Comparison of age-related macular degeneration treatments trials(CATT)reported the results of the first year:At 1 year,bevacizumab and ranibizumab had equivalent effects on visual acuity when administered according to the same schedule.Ranibizumab given as needed with monthly evaluation had effects on vision that were equivalent to those of ranibizumab administered monthly.Bevacizumab is a monoclonal antibody(MAb)and full-length anti-VEGF antibody that successfully prevents binding of all the biologically active isoforms of VEGF to the receptor.Ranibizumab is a isolated antigen-binding fragment (Fab)from bevacizumab using recombinant genetic techniques.Ranibizumab has been clinically evaluated in 4 Phase Ⅰ/Ⅱ studies.The cost of Avastin is ＄50 per dose compared with ＄ 2000 per dose for Ranibizumab.If Avastin could improve vision and macular anatomy,then it would not only be clinically superior to Ranibizumab.The CATT data support the continued global use of intravitreal bevacizumab as an effective.low-cost alternative to ranibizumab,particularly for patients paying all costs out of pocket.

Corticosteroids are widely used to treat ocular fundus diseases such as inflammatory disease,macular edema and choroidal neovascularization.To increase local drug concentration and reduce systemic side effects,corticosteroids are often delivered by periocular or intravitreal iniection.However there are still more and more clinical complications with the expanded scope of application of these drugs.In order to achieve the best risk-benefit ratio,fully understanding the pharmacological characteristics,indications,contraindications and complications of corticosteroid is critical for clinicians to prescribe this drug to their patients.

Objective To explore the related risk factors for diabetic retinopathy(DR)in type 2diabetes.Methods The clinical data of 412 type 2 diabetes patients,diagnosed between 2003 and 2010,were analyzed retrospectively.The diagnosis of DR and proliferative diabetic retinopathy(PDR)was confirmed by ophthalmoloseopy and fundus fluorescein angiography.Glycated hemoglobin Alc,glucose,insulin,and C-peptide of fasting plasma,and 1,2 and 3 hours postprandial plasma were measured.According to the above-mentioned data,get the fluctuation of glucose,insulin and C-peptide of 1,2 and 3hour postprandial plasma.Results The morbidity of DR and PDR increased following the longer disease duration.Age,diabetic duration,body mass index(BMI),hypertension grade,HbAlC,fasting plasma insulin and C-peptide,2 and 3 hours postprandial plasma glucose,1 and 2 hours postprandial plasma insulin,1,2 and 3 hour postprandial plasma C-peptide,1,2 and 3 hours postprandial plasma glucose,insulin and C-peptide fluctuation are different statistically among non-DR group,non-PDR group and PDR group(P＜0.05).3 hours postprandial plasma glucose and fasting plasma insulin were risk factors of DR (P＜0.05).Conclusions Postprandial plasma glucose and fasting plasma insulin were risk factors of DR.Nevertheless,postprandial insulin,fasting and postprandial C-peptide,postprandial plasma glucose,insulin and C-peptide fluctuation were useful for DR diagnosis.

Objective To investigate the amounts of endothelial progenitor cells(EPCs)in peripheral blood of patients with proliferative diabetic retinopathy(PDR).Methods Forty patients with PDR(PDR group),thirty patmnts with type 2 diabetes mellitus(DM)without DR(DM group),and twenty agematched normal subjects(control group)were enrolled in this study.Blood samples were treated bv repeated centrifugation and stained with monoclonal antibodies.At least 2 × 105 cells were analyzed bv flow cytometry.EPCs were identified by CD34 and CD133 antibody.The correlation between EPCs numbers and DR duration,glycosylated hemoglobin,serum lipids was analyzed.Results The number of EPCs in PDR,DM and control group were(49±12)、(35±11)、(90±25)cells/ml respectively,the difference was statistically significant(F=56.260,P=0.000).There was a positive correlation between EPCs numbers and DR duration(r=0.564,P＜0.05).However there was no correlation between EPCs numbers and glycosylated hemoglobin(r=-0.170,P>0.05)or triglyceride levels(r=0.261,P>0.05).Conclusions The number of EPCs in peripheral blood of PDR patients was decreased. EPCs might play an important role in the pathogenesis of PDR.

Objective To observe the retinal toxicity of repeated intravitreal injection with bevacizumab(Avastin)in diabetic rats.Methods Forty male Sprague Dawley(SD)rats were randomly divided into normal group(Group A,10 rats)and diabetes mellitus group(30 rats).The rats in diabetes mellitus group were induced with streptozotocin injection for diabetic retinopathy model.And then randomly divided into diabetic retinopathy(DR)group(Group B,10 rats),the rats were not intervened;the left eyes of the other 20 rats were intravitreal injected with bevaeizumab 3 μ1(25 mg/m1)for 3 times as experimental group(Group C);the right eyes of the 20 rats were not intervened as experimental control group(Group D),20 days after last intravitreal injection,retinal function was measured by Flicker Electroretinogram (F-ERG);retinal vascular pattern was determined by fluorescence microscopy of ethidium bromide(EB)stained retinal flat mounts;retinal morphological changes were determined by light microscope on hematoxylin-eosin (HE) stained sections;Thy-1 and VEGF expression was measured by immunohistochemistry staining.Results F-ERG showed that-the differences of a-and b-waves-the b-wave amplitude and the Ops-wave amplitude in the implicit time between group A,B,C and D were significant (F=33.165,36.162,19.955,23.243;P=0.000);the differences of a-wave amplitude between group A,B,C and D was not significant(F=0.097,P=0v961).Retinal blood vessel pattern was normalin Group A;retinal vascular vessels were tortuous and irregularly expanded in Group B:retinal vascular vessels of Group C were regular and thinner than Group A;microaneurysm were showed in Group D.Light microscope displayed that the layers of the rat retina of Group A were regular,the retinal architectures of Group B were irregular,the retinal layers were regular in Group C,the retinal layers were irregular in Group D.Immunohistochemistry staining discovered that Thy-1 and VEGF were mainly expressed in ganglion cell layer(GCL).Conclusion Repeated intravitreal injection of bevacizumab iS toxic tO retina of diabetes mellitus rats.

Objective To observe the effect of diabetic retinopathy on endothelial progenitor cells (EPCs)from peripheral blood.Methods Sixty male Wistar rats were divided into control group and diabetes group.The rats in diabetes group were induced with streptozotocin(STZ)injection for diabetic retinopathy model.Flow cytometry was used to identify and count the number of EPCs from peripheral blood at 1 week.1,3 and 6 months after injection.All eyeballs were examined by hematoxylin and eosin (HE)staining,periodic acid-Schiffs(PAS)staining of trypsin-digested retinal vessels flat preparation and transmission electron microscope.EPCs count,and the relationship between DR morphological changes and EPCs count were compared and analyzed.Results The quantity of EPCs from peripheral blood at 1 week,1,3 and 6 months after STZ injection were 25±7,28±8,39±7,43±7 cells per 200 000 monocytes respectively,which decreased compared with the control group 45±4 cells per 200 000 monocytes(F=8.933,P＜0.0 1).The quantity of EPCs was gradually increased at 1 week,1,3 and 6 months after STZ injection,accompanied with responsive pathological changes of retinal structure and vessels.The thickness of retina at 1 week and 1 month after injection were reduced slightly.The number of retinal ganglion cells reduced,with the time passing by.Endothelial cells were edema,mitochondrial was swollen,capillary basement membrane was thicken,lumen was significant stenosis,lumen occlusion and retinal artery aneurysm were observed at 6 months after STZ injection.Conclusion The number of EPCs increases gradually throughout the development of DR.

Objective To observe the fixation features of foveoschisis in pathological myopia patients.Methods 36 patients(42 eyes)with>-6.00D myopic degree and foveoschisis who diagnosed by optical coherence tomography were included.The patients were divided into foveoschisis with retinal detachment group(11 eyes),foveoschisis with macular hole group(12 eyes)and only foveoschisis group(19 eyes).Micro-perimeter MP-1 was used to identify the fixation location and fixation stability.Results The eccentric fixation were formed above the foyea in the foveoschisis with retinal detachment and foveoschisis with macular hole group,the fixation location was formed on fovea in the only foveoschisis group.The fixation stability of the foveoschisis with retinal detachment,foveoschisis with macular hole and only foveoschisis group were(23±4)0A,(59±6)% ,(91±11)% respectively,the difference was statistically significant(F=243.47,P＜0.01).Conclusions The fixation location is formed on foyea in the patients with foveoschisis in pathological myopia.The eccentric fixation is formed above the fovea in the patients who has foveoschisis with retinal detachment and macular hole in pathological myopia.

Objective To investigate the characteristics and diagnostic value of fundus fluorescein angiography(FFA)for familial exudative vitreoretinopathy(FEVR).Methods 34 children(68 eyes)with FEVR and 64 parents(1 28 eyes)were included.All the clients were received examinations of slit-lamp biomicroscopy and indirect ophthalmoscopy.Meanwhile the children were examined by Retcam Ⅱ,the best corrected visual acuity of parents were recorded.The children and their parents were classified according to the ocular findings.Among 68 eyes of children,3 eyes(4.41% )were normal,4 eyes(5.88% )were in stage 1,7 eyes(10.29% )were in stage 2,2 eyes(2.94% )were in stage 3,8 eyes(11.76% )were in stage 4 and 44 eyes(64.71% )were in stage 5.Among 128 eyes of parents,74 eyes(57.81% )were normal,51eyes(39.84% )were in stage 1,1 eyes(O.78% )were in stage 2 and 2 eyes(1.56% )were in stage 5.FFA was performed on the children with RetcamⅡunder anesthesia and on the parents with HR2 in order to observe the FFA characteristics in different stage.Results FFA characte ristics in children included uncompleted vascularization of the periphery,peripheral avascular zone(stage 1);neovascularization and/or peripheral subretinal and intraretinal exudation(stage 2);subtotal retinal detachment with attached foyea (stage 3);subtotal retinal detachment with detached foyea(stage 4)and total retinal detachment(stage 5).FFA characteristics in parents included abrupt cessation of the peripheral retinal capillary network and a peripheral avascular zone(stage 1); abnormal peripheral arteriovenous shunts, neovascularization or exudation(stage 2)and atrophia bulbi(stage 5).Conclusions FEVR in different stage has different FFA characteristics.FFA plays an important role in early diagnosis of FEVR.

Objective To observe the effect of cyanin on the expression of L-glutamate/ L-aspartate transporter (GLAST) in high glucose cultured retina Müller cells. Methods The retinal tissue of SpragueDawley (SD) rats was collected at postnatal 10 day, and Müller cells were isolated and cultured according to literature. The Müller ceils (2nd-4th generations) were treated with five different medium as normal group (group A), high glucose control group (group B), high glucose+30 μmol/L cyanin group (group C), high glucose+60 μmol/L cyanin group (group D) and high glucose+100 μmol/L cyanin group (group E). Cell relative survival rates (A value) were measured by MTT assay at 570 nm. The GLAST protein expression in M011er cells was observed by Western blot. Results MTT assay showed that the A value of the five group were 0. 450 8±0. 020 4, 0. 270 1±0. 031 4, 0. 332 0±0. 023 2, 0. 428 3±0. 017 2, 0. 361 9±0. 027 0,the cell relative survival rate were 100. 0%, 59. 9%, 73.6%, 95%, 80.3% respectively. The A value of group C, D, E were significantly higher than that of group B (F=32.25, P<0.05), the A value of group D were significantly higher than that of group C and E (F=21.07, P<0. 05). Western blot showed that the GLAST protein expression of group B was lower than that of group A (t=5.25, P<0. 05) ; there was no obvious changes of GLAST protein expression in group A, C, D and E (F= 2. 979, P>0.05).Conclusion Cyanin can rescue high glucose-induced GLAST reduction.

Objective To develop a method for the primary culture of retinal Müller cells of adult rabbit in vitro. Methods Retina was isolated from adult rabbit, cut into 1 mm × 1 mm pieces, and placed into Dulbecco modified Eagle medium/F12 containing 20 % fetal bovine serum to culture. Cultured cells were identified by inverted phase contrast microscope, transmissim electron microscope and immunohistochemistry staining method. Results Visible cell processes grew out from the retinal tissues after three days culture, and more cells grew radically around the retina after seven days culture. The cultured cells were often inflated at one side and had one long process at another side, and the nuclei were elliptical and there were two or more than two nucleoli under inverted phase contrast microscope. The cytoplasm was rich and contained abundant microfilaments in eight to ten nanometers under transmission electron microscope. Immunohistochemistry assay showed that 95% of the cells were positive for glial can be cultured by the explant culture method.