BACKGROUNDMorphological changes of the vasculature system in patients with myopia have been observed by Doppler ultrasound and fundus fluorescein angiography (FFA); however, these studies have limitations. Doppler ultrasound provides low-resolution images which are mainly obtained from visualized large vessels, and FFA is an invasive examination. Optic coherence tomography (OCT) angiography is a noninvasive, high-resolution measurement for vascular density. The purpose of this study was to investigate the change of vascular density in myopic eyes using OCT angiography.

METHODSThis cross-sectional study includes a total of 91 eyes from 47 participants including control, moderate, and high myopia that were evaluated by OCT angiography. Patients with myopia were recruited from the Refractive Department, Shenzhen Aier Eye Hospital, from August 5, 2015 to April 1, 2016. Emmetropic eyes were from healthy volunteers. The vascular density at macula and optic disc regions, ganglion cell complex (GCC) thickness, and retinal nerve fiber layer (RNFL) thickness were measured. Their relationships with axial length (AL) and refractive error were analyzed. One-way analysis of variance (ANOVA), Pearson's correlation, and generalized estimating equation were used for statistical analysis.

RESULTSBoth superficial and deep macular vascular density were highest in control (25.64% ± 3.76% and 37.12% ± 3.66%, respectively), then in moderate myopia (21.15% ± 5.33% and 35.35% ± 5.50%, respectively), and lowest in high myopia group (19.64% ± 3.87% and 32.81% ± 6.29%, respectively) (F = 13.74 and 4.57, respectively; both P < 0.001). Both superficial (β = -0.850 and 0.460, respectively) and deep (β = -0.766 and 0.396, respectively) macular vascular density were associated with AL and spherical equivalent (all P < 0.001). Superficial macular vascular density was associated with GCC thickness (β = 0.244, P = 0.040), independent of spherical equivalent. The vascular density in optic disc region had no difference among the three groups, and it was not associated with AL, spherical equivalent, or RNFL thickness.

CONCLUSIONOur results suggested that with the increase of myopia, the vascular density decreased in macular region, but not in optic disc region.

Adult ; Cross-Sectional Studies ; Eye ; blood supply ; Female ; Fluorescein Angiography ; Humans ; Macula Lutea ; pathology ; physiopathology ; Male ; Middle Aged ; Myopia ; pathology ; physiopathology ; Optic Disk ; pathology ; physiopathology ; Prospective Studies ; Retina ; pathology ; physiopathology ; Retinal Ganglion Cells ; pathology ; Tomography, Optical Coherence ; Young Adult

PURPOSE: To evaluate choroidal blood flow changes in eyes with high myopia according to the pulsatile components of ocular blood flow analysis. METHODS: A total of 104 subjects (52 males and 52 females) were included in this study. One eye of each participant was randomly selected and assigned to one of four refractive groups, designated as, hyperopes (n = 20; refractive error, > or =+1.00 diopter [D]), emmetropes (n = 28; refractive error, +/-0.75 D), lower myopes (n = 33; refractive error, -1.00 to -4.75 D), and high myopes (n = 23; refractive error, < or =-5.00 D). Components of pulse amplitude (OBFa), pulse volume (OBFv), pulse rate (OBFr), and pulsatile ocular blood flow (POBF) were analyzed using a blood flow analyzer. Intraocular pressure and axial length were measured. RESULTS: Pulsatile components of OBFa, OBFv, and POBF showed positive correlations with refractive error and showed negative correlations with axial length (r = 0.729, r = 0.772, r = 0.781, respectively, all p < 0.001; r = -0.727, r = -0.762, r = -0.771, respectively, all p < 0.001). The correlations of refractive error and axial length with OBFr were irrelevant (r = -0.157, p = 0.113; r = 0.123, p = 0.213). High myopes showed significantly lower OBFa, OBFv, and POBF than the other groups (all p < 0.001). CONCLUSIONS: Axial length changes in high myopes potentially influence choroidal blood flow, assuming the changes are caused by narrowing of the choroidal vessel diameter and increasing rigidity of the choroidal vessel wall. These finding explains the influence of axial length on OBFa, OBFv, and POBF, but not on OBFr. Thus, changes in axial length and the possible influence of these changes on the physical properties of choroidal vessels is the mechanism believed to be responsible for putting high myopes at risk for ocular vascular diseases.
Adult ; *Axial Length, Eye ; Choroid/*blood supply ; Female ; Humans ; Male ; Myopia/diagnosis/*physiopathology ; Regional Blood Flow/*physiology ; Young Adult

OBJECTIVEThis review aims to summarize the progress of current clinical studies in ocular angiogenesis treated with anti-vascular endothelial growth factor (VEGF) therapy and to discuss the benefits and challenges of the treatment.

DATA SOURCESPubmed, Embase and the Cochrane Library were searched with no limitations of language and year of publication.

STUDY SELECTIONClinical trials and case studies presented at medical conferences and published in peer-reviewed literature in the past decade were reviewed.

RESULTSAnti-VEGF agents have manifested great potential and promising outcomes in treating ocular neovascularization, though some of them are still used as off-label drugs. Intravitreal injection of anti-VEGF agents could be accompanied by devastating ocular or systemic complications, and intimate monitoring in both adult and pediatric population are warranted. Future directions should be focused on carrying out more well-designed large-scale controlled trials, promoting sustained duration of action, developing safer and more efficient generation of anti-VEGF agents.

CONCLUSIONSAnti-VEGF treatment has proved to be beneficial in treating both anterior and posterior neovascular ocular diseases. However, more safer and affordable antiangiogenic agencies and regimens are warranted to be explored.

Antibodies, Monoclonal, Humanized ; therapeutic use ; Aptamers, Nucleotide ; therapeutic use ; Bevacizumab ; Eye ; blood supply ; drug effects ; pathology ; Humans ; Neovascularization, Pathologic ; drug therapy ; Ranibizumab ; Vascular Endothelial Growth Factor A ; antagonists & inhibitors

Acupuncture Therapy ; adverse effects ; Adolescent ; Adult ; Eye ; blood supply ; Eye Diseases ; therapy ; Hemorrhage ; etiology ; Humans ; Male

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

Color Doppler imaging (CDI) was carried out to evaluate the effects of anti-glaucoma drugs on ophthalmic circulation using CDI-derived resistive index (RI) values. CDI was performed on nine Beagle dogs, and RI values were calculated for the medial long posterior ciliary artery before and after the administration of anti-glaucoma drugs. A significant increase in RI values was found after topical administration of levobunolol (p < 0.05) or dipivefrin (p < 0.05). Pilocarpine showed no effects on RI values after topical administration. The results suggest that some anti-glaucoma drugs could affect ophthalmic blood flow.
Adrenergic Agonists/pharmacology ; Animals ; Ciliary Arteries/*drug effects/*ultra ; Dogs ; Epinephrine/analogs & derivatives/therapeutic use ; Eye/*blood supply ; Female ; Glaucoma/*drug therapy ; Levobunolol/therapeutic use ; Male ; Ocular Physiological Phenomena ; Pilocarpine/therapeutic use ; Ultra ; *Vascular Resistance

OBJECTIVETo evaluate the antiangiogenic property of pigment epithelium-derived factor(PEDF) in heptocarcinoma cell lines and explore its possible application in the gene therapy of human hepatocellular carcinoma (HCC).

METHODSThe gene encoding human PEDF was subcloned into lentiviral vector to generate the recombinant plasmid pLenti-PEDF. The plasmid pLenti-PEDF and two other packaging plasmids were cotransfected to 293T cells by calcium phosphate. Then HepG2 was infected with recombinant lentivirus and the expression efficiency of PEDF was analyzed by western blot. Proliferation and migration assay of human umbilical vein endothelial cells (HUVEC) was used to evaluate the biological activity of PEDF in vitro. Murine subcutaneous tumor model was established to investigate the therapeutic effects of Lenti-PEDF on HCC, and the expression of PEDF mRNA in tumor tissues was analyzed by RT-PCR.

RESULTSRestriction enzyme digestion and DNA sequencing demonstrated that the recombinant plasmid pLenti-PEDF was constructed successfully. HepG2 secreted PEDF in the media effectively after infected with the recombinant lentivirus and this protein exhibited strong inhibitory effects on proliferation and migration of human umbilical vein endothelial cells (P less than 0.01). Intratumoral injection of Lenti-PEDF caused significant inhibition of tumor growth (P less than 0.01), and high level expression of PEDF mRNA was detected in tumor tissues by RT-PCR.

CONCLUSIONSOur data suggest that PEDF may exert an inhibitory effect on tumor angiogenesis and PEDF gene therapy may provide a new approach for the treatment of HCC.

Animals ; Cell Proliferation ; Endothelial Cells ; metabolism ; Eye Proteins ; genetics ; metabolism ; Genetic Therapy ; Genetic Vectors ; Hep G2 Cells ; Humans ; Lentivirus ; genetics ; Liver Neoplasms ; blood supply ; genetics ; therapy ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Neovascularization, Pathologic ; therapy ; Nerve Growth Factors ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Serpins ; genetics ; metabolism ; Transfection ; Umbilical Veins ; cytology

OBJECTIVETo observe the therapeutic effect of eye acupuncture on cognition disorders in patients of chronic cerebral circulation insufficiency (CCCI).

METHODSSixty cases were randomly divided into an observation group and a control group, 30 cases in each group. All patients were treated with oral administration of compound Danshen tablets, and the observation group was treated with eye acupuncture based on the pharmacotherapy and upper energizer area, kidney area, spleen area were selected. Their therapeutic effects were observed after 8 weeks.

RESULTSThe total effective rate of 80.0% in the observation group was better than that of 53.3% in the control group (P<0.05). The score of mini-mental state (MMSE) in the observation group was also higher than that in the control group (P<0.05).

CONCLUSIONEye acupuncture has a good effect on cognition disorders in patients of CCCI and can enhance life quality of the patients.

Acupuncture Points ; Acupuncture Therapy ; Aged ; Cerebrovascular Circulation ; Cerebrovascular Disorders ; congenital ; physiopathology ; therapy ; Cerebrum ; blood supply ; Chronic Disease ; therapy ; Eye ; anatomy & histology ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

We report a case of ocular ischemic syndrome accompanied by neovascular glaucoma that was successfully treated with Bevacizumab. A 70-year-old male patient diagnosed with neovascular glaucoma of the left eye 3-4 years prior complained of continuous left eye pain and declining visual acuity despite receiving the latest treatment methods. At the time of admission the patient had no light perception in the left eye and his intraocular pressure was 30 mmHg. Anterior segment and fundus examinations revealed neovascularization of the iris and stenosis of the retinal vessel. Hypofluorescence of the choroid and retinal vessels was observed on fluorescence fundus angiography. Left internal carotid artery stenosis was observed on a brain MRI. Despite being treated with eye solution and oral medication, intraocular pressure was not controlled. After 7 days, we performed an intravitreal Bevacizumab 1.25 mg/0.05mL injection. One day after the intravitreal Bevacizumab injection, the neovascularization had nearly regressed and intraocular pressure was 30 mmHg. Intravitreal Bevacizumab injection produced regression of neovascularization and proved effective for treatment of neovascular glaucoma in this case of ocular ischemic syndrome.
Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Carotid Stenosis/*complications/diagnosis ; Diagnosis, Differential ; Eye/*blood supply ; Fluorescein Angiography ; Fundus Oculi ; Glaucoma, Neovascular/diagnosis/*drug therapy/etiology ; Humans ; Injections ; Ischemia/*complications/diagnosis ; Magnetic Resonance Angiography ; Male ; Vascular Endothelial Growth Factor A ; Vitreous Body

We report a case of ocular ischemic syndrome accompanied by neovascular glaucoma that was successfully treated with Bevacizumab. A 70-year-old male patient diagnosed with neovascular glaucoma of the left eye 3-4 years prior complained of continuous left eye pain and declining visual acuity despite receiving the latest treatment methods. At the time of admission the patient had no light perception in the left eye and his intraocular pressure was 30 mmHg. Anterior segment and fundus examinations revealed neovascularization of the iris and stenosis of the retinal vessel. Hypofluorescence of the choroid and retinal vessels was observed on fluorescence fundus angiography. Left internal carotid artery stenosis was observed on a brain MRI. Despite being treated with eye solution and oral medication, intraocular pressure was not controlled. After 7 days, we performed an intravitreal Bevacizumab 1.25 mg/0.05mL injection. One day after the intravitreal Bevacizumab injection, the neovascularization had nearly regressed and intraocular pressure was 30 mmHg. Intravitreal Bevacizumab injection produced regression of neovascularization and proved effective for treatment of neovascular glaucoma in this case of ocular ischemic syndrome.
Aged ; Angiogenesis Inhibitors/*administration & dosage ; Antibodies, Monoclonal/*administration & dosage ; Carotid Stenosis/*complications/diagnosis ; Diagnosis, Differential ; Eye/*blood supply ; Fluorescein Angiography ; Fundus Oculi ; Glaucoma, Neovascular/diagnosis/*drug therapy/etiology ; Humans ; Injections ; Ischemia/*complications/diagnosis ; Magnetic Resonance Angiography ; Male ; Vascular Endothelial Growth Factor A ; Vitreous Body