Macular Degeneration: Chen YX

Chen YX. · No affiliation provided · Zhonghua Yan Ke Za Zhi. · Pubmed #19576058 No free full text.

Abstract: Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. The impact of AMD to the economics, society and the patients are huge. However, the awareness of AMD is alarmingly low. Even in developed countries, the awareness of AMD is below 30%. In terms of the risk factors of AMD, the awareness is also quite low, e.g., only 32% were aware of the causal link between smoking and AMD. Although cataract is the leading cause of the blindness in China, as the economic and social progress, as the coming of the aging society, as people pursuing higher quality of life, AMD will become a unignoring public health problem. Thus, it is urgent to take action now to increase the public awareness of AMD.

Chen YX. · Chinese Academy of Medical Sciences, 100730 Beijing, China. · Zhonghua Yan Ke Za Zhi. · Pubmed #18785540 No free full text.

Abstract: Although great progress have been achieved in treating neovascularization (CNV) secondary to age-related macular degeneration (AMD) in recent years, some essential problem should be considered in gaining better therapeutic results for CNV patients. Firstly we need to know clearly whether the CNV is classic or occult? Secondly we need to understand whether the CNV lesion is actually polypoidal choroidal vasculopathy (PCV) or retinal angiomatous proliferation (RAP)? Thirdly we need to determine to choose photodynamic therapy (PDT) or anti-vascular endothelial growth factor (VEGF) therapy or combination therapy for a individual AMD patient.

Chen YX, Ge J, Yan M, Jin CJ, Zhang MX, Dong FT, Lu F, Zhang CF, Zhao JL. · Department of Ophthalmology, Peking Union Medical College Hospital, Eye Research Center of Chinese Academy of Medical Sciences, Beijing 100730, China. · Zhonghua Yan Ke Za Zhi. · Pubmed #17605900 No free full text.

Abstract: OBJECTIVE: To determine the safety and efficacy of verteporfin (visudyne) photodynamic therapy in age-related macular degeneration patients with subfoveal predominant choroidal neovascularization in China. METHODS: Multicenter, open-label, non-controlled clinical study. The included patients are diagnosed AMD patients with predominant classic CNV. The included patients received verteporfin intravenously followed by 689 nm laser light administration 15 minutes after the infusion start. The patients were be followed up for 24 weeks (+/-12 days) after initial verteporfin PDT treatment. Clinical follow-up was done at the end of week 12 (+/-12 days) and week 24 (+/-12 days) after the initial treatment. Additional treatment was given after 12 weeks from initial treatment if leakage from CNV was observed on fundus fluorescein angiogram. The visual acuity with ETDRS visual chart and the retinal lesion changes were documented and compared with baseline. The adverse events both in the process of treatment and in the follow-up were recorded throughout the entire study period. RESULTS: Thirty-one patients (31 eyes) were included and completed the trial with vertepofin PDT treatment. During the 24 weeks of the trial, 38.7% of the treated eyes had a vision gain more than 5 letters, 83.9% of the treated eyes had less than 15 letters vision loss. At week 12 after the initial treatment, 12.9% of the treated eyes had no leakage; 61.3% of the treated eyes had leakages, but limited to the former lesion, 25.8% of the treated eyes had increased leakage. The results at week 24 after the initial treatment were similar to those at week 12. At week 24 after the initial treatment, there were only slight enlargements in the lesion size, area of retinal lesion, the lesion surrounding area, and greatest linear dimension (GLD) of the lesion, but no statistical significant difference was found between baseline and week 12 after initial treatment (P = 0.65, 0.31, 0.12, respectively). No obvious progress of the fibrosis was detected in most of the PDT treated eyes. Eleven cases of adverse events (AE) occurred in our trial and the incidence was 34.4%. Among the 11 patients with reported adverse event, 7 (21.9%) had mild adverse event; 3 (9.4%) had moderate adverse events; 1 (3.1%) had a serious adverse event. During the study period, no abnormal changes were found in most of the laboratory tests including serum and urine biochemistry, hematology and Electrocadiogram. CONCLUSIONS: The results of this trial showed positive efficacy of PDT with verteporfin in the treatment of predominantly subfoveal CNV secondary to AMD by reducing the risk of vision loss. The incidence of serious adverse events was only 3.1%. It is highly safe to use PDT with verteporfin in Chinese AMD patients with subfoveal predominant classical CNV.

Zhang CF, Dong FT, Chen YX, Li ZQ, Jia Y, Du H, Han BL. · Department of Ophthalmology, Peking Union Medical College Hospital, Eye Research Center of Chinese Academy of Medical Sciences, Beijing 100730, China. · Zhonghua Yan Ke Za Zhi. · Pubmed #16271171 No free full text.

Abstract: OBJECTIVE: To evaluate the efficacy of transpupillary thermotherapy (TTT) on circumscribed choroidal hemangioma. METHODS: Ten eyes of 10 cases with circumscribed choroidal hemangioma (age 16-48, average 34.4) were included in the present study. Six cases had previous green laser (4 argon and 2 krypton) photocoagulation, TTT as a primary treatment was used for other 4 cases without previous laser application. Fluorescein angiography, visual acuity, anterior segment and fundus examination, perimetry test, FFA/ICGA and ultrasonography were performed in all patients before the treatment. One to five infra red diode laser spots (810 nm with power of 800-1200 mW, diameter of 3 mm) were delivered on the surface of tumor with 60 seconds exposure, additional 10-20 seconds exposure was used in some cases. Second treatment was given 1-3 month later if there was active leakage demonstrated by fluorescein angiography. The followed-up period was 6-36 months (averaged 14.5 month). RESULTS: After transpupillary thermotherapy, 9 eyes (90%) showed partial regression of the tumor. Average visual acuity was 0.25 and 0.6 before and after TTT, respectively. Six patients showed improvement of vision acuity, but vision acuity in 4 patients with cystic macular degeneration remained unchanged. No recurrences were observed within follow-up averaged 14.5 months. Transpupillary thermotherapy did not associate with any significant complications. CONCLUSION: Transpupillary thermotherapy is effective to treat circumscribed hemangioma of choroid either as a primary treatment or supplementary therapy to previous laser photocoagulation.