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AIM: To investigate the clinical efficacy of the compound anisodine combined with retinal laser photocoagulation in the treatment of severe non-proliferative diabetic retinopathy(NPDR). METHODS: According to the retrospective study, totally 120 eyes of patients with severe NPDR who admitted to Daxing Teaching Hospital Affiliated to Capital Medical University from May 2023 to July 2023 were selected. The patients were divided into the observation group and the control group according to treatment methods, with 60 eyes in each group. The observation group was treated with panretinal photocoagulation combined with the compound anisodine injection. The control group was only treated with panretinal photocoagulation. The optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT)were used to quantitatively analyze the fundus retinal structure and blood flow. Furthermore, the best corrected visual acuity(BCVA), superficial vascular density(SVD), deep vascular density(DVD), choroidal blood flow density and central macular foveal retinal thickness(CMT)were compared before treatment and at 1 d, 1 and 2 mo after treatment.RESULTS:At 2 mo postoperatively, the rate of visual improvement and the BCVA in the observation group of patients were significantly better than those of the control group, and the incidence of macular edema in the observation group was significantly lower than the control group(P<0.05). The BCVA at 1 and 2 mo after treatment were significantly higher than those before treatment in both groups(P<0.05). The SVD in the observation group was better than the control group at 1 d, 1 and 2 mo after treatment(all P<0.05). The DVD and choroidal flow density in the observation group were better than those of the control group at 1 d after treatment(all P<0.05). The CMT of the observation group was smaller than that of the control group at 1 d after treatment(P<0.05).CONCLUSION:Compound anisodine can effectively improve the fundus microcirculation after panretinal photocoagulation and reduce the incidence of macular edema, thus promoting the visual function.
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AIM: To investigate the differences in varying stages of non-proliferative diabetic retinopathy(NPDR)using optical coherence tomography angiography(OCTA).METHODS: Cross-sectional study. A total of 77 cases(77 eyes)of diabetic patients were included, and they were divided into non-diabetic retinopathy(NDR; 23 eyes)and non-proliferative diabetic retinopathy(NPDR; 54 eyes)groups, further subdivided into mild NPDR(20 eyes), moderate NPDR(20 eyes), and severe NPDR(14 eyes). Foveal avascular zone(FAZ)area, superficial and deep capillary plexus densities(SSP and DSP), and visual acuity(LogMAR)were compared between NDR and NPDR groups. Furthermore, the visual acuity, FAZ area and levels of SSP and DSP were compared in different degrees of NPDR. Correlation analysis were conducted to elucidate relationships between FAZ area, visual acuity, SSP, DSP, and severity of the disease.RESULTS: Compared with the NDR group, the visual acuity(LogMAR)and macular FAZ area increased, while SSP and DSP were decreased in the NPDR group(P&#x003C;0.05); there were significant differences in visual acuity, FAZ area and SSP and DSP levels in different degrees of NPDR(P&#x003C;0.05). Visual acuity(LogMAR)and FAZ area displayed a positive correlation with the severity of disease, while SSP and DSP showed a negative correlation.CONCLUSION: With the progression of NPDR, the visual acuity(LogMAR)and FAZ area increased, and the SSP and DSP decreased.
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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 observe the clinical efficacy of modified Buyang Huanwu Decoction in treating non-proliferative diabetic retinopathy(NPDR)of qi and yin deficiency and stagnation of collaterals, and to quantitatively analyze the changes in peripapillary vessel density before and after treatment using optical coherence tomography angiography(OCTA).METHODS:A randomized controlled trial was used to collect a total of 58 patients(99 eyes)with qi and yin deficiency and stagnation of collaterals NPDR who visited our hospital from June 2022 to November 2022, and patients were randomly divided into an observation group(n=29, 51 eyes)and a control group(n=29, 48 eyes). The control group received basic treatment according to the recommendations for DR published by the American Academy of Ophthalmology in 2019(blood glucose control, diabetes health education, and regular follow-up for patients with mild NPDR; and add local/grid-like laser photocoagulation if necessary for patients with moderate NPDR), while the observation group received modified Buyang Huanwu Decoction in addition to the basic treatment for 1mo. The best-corrected visual acuity(BCVA), traditional Chinese medicine(TCM)efficacy, peripapillary telangiectasia vessel density(ppVD), and changes in peripapillary retinal nerve fiber layer(pRNFL)thickness were compared between the two groups before and after treatment.RESULTS:The BCVA(LogMAR)of the observation group was 0.20(0.10, 0.30)after 1mo of treatment, which was significantly improved compared with that of the control group of 0.30(0.20, 0.40; P<0.05). The TCM efficacy in the observation group after 1mo of treatment was better than that in the control group(P<0.05). The ppVD in all quadrants of the observation group showed a significant improvement at 1mo after treatment, and the ppVD in all quadrants of the observation group was higher than that of the control group(P<0.05). The pRNFL thickness in the superior, temporal, and average peripapillary areas of the observation group increased after 1mo of treatment, and the pRNFL thickness in the superior, temporal, inferior quadrants, and average peripapillary area of the observation group was higher than that of the control group(P<0.05).CONCLUSION:Modified Buyang Huanwu Decoction can improve visual acuity and enhance TCM efficacy in patients with NPDR of qi and yin deficiency and stagnation of collaterals. It may be related to its ability to improve ppVD and reduce damage to the pRNFL.
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Objective:To observe the safety and efficacy of Keluoxin capsules in the treatment of moderate to severe non-proliferative diabetic retinopathy (NPDR).Methods:An open-label, multi-center, single-arm, phase Ⅱa clinical trial. From May 2014 to December 2016, the patients diagnosed with moderate to severe NPDR who received Keroxin treatment in General Hospital of Central Theater Command, Affiliated Eye Hospital to Nanchang University, Xiyuan Hospital of China Academy of Chinese Medical Sciences, and Eye Hospital China Academy of Chinese Medical Sciences were divided into moderate NPDR group and severe NPDR group. The baseline data of the patients were obtained, best-corrected visual acuity (BCVA), optical coherence tomography, fundus fluorescein angiography and fundus photography were performed. On the basis of maintaining the original diabetes treatment, all patients took Keluoxin capsules orally for 24 weeks; 24 weeks after treatment was used as the time point for evaluating the efficacy. BCVA letters, central macular thickness (CMT) and 6 mm diameter total macular volume (TMV), retinal vascular leakage area, and retinal non-perfusion (RNP) area within an average diameter of 6 mm were compared between the two groups at baseline and 24 weeks after treatment. Independent sample Mann-Whitney U test was used to compare continuous variables between groups. Categorical data were compared by χ2 test. Results:A total of 60 NPDR patients and 60 eyes were included, 9 cases were lost to follow-up, and 51 cases and 51 eyes were finally included, including 37 eyes in the moderate NPDR group and 14 eyes in the severe NPDR group, respectively. At baseline, BCVA in moderate NPDR group and severe NPDR group were (80.1±6.8), (81.4±6.3) letters, respectively. CMT were (249.5±32.1), (258.9±22.2) μm, respectively. TMV were (8.79±1.09), (8.95±1.31) mm 3, respectively. Retinal vascular leakage areas were (7.69±10.63), (10.45±7.65) mm 2, respectively. RNP area were (2.48±5.74), (10.63±20.06) mm 2, respectively. There were 11 (29.7%, 11/37) and 4 (28.6%, 4/14) eyes with diabetic macular edema (DME), respectively; 24 weeks after treatment, BCVA in moderate NPDR group and severe NPDR group increased by (1.3±5.2), (3.2±3.0) letters, respectively. Compared with baseline, there was a statistically significant difference in the severe NPDR group ( t=-3.986, P=0.033). CMT were (252.1±45.6), (269.8± 57.2) μm, respectively. There were no significant differences compared with baseline ( t=-0.567, -0.925; P>0.05). TMV were (9.96±1.16), (10.09±1.32) mm 3, respectively. There were no significant differences compared with baseline ( t=-0.996, -1.304; P>0.05). Retinal vascular leakage area decreased (0.19±6.90), (1.98±7.52) mm 2, respectively. There were no significant differences compared with baseline ( t=0.168, 0.983; P>0.05). RNP area were (3.01±6.47), (10.36±19.57) mm 2, respectively. Compared with baseline, the differences were statistically significant ( t=-1.267, 0.553; P>0.05). There were 8 (21.6%, 8/37) and 3 (21.4%, 3/14) eyes with DME, respectively. Compared with baseline, the difference was statistically significant ( χ2=11.919, 4.571; P=0.001, 0.033). Conclusion:Keluoxin capsules can stabilize or improve BCVA, CMT, TMV and RNP area in patients with moderate and severe NPDR, and reduce the area of retinal vascular leakage.
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Objective@#To investigate the factors affecting the development of non-proliferative diabetic retinopathy (NPDR) among patients with type 2 diabetic mellitus (T2DM), so as to provide insights into manangement of NPDR.@*Methods@#T2DM patients without obvious eye discomfort at ages of 18 years and older admitted to Department of Endocrinology, Jining No. 1 People's Hospital during the period from December 2019 to May 2021 were enrolled. Participants' demographics, smoking, alcohol consumption, medical history of diabetes and use of medicines were collected, and the height, weight and blood pressure were measured. The levels of glycosylated hemoglobin (HbA1c), fasting blood glucose, blood C-peptide, lipid and creatinine were tested, and retinopathy was examined with a non-mydriatic fundus camera. The factors affecting the development of NPDR were identified among T2DM patients using a multivariable logistic regression model.@*Results@#A total of 486 T2DM patients were enrolled, including 354 men (72.84%), with a median age of 48.00 (15.25) years, and median diabetes duration of 35.00 (104.25) months. The prevalence of NPDR was 19.34% among the participants. multivariable logistic regression analysis identified an educational level of senior high school and above (OR=0.546, 95%CI: 0.325-0.918), duration of diabetes (OR=1.008, 95%CI: 1.005-1.012), HbA1c (OR=1.183, 95%CI: 1.034-1.354) and use of non-sulfonylurea insulin secretagogues (OR=1.859, 95%CI: 1.082-3.196) as factors affecting the risk of NPDR among T2DM patients.@*Conclusion@#A high risk of NPDR is found among T2DM patients with a low educational level, long duration of diabetes, poor HbA1c control and use of non-sulfonylurea insulin secretagogues.
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【Objective】 To investigate the clinical effect of optical coherence tomography angiograph (OCTA) applied in retinal microvascular screening in patients with non-proliferative diabetic retinopathy (NPDR). 【Methods】 Thirty patients with NPDR (NPDR group) diagnosed at The Third Affiliated Hospital of Soochow University and 30 healthy volunteers (control group) were selected to receive OCTA examination. The area, perimeter, and circularity of the fovea avascular zone (FAZ) were measured and blood flow density in the superior, inferior, nasal, temporal quadrants of the macular superficial retinal capillary layer (SCP) and the peripapillary radial capillary layer (RPC) of the optic disc were quantified. 【Results】 In NPDR group, blood flow density in the four quadrants of macular SCP and RPC were decreased significantly compared with that in control group (43.68±3.03 vs. 46.98±3.04, 42.79±3.17 vs. 50.45±2.25, 43.21±2.67 vs. 47.44±2.42, 44.21±3.22 vs. 51.72±5.32, 46.43±3.54 vs. 53.02±2.62, 45.97±3.67 vs. 52.53±2.82, 44.63±2.73 vs. 48.19±3.67, 41.73±3.15 vs. 45.12±3.31) (all P<0.01). The area and perimeter of FAZ in NPDR group were significantly higher than those in control group [(0.50±0.06 vs. 0.43±0.47) mm2, (3.10±0.21 vs. 2.87±0.22) mm]. The circularity of FAZ was significantly lower in NPDR group than in control group [(0.63±0.05 vs. 0.67±0.05)%, P<0.01]. 【Conclusion】 OCTA can detect early retinal microstructure changes in NPDR, and thus can be used as an auxiliary screening of NPDR to provide information for early diagnosis and treatment.
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@#AIM: To observe the efficacy of addition and subtraction of Buyang Huanwu decoction in the adjuvant treatment of non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis and its effects on traditional Chinese medicine(TCM)syndromes and visual function level. <p>METHODS: A total of 110 patients with non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis in our hospital between January 2017 and December 2019 were selected and divided into observation group(55 cases, 110 eyes)and control group(55 cases, 110 eyes). Patients in control group received conventional treatment according to the condition of patients with reference to relevant guidelines, and patients in observation group were combined with addition and subtraction of Buyang Huanwu decoction adjuvant therapy on this basis. The clinical efficacy after 3mo of treatment, and TCM syndromes scores, clinical indicators(macular edema score, macular retinal volume, macular foveal retinal thickness), visual function(best corrected visual acuity, average visual field sensitivity)and serum biochemical indicators \〖vascular endothelial growth factor(VEGF), hypoxia-inducible factor-1(HIF-1)\〗 before treatment and 3mo after treatment were compared between the two groups.<p>RESULTS: After 3mo of treatment, the total effective rate of treatment in observation group was significantly higher than that in control group(<i>P</i><0.05). After 3mo of treatment, the TCM syndromes scores in the two groups were decreased compared with those before treatment, and the scores in observation group were lower than those in control group(<i>P</i><0.05). After 3mo of treatment, the macular edema score, macular retinal volume and macular foveal retinal thickness in the two groups were reduced compared with those before treatment, and the indexes in observation group were smaller than those in control group(<i>P</i><0.05). After 3mo of treatment, the best corrected visual acuity and average visual field sensitivity in the two groups were improved compared with those before treatment, and the indexes in observation group were higher than those in control group(<i>P</i><0.05). After 3mo of treatment, the levels of serum VEGF and HIF-1 in the two groups were decreased compared with those before treatment, and the levels in observation group were lower than those in control group(<i>P</i><0.05). <p>CONCLUSION: Addition and subtraction of Buyang Huanwu decoction has an exact efficacy in the adjuvant treatment of non-proliferative diabetic retinopathy of Qi-Yin deficiency and blood stasis, and it can improve symptoms and promote visual function recovery by reducing the expressions of VEGF and HIF-1.
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@#AIM:To investigate the effect of anti-VEGF combined with panretinal photocoagulation(PRP)in the treatment of severe non-proliferative diabetic retinopathy(sNPDR)with diabetic macular edema(DME)on the change of macular blood flow density.<p>METHODS: Data of 30 eyes in 30 patients at Guangxi Zhuang Autonomous Region People's Hospital from October 2018 to April 2019 were retrospectively reviewed, and they were randomly divided into group A and group B each with 15 cases. Group A was received PRP treatment after one initial intravitreal ranibizumab injection followed by pro re nata(PRN)at 7d, while group B was administered PRP alone. The blood flow density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)in macular area(6mm×6mm), central macular thickness(CMT), and best corrected visual acuity \〖BCVA(LogMAR)\〗 were compared between the two groups before and after treatment. <p>RESULTS: Compared with before operation, the DCP blood flow density was significantly increased, CMT was obviously decreased, and BCVA was markedly improved in group A at 2wk and 1mo after surgery(all <i>P</i><0.05), while CMT was decreased and BCVA was improved in group B at 1mo after operation(all <i>P</i><0.05). Postoperative in group A at 2wk and 1mo, the DCP blood flow density was significantly higher than that in group B(43.37%±2.72% <i>vs</i> 41.03%±2.60%, 45.01%±2.28% <i>vs</i> 41.20%±2.43%, <i>P</i><0.05), CMT was obviously lower than group B(303.4±30.36μm <i>vs</i> 329.60±31.47μm, 268.67±30.27μm <i>vs</i> 319.40±28.63μm, all <i>P</i><0.05), and BCVA(LogMAR)was markedly improved compared with group B(0.28±0.11 <i>vs</i> 0.40±0.13, 0.23±0.14 <i>vs</i> 0.38±0.15, all <i>P</i><0.05).<p>CONCLUSION: Anti-VEGF combined with PRP can effectively increase DCP blood flow density, reduce macular edema and improve visual acuity in the short term in patients with sNPDR with DME.
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Objective:To investigate the combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection in treatment of patients with nonproliferative diabetic retinopathy.Methods:106 cases were randomly selected from the patients with nonproliferative diabetic retinopathy admitted in Traditional Chinese and Western Hospital of Dazhou City from Jan. 2019 to Dec. 2019. Based on the random numbers table, the cases were divided into control group and intervention group, with each group 53 patients. They were respectively treated with the therapy of calcium dobesilate capsules alone and the combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules and intravenous drip of Danhong injection, and the therapeutic effects were compared.Results:After treatment, the visual acuity of patients in both groups significantly improved ( P<0.05) , and the visual acuity of patients in the intervention group was higher than that of patients in the control group ( P<0.05) ; after treatment, the peak systolic velocity (PSV) and end diastolic velocity (EDV) of the central retinal artery (CRA) and posterior ciliary artery (PCA) of the patients in both groups significantly increased ( P<0.05) , while RI significantly reduced ( P<0.05) , and PSV and EDV of CRA and PCA in the intervention group were significantly higher than those of the control group ( P<0.05) , while RI was significantly lower than that of the control group ( P<0.05) . After treatment, the therapeutic efficiency of the intervention group was 96.23%, significantly higher than 79.25% in the control group ( χ2=7.102, P<0.05) . The incidence of adverse reactions in the intervention group was 9.43%, which had no significant difference with 3.78% in the control group ( χ2=1.377, P>0.05) . After targeted treatment was given, the adverse reactions disappeared. Conclusion:The combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection was significantly effective in treatment of patients with nonproliferative diabetic retinopathy.
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@#AIM: To investigate the timing of using anti-VEGF drugs in severe non-proliferative diabetic retinopathy(SNPDR)patients with diabetic macular edema(DME)treated with intravitreal injection of Conbercept(IVC)combined with panretinal photocoagulation(PRP). <p>METHODS: Totally 85 SNPDR patients(85 eyes)with DME diagnosed in our hospital from May 2017 to October 2018 were randomly divided into control group(<i>n</i>=29 cases), IVC group(<i>n</i>=28 cases), PRP group(<i>n</i>=28 cases). The control group was treated with PRP only; the IVC group was given PRP 1wk after IVC; the PRP group was given IVC 1wk after PRP. The follow-up time was 12mo. Changes of the best corrected visual acuity(BCVA)and central macular thickness(CMT)were observed before and 1, 3, 6, 12mo after treatment, and the frequency of IVC were recorded.<p>RESULTS: Compared with before treatment, the BCVA of the three groups after treatment improved, and the CMT decreased(<i>P</i><0.05). after treatment, the BCVA of the IVC group and the PRP group was better than the control group, and the CMT was lower than the control group(<i>P</i><0.05). 3mo after treatment, BCVA(0.24±0.18, LogMAR)in the ICV group decreased more than that in the PRP group(0.38±0.29, LogMAR)(<i>P</i><0.05). At 1 and 3mo after treatment, CMT in the ICV group(1mo 313.89±61.69um, 3mo 287.64±43.94μm)decreased more than that in the PRP group(1mo 347.50±56.55μm, 3mo 318.04±49.334μm), and the difference was significant difference(<i>P</i><0.05). The frequency of IVC was(3.07±1.33)times in the IVC group and(3.93±1.60)times in the PRP group(<i>P</i><0.05).<p>CONCLUSION: In SNPDR patients with DME, IVC combined with PRP is better than PRP alone. Anti-VEGF drugs before PRP can obtain better BCVA, reduce macular edema in the short-term observation. In long-term observation, it can also reduce the frequency of IVC, the risk of infection and the financial burden.
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@#AIM: To analyse the characteristic of macular microcirculation detected by optical coherence tomography angiography(OCTA)in nonproliferative diabetic retinopathy(NPDR).<p>METHODS: Vessel density of 3mm×3mm centered on the fovea(3mm×3mm VD), parafoveal vessel density(parafoveal VD)and foveal vessel density(foveal VD)were measured by OCTA in healthy people, NDR, mild NPDR, moderate NPDR, and severe NPDR groups. <p>RESULTS: Deep 3mm×3mm VD, deep parafoveal VD and deep foveal VD were decreased gradually in groups. There was statistically significant difference between moderate NPDR, severe NPDR and others in deep 3mm×3mm VD and parafoveal VD(<i>P</i><0.01). There was statistically significant difference between severe NPDR and control group in deep foveal VD(<i>P</i>=0.006). Superficial 3mm×3mm VD and superficial parafoveal VD are statistically significant in groups. There was statistically significant difference between moderate NPDR group and control group in superficial 3mm×3mm VD and parafoveal VD(<i>P</i><0.01). There was statistically significant difference between severe NPDR group and others except moderate NPDR group in superficial 3mm×3mm VD, parafoveal VD(<i>P</i><0.01). There was a significant correlation of deep and superficial 3mm×3mm VD,deep and superficial parafoveal VD, deep parafoveal VD with VA.<p>CONCLUSION: Deep vessel density decreased more significantly in moderate NPDR and severe NPDR groups and deep parafoveal vessel density might be a potential biomarker of DR.
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Purpose: To identify optical coherence tomography-angiography (OCT-A) findings to predict treatment response during anti-vascular endothelial growth factor (VEGF) therapy in eyes with para foveal telangiectasia (PFT) group II. Methods: In this retrospective series, Twelve eyes of seven patients diagnosed with PFT group II without evidence of sub-retinal neovascular membrane (SRNVM) clinically or on spectral domain-OCT (SD-OCT) were included. All patients underwent OCT-A on the Topcon DRI OCT Triton® with 4.5 mm macula scans. The patients with abnormal vascular nets were further classified into type A and B nets and administered intravitreal anti-VEGF therapy. Visual acuity and size of type A and B nets were evaluated pre- and post-injection. Paired t- test and intraclass correlation were used to analyse data. Results: Patients with type A net showed significant improvement in visual acuity (logMAR 0.38, P = 0.0047). The size of type A net showed statistically significant decrease (P = 0.0008) on 6 month follow up. Type B net did not show statistically significant difference in visual acuity or size following anti-VEGF therapy. Conclusion: OCT-A plays an important role in early detection of possible neovascular nets (type A), in the absence of obvious SRNVM. Treatment decisions based on OCT-A may be helpful to achieve better visual outcome.
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@#AIM: To investigate the effect of calcium oxybenzenesulfonate dispersible tablets combined with Mingmu Dihuang pills on clinical evaluation indexes, retinal angiogenesis factors and blood lipid levels in patients with non-value-added diabetic retinopathy. <p>METHODS: Totally 100 cases of non-proliferative diabetic retinopathy(NPDR)patients treated in our hospital from January 2017 to March 2018 were selected as the study subjects. They were randomly divided into observation group(<i>n</i>=50)and control group(<i>n</i>=50). The control group was treated with calcium oxybenzosulfonate dispersible tablets, the observation group was treated with Mingmu Dihuang pills on the basis of the control group. The clinical evaluation indexes, retinal angiogenic factors and blood lipid levels of the two groups before and after treatment were observed and compared. <p>RESULTS: Before treatment, there were no significant differences in clinical evaluation indexes, retinal angiogenic factor and blood lipid levels between the two groups(<i>P</i>>0.05).After treatment, the visual field gray value, hemangioma volume, macular thickness, hemorrhage area, vascular endothelial growth factor(VEGF), insulin-like growth factor-1(IGF-1), tissue factor(TF), total cholesterol(TC), triglyceride(TG)and low-density lipoprotein cholesterol(LDL-C)levels in the two groups were significantly lower than before treatment(<i>P</i><0.05). Visual acuity, pigment epithelial-derived factor(PEDF)and high-density lipoprotein cholesterol(HDL-C)were significantly higher than before treatment(<i>P</i><0.05). The levels of VEGF, IGF-1, TF, TC, TG and LDL-C in the observation group were significantly lower than those in the control group(<i>P</i><0.05), and the levels of visual acuity, PEDF and HDL-C were significantly higher than those in the control group(<i>P</i><0.05). <p>CONCLUSION: Calcium oxybenzosulfonate dispersible tablets combined with Mingmu Dihuang pills can significantly improve the clinical evaluation index, inhibit angiogenesis and improve the level of blood lipid.
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Objective To observe the clinical efficacy of Tangzhiping Prescription on non-proliferative diabetic retinopathy (NPDR) and the effects on serum vascular epithelial growth factor (VEGF) and pigment epithelium derived factor (PEDF). Methods Totally 86 NPDR patients were randomly divided into treatment group (43 cases) and control group (43 cases). Both groups were given hypoglycemic, anti hypertensive and lipid-regulatory basic therapy. The control group was given calcium distillate capsules, 0.5 g per time, 3 times a day, orally; the treatment group was treated with Tangzhiping Prescription based on the control group, 1 dosage per day, twice a day, orally. Four weeks were set as one treatment course. Treatment for both groups lasted for three courses. Clinical efficacy and fundus efficacy of both groups were evaluated. TCM symptom scores, fundus scores, and visual condition were observed; FPG, 2 h PG, Hb A1 C, TC, TG, HDL-C and LDL-C and changes in the contents of VEGF and PEDF were detected. Results The control group and the treatment group lost 2 and 3 cases respectively. The total effective rate of clinical efficacy and total fundus efficiency of the control group were 65.00％ and 68.35％, respectively, and the treatment group were 87.50％ and 84.62％ respectively, with statistical significance (P＜0.05). Compared with before treatment, TCM symptom scores and fundus scores decreased significantly after treatment in both groups (P＜0.01); After treatment, the TCM symptom scores and fundus scores in the treatment group were lower than those in the control group (P＜0.05, P＜0.01). Compared with before treatment, visual acuity improved significantly after treatment in both groups (P＜0.05, P＜0.01). Compared with before treatment, levels of FPG, 2 h PG, Hb A1 c, TC, TG, and LDL-C decreased significantly in both groups after treatment (P＜0.01). After treatment, the levels of 2 h PG, Hb A1 c, TC, TG, and LDL-C in the treatment group were significantly lower than the control group (P＜0.05, P＜0.01). Compared with before treatment, the levels of VEGF decreased and PEDF levels increased in both groups, with statistical significance (P＜0.01). After treatment, the improvement of VEGF and PEDF in the treatment group was better than that in the control group (P＜0.05, P＜0.01); negative correlation was found between VEGF and PEDF (r=-0.320, P＜0.01). Conclusion Tangzhiping Prescription can effectively improve the clinical symptoms of patients with NPDR and slow down the progress of NPDR via reducing the blood glucose and blood lipids, and regulating the contents of VEGF and PEDF.
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AIM To observe the therapeutic effects of Safflor Yellow Sodium Chloride Injection and Compound Anisodine Injection on patients with non-proliferative diabetic retinopathy (NPDR).METHODS Sixty-eight pa-tients (102 eyes) were randomly divided into control group (32 cases,48 eyes) and observation group (36 cases,54 eyes).The observation group was given Safflor Yellow Sodium Chloride Injection and Compound Anisodine Injection in addition to conventional therapy administered to the control group,and yet patients of both groups had their changes of vision,fundus hemorrhage,effusion,microaneurysm and central macular thickness checked and compared before and after the treatment.RESULTS The observation group displayed better post-treatment vision recovery,fundus improvement and central macular thickness control than the control group (P ＜ 0.05,P ＜ 0.01).CONCLUSION The combination therapy of Safflor Yellow Sodium Chloride Injection and Compound Anisodine Injection can be an appropriate option for NPDR patients to improve vision and slow progression.
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@#AIM: To observe the changes of choroidal thickness(CT)in diabetic patients with different stages of non-proliferative diabetic retinopathy(NPDR)and then investigate the relationship between CT and diabetic retinopathy(DR), to assess the value of enhanced depth imaging optical coherence tomography(EDI-OCT)in the diagnosis of choroidopathy in early-stage DR. <p>METHODS: A total of 85 eyes of 55 patients with type 2 diabetes mellitus(DM)were included in this study. The patients were divided into three groups according to China Clinical Guidelines of DR in 2014, including non-diabetic retinopathy(NDR)group(28 eyes), mild and moderate NPDR group(27 eyes), and severe NPDR group(30 eyes). The control group included 24 normal subjects(35 eyes). The best corrected visual acuity(BCVA)and CT among normal eyes, and eyes with NDR, mild/moderate NPDR and severe NPDR were compared. Data were analyzed using SPSS 18.0. <p>RESULTS: Visual changes: The median LogMAR BCVA visions were 0.00 in control group, 0.10 in NDR group, 0.15 in mild and moderate NPDR group and 0.30 in severe NPDR group, the difference between each group was statistically significant(<i>P</i><0.01). The changes of CT in diabetic patients with different stages of NPDR: CT in the subfoveal area and T1, T3, N1, N3, S1, S3, I1 and I3 sites in the four groups were statistically significant(<i>F</i>=3.975, 3.365, 3.991, 4.290, 6.208, 5.079, 3.234, 2.907, 3.843, <i>P</i><0.05). CT in the mild and moderate NPDR group decreased and were thinner than the control group, but CT in the severe NPDR group increased significantly. <p>CONCLUSION: CT in the mild and moderate NPDR group decreased, but it increased significantly in the severe NPDR group, suggesting DM affected not only retina but choroids as well. The study hypothesizes that the changes of CT may played an important role in the progression of DR and the changes of CT had been initiated before DR. This provides significance in the early diagnosis of diabetic choroidopathy.
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@#AIM:To explore the therapeutic effect and safety evaluation of Qiming Granule on non-proliferative diabetic retinopathy(NPDR). <p>METHODS: Totally 94 cases(120 eyes)of NPDR patients treated in endocrinology department of our hospital from January 2016 to November 2017 were selected and randomly divided into the control group(<i>n</i>=47, 60 eyes)and the experimental group(<i>n</i>=47, 60 eyes). The control group was treated with calcium dobesilate, and the experimental group was treated with Qiming granule. The clinical efficacy, central macular thickness, retinal circulation time, best corrected visual acuity and adverse reactions between two groups were evaluated and compared after 6-month treatment. <p>RESULTS: Before treatment, there were no significant difference in central macular thickness, retinal circulation time, and best corrected visual acuity between two groups(<i>P</i>>0.05). After treatment, comparing with the control group, the retinal circulation time were not significantly different, the improvement of macular edema and the recovery of visual acuity were significantly better in the experimental group. The total effective rate of the experimental group was 97%, which was significantly higher than that of the control group(57%), and the incidence of adverse reactions was significantly decreased. The difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION: The therapeutic effect of Qiming Granule on NPDR is better than that of calcium dobesilate. Qiming Granule can improve visual acuity, macular edema, the retinal circulation time with less adverse reactions.
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@#AIM: To investigate the clinical effect of Qi Ming granule combined with calcium dobesilate in treatment of non-proliferative diabetic retinopathy(NPDR).<p>METHODS: Totally 94 patients with I～III stage NPDR in our hospital from January 2014 to May 2016 were collected and randomly divided into control group and observation group, all were unilateral, with 47 eyes in each group. The two groups were given control of blood glucose, diet and exercise therapy and other conventional treatment. The control group were treated with conventional western medicine calcium dobesilate treatment, 0.5g,3 times per day, the observation group combined with Qi Ming granule treatment based on control group treatment. Both groups were treated for 3mo. Two groups were observed before and after treatment for visual sensitivity and changes of serum cytokines \〖vascular endothelial growth factor(VEGF)and insulin-like growth factor-1(IGF-1), pigment epithelium derived factor(PEDG)\〗. Therapeutic effect and safety of the two groups were comprehensively evaluated and compared. <p>RESULTS: The average sensitivity of the observation group after treatment was lower than that before treatment and the control group after treatment, the difference were statistically significant(<i>P</i><0.05).The VEGF,IGF-1,PEDG of observation group after treatment, were significantly improved compared with the control group, the difference were statistically significant(<i>P</i><0.05). There were no obvious adverse reactions in the two groups, the total effective rate was 89% in the observation group, which was higher compared with the control group 72%, and the difference was statistically significant(<i>P</i><0.05). <p>CONCLUSION: Qi Ming granule combined with western medicine in the treatment of DR can effectively improve the function of the retina and ease the progress of the disease, and the safety is good, the clinical treatment effect is remarkable.
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AIM: To investigate the clinical effect of one-dose multiple point scanning panretinal photocoagulation (PRP) in the treatment of non-proliferative diabetic retinopathy (NPDR).METHODS:Selected 78 patients 132 eyes with NPDR in our hospital from January 2015 to June 2016,the patients were randomly divided into observation group (42 patients of 72 eyes) and control group (36 patients of 60 eyes).The observation group was given one-dose multi-point scanning PRP.The control group was given a single point scanning,3 to 4 times to complete the PRP.To observethe therapeutic effect in two groups,the average visual field threshold,the flash electroretinogram (F-ERG) a,b wave amplitude,the laser energy and so on were observed.RESULTS:The effective rate of the observation group and the control group were 84.7% and 83.3%,the difference was not statistically significant (P>0.05).In the observation group and the control group,at 6mo after treatment,the leakage area of retinal neovascularization was lower than that before treatment (P0.05).F-ERG b wave amplitude were 221.94±70.18mV and 219.82±69.56mV in the observation group and the control group at 6mo after treatment which were significantly lower than that before treatment (P<0.05).The laser energy of the observation group was 541.23 ± 56.39mW,significantly higher than the control group 326.39±78.83mW (P<0.05),while the energy density was 0.34±0.14mW·ms/mm2,significantly less than the control group 2.01±0.97mW·ms/mm2(P<0.05).The incidence of complications in the observation group and the control group were 8.3% and 15.0%,the difference was statistically significant (P<0.05).CONCLUSION:The clinical effect of multiple point scanning PRP in the treatment of NPDR is better than single point multiple PRP with advantages of lower energy density and less laser damage.