we have considered 90 OCT volumes (30 Healthy, 30 CSR and 30 ME) of 73 patients to test the proposed system where our proposed system correctly classified 89 out of 90 cases and has promising receiver operator characteristics (ROC) ratings with accuracy, sensitivity and specificity of 98.88%, 100%, and 96.66% respectively.
    CONCLUSIONS: The proposed system is quite fast and robust in detecting all the three types of retinal pathologies from volumetric OCT scans. The proposed system is fully automated and provides an early and on fly diagnosis of ME and CSR syndromes. 3D macular thickness surfaces can further be used as decision support parameter in clinical studies to check the volume of cyst.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

公众号