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Increasing prevalence and incidence of diabetes mellitus(DM)-the most common chronic consumptive disease worldwide-has a devastating impact on people's daily lives, particularly through the deterioration or complete loss of vision brought on by diabetic retinopathy(DR). Therefore, it is imperative to investigate the pathogenesis and effective treatment of DR. Meanwhile, Pueraria lobata is the extensively used dried root of kudzu or dried kudzu, also known as Pueraria flavonoids. Moreover, its roots are primarily composed of isoflavones, Pueroside ABC, triterpenes, and alkaloids, which can calm cardio-cerebrovascular smooth muscle and enhance microcirculation. Currently, it is widely employed for the treatment of cardio-cerebrovascular diseases, osteonecrosis, DM and its complications, neurodegenerative disorders, endometriosis and tumor diseases. Inhibiting retinal neovascularization, alleviating ischemia and hypoxia, decreasing advanced glycation end products in diabetes, raising insulin-like growth factor(IGF)expression while decreasing tumor necrosis factor-α(TNF-a)expression, decreasing vascular endothelial growth factor(VEGF)expression, reducing retinal nerve cell death, inhibiting the NOD-like receptor protein 3(NLRP3)inflammatory pathway and inhibiting ferroptosis are all mechanisms by which puerarin(Pue)has been found to protect the retina in recent studies. Thus, this article summarizes the current comprehension of the mechanism and protective effect of Pue on diabetic retina, serving as a guidepost for its future development and application.
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AIM: To investigate the relationship between blood biochemical parameters and choroidal thickness(CT)in na&#xEF;ve-treatment of patients with nonproliferative diabetic retinopathy(NPDR).METHODS: Prospective cross-sectional study. A total of 92 patients(92 eyes)with na&#xEF;ve-treated NPDR were selected in the Affiliated Eye Hospital of Nanchang University from July 2021 to July 2022. All of the patients included in this study were subjected to ophthalmologic examination including enhanced depth imaging optical coherence tomography(EDI-OCT), best corrected visual acuity(BCVA), fundus fluorescence angiography, intraocular pressure, slit lamp and fundus examination. At the same time, they were also underwent hematological examination including blood glucose, glycosylated hemoglobin(HbA1c), serum creatinine, uric acid, urea, β2 microglobulin, high density lipoprotein(HDL), low density lipoprotein(LDL), serum calcium, serum potassium and other tests. According to the glomerular filtration rate(eGFR)and CT, the patients were divided into normal, mild and moderate to severe renal function group, pachychoroid group and the leptochoroid group. The blood biochemical indexes, CT differences and theirs correlation were analyzed in na&#xEF;ve-treated NPDR patients.RESULTS: A total of 92 cases(92 eyes)were included in this study, with 51 males(51 eyes), 41 females(41 eyes), 45 right eyes and 47 left eyes. There was no significant difference in age, axial length and disease duration among the three groups(all P>0.05). There were significant differences in nasal 0.5, 1.5mm, subfoveal and temporal 0.5, 1.5mm CT among three groups(all P<0.05). There was no statistical significance in age, axial length and the course of disease between the pachychoroid and leptochoroid groups(all P>0.05). There were significant differences in creatinine, eGFR, uric acid, urea, potassium and β2-microglobulin between the pachychoroid group and the leptochoroid group(all P<0.05). There were no significant differences in total cholesterol, triglyceride, HDL, LDL, HbA1c, serum calcium and glucose between the two groups(all P>0.05). CT was negatively correlated with creatinine, urea, uric acid and β2-microglobulin, and positively correlated with eGFR. Multiple regression analysis showed that the thicker the nasal 0.5mm CT, the higher the eGFR(B=0.292, P<0.001). CT affected creatinine, eGFR, urea, uric acid and β2-microglobulin(B=16.5, 64.6, 24.1, 18.1, 20.3; P=0.008, <0.001, <0.001, 0.004, 0.001), while there were no significant effects on total cholesterol, triglyceride, glucose, serum calcium, HDL and LDL(all P>0.05).CONCLUSION: In patients with na&#xEF;ve-treated NPDR, the thicker the CT, the better the renal function. The decrease of CT in newly diagnosed NPDR patients is an important hint to pay attention to the renal function.
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AIM: To evaluate the efficacy and safety of foveal-sparing internal limiting membrane peeling(FSIP)or complete internal limiting membrane peeling(CMIP)for the treatment of myopic traction maculopathy(MTM)during vitrectomy.METHODS: CNKI, Wanfang, VIP, PubMed, Embase, Cochrane Library, and Web of Science were searched from January 1th 2000 to July 1th 2022, and studies that compared FSIP and CMIP for MTM were collected. The change and recovery rate of best corrected visual acuity(BCVA), incidence of full-thickness macular hole(FTMH), change of central foveal thickness(CFT)and the rate of complete reattachment.RESULTS: A total of 484 eyes from 12 literatures were included, with 203 eyes in the FSIP group and 281 eyes in the CMIP group. The results of Meta-analysis showed that FSIP group were superior to the CMIP group in the mean change of BCVA(SMD=0.52, 95%CI: 0.20～0.85, P=0.002), the improvement rate of BCVA(RR=1.50, 95%CI: 1.22～1.85, P=0.0002)and the incidence of postoperative FTMH(RR=0.23, 95%CI: 0.10～0.54, P=0.0008). There was no statistical difference between the two surgical methods in terms of mean change in CFT(SMD=0.04, 95%CI: -0.19～0.26, P=0.75)and the rate of complete reattachment(RR=1.12, 95%CI: 0.94～1.32, P=0.20).CONCLUSION: FSIP have similar anatomical outcomes compared to CMIP, but FSIP resulted in better visual acuity and lower incidence of postoperative FTMH.
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AIM: To analyze the efficacy and safety of safflor yellow injection combined with anti-vascular endothelial growth factor(VEGF)drug in the treatment of non-ischemic central retinal vein occlusion(CRVO).METHODS: A total of 91 patients(91 eyes)with non-ischemic CRVO complicated with macular edema who were treated in the Affiliated Eye Hospital of Nanchang University from April 2017 to December 2021 were selected. They were randomly divided into observation group, with 47 cases(47 eyes)treated with safflor yellow injection combined with intravitreal injections of ranibizumab, and control group with 44 cases(44 eyes)who were treated with intravitreal injections of ranibizumab. Followed-up for 11mo, the best corrected visual acuity(BCVA)and macular central retinal thickness(CRT)of the two groups were observed and the cases of complete absorption of retinal hemorrhage, the times of anti-VEGF drug injections, the cases of ischemic CRVO, and the occurrence of systemic or ocular complications were recorded.RESULTS: At 1, 2, 3, 5, 7, 9 and 11mo after treatment, the BCVA and CRT in both groups were significantly improved compared with those before treatment, and BCVA and CRT in the observation group were superior to the control group at 3, 5, 7, 9 and 11mo after treatment(all P<0.05). At 5, 7, 9 and 11mo after treatment, the complete absorption rate of retinal hemorrhage in the observation group was higher than that in the control group(P<0.05). During the follow-up period, the anti-VEGF drug injection in the observation group was significantly less than that in the control group(4.83±1.05 vs. 5.75±1.01, P<0.05), and the incidence of ischemic CRVO was significantly lower than that in the control group(21% vs. 86%, P<0.05), and there were no treatment-related systemic and ocular complications in both groups.CONCLUSION: Safflor yellow injection combined with anti-VEGF drugs is a safe and effective method for the treatment of non-ischemic CRVO, which can significantly improve vision and reduce CRT. It can increase the complete absorption rate of retinal hemorrhage, reduce the times of anti-VEGF drug injections and the incidence of ischemic CRVO compared with monotherapy of anti-VEGF drug.
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Diabetic macular edema (DME),a common eye complication,is one of the main causes of visual impairment in diabetes patients.There are many treatments for DME.In recent years,drug therapy,especially the steroids drug delivery.This article will summarize the progress in drug treatment for DME.
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Background Curcumin derives from the rhizome of curcuma longa.It has proven to have an antiproliferative effect in previous studies on vast majority of endothelial and epithelial cells,however,the study of its inhibiting effect on the proliferation of retinal pigment epithelial (RPE) cells and underlying mechanism is rare.Objective Aim of this study was to investigate the potential inhibitory effect of curcumin on the proliferation of cuhured human RPE cells in vitro and its possible mechanism.Methods Human RPE cells harvested by trpsinEDTA were suspended in DMEM/F12 medium with serial dilutions of curcumin (5,10,15,20 mg/L),and the human RPE cells cultured by DMEM/F12 without curcumin were used as control.The proliferation value of human RPE cells (A value) was measured by water-soluble tetrazole-1 (WST-1) assay,the optimized dose of antiproliferation of curcumin was determined and applied for further experimental process.Apoptosis and cell cycle of human RPE cells were detected by flow cytometric analysis at 48 hours and 72 hours after curcumin treatment.The ultrastructure profile of the cells were examined by transmission electron microscopy (TEM).Western blot analysis was performed to measure the relative expressing level of the pro-apoptotic factors p53,p21 WAF1/CIP1 and proliferating cell nuclear antigen (PCNA) in the cells,respectively.Factorial design of two factor analysis of variance of SPSS 17.0 software was used to compare the difference of A values of the cells among the various groups and time points,and independent-sample t test was used to compare the differences of apoptosis rate and cell ratio in different cycles between curcumin group and control group.Results WST-1 assay showed that the A value was gradually reduced with the increase of curcumin dose (F tion =96.55,P =0.00),and gradually increased with the lapse of time (Ftime =4634.28,P =0.00).The early apoptotic rate of the cells was (13.37±1.26) ％ in the curcumin group 48 hours after treated by 15 mg/L curcumin,and that of the control group was (7.03 ±0.37) ％,with a significant difference between them (t =8.33,P=0.00).In 72 hours after treated by 15 mg/L curcumin,the early and middle-late apoptotic rates of the cells were (15.97±0.16) ％ and (0.26±0.03) ％,which were significantly higher than those of the control group (7.29±0.37) ％ and (0.14±0.02) ％ (t=37.80,P=0.00;t=7.44,P=0.00).The cell ratio of G0/G1 phase in the curcumin group was (57.17±1.17)％ 48 hours after treated by 15 mg/L curcumin,and that in the control group was (67.73± 1.10)％,showing a significant difference (t =11.40,P =0.00).M itochondrial swelling and vacuolar degeneration were seen in the cells after treated by 15 mg/L curcumin.The relative expression levels of p53 and p21WAF1/CIP1 protein in the cells were higher in the curcumin group than those of the control group at 24,48 and 72 hours (all at P＜0.05),but the expression levels of PCNA protein were lower in the curcumin group than those of the control group in various time points (all at P ＜ 0.05).Conclusions Curcumin can effectively inhibit the proliferation of human pigment epithelial cells in a dose-and time-dependent manner.P53 pathway may participate in anti-proliferating process.
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Background The dosage of verteporfin photodynamic therapy (PDT) for central exudative chorioretinopathy(CEC) depends on the calculation formula of Treatment of Age-related Macular Degeneration with Photodynamic Therapy Study Group(TAP)and Verteporfin in Photodynamic Therapy Study Group(VIP).Some local adverse responses or normal tissue damage have been noted under the standard dose of verteporfin during the treatment of CEC.So it is necessary to explore an appropriate therapeutic dosage of verteporfin.Objective This clinical study aimed to observe and compare the clinical efficacy and safety of different doses of verteporfin PDT for CEC.Methods Ninety eyes of 90 patients with CEC were enrolled in this study with the approval of the Ethic Commission of Affiliated Second Hospital of Nanchang University.Written informed consent was obtained before PDT.The patients were randomly divided into standard dose group,half dose group and 1/3 dose group.All of the patients received PDT.Standard dose(6 mg/m2),3 mg/m2 or 2 mg/m2 of verteporfin was applied in the three groups respectively,with the laser intensity 50 J/cm2.The patients were followed-up for 3 months.Repeat treating regimen was performed in the same way in the patient with fundus fluorescein leakage after initial PDT.Results The BCVA(logMAR) value was 0.44±0.36 after PDT in the standard dose group.Visual acuity improved in 20 patients (66.67％),stabilized in 8 patients(26.67％)and decreased in 2 patients (6.67％).The BCVA showed a significant difference between the preoperative and postoperative BCVA (t =6.719,P =0.000).CNV disappeared in 19 patients (63.33％),obviously improved in 7 patients (23.33％),partially disappeared in 3 patients (10.00％) and unchanged in 1 patient (3.33％).The central fovea thickness (CFT)value was significantly declined in postoperation compared with preoperation (t =5.758,P =0.000).Eight patients received secondary PDT with the recurrence rate 26.67％.In the half dose group,visual acuity improved in 18 patients(60.00％),stabilized in 11 patients(36.67％)and decreased in 1 patient (3.33％).CNV disappeared in 16 patients (53.33％),obviously improved in 8 patients (26.67％),partially disappeared in 5 patients (16.67％) and unchanged in 1 patient (3.33 ％).Significant difference was seen between the preoperative BCVA and postoperative BCVA(t=8.294,P =0.000).The decrease of C FT was significant in postoperation(t =8.493,P =0.000).Ten patients received secondary treatment with the recurrence rate 33.33％.In 1/3 dose group,visual acuity improved in 8 patients (26.67 ％),stabilized in 12 patients (40.00％),decreased in 10 patient (33.3％).CNV disappeared in 8 patients (26.67％),obviously improved in 8 patients (26.67％),partially disappeared in 6 patients (20.00％) and unchanged in 8 patient (26.67％).There was no significant difference between the preoperative BCVA and postoperative BCVA (t =0.536,P =0.596).The difference between preoperative CFT and postoperative CFT was insignificant(t =0.942,P=0.354).Fourteen patients received secondary PDT and 8 patients received three times with the recurrence rate 73.33％.Conclusions 3 mg/m2 verteporfin PDT for CEC shows a similar clinical efficiency and safety to 6 mg/m2 verteporfin.3 mg/m2 verteporfin PDT can decrease cost,but the effect of 2 mg/m2verteporfin PDT is not satisfacted.