Optical coherence tomography (OCT) is a noninvasive objective diagnostic technique that has become a powerful method for the clinical assessment of diabetic macular edema. It is a very useful imaging technique to diagnose and follow-up diabetic macular edema (DME). The present paper aims to present an overview of the principles,progress, and uses of OCT in the diagnosis and management of DME.

AIM: To evaluate the surgical efficacy of vitrectomy for diabetic macular edema (DME) at one year's follow-up.METHODS: The surgical outcomes in 116 consecutive eyes of 89 patients who had vitrectomy for diabetic macular edema were retrospectively reviewed and analyzed. All the patients were followed up for one year or longer postoperatively.RESULTS: The one year postoperative mean best-corrected visual acuity (BCVA) (0.428± 0.387) was significantly better than the mean preoperative BCVA (0.285±0.249;Wilcoxon signed-rank test, P＜0.0001). In 41 eyes with nonproliferative diabetic retinopathy (NPDR), mean BCVA improved significantly from 0.291± 0.201 preoperatively to 0.45± 0.41 at one year of follow-up (Wilcoxon signed-rank test, P=0.0171). In 75 eyes with proliferative diabetic retinopathy (PDR), mean BCVA improved significantly from 0.282± 0.272 preoperatively to 0.416± 0.376at one year of follow-up (Wilcoxon signed-rank test, P＜0.0001). The stage of diabetic retinopathy did not influence final visual acuity. Macular edema resolved in 74 of 116 eyes (63.8%) after the surgery. BCVA improved by 2 or more lines in 53 eyes (45.7%), remained unchanged in 39 eyes (33.6%), and exacerbated by 2 or more lines after the surgery in 24 eyes (20.7%). The intraoperative and postoperative complications included iatrogenic retinal tears (9 eyes), vitreous hemorrhage (10 eyes), neovascular glaucoma (6 eyes), hard exudates deposition in the center of macula (18 eyes), macular atrophy (19 eyes) and epiretinal membrane (3 eyes). Among these complications,exacerbation of BCVA by 2 or more lines occurred due to neovascular glaucoma (4 eyes), macular atrophy (10 eyes), hard exudates deposition (9 eyes) and epiretinal membrane (1 eyes).CONCLUSIONS: Vitrectomy is an effective procedure for improving visual acuity and reducing macular edema in eyes with DME. However, careful preoperative examinations and adequate surgical techniques are imperative to avoid severe complications of this treatment.

This is a case report of a 57-year-old woman with high aortic occlusion (HAO) who had acute symptoms of severe ischemia of the lower extremities and the intrapelvic organs. Generally, HAO is a chronic ischemic disease of the lower extremities and the intrapelvic organs; therefore, acute HAO is relatively rare. Acute thrombotic occlusion of a major collateral artery might be the cause of acute HAO. Laser Doppler flowmetry of the sigmoid colon was useful to evaluate the ischemia of intrapelvic organs. Thrombectomy of the juxtarenal portion with the suprarenal aortic cross clamp was performed within four minutes, then the clamp was moved to the infrarenal portion. The remaining occluded aorta was replaced with a Y-shaped knitted Dacron graft. She had no symptoms after the surgery except renovascular hypertension. Seventy five percent stenosis of the right renal artery was exacerbated to 99%. Vascular clamping of the right renal artery might have been the cause of severe stenosis. Percutaneous transluminal renal angioplasty was successfully performed after the surgery. Aggressive renal artery reconstruction during surgery is recommended in cases with moderate or severe renal artery stenosis.

PURPOSE: Plasma neurotrophin-3 (NT-3) levels are associated with several neural disorders. We previously reported that neurotrophins were released from salivary glands following acute immobilization stress. While the salivary glands were the source of plasma neurotrophins in that situation, the association between the expression of neurotrophins and the salivary gland under chronic stress conditions is not well understood. In the present study, we investigated whether NT-3 levels in the salivary gland and plasma were influenced by chronic stress. MATERIALS AND METHODS: Expressions of NT-3 mRNA and protein were characterized, using real-time polymerase chain reactions, enzyme-linked immunosorbent assay, and immunohistochemistry, in the submandibular glands of male rats exposed to chronic stress (12 h daily for 22 days). RESULTS: Plasma NT-3 levels were significantly increased by chronic stress (p<0.05), and remained elevated in bilaterally sialoadenectomized rats under the same condition. Since chronic stress increases plasma NT-3 levels in the sialoadenectomized rat model, plasma NT-3 levels were not exclusively dependent on salivary glands. CONCLUSION: While the salivary gland was identified in our previous study as the source of plasma neurotrophins during acute stress, the exposure to long-term stress likely affects a variety of organs capable of releasing NT-3 into the bloodstream. In addition, the elevation of plasma NT-3 levels may play important roles in homeostasis under stress conditions.
Animals ; Male ; Neurotrophin 3/*blood/genetics ; Rats ; Rats, Sprague-Dawley ; Stress, Physiological/*physiology ; Submandibular Gland/*metabolism

OBJECTIVETo review articles aiming to present an overview of the principles, progress, uses and limitations of laser speckle flowgraphy (LSFG) in posterior fundus circulation research.

DATA SOURCESThe data used in this review was obtained mainly from the studies reported in PubMed using the key terms "laser speckle", "ocular blood flowmetry" and "retinal imaging".

STUDY SELECTIONRelevant literatures on studies of LSFG were selected.

RESULTSLSFG is a unique, noninvasive imaging instrument to quantitatively visualize posterior fundus circulation in vivo. This review delineates the LSFG principles and development, demonstrates its extensive applicability for measurement of retina, choroid and optic nerve head circulation, compares it with other retinal imaging technologies and discusses unresolved issues.

CONCLUSIONSLSFG is a noninvasive, two-dimensional objective diagnostic technique that has become a powerful method for the clinical and scientific assessment of posterior fundus circulation. Further studies may help to develop a more comprehensive evidence-based measurement and facilitate the correlation with other methods for chorioretinal circulation assessment.

Eye ; blood supply ; Fundus Oculi ; Humans ; Laser-Doppler Flowmetry ; methods ; Optic Disk ; blood supply