Background Two cases with refractory macular edema secondary to adult-onset Coats’ disease underwent unsatisfactory treatment by intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs and retinal photocoagulation. Case presentation The authors highlight the guiding effect of the measurement of cytokines in the aqueous humor for the treatment of adult-onset Coats’ disease with refractory macular edema. In the two cases, typical Coats’ disease changes, including telangiectasis, subretinal exudation and macular edema were observed. Initial treatment consisted of intravitreal anti-VEGF drugs and retinal laser photocoagulation; however, the response was poor. Then, the aqueous humor was acquired and the cytokine concentrations were measured (Flow Cytometry Analysis, Beijing Giantmed Medical Diagnostics Lab). When the cytokine levels were tested every time there would be quality control, with a fixed concentration of cytokines samples to detect before the results reported. A low level of VEGF and a high level of inflammatory cytokines were found. Then, treatment was switched to intravitreal injection of dexamethasone implant (Ozurdex®) (Allergan, Inc., Irvine, Calif., USA), which resulted in resolution of the refractory macular edema and improvement of visual acuity in both cases. Conclusions For refractory macular edema secondary to adult-onset Coats’ disease, measurement of the levels of VEGF and inflammatory cytokines can help clinic doctors precisely investigate the molecular mechanism of macular edema and thereby find a suitable treatment.

Abnormal bilirubin metabolism results in abnormally raised serum bilirubin level thus presenting as yellowing of face, skin and mucosa to varying degrees. Purpose: To observe clinical effects on neonatal jaundice of micro-ecological preparation combined with blue light irradiation. Study Design: Randomized control trial. Methodology: Enrolled 100 neonatal jaundiced children (50 each group). Control group received blue light irradiation while observation group was given probiotics on the basis of blue light irradiation. Percutaneous bilirubin levels, clinical efficacy and the incidence of side effects were compared between pre and post-treatment groups. Statistical analysis: Data analyzed by SPSS 20.0v. Results: Post-treatment, levels of percutaneous bilirubin were significantly lower than pre-treatment. Observational group had significantly lower levels than the control group, having significant p-value (P<0.05). However, total effective rate of the observational group was significantly higher than control group with statistically significant p-value (P<0.05).The difference in incidence of ADR was significant (P<0.05). Conclusion: This study concluded that microecological preparation combined with blue light irradiation had a definite effect on the treatment of neonatal jaundice, not only effectively reduced the bilirubin level of children, but also reduced adverse reactions hence the safety was high. Therefore, it was worthy of application and promotion. Key Words: Neonatal Jaundice, Micro-ecological Preparations, Blue Light Exposure