AbstractBackground:To compare the proportion of rhegmatogenous retinal detachment associated with choroidal detachment (RRDCD) in the emergency surgery group with the routine inpatient surgery group and determine risk factors for RRDCD. Methods:A total of 694 patients (eyes) diagnosed with rhegmatogenous retinal detachment (RRD) in the emergency surgery group were included from the Department of Ophthalmic Emergency, and 692 patients (eyes) in the routine inpatient surgery group were selected randomly from the Ocular Fundus Department. Demographics, refractive status, macular status, lens status, extent of retinal detachment, number of retinal breaks, duration of symptoms before surgery, and the incidence of RRDCD were compared. A logistic regression analysis was used to determine potential risk factors for RRDCD. Results: Compared to the routine inpatient surgery group, the emergency surgery group had a significant less median time to surgery (P < 0.001) and a decreased proportion of RRDCD (2.88% vs. 10.84%, P < 0.001). Logistic regression analysis revealed that a prolonged duration of RRD [OR 3.51, 95% CI (1.98-6.23)], pseudophakia/aphakia status [OR 2.74, 95% CI (1.50-4.98)], multiple retinal breaks [OR 1.67, 95% CI (1.03-2.70)], and a substantial extent of RRD [OR 11.58, 95% CI (7.12-18.84)] were independent risk factors for RRDCD. Conclusions: Emergency surgical pattern of RRD demonstrated a lower incidence of RRDCD. The adoption of an expedited surgical approach has the potential to reduce the duration of RRD, possibly correlating with a decreased risk of RRDCD development.
Psoriatic arthritis (PsA) is an immune-mediated form of chronic inflammatory arthritis associated with psoriasis (PsO). It constitutes a significant comorbidity of PsO and is distinguished by the presence of widespread musculoskeletal inflammation.
Retinal ischemia/reperfusion (I/R) is one of the most common pathologies of many vision-threatening diseases and is caused by blood-retinal barrier (BRB) breakdown and the resulting inflammatory infiltration. Targeting BRB is promising for retinal I/R treatment. Mesenchymal stromal cells (MSCs) are emerging as novel therapeutic strategies. Although intravitreal injection targets the retina, the restricted number of injected cells still requires the precise biodistribution of MSCs near the injury site. Here, we found that retinal I/R led to BRB breakdown, which induced protein and cell leakage from the circulation. Retinal cell death and diminished visual function were subsequently detected. Moreover, the expression of the chemokine CCL5 increased after retinal I/R, and CCL5 colocalized with the BRB. We then overexpressed CCR5 in human induced pluripotent stem cell-derived MSCs (iMSCs). In vivo, intravitreal-injected iMSCCCR5 preferentially migrated and directly integrated into the BRB, which preferably restored BRB integrity and eventually promoted retinal function recovery after retinal I/R. In summary, our work suggested that iMSCs act as biopatches for BRB preservation and that iMSC-based therapy is a promising therapeutic approach for retinal diseases related to I/R.
Abstract Purpose To evaluate the safety and efficacy of pars plana vitrectomy (PPV) for recalcitrant vitreous seeding from retinoblastoma and concurrent retinal detachment. Methods In this retrospective interventional case series, intravitreal chemotherapy-assisted PPV was performed in 6 patients with persistent retinoblastoma vitreous seeds and concurrent retinal detachment. Globe salvage, retinal reattachment, and visual preservation at last follow-up visit were calculated. Results Six eyes, initially classified as group D (n=4) or E (n=2) with sphere and (or) cloud vitreous seeds, received standard systemic with intravitreal chemotherapy and subsequently developed refractory vitreous seeds with concurrent retinal detachment. PPV produced complete elimination of vitreous seeds in all 6 eyes and no vitreous seeding recurred over a mean follow-up of 29.6 months. Globe salvage and complete retina reattachment were attained in all 6 eyes (100%). Last follow-up vision acuity was assessable in 4 eyes with 80% (3/4) better than 0.4. Three eyes (50%) received repeated systemic or focal treatment because of the recurrent retinal tumor. There was no case of extraocular tumor extension or systemic metastasis. Conclusion Administration of intravitreal chemotherapy-assisted PPV appears to be a safe and effective alternation for the initial treatment of refractory vitreous seeds from retinoblastoma. It is also a promising therapeutic strategy to repair concurrent retinal detachment and preserve the remaining visual function.
Obstructive Sleep Apnea (OSA) is a widespread sleep disturbance linked to metabolic and cardiovascular conditions. The Non-High-Density Lipoprotein Cholesterol to High-Density Lipoprotein Cholesterol Ratios (NHHR) has been proposed as being a potential biomarker to gauge cardiovascular risk. However, its relationship with OSA remains unclear.
BACKGROUND Widespread access to the internet has boosted the emergence of online hospitals. A new outpatient service called “internet hospital plus drug delivery” (IHDD) has been developed in China, but little is known about this platform. OBJECTIVE The aim of this study is to investigate the characteristics, acceptance, and initial impact of IHDD during the outbreak of COVID-19 in a tertiary hospital in South China METHODS The total number of and detailed information on online prescriptions during the first 2 months after work resumption were obtained. Patients’ gender, age, residence, associated prescription department, time of prescription, payment, and drug delivery region were included in the analysis. RESULTS A total of 1380 prescriptions were picked up or delivered between March 2 and April 20, 2020. The largest group of patients were 36-59 years old (n=680, 49.3%), followed by the 18-35 years age category (n=573, 41.5%). In total, 39.4% (n=544) of the patients chose to get their medicine by self-pickup, while 60.6% (n=836) preferred to receive their medicine via drug delivery service. The top five online prescription departments were infectious diseases (n=572, 41.4%), nephrology (n=264, 19.1%), endocrinology (n=145, 10.5%), angiocardiopathy (n=107, 7.8%), and neurology (n=42, 3%). Of the 836 delivered prescriptions, 440 (52.6%) were sent to Guangdong Province (including 363 [43.4%] to Shenzhen), and 396 (47.4%) were sent to other provinces in China. CONCLUSIONS The IHDD platform is efficient and convenient for various types of patients during the COVID-19 crisis. Although offline visits are essential for patients with severe conditions, IHDD can help to relieve pressure on hospitals by reducing an influx of patients with mild symptoms. Further efforts need to be made to improve the quality and acceptance of IHDD, as well as to regulate and standardize the management of this novel service.
Background. To analyze the effects of the implementation of emergency surgical patterns in patients with rhegmatogenous retinal detachment (RRD) and provide evidence for promoting emergency surgical patterns for RRD. Methods. We reviewed the electronic medical records of 346 patients (348 eyes) who underwent surgical repair of RRD at the Zhongshan Ophthalmic Center in Southern China. A total of 140 patients (140 eyes) in the routine inpatient surgery group were collected at the fundus disease department between January 2019 and December 2019, and 206 patients (208 eyes) in the emergency surgery group were collected at the ophthalmic emergency department between January 2021 and December 2021. Demographics, best-corrected visual acuity (BCVA) expressed as the logarithm of the minimum angle of resolution (logMAR), the status of the macula before surgery, time to presentation, treatment interval, and postoperative BCVA measured at least three months follow-up were compared. Results. The preoperative BCVA (logMAR) of the emergency surgery group and the inpatient surgery group were 1.0 (0.4–1.7) and 1.4 (0.7–1.7), respectively, with significant differences between groups ( ). However, patients had a shorter time to presentation (7 days vs. 21 days, ), shorter treatment interval (2 days vs. 12 days, ), and significantly better postoperative BCVA (logMAR 0.5 vs. logMAR 1.0, ) in the emergency surgery group than in the inpatient surgery group. There was no significant difference in primary anatomical success between the two groups ( ). The median follow-up for the emergency surgery group and the inpatient surgery group were 6.08 months and 6.2 months, respectively, with no significant differences ( ). Conclusions. Patients who underwent emergency surgical patterns of RRD had better visual outcomes after surgery than patients with routine inpatient surgery, which might be attributed to a shorter duration, shorter treatment interval, and the preoperative status of the macula in the emergency surgery pattern. Emergency surgical patterns for RRD should be considered to achieve better surgical outcomes in suitable patients.
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