AIM:To report the effect of focal laser photocoagulation on both the severity of hard exudates(HEs) and the rate of disease progression in eyes with mild to moderate non-proliferative diabetic retinopathy(NPDR).M...AIM:To report the effect of focal laser photocoagulation on both the severity of hard exudates(HEs) and the rate of disease progression in eyes with mild to moderate non-proliferative diabetic retinopathy(NPDR).METHODS: We retrospectively reviewed the medical records of 33 patients(60 eyes) who had been diagnosed with mild to moderate NPDR between January 2006 and December 2012.The patients were divided into 2 groups:Group A(38 eyes in 20 patients treated using focal laser photocoagulation) and Group B(treated without laser photocoagulation).We also reviewed the best corrected visual acuity measurements,and the fundus photographs taken at both baseline and follow-up visits. RESULTS: In Group A,HE severity grade had decreased significantly from baseline to the final visit(P 〈0.05),but this was not the case in Group B(P =0.662).The cumulative probabilities of retinopathy progression at 5y were 26% in Group A and 30% in Group B.KaplanMeier survival curves showed no significant difference between the groups with regard to retinopathy progression(P =0.805).CONCLUSION: Focal laser photocoagulation reduced the levels of HEs in eyes with mild to moderate NPDR.However,the treatment was not able to decelerate the progression of DR.展开更多
●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of ...●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of 29 patients(53 eyes)with severe non-proliferative DR(SNPDR)or proliferative DR(PDR)who received PRP and follow-up at our hospital from 2008 to 2013.Sixteen patients(29 eyes)received PASCAL PRP and 13 patients(24 eyes)received 100-ms conventional laser PRP.●RESULTS:After long-term follow-up(mean,min-max days:719.8,290-1666 for PASCAL PRP vs 743.5,240-1348 for conventional PRP,P=0.569),patients receiving PASCAL PRP required fewer photocoagulation sessions than the conventional PRP group(2.6±1.0 vs 3.9±0.9,P<0.01).Best corrected visual acuity(BCVA)was reduced slightly in PASCAL PRP group while reduced significantly in conventional PRP group.At last visit,24 eyes in the PASCAL group(88.9%)and 21 eyes in the conventional group(91.7%)were improved or stable.Two eyes in PASCAL PRP group(7.4%)and 3 eyes in the conventional PRP group(12.5%)developed vitreous hemorrhage or vitreous fibrovascular proliferation.●CONCLUSION:PASCAL PRP is as effective and may be more conducive to maintaining visual acuity with less treatment sessions for DR treatment compared to conventional laser PRP.展开更多
●AIM:To observe the effect of inhibiting long non-coding RNA(lncRNA)metastasis-associated lung adenocarcinoma transcript 1(MALAT1)on diabetic neurodegeneration.●METHODS:Thirty-six 8-week-old C57 BL/6 mice were rando...●AIM:To observe the effect of inhibiting long non-coding RNA(lncRNA)metastasis-associated lung adenocarcinoma transcript 1(MALAT1)on diabetic neurodegeneration.●METHODS:Thirty-six 8-week-old C57 BL/6 mice were randomly divided into normal control,diabetic control,diabetic scrambled small interfering RNAs(siRNAs)and diabetic MALAT1-siRNA groups.After diabetic induction with streptozocin intraperitoneally-injection,the diabetic M A L AT 1-s i R N A g ro u p w a s i n t r av i t r e a l l y i n j e c te d with 1μL 20μmol/L MALAT1 siRNA,and the diabetic scrambled siRNA group was injected with the same amount of scrambled siRNA.Electroretinography was performed to examine photoreceptor functions 16 wk after diabetes induction.MALAT1 expression was detected via real time polymerase chain reaction.Cone morphological changes were examined using immunofluorescence.Rod morphological changes were examined by determining outer nuclear layer(ONL)thickness.●RESULTS:The upregulation of retinal MALAT1 expression was detected in the diabetic control mice,while MALAT1 expression in the diabetic MALAT1-siRNA mice was decreased by 91.48%compared to diabetic control mice.The diabetic MALAT1-siRNA and diabetic control mice showed lower a-wave and b-wave amplitudes than did the normal control mice in scotopic and photopic electroretinogram,while the diabetic MALAT1-siRNA mice showed higher amplitudes than diabetic control mice.Morphological examination revealed that ONL thickness in the diabetic MALAT1-siRNA and diabetic control mice was lower than normal control mice.However,ONL thickness was greater in the diabetic MALAT1-siRNA mice than diabetic control mice.Moreover,the diabetic control mice performed a sparser cone cell arrangement and shorter outer segment morphology than diabetic MALAT1-siRNA mice.●CONCLUSION:Inhibiting retinal MALAT1 results in mitigative effects on the retinal photoreceptors,thus alleviating diabetic neurodegeneration.展开更多
AIM: To assess if the included vascular endothelial growth factor (VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mel...AIM: To assess if the included vascular endothelial growth factor (VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mellitus (T2DM). METHODS: A case-control study was conducted in adult individuals with T2DM associated to proliferative retinopathy or non-proliferative retinopathy from Oct. 2014 to Jun. 2015 from the Retina Department of the Asociation to Prevent Blindness in Mexico. The selected patients were adults with a diagnosis of T2DM ≥5y. All subjects had a comprehensive ocular examination and the classification of the retinopathy severity was made considering the Early Treatment Diabetic Retinopathy Study (ETDRS) standardization protocols. Genomic DNA was extracted from whole fresh blood. All samples were genotyped by qPCR for selected VEGF polymorphisms. Hardy-Weinberg equilibrium was calculated by comparing Chi-square values between the expected and the observed values for genotype counts.RESULTS: In total 142 individuals were enrolled, 71 individuals with T2DM and associated proliferative retinopathy and 71 individuals with non-proliferative retinopathy. One-sided Fisher’s exact test was performed for rs3025021 [OR (95% CI)=0.44(0.08-2.2); P=0.25] and rs2010963 [OR (95% CI)=0.63(0.25-1.6); P=0.23]. The minor allelic frequencies obtained were 26% for rs3025021, 10% for rs3025035 and 61% for rs2010963. The pairwise linkage disequilibrium between the three SNP was assessed, and was as follows: rs3025021 vs rs3025035: D’=1.0, r2=0.1043, P≤0.0001; rs3025021 vs rs2010963: D’=0.442, r2=0.0446, P=0.149; rs3025035 vs rs2010963: D’=0.505, r2=0.0214, P=0.142.CONCLUSION: This is the first analysis involving VEGF polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that different populations have different associations for the same polymorphisms.展开更多
Objective. To study the changes of microcirculation in patients with diabetic retinopathy(DR). Methods. Examination were performed in 153 cases of type Ⅱ diabetes mellitus, among them, 7...Objective. To study the changes of microcirculation in patients with diabetic retinopathy(DR). Methods. Examination were performed in 153 cases of type Ⅱ diabetes mellitus, among them, 72 cases were male, 81 cases were female, mean age 57.0±10.0 years, mean disease course 8.2±7.5 years. All cases were examined fundi by ophthalmologist, urinary albumin excretion rate (UAE) in 24 hours was measured by radioimmunoassay. Moreover, we examined the blood glucose, blood pressure, blood viscosity and observed the changes of naifold microcirculation. Results.It was found that there were more evident disturbance of microcirculation, markedly slowed velocity of blood flow(P<0.05), significantly increased aggregation of blood cells(P<0.05) and exudation around the loop(P<0.05) in the group with DR, compared with the group without DR. Conclusion. It was more evident disturbance of nailfold microcirculation in patients with diabetic retinopathy.展开更多
目的探讨参芪降糖颗粒联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的效果及对血小板源性生长因子(PDGF)、骨形成蛋白-2(BMP-2)水平的影响。方法选取2020年2月至2023年1月收治的100例非增殖期糖尿病视网膜病变患者作为研究对象,...目的探讨参芪降糖颗粒联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的效果及对血小板源性生长因子(PDGF)、骨形成蛋白-2(BMP-2)水平的影响。方法选取2020年2月至2023年1月收治的100例非增殖期糖尿病视网膜病变患者作为研究对象,按随机数字表法将其分为对照组和观察组,每组50例。对照组在常规治疗基础上加羟苯磺酸钙分散片治疗,观察组在对照组基础上采用参芪降糖颗粒治疗。比较两组的治疗效果。结果观察组的治疗总有效率明显高于对照组(P<0.05)。治疗后,观察组的空腹血糖(FBG)、餐后2 h血糖(2 h PG)水平及糖化血红蛋白(HbA1c)均低于对照组(P<0.05)。治疗后,观察组的最佳矫正视力高于对照组,黄斑中心凹视网膜厚度低于对照组(P<0.05)。治疗后,观察组的PDGF、BMP-2水平均低于对照组(P<0.05)。结论参芪降糖颗粒联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的效果确切,可有效降低血糖水平,改善患者视力,降低黄斑中心凹视网膜厚度,抑制PDGF、BMP-2表达。展开更多
Background Diabetic retinopathy (DR) is one of the most common complications of diabetes.Angiotensin-converting enzyme inhibitor is thought to play an important role in preventing and treating retinal diseases in an...Background Diabetic retinopathy (DR) is one of the most common complications of diabetes.Angiotensin-converting enzyme inhibitor is thought to play an important role in preventing and treating retinal diseases in animal models of DR.The aim of the present study was to investigate the role of angiotensin-converting enzyme inhibitor (ACEI,captopril) in the treatment of patients with non-proliferative DR.Methods Three hundred and seventeen type 2 diabetic patients (88.05% of participants) without or with mild to moderate non-proliferative retinopathy were randomly divided into captopril group (n=202) and placebo group (n=115).All subjects received 24-month follow-up.General clinical examinations,including blood pressure and glycated hemoglobin,as well as comprehensive standardized ophthalmic examinations were performed.Color fundus photography and optical coherence tomography (OCT) were used to grade diabetic retinopathy and detect macular edema respectively.Results The levels of blood pressure and glycated hemoglobin in the two groups of patients remained within the normal range during the entire follow-up and no significant difference was found between the initial and last visits,suggesting that ACEI drugs play a protective role on the DR patients independent of its anti-blood pressure role.DR classification showed that 169 eyes (83.66%) remained unchanged and the DR grade of 33 eyes (16.34%) increased in captopril group,while 84 eyes (73.04%) remained unchanged and the grade of 31 eyes (26.96%) increased in placebo group (P=0.024).Captopril treatment improved macular edema in 55.45% eyes,which was significantly higher than the 37.39% improvement in placebo group (P=0.002).No significant difference was found in the visual acuity between the two groups (P=0.271).Conclusion Captopril can improve or delay the development of DR and macular edema,which can be used in the early treatment of DR patients with type 2 diabetic mellitus.展开更多
文摘AIM:To report the effect of focal laser photocoagulation on both the severity of hard exudates(HEs) and the rate of disease progression in eyes with mild to moderate non-proliferative diabetic retinopathy(NPDR).METHODS: We retrospectively reviewed the medical records of 33 patients(60 eyes) who had been diagnosed with mild to moderate NPDR between January 2006 and December 2012.The patients were divided into 2 groups:Group A(38 eyes in 20 patients treated using focal laser photocoagulation) and Group B(treated without laser photocoagulation).We also reviewed the best corrected visual acuity measurements,and the fundus photographs taken at both baseline and follow-up visits. RESULTS: In Group A,HE severity grade had decreased significantly from baseline to the final visit(P 〈0.05),but this was not the case in Group B(P =0.662).The cumulative probabilities of retinopathy progression at 5y were 26% in Group A and 30% in Group B.KaplanMeier survival curves showed no significant difference between the groups with regard to retinopathy progression(P =0.805).CONCLUSION: Focal laser photocoagulation reduced the levels of HEs in eyes with mild to moderate NPDR.However,the treatment was not able to decelerate the progression of DR.
基金Supported by National Natural Science Foundation of China(No.81670866)Sun Yat-Sen University Clinical Research 5010 Project(No.2013007).
文摘●AIM:To evaluate the long-term effects of pattern scan laser(PASCAL)pan-retinal photocoagulation(PRP)on diabetic retinopathy(DR)in Chinese patients.●METHODS:In this retrospective study,we evaluated clinical data of 29 patients(53 eyes)with severe non-proliferative DR(SNPDR)or proliferative DR(PDR)who received PRP and follow-up at our hospital from 2008 to 2013.Sixteen patients(29 eyes)received PASCAL PRP and 13 patients(24 eyes)received 100-ms conventional laser PRP.●RESULTS:After long-term follow-up(mean,min-max days:719.8,290-1666 for PASCAL PRP vs 743.5,240-1348 for conventional PRP,P=0.569),patients receiving PASCAL PRP required fewer photocoagulation sessions than the conventional PRP group(2.6±1.0 vs 3.9±0.9,P<0.01).Best corrected visual acuity(BCVA)was reduced slightly in PASCAL PRP group while reduced significantly in conventional PRP group.At last visit,24 eyes in the PASCAL group(88.9%)and 21 eyes in the conventional group(91.7%)were improved or stable.Two eyes in PASCAL PRP group(7.4%)and 3 eyes in the conventional PRP group(12.5%)developed vitreous hemorrhage or vitreous fibrovascular proliferation.●CONCLUSION:PASCAL PRP is as effective and may be more conducive to maintaining visual acuity with less treatment sessions for DR treatment compared to conventional laser PRP.
基金Supported by National Natural Science Foundation of China(No.81960158,No.81760176)Key Scientific research Program of Jiangxi Education Department(No.GJJ190003).
文摘●AIM:To observe the effect of inhibiting long non-coding RNA(lncRNA)metastasis-associated lung adenocarcinoma transcript 1(MALAT1)on diabetic neurodegeneration.●METHODS:Thirty-six 8-week-old C57 BL/6 mice were randomly divided into normal control,diabetic control,diabetic scrambled small interfering RNAs(siRNAs)and diabetic MALAT1-siRNA groups.After diabetic induction with streptozocin intraperitoneally-injection,the diabetic M A L AT 1-s i R N A g ro u p w a s i n t r av i t r e a l l y i n j e c te d with 1μL 20μmol/L MALAT1 siRNA,and the diabetic scrambled siRNA group was injected with the same amount of scrambled siRNA.Electroretinography was performed to examine photoreceptor functions 16 wk after diabetes induction.MALAT1 expression was detected via real time polymerase chain reaction.Cone morphological changes were examined using immunofluorescence.Rod morphological changes were examined by determining outer nuclear layer(ONL)thickness.●RESULTS:The upregulation of retinal MALAT1 expression was detected in the diabetic control mice,while MALAT1 expression in the diabetic MALAT1-siRNA mice was decreased by 91.48%compared to diabetic control mice.The diabetic MALAT1-siRNA and diabetic control mice showed lower a-wave and b-wave amplitudes than did the normal control mice in scotopic and photopic electroretinogram,while the diabetic MALAT1-siRNA mice showed higher amplitudes than diabetic control mice.Morphological examination revealed that ONL thickness in the diabetic MALAT1-siRNA and diabetic control mice was lower than normal control mice.However,ONL thickness was greater in the diabetic MALAT1-siRNA mice than diabetic control mice.Moreover,the diabetic control mice performed a sparser cone cell arrangement and shorter outer segment morphology than diabetic MALAT1-siRNA mice.●CONCLUSION:Inhibiting retinal MALAT1 results in mitigative effects on the retinal photoreceptors,thus alleviating diabetic neurodegeneration.
基金Supported by a grant from the Asociation to Prevent Blindness in Mexico(No.RE-14-02)
文摘AIM: To assess if the included vascular endothelial growth factor (VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mellitus (T2DM). METHODS: A case-control study was conducted in adult individuals with T2DM associated to proliferative retinopathy or non-proliferative retinopathy from Oct. 2014 to Jun. 2015 from the Retina Department of the Asociation to Prevent Blindness in Mexico. The selected patients were adults with a diagnosis of T2DM ≥5y. All subjects had a comprehensive ocular examination and the classification of the retinopathy severity was made considering the Early Treatment Diabetic Retinopathy Study (ETDRS) standardization protocols. Genomic DNA was extracted from whole fresh blood. All samples were genotyped by qPCR for selected VEGF polymorphisms. Hardy-Weinberg equilibrium was calculated by comparing Chi-square values between the expected and the observed values for genotype counts.RESULTS: In total 142 individuals were enrolled, 71 individuals with T2DM and associated proliferative retinopathy and 71 individuals with non-proliferative retinopathy. One-sided Fisher’s exact test was performed for rs3025021 [OR (95% CI)=0.44(0.08-2.2); P=0.25] and rs2010963 [OR (95% CI)=0.63(0.25-1.6); P=0.23]. The minor allelic frequencies obtained were 26% for rs3025021, 10% for rs3025035 and 61% for rs2010963. The pairwise linkage disequilibrium between the three SNP was assessed, and was as follows: rs3025021 vs rs3025035: D’=1.0, r2=0.1043, P≤0.0001; rs3025021 vs rs2010963: D’=0.442, r2=0.0446, P=0.149; rs3025035 vs rs2010963: D’=0.505, r2=0.0214, P=0.142.CONCLUSION: This is the first analysis involving VEGF polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that different populations have different associations for the same polymorphisms.
文摘Objective. To study the changes of microcirculation in patients with diabetic retinopathy(DR). Methods. Examination were performed in 153 cases of type Ⅱ diabetes mellitus, among them, 72 cases were male, 81 cases were female, mean age 57.0±10.0 years, mean disease course 8.2±7.5 years. All cases were examined fundi by ophthalmologist, urinary albumin excretion rate (UAE) in 24 hours was measured by radioimmunoassay. Moreover, we examined the blood glucose, blood pressure, blood viscosity and observed the changes of naifold microcirculation. Results.It was found that there were more evident disturbance of microcirculation, markedly slowed velocity of blood flow(P<0.05), significantly increased aggregation of blood cells(P<0.05) and exudation around the loop(P<0.05) in the group with DR, compared with the group without DR. Conclusion. It was more evident disturbance of nailfold microcirculation in patients with diabetic retinopathy.
文摘目的探讨参芪降糖颗粒联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的效果及对血小板源性生长因子(PDGF)、骨形成蛋白-2(BMP-2)水平的影响。方法选取2020年2月至2023年1月收治的100例非增殖期糖尿病视网膜病变患者作为研究对象,按随机数字表法将其分为对照组和观察组,每组50例。对照组在常规治疗基础上加羟苯磺酸钙分散片治疗,观察组在对照组基础上采用参芪降糖颗粒治疗。比较两组的治疗效果。结果观察组的治疗总有效率明显高于对照组(P<0.05)。治疗后,观察组的空腹血糖(FBG)、餐后2 h血糖(2 h PG)水平及糖化血红蛋白(HbA1c)均低于对照组(P<0.05)。治疗后,观察组的最佳矫正视力高于对照组,黄斑中心凹视网膜厚度低于对照组(P<0.05)。治疗后,观察组的PDGF、BMP-2水平均低于对照组(P<0.05)。结论参芪降糖颗粒联合羟苯磺酸钙分散片治疗非增殖期糖尿病视网膜病变的效果确切,可有效降低血糖水平,改善患者视力,降低黄斑中心凹视网膜厚度,抑制PDGF、BMP-2表达。
文摘Background Diabetic retinopathy (DR) is one of the most common complications of diabetes.Angiotensin-converting enzyme inhibitor is thought to play an important role in preventing and treating retinal diseases in animal models of DR.The aim of the present study was to investigate the role of angiotensin-converting enzyme inhibitor (ACEI,captopril) in the treatment of patients with non-proliferative DR.Methods Three hundred and seventeen type 2 diabetic patients (88.05% of participants) without or with mild to moderate non-proliferative retinopathy were randomly divided into captopril group (n=202) and placebo group (n=115).All subjects received 24-month follow-up.General clinical examinations,including blood pressure and glycated hemoglobin,as well as comprehensive standardized ophthalmic examinations were performed.Color fundus photography and optical coherence tomography (OCT) were used to grade diabetic retinopathy and detect macular edema respectively.Results The levels of blood pressure and glycated hemoglobin in the two groups of patients remained within the normal range during the entire follow-up and no significant difference was found between the initial and last visits,suggesting that ACEI drugs play a protective role on the DR patients independent of its anti-blood pressure role.DR classification showed that 169 eyes (83.66%) remained unchanged and the DR grade of 33 eyes (16.34%) increased in captopril group,while 84 eyes (73.04%) remained unchanged and the grade of 31 eyes (26.96%) increased in placebo group (P=0.024).Captopril treatment improved macular edema in 55.45% eyes,which was significantly higher than the 37.39% improvement in placebo group (P=0.002).No significant difference was found in the visual acuity between the two groups (P=0.271).Conclusion Captopril can improve or delay the development of DR and macular edema,which can be used in the early treatment of DR patients with type 2 diabetic mellitus.