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PurposeTo evaluate the prevalence and factors associated with posterior pole and peripheral retinal lesions in Chinese subjects with high myopia.MethodsThree hundred and thirty-seven asymptomatic adults with high myopia of refractive error −6 D were examined in a cross-sectional community-based study. All subjects underwent cycloplegic refraction, ultrasound biometry and dilated fundal examination. Statistical analysis was performed to assess factors associated with the presence of posterior pole and peripheral retinal lesions.ResultsThe mean age of the 337 subjects was 36.0 years and the mean spherical equivalent refractive error was −10.2 D. Thirty-eight eyes (11.3%, 95% CI=8.1–15.2%) were found to have one or more posterior pole lesions and subjects with posterior pole lesion had significantly older age, longer axial length and higher degree of myopia (all P<0.001) compared with subjects without posterior pole lesion. After controlling for axial length, both the severity of refractive error and older age were significantly associated with the presence of posterior pole lesion (both P<0.001). For peripheral retinal lesions, 189 eyes (56.1%, 95% CI=50.6–61.5%) were found to have one or more peripheral retinal lesions. The presence of peripheral retinal lesion was associated with younger age and higher degree of refractive error (P=0.046 and 0.002, respectively).ConclusionPosterior pole and peripheral retinal degenerative lesions were found in a considerable proportion of subjects with high myopia. As some of these retinal lesions might predispose to visual impairment, highly myopic individuals should be educated on the symptoms of various eye conditions and seek care immediately if symptoms arise.Eye (2008) 22, 209–213; doi:10.1038/sj.eye.6702573; published online 1 September 2006 [ABSTRACT FROM AUTHOR]

Purpose: To study the efficacy of photodynamic therapy (PDT) with verteporfin in the treatment of juxtafoveal choroidal neovascularization (CNV) secondary to pathologic myopia.Methods: Prospective, open label, two-centre, noncomparative, interventional case series. Consecutive patients with juxtafoveal CNV associated with pathologic myopia were recruited and treated with a standard regimen of PDT with verteporfin. Patients were being followed up every 3-monthly and retreatment was considered when there was evidence of angiographic leakage. Outcome measures included changes in the mean best-corrected visual acuity (BCVA) at the 1-year follow-up when compared with the baseline, the proportion of patients who had stable (within 1 line) and improved visions.Results: A total of 11 eyes from 11 patients with juxtafoveal CNV secondary to pathologic myopia were recruited and all completed the 1-year follow-up. The mean age at presentation was 44.8 years. The refractive error ranged from -6.0 to -15.0 D (+/-SD was -9.55+/-3.04 D). The logMAR BCVA improved from 0.57 to 0.39 at the 1-year follow-up (Wilcoxon signed-ranks test, P=0.027). The mean improvement was 1.8 lines. Five eyes (45.4%) had BCVA improved by >or=3 lines. None of the treated patients had visual loss of >or=1 line. The mean number of treatments over the 12-month study period was 2.3 sessions.Conclusions: The results are encouraging, especially on considering the low retreatment rate, stable or improved BCVA in all treated eyes, and consistently good safety profile. Juxtafoveal myopic CNV may be an expanded indication for PDT with verteporfin. [ABSTRACT FROM AUTHOR]

AimsTo assess the safety and efficacy of phacoemulsification with intravitreal triamcinolone (ivTA) injection in diabetics with cataract and clinically significant macular oedema (CSMO).MethodsA total of 19 eyes of 15 consecutive diabetic patients with cataract and CSMO were prospectively recruited. Patients underwent phacoemulsification and intraocular lens implantation with 4 mg ivTA injection at completion of surgery. Patients were followed up on day 1, then weekly for 1 month, and thereafter monthly until 6 months postoperatively. Best corrected visual acuity (BCVA), central macular thickness (CMT) measured by optical coherence tomography, and adverse events were recorded.ResultsIn total, 17 eyes completed 6 months of follow-up. In all, 58.8% showed improvement in BCVA of 2 lines, with statistically significant improvement in mean Snellen BCVA of 2.4 lines at 6 months. The peak BCVA was achieved at 4 months. The mean CMT decreased from a baseline of 449 μm to a minimum of 321±148 μm (28.5% reduction) achieved at 2 months, with statistically significant reduction at all postoperative time intervals until 6 months. Of 17 eyes, 4 (23.5%) developed transiently elevated intraocular pressure that normalised by 6 months in all but one patient. No injection- or surgery-related complications were encountered.ConclusionsPhacoemulsification with concurrent 4 mg ivTA injection appears to be a safe option for managing diabetics with cataract and CSMO. However, large-scaled randomised controlled trials are necessary for delineating the relative contributions of cataract removal and CMT reduction to visual improvement. Moreover, the transient effect on CMT may warrant further studies to determine optimal timing and dosage of further ivTA injections.Eye (2005) 19, 885–890. doi:10.1038/sj.eye.6701686; published online 24 September 2004 [ABSTRACT FROM AUTHOR]

PURPOSE: To assess the intraocular pressure (IOP) and corneal endothelial changes, over a 6-month period, after a single injection of intravitreal triamcinolone (ivTA) in Chinese patients. METHODS: A total of 43 eyes of 43 consecutive Chinese patients with various macular diseases received a single bolus injection of 4 mg ivTA, of which, 14 eyes with significant cataracts underwent simultaneous phacoemulsification and primary intraocular lens implantation. IOP was measured preoperatively and weekly in the first month, and then monthly until 6 months postinjection. Specular microscopy was performed on 24 of the 29 eyes without simultaneous cataract surgery, preoperatively and at months 1, 3, and 6. RESULTS: All patients completed 6 months of follow-up. Nine out of 43 (20.9%) eyes had IOP>21 mmHg. Their mean maximum IOP was 29.2 mmHg (range 23.0–37.0), necessitating the use of 2.0 types of topical antiglaucomatous medications on average. The IOP elevation occurred at a mean of 5.2 weeks (range 1–17) postinjection. All IOPs returned to normal, without additional antiglaucomatous medications, by 6 months. There was no statistically significant difference (paired t-test, P<0.05) in the corneal endothelial cell count and other specular microscopy parameters up to 6 months after the injections. CONCLUSION: A single 4 mg bolus injection of ivTA appeared to have no harmful effects on the corneal endothelium. IvTA caused transient IOP elevations in 20.9% of Chinese patients, similar to that observed in Caucasians. As the IOP rise can occur as early as 1 week after the injection, early monitoring will help its early detection and prevent optic nerve damage.Eye (2005) 19, 625–630. doi:10.1038/sj.eye.6701585 Published online 28 May 2004 [ABSTRACT FROM AUTHOR]

Aims: To evaluate the visual and fluorescein angiographic outcomes of photodynamic therapy (PDT) with verteporfin in patients with subfoveal choroidal neovascularisation (CNV) caused by pathologic myopia in the Chinese. Methods: Prospective, non-comparative, two centre interventional study. Patients with CNV secondary to pathologic myopia of Chinese ethnicity were recruited and treated with a standard regimen of PDT with verteporfin. Results of this study in Chinese eyes with pigmented retinal pigment epithelium were compared with those from the Verteporfin in Photodynamic Therapy (VIP) Study of predominantly white eyes. Results: Thirty one and 22 eyes that completed the 12 month and 24 month follow up studies respectively were analysed. The mean and median best corrected visual acuities (BCVA) could be maintained at the baseline level at the 12 month and 24 month visits. Fourteen (63.6%) eyes had stable or improved BCVA at 24 months and six (27.3%) of them had a moderate gain in vision (improved by three or more lines). Visual results were comparable with that of the VIP study, but the average accumulative PDT treatments required in one and two years were 1.7 and 2.3 respectively, which were significantly less than 3.4 and 5.1 treatments in VIP study. Mean logMAR BCVA of the younger age group (<55 years) at 24 months was 0.41 (SD 0.29), which was significantly better than the older age group (&ges;=55 years) of 0.82 (SD 0.40) (Mann-Whitney U test, p = 0.029). Conclusions: PDT using the predetermined treatment protocol has achieved similar visual outcomes in the Chinese population as in white people with subfoveal myopic CNV over a 2 year study period. The complete cessation of CNV leakage can be accomplished, on average, with fewer PDT retreatments than reported in the VIP study. The disparity may be due to ethnic differences in these two populations. [ABSTRACT FROM AUTHOR]