ABSTRACT
Diabetic retinopathy (DR) is one of the microvascular complications of diabetes mellitus (DM).Like other macrovascular complications of DM,the development and progression of DR is influenced by a variety of systemic and local factors.It is essential to understand the importance of multidisciplinary collaboration.Systemic risk fators such as hyperglycemia,hypertension,dyslipidemia and diabetic nephropathy should be treated before effective DR management can be implemented.Through multidisciplinary collaboration,we can prevent the development of DR,slow the progression of DR,and improve the safety of perioperative care.Thereby enhancing the level of prevention and control of DM complications,including DR.
ABSTRACT
Background Panretinal photocoagulation (PRP) is an effective method for diabetic retinopathy (DR).However,PRP causes macular edema and visual impairment.The application of compound anisodine,a vascular dynamic drug can alleviate the adverse effect of PRP,but its effectiveness is not verified yet.Objective This study aimed to investigate the clinical therapeutic effect of compound anisodine on retinal functional damage following PRP in the eyes with non-proliferative diabetic retinopathy (NPDR).Methods A prospective cohort study was carried out from August 2013 to February 2014 in Beijing Tongren Hospital.One hundred and ten eyes with NPDR were included and PRP were performed.The operative eyes were randomized into the compound anisodine group (64 eyes) and control group (46 eyes).Compound anisodine solution of 2 ml was injected via temporal subcutaneous tissue since the second day after photocoagulation,and the injection was performed once per day for 4 courses in 3-day interval between each course (1 course for 14 days) in the compound anisodine group,and no any drug was used in the control group.The visual acuity,30° to 60° ring visual field and flash electroretinaogram (F-ERG) were examined before photocoagulation and 1 day,1 month and 2 months after photocoagulation to compare the retinal function between the two groups.ResultsThe vision acuity improved in 55 eyes in the compound anisodine group with the rate 85.94％,and that in the control group was 11 eyes with the rate 23.91％,showing a significant difference between the two groups (x2 =15.425,P =0.000).The mean sensitivities of visual field were (4.15 ± 1.42),(3.94 ± 1.40) and (4.81 ± 1.41) dB in 1 day,1 month and 2 months after photocoagulation in the compound anisodine group,which were significantly higher than (3.76± 1.52),(3.53± 1.55) and (3.64 ± 1.50) dB of the control group (t =1.39,1.44,1.15,all at P＜0.05).The amplitudes of a-wave and b-wave of F-ERG were all higher in the compound anisodine group than those in the control group in various time points after photocoagulation (all at P＜0.05).Conclusions The injection of compound anisodine via temporal subcutaneous tissue can relieve visual functional damage caused by PRP in NPDR eyes.
ABSTRACT
Objective To investigate the early influences of laser photocoagulation on macular retinal thickness in diabetic retinopathy(DR). Methods Optic coherence tomography examination was performed in 30 eyes with DR(phase Ⅲ~Ⅳ) before, and on the 3rd day and the 7th day after photocoagulation respectively. The thickness of neuroretina and pigment epithelium were measured in the areas of fovea macula and 750 ?m from fovea macula. Results Three days after photocoagulation, significant thickening of neuroretina was observed in the fovea macula, which is positively related with age, fasting blood sugar and duration of DR. There was no significant changes in the thickness of pigment epithelium in macula and in the thickness of neuroretina 750 ?m from fovea macula. Conclusion Significant thickening of neuroretina in fovea macula in DR early after photocoagulation reveals progressed macular edema induced by photocoagulation which is positively related with age, fasting blood sugar and duration of DR.