心血管状况与糖尿病视网膜血管内皮细胞的相关性（英文）

糖尿病视网膜病变及其并发大血管病变表明两者之间致病存在相关性。血管内皮细胞是糖尿病血管损伤的主要部位。糖尿病视网膜病变能并发全身动脉硬化和改变血管内皮的功能及结构。在黄斑,动静脉交叉处和在筛板区视神经中的视网膜血管内皮细胞不同与其余视网膜血管中内皮细胞。中央视网膜在视神经中动脉和静脉非常接近且共用同一外膜;因此,增加动脉壁的硬度和厚度可以影响该区域中的相邻中央视网膜静脉中的血流量。此外,小动脉床中的动脉硬化加剧与视网膜微血管扩张有关;这表明筛板中视网膜中央动脉压迫视网膜中央静脉的可能性,从而损害糖尿病患者视网膜中的小静脉流出。经观察发现糖尿病视网膜病变患者在后层流区的视网膜中央静脉中的血流量发生改变。在视网膜中央静脉中增加静水压可能在糖尿病视网膜病变的病情进展过程中起重要作用。这篇综述文章的主旨是强调这种常常被忽视的发病机制。

Vitreous hemorrhage and fibrovascular proliferation after laser-induced chorioretinal venous anastomosis

·AIM:To describe a case in which vitrectomy was required for vitreous hemorrhage and fibrovascular proliferation after laser-induced chorioretinal venous anastomosis (LCVA) for non-ischemic central retinal vein occlusion (CRVO).·METHODS:Observational case report.·RESULTS:A 72-year-old man complained of central scotoma in the left eye,and was diagnosed as suffering from non-ischemic CRVO.LCVA was performed in another hospital.Although favorable visual function was briefly maintained postoperatively,severe vitreous hemorrhage developed in his left eye,necessitating vitrectomy.·CONCLUSION:Considering that LCVA carries a risk of serious complications,we must apply this treatment with caution,especially in ethnic groups,such as the Japanese,in whom pigmentation reacts to photocoagulation excessively.·

Female Preponderance in the Discordant Association between Retinopathy and Nephropathy in Patients with Type 2 Diabetes Mellitus

Aim: To elucidate clinical features in patients with type 2 diabetes with advanced retinopathy but without nephropathy. Methods: This study examined 1324 patients (784 males and 540 females) with type 2 diabetes mellitus. Diabetic reti-nopathy was graded according to the International Clinical Classification of Diabetic Retinopathy as no diabetic reti-nopathy, mild or moderate non-proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy. Diabetic nephropathy was classified into four stages of severity according to the Guideline Committee of the Japan Diabetes Society. Each patient was examined for retinopathy grade and nephropathy stage. Clinical features of patients with proliferative diabetic retinopathy were compared with regard to the four grades of diabetic nephropathy. Results: Fifty-two patients with type 2 diabetes (3.9% of the whole series of 1324 patients with type 2 diabetes and 25.7% of patients with proliferative diabetic retinopathy) had proliferative diabetic retinopathy without the presence of nephropathy. Multiple statistical analysis using a proportional odds model revealed that pa-tients with proliferative diabetic retinopathy without nephropathy had a significantly lower systolic blood pressure (p < 0.001) than those who did and were preponderantly female (p < 0.05). Conclusions: A possible susceptibility of dia-betic females to proliferative advanced retinopathy without nephropathy encourages further studies on the role of hor-mones and blood coagulation in the pathogensis of proliferative diabetic retinopathy.

激光诱导脉络膜视网膜静脉吻合术后玻璃体出血及纤维血管增生1例(英文)

目的:报告1例非缺血性中央视网膜静脉阻塞的患者实施激光诱导脉络膜视网膜静脉吻合术后出现玻璃体出血及纤维血管增生而进行玻璃体切割术。方法:病例报告。结果:患者,男,72岁,主诉左眼中央有一暗点,诊断为非缺血性中央视网膜静脉阻塞。在其他医院实施激光诱导脉络膜视网膜静脉吻合术。术后患者左眼视力短暂恢复,但并发严重的玻璃体出血,遂来我院实施玻璃体切割术。结论:激光诱导脉络膜视网膜静脉吻合术有发生严重并发症的危险,要求临床医师慎重选择,特别是对于某些种族(比如日本),因为色素沉着可引起光凝过度反应。

Spontaneous resolution of a macroaneurysm on the optic disc

Dear Sir,Iam Dr.Taku Toyama,from the Department of Ophthalmology,University of Japan.I write to present a case report of macroaneurysm on the optic disc.A 63-year-old woman had initially visited an eye clinic because she experienced anorthopia in her left eye.A macroaneurysm on the left optic disc was suspected.She was referred to our hospital for a medical work-up.At 61 years of age,she had undergone a laser photocoagulation treatment