外伤性感染性眼内炎患者脱盲因素研究

目的:探讨影响外伤性感染性眼内炎(PTIE)患者脱盲的因素。方法:回顾性分析2010-01/2020-12在南通大学附属医院眼科就诊的PTIE患者169例169眼临床资料。患者接受玻璃体腔注射抗生素(IVIA)和/或玻璃体切除术(PPV)治疗后,末次随访最佳矫正视力(BCVA)≥0.05为脱盲组(103眼)和BCVA<0.05为单眼盲组(66眼),分析影响患者脱盲的因素。结果:PTIE患者治疗后脱盲率为53.5%。单因素分析显示治疗前BCVA≥手动、不伴有视网膜脱离、眼内炎眼底分级<3级以及未培养出毒力强微生物是患者脱盲的有利因素(P<0.05);多因素Logistic分析显示治疗前BCVA分两组,BCVA≥手动(OR=0.253, 95%CI:0.108~0.592)以及不伴有视网膜脱离(OR=0.241, 95%CI:0.103~0.564)是患者脱盲的有利因素。结论:治疗前BCVA较好、不伴有视网膜脱离、眼内炎眼底分级<3级以及未感染毒力强微生物是PTIE患者最终脱盲的有利因素。

Association between retinopathy,nephropathy,and periodontitis in type 2 diabetic patients:a Meta-analysis

AIM:To verify the association between retinopathy,nephropathy,and periodontitis in type 2 diabetic(T2 D)patients.METHODS:Several electronic databases were available for our comprehensive search including China National Knowledge Infrastructure(CNKI),Chinese VIP Information(VIP),Wanfang,Web of Science,ScienceDirect and PubMed and were queried for relevant citations(updated to Mar.2019).RevMan was utilized to perform Meta analysis and publication bias detection.After evaluation of the methodological quality of included studies,a fixed or random effect model was utilized to analyze data from included studies.RESULTS:A total of eight articles were finally included in this Meta analysis.In all 3987 subjects,there were 1207 T2 D patients accompanying with microvascular complications and 1734 patients with periodontitis as well.The Meta forest plot presented little heterogeneity of the eight studies(P<0.00001,I^(2)=89%).The total effect demonstrated periodontitis was associated with overall microvascular complications(OR:1.96,95%CI:1.67-2.30,Z=8.25,P<0.00001).Subgroup investigations among the studies in Asian(OR:2.33,95%CI:1.91-2.85)and North American(OR:1.42,95%CI:1.08-1.86)populations confirmed the existed association between retinopathy,nephropathy,and periodontitis.While the strength of such associations between periodontitis and diabetic microvascular complications were more obvious in the Asians than North Americans.All the results indicated that periodontitis was associated with diabetic retinopathy(OR:3.77,95%CI:2.71-5.24),diabetic nephropathy(OR:1.55,95%CI:1.24-1.94)in T2 D patients.CONCLUSION:The periodontitis is associated with diabetic retinopathy,diabetic nephropathy among T2 D patients and further large sample size clinical trials are in need to confirm the findings.

Association between cystatin C and diabetic retinopathy among type 2 diabetic patients in China: a Meta-analysis

AIM:To explore the correlation between cystatin C(Cys-C)and diabetic retinopathy(DR)in those patients with type 2 diabetes mellitus(DM)in China.METHODS:Articles were collected from China National Knowledge Infrastructure(CNKI),Wanfang,VIP,Pub Med,EMBASE,Cochrane Library,Clinical Trials.gov,and Google Scholar.Quality and risk of bias within included studies was assessed using the Newcastle-Ottawa scale(NOS).Heterogeneity was determined by using Cochran’s Q-test and Higgins I^(2) statistics.Mean differences(MDs)and 95%confidence intervals(CIs)of Cys-C within the diabetes without retinopathy(DWR)and DR,DWR and non-proliferative diabetic retinopathy(NPDR),NPDR and proliferative diabetic retinopathy(PDR)were collected by using random-effects model because of high heterogeneity.Meta-analysis was conducted based on 23 articles of 2331 DR including NPDR and PDR patients and 2023 DWR patients through Review Manager 5.3.Subgroup analyses were also performed according to DM duration,body mass index(BMI),total cholesterol(TC),total triglycerides(TG),low-density lipoprotein C(LDL-C),and high-density lipoprotein C(HDL-C),sample origins and methods.Publication bias was assessed by the funnel plot.RESULTS:Cys-C level in DR patients was increased compared with that of DWR(total MD:0.69,95%CI:0.41 to 0.97,Z=4.79,P<0.01).Besides,the synthesized results of the studies showed the similar findings in the DWR vs NPDR group(total MD:0.29,95%CI 0.20 to 0.39,Z=6.02,P<0.01)and the NPDR vs PDR group(total MD:0.63,95%CI 0.43 to 0.82,Z=6.33,P<0.01).Heterogeneity of most of the subgroup analyses was still obvious(I^(2)≥50%,P<0.1).Forest plots of different subgroups indicated that there was a slight increase of Cys-C during the period between DWR and DR,DWR and NPDR,NPDR and PDR.Funnel plot showed that there was no significant publication bias.CONCLUSION:The elevated Cys-C is closely related with DR and probably plays a critical role in its progression.

Computer aided diabetic retinopathy detection based on ophthalmic photography: a systematic review and Meta-analysis

AIM: To ensure the diagnostic value of computer aided techniques in diabetic retinopathy(DR) detection based on ophthalmic photography(OP). METHODS: PubM ed, EMBASE, Ei village, IEEE Xplore and Cochrane Library database were searched systematically for literatures about computer aided detection(CAD) in DR detection. The methodological quality of included studies was appraised by the Quality Assessment Tool for Diagnostic Accuracy Studies(QUADAS-2). Meta-Di Sc was utilized and a random effects model was plotted to summarize data from those included studies. Summary receiver operating characteristic curves were selected to estimate the overall test performance. Subgroup analysis was used to identify the efficiency of CAD in detecting DR, exudates(EXs), microaneurysms(MAs) as well as hemorrhages(HMs), and neovascularizations(NVs). Publication bias was analyzed using STATA. RESULTS: Fourteen articles were finally included in this Meta-analysis after literature review. Pooled sensitivity and specificity were 90%(95%CI, 85%-94%) and 90%(95%CI, 80%-96%) respectively for CAD in DR detection. With regard to CAD in EXs detecting, pooled sensitivity, specificity were 89%(95%CI, 88%-90%) and99%(95%CI, 99%-99%) respectively. In aspect of MAs and HMs detection, pooled sensitivity and specificity of CAD were 42%(95%CI, 41%-44%) and 93%(95%CI, 93%-93%) respectively. Besides, pooled sensitivity and specificity were 94%(95%CI, 89%-97%) and 87%(95%CI, 83%-90%) respectively for CAD in NVs detection. No potential publication bias was observed. CONCLUSION: CAD demonstrates overall high diagnostic accuracy for detecting DR and pathological lesions based on OP. Further prospective clinical trials are needed to prove such effect.