ABSTRACT
AIM:To explore the effect of compound Xueshuantong capsule combined with calcium dobesilate in patients with early diabetic retinopathy.METHODS:Totally 120 patients with early diabetic retinopathy were selected,and they were randomly divided into study group and control group according to the random number table method,each had 60 cases.Patients in the control group were treated with compound Xueshuantong capsule,and the patients in the study group were treated with compound Xueshuantong capsule combined with calcium dobesilate.We observed and compared the clinical symptoms (hemangioma volume,hemorrhagic spot area,macular thickness,visual gray value,visual acuity,threshold sensitivity within 30°),inflammatory factors (serum hs-CRP,VEGF,IGF-1),clinical efficacy and adverse events.RESULTS:(1) The hematoma volume,hemorrhage spot area,macular thickness and visual gray value of the two groups were lower than those before treatment (tstudy group =24.81,19.59,8.567,17.79,tcontrol group =12.02,8.60,10.32,10.85;P＜0.05);visual acuity,threshold sensitivity within 30°were significantly higher than before (tstudygroup =-5.24,-8.79,tstudy group =-2.26,-3.39;all P＜0.05).After treatment,hemangioma volume,haemorrhagic area,macular thickness and visual gray value of the study group were lower than those of the control group,visual acuity and threshold sensitivity within 30°were higher than those of the control group (t=-12.97,-9.47,-13.54,-5.59,2.65,4.05;all P＜0.05).(2) The levels of hs-CRP,VEGF and IGF-1 in the two groups were lower than those before treatment (tstudy group =34.30,23.33,42.118,tcontrol group =18.68,17.46,26.73;all P＜0.05).The levels of hs-CRP,VEGF and IGF-1 in the study group were significantly lower than those in the control group (t=-14.79,-7.43,-15.35,all P＜0.05).(3)The total effective rate was 92.0％ in the study group,which was higher than 70.8％ in the control group (x2 =16.352,P＜0.05).(4) The incidence of adverse reactions was 10％ in the study group and 13％ in the control group.There was no significant difference in the incidence of adverse reactions between the two groups (x2 =0.32,P＞0.05).CONCLUSION:Compound Xueshuantong capsule combined with calcium dobesilate in the treatment of early diabetic retinopathy can effectively improve the clinical symptoms of retinal defects,the mechanism of action is related to the level of inflammatory factors,the clinical efficacy is better,security is high.
ABSTRACT
AIM:To investigate the effect of Ahmed glaucoma drainage valve implantation on corneal endothelial cell density and intraocular pressure in patients with neovascular glaucoma.METHODS:Totally 200 cases (200 eyes) of patients with neovascular glaucoma in our hospital from June 2013 to June 2016 were enrolled in this study.All patients were treated with glaucoma drainage valve implantation.The medical records of the patients were retrospectively analyzed;the evaluation of operation completion was made;intraocular pressure at preoperative and postoperative 1wk,1mo,1a was detected using non-contact tonometry;the corneal endothelial cell density at preoperative and postoperative 1 wk,1mo and 1 a was tested by corneal endothelial microscopy,and visual acuity of patients before operation and at 1 a after operation was recorded.All patients' complications and intervention methods were followed-up and recorded.RESULTS:All patients' complete success rate was 81.0％,the conditional success rate was 92.0％.The proportion of preoperative and postoperative vision without light perception,hand moving to 0.01,0.02-0.05,0.06-＜0.10,≥0.10 had significant difference (P＞0.05).Intraocular pressure before treatment was 42.43±3.43mmHg,and were 13.45 ± 2.34mmHg,15.89 ± 2.67mmHg,16.34±2.88mmHg at 1wk,1mo and 1a after operation respectively,showing significant difference (F=4570.62,P＜ 0.001).Before treatment,corneal endothelial cell density was 2453.67± 342.34/mm2,and were 2216.67-± 332.32/mm2,2087.34 ± 326.45/mm2,1959.67±303.34/mm2 at 1wk,1mo and 1 a after operation respectively,holding significantly different (F=83.42,P＜0.001).There were macular degeneration 20 eyes of hyphema,13 eyes of low pressure,8 eyes of drainage valve displacement and 21 eyes of shallow anterior chamber.CONCLUSION:Ahmed glaucoma drainage valve implantation for neovascular glaucoma can effectively control intraocular pressure but the presence of corneal endothelial cell loss exists,can effectively protect and recover residual vision of patients,relief complications and recover it after simple intervention,it is an effective method for neovascular glaucoma.