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PURPOSE: To evaluate the association between diabetic retinopathy (DR) and cerebral disease or cognitive impairment. DESIGN: systematic review and meta-analysis. METHOD: The hypothesis was formulated prior to data collection. Cross-sectional studies and cohort studies that assessed the association between any measure of DR and cerebral small vessel disease or any type of cognitive impairment in diabetic participants were included. The data were independently extracted by two investigators. This systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology guidelines RESULTS: Twenty-seven studies were included. The combined odds ratio of five cross-sectional/cohort studies that reported that the associations between DR and cerebral structural changes was 1.75 (95% confidence interval [CI]: 1.36-2.25). The combined hazard ratio of four cohort studies that examined the association between DR and cognitive impairment events was 1.47 (95%CI: 1.22-1.78). The combined odds ratio of 14 cross-sectional/cohort studies that examined the association between DR and different cognitive impairment events was 1.43 (95%CI: 1.06-1.93). The overall coefficient (b) of four studies that examined the relationship between DR and specific cognitive performance was 0.09 (95%CI: 0.00-0.18). Considering the quality of the data, we have performed subgroup analysis in studies scored >7 and studies scored

Li-Yun Jia, Yan-Xia Sun, Yong-Peng Zhang, Kai Ma Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Kai MaBeijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, People’s Republic of ChinaTel/Fax +86 1058269508Email jialiyun@126.comObjective: To identify potential risk factors for recurrent retinal detachment after surgical treatment for rhegmatogenous retinal detachment with choroidal detachment (RRD-CD) in a Chinese population.Methods: A total of 1212 patients with RRD-CD admitted to Beijing Tongren Hospital from 2004 to 2018 were reviewed retrospectively. The rate of recurrent retinal detachment was calculated, and risk factors were analyzed by logistic regression analysis.Results: The average age of the patients was 48.51 years, 760 patients (62.7%) were male, and 630 patients (52.0%) had right eye disease. The recurrence rate in the same eye was 21.3%. The incidence of recurrence retinal detachment was higher in patients who were male, middle age, and with poor preoperative vision, longer axial length, and scleral buckling. Recurrence usually occurred 3 months after surgery.Conclusion: Male, middle age, longer axial length, and scleral buckling could be risk factors for recurrent retinal detachment following surgical treatment in patients with RRD-CD.Keywords: rhegmatogenous retinal detachment, choroidal detachment, risk factor

To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD.A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD.The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD.There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.

AIM: To evaluate the peripheral arterial filling time (PAFT) and venous filling time (VFT) in eyes without known diseases that may influence filling process using ultra-widefield (UWF) fluorescein angiography (FA), and to review the peripheral retina fluorescence features. METHODS: A total of 30 eyes of 30 patients were retrospectively reviewed in this observational study. UWF-FA was performed using Optos 200Tx. PAFT and VFT was recorded. The interval between the arterial or venous filling completion and the previous photo was documented. The appearance of the far peripheral retina was described as either granular background fluorescence or mottled fluorescent band or vascular leakage. Terminal vascular patterns was described as loop pattern or branching pattern. Microvascular abnormalities such as arteriovenous shunting, vessels crossing the horizontal raphe, right angle vessels, terminal networks, capillary nonperfusion, drusen or microaneurysms were evaluated. RESULTS: The normal limits of PAFT was 3.397-8.984s and 4.399-11.753s for VFT. The appearance of the far peripheral retina, defined as granular background (63%), mottled fluorescence (20%), or vascular leakage (17%), was symmetrical between both eyes. Capillary nonperfusion (23%) and microaneurysms (40%) were more frequently found in eyes with loop pattern than in eyes with branching pattern. Other peripheral signs such as right-angle vessels (73%), and terminal networks (80%) were commonly seen on UWF-FA in the normal peripheral retina. CONCLUSION: The main courses of retinal artery and vein filling time are overlapping with each other on UWF-FA. Notably, the arterial filling process is completed in the arteriovenous phase rather than the traditionally named arterial phase. There are various manifestations in the peripheral retina of normal eyes.

A “Two-dimensional Dynamic Optimal Correlation” algorithm is proposed based on the traditional monopulse radar tracking data processing algorithm and considering the characteristics of monopulse track for Missile-borne SAR radar. The algorithm has been successfully applied to a Missile-borne SAR radar system and has been effectively improved guidance accuracy in a monopulse tracking test process, so this algorithm has a high practical application value.

To research the clinical application of lower cervical pedicle screw fixation procedure.From September 2011 to July 2013,32 patients underwent posterior pedicle screw-rod system fixation were retrospective analyzed includinig 20 males and 12 females with an average age of 56.4 years old ranging from 21 to 78 years. Among them, 10 patients were traumatic cervical spinal injury, 9 patients were cervical spinal canal tumors, 7 cases were posterior longitudinal ligament ossification of cervical vertebrae, 6 cases were multiple segmental cervical spondylopathy. Preoperatively, X-ray, computed tomography, magnetic resonance imaging and magnetic resonance angiography of the vertebral artery were performed in all patients. After the operation and during the follow-up,X-ray and computed tomography were performed to confirm the pedicle screw position. The accuracy of the pedicle screw placement was evaluated by 4 grades classification from Lee. The spinal cord function was assessed by ASIA impairment scale for traumatic patients and JOA score for non traumatic patients.Totally 144 pedicle screws performed on 32 patients from C3 to C7 involving 132 screws of grade 0,5 screws of grade 1,5 of screws grade 2 and 2 screws of grade 3 according to postoperative CT. There were 12 screws penetrating the pedicle cortex including 8 screws at lateral,2 screws at caudal, 1 screw at medial and 1 screw at cranial. The follow-up time was 12 to 33 months with an average of (21.0±1.5) months. The spinal cord function was not improved in 6 complete cervical spinal cord injury patients,but their paraplegic level descended 1 to 3 segments. Four incomplete cervical spinal cord injury patients' ASIA impairment scale was increased by 1 to 2 grades in average. The JOA score of 22 atraumatic patients increased from preoperative 11.5±0.8 to 15.9±0.6 of postoperative at 6 months (P0.01). There were no screw loosening,screw pullout and screw-rod breakage.The lower cervical pedicle screw fixation can provide excellent 3D stability of the vertebral column. The operation risk and Complication could be minimized by adequate preoperative evaluation for appropriate cases and individual pedicle screw placement. It deserved the clinical expansion.

Background: The aim of this study was to determine whether pretreatment spectral-domain optical coherence tomographic (SD-OCT) features are associated with visual prognosis after treatment for idiopathic subfoveal choroidal neovascularization (ISCNV) with intravitreal ranibizumab. Methods: We retrospectively evaluated SD-OCT images of eyes with ISCNV undergoing treatment with intravitreal ranibizumab with a mean follow-up of 7 months. Results: This study included 22 patients (22 eyes) with a mean age of 32.7 ± 8.1 years. In univariate analysis, better final visual acuity expressed in logMAR units was significantly associated with a lower amount of pretreatment ellipsoid zone defects (p = 0.03; standardized correlation coefficient β = 0.46) and a lower amount of pretreatment external limiting membrane (ELM) damage (p = 0.007; β = 0.56). All other SD-OCT parameters were not significantly associated with final visual acuity. A higher improvement in visual acuity was marginally significantly associated with larger pretreatment ellipsoid zone defects (p = 0.049; β = -0.43). Conclusions: The integrity of the outer retinal layers at baseline, in particular of the ELM, is of importance in predicting the final visual outcome in patients undergoing intravitreal medical therapy for ISCNV.

PURPOSE To investigate changes in subfoveal choroidal thickness (SFCT) after intravitreal injections of ranibizumab for idiopathic subfoveal choroidal neovascularization (ISCNV). METHODS The prospective consecutive case series study included 16 patients with unilateral ISCNV. All eyes with ISCNV were treated with a single intravitreal injection of 0.5 mg ranibizumab followed by as-needed dosing. Subfoveal choroidal thickness was measured using enhanced depth imaging optical coherence tomography. RESULTS The mean total follow-up time was 4.9 ± 1.5 months, and the follow-up after the last intravitreal ranibizumab injection was 4.4 ± 1.3 months. In the treated eyes, the SFCT decreased significantly from 354 ± 84 μm at baseline to 328 ± 79 μm at 1 month later (P < 0.001) and reincreased (P = 0.02) to 342 ± 75 μm at the final visit (P = 0.15 versus baseline value). Change in SFCT was marginally (P = 0.11) associated with the change in retinal foveal thickness. In the contralateral unaffected eyes, the SFCT did not change significantly during follow-up (P = 0.76). CONCLUSION In patients with unilateral ISCNV, intravitreal ranibizumab therapy was associated with a thinning of an abnormally thick subfoveal choroid, marginally in association with a parallel decrease in retinal foveal thickness. It remained elusive whether the choroidal thinning was due to a direct pharmacological effect of ranibizumab or whether it was secondary due to the foveal retinal thinning. In view of the significant differences in SFCT between affected eyes and unaffected contralateral eyes at baseline and in view of the significant therapy-associated decrease in SFCT, the potential role of SFCT as an additional marker for the diagnosis and follow-up of ISCNV and other neovascular maculopathies may be examined in future studies.

Purpose: To evaluate choroidal thickness in patients with idiopathic choroidal neovascularization. Methods: The observational case series study included patients who were consecutively diagnosed with idiopathic unilateral choroidal neovascularization as demonstrated by ophthalmoscopy, fluorescein angiography and enhanced depth imaging optical coherence tomography (EDI-OCT). Using EDI-OCT, choroidal thickness was measured at the fovea and at locations in a distance of 500, 1,000 and 1,500 μm temporal and nasal to the fovea. Results: Mean subfoveal choroidal thickness was significantly (p = 0.002) thicker in the study group than in the control group (357 ± 99 vs. 316 ± 83 μm). In a parallel manner, the differences between the study group and the control group in choroidal thickness were significant for all other measurement points, except for the examination at 1,500 μm nasal to the fovea (p = 0.09). The results remained unchanged after adjusting for axial length and age. Conclusions: Idiopathic unilateral choroidal neovascularization is associated with a thickening of the choroid.

To examine and quantify the potential relation between diabetic retinopathy (DR) and risk of all-cause mortality, stroke and heart failure (HF).The resources of meta-analysis of epidemiological observational studies were from Pub-med, EMBASE, CINAHL, Cochrane Library, conference, and proceed

To examine the hyperglycemic effects of periocular dexamethasone injection in type 2 diabetic patients after vitreoretinal surgery (VRS).This was a retrospective non-randomized controlled trial. Twenty consecutive hospitalized patients with type 2 diabetes and ocular inflammatory reaction after VRS were enrolled in this study. Ten patients received 2.5 mg dexamethasone and 10 patients received 5 mg dexamethasone. Fourteen consecutive type 2 diabetic patients without ocular inflammatory reaction after VRS were used as control group. We measured fasting blood glucose (FBG) and at 2 h after each meal (post prandial glucose, PBG; 09:00, 13:00, and 19:00 h) after periocular dexamethasone injection. Differences among three groups were determined by q tests.The PBG levels in both dexamethasone-treated groups started to increase within 5 h after injection (i.e., PBG at 13:00 h), and were significantly increased at 19:00 h after injection (P0.05). BG levels were almost 2-fold higher than at baseline and compared with the control group. The BG values declined gradually by 24 h to 48 h after injection. There were no differences in BG levels between the two dexamethasone-treated groups (P0.05), except for PBG at 19:00 h on day 2 after injection (P0.05).Periocular dexamethasone injection can cause transient hyperglycemia in diabetic patients after VRS. BG monitoring should be performed following such injection.

To analyze the changes of color Doppler flow imaging (CDFI) and hemodynamics of retrobulbar blood vessels in Coats disease.It was a prospective and self-comparative study in which 18 cases (18 eyes) were included. Axial eye length was measured with A scan. Routine CDFI was performed in all cases. We examined ophthalmic arteries (OA), central retinal arteries (CRA) and posterior ciliary arteries (PCA) by CDFI, and recorded the peak systolic velocities (PSV), end diastolic velocities (EDV), time averaged maximum velocities (TAMX), pulsatility indexes (PI) and resistance indexes (RI) in all cases. Each hemodynamic parameter in the affected eye (21.36 ± 1.19) mm was compared with those in the contralateral normal eye (controls). T-test was used for the estimation of significance of the difference between the diseased and normal eyes.The axial length in diseased eyes was significantly shorter than that of the controls (22.92 ± 1.09) mm (t = 3.617, P0.05). The changes of CDFI in diseased eyes included retinal detachment, retinal cyst, subretinal organization, etc. Vitreoretinal traction, intraocular ossification and calcification were uncommon. The PSV (6.96 ± 1.21) cm/s and EDV (1.99 ± 0.36) cm/s in the diseased eyes were significantly lower than the PSV (8.30 ± 1.46) cm/s and EDV (2.48 ± 0.47) cm/s in the control eyes (t = 2.995, 3.476;P0.05). No significance difference was present in other hemodynamic parameters between diseased and normal eyes.Coats disease is a congenital disease that may influence the development of the eye. The ultrasonography is helpful for the diagnosis and differential diagnosis in Coats disease. Low perfusion of the central optic artery might exist in Coats disease. The hemodynamics changes in Coats disease require further studies.

To understand some of the factors involved in weaning and growth faltering in rural China, a cross-sectional positive deviance study was undertaken among 389 rural 4-12-month-old infants from two townships of a county in Sichuan. The infants' mothers were interviewed about their child-feeding practices and other sociodemographic information, and anthropometric measurements were made on their infants. Positive deviant infants (those growing adequately in environments in which the majority of the children suffer from growth retardation and malnutrition) were identified from the Chinese WAZ-scores calculated from the anthropometric measurements. Feeding practices found to be associated with the better growth of the positive deviant infants included breastfeeding through age 12 months, feeding soybean milk, liver and pork blood products on a more than weekly basis during the ages of 7-9 months, not feeding rice flour (mifen) before age 7 months, and not giving supplements or tonics. Mothers' nutrition knowledge was also associated with positive deviance status. The relevance of the findings is discussed with respect to designing nutrition education interventions for rural Sichuan.