ABSTRACT
@#AIM: To analyze the effect of 532nm laser panretinal photocoagulation(PRP)combined with calcium dobesilate on fundus microcirculation and macular thickness in patients with diabetic retinopathy(DR), so as to provide experimental data for their clinical treatment. <p>METHODS: According to the non-randomized clinical concurrent control study and voluntary principle, 174(239 eyes)DR patients were divided into observation group and control group. Both groups were treated with 532nm laser PRP, and the observation group was additionally treated with calcium dobesilate. BCVA(LogMAR)vision, clinical effect, fundus microcirculation, macular thickness and other clinical indexes were compared between the two groups before and after treatment(at 3mo after PRP). The incidence of complications during treatment was statistically analyzed. <p>RESULTS: After treatment, BCVA in both groups were increased, and it was higher in observation group than control group. The clinical curative effect of observation group was better than that of control group(<i>P</i><0.001). After treatment, the resistance index(RI)of central retinal artery(CRA)and osterior ciliary artery(PCA)in both groups were decreased(<i>P</i><0.05), while the peak systolic velocity(PSV)and end diastolic velocity(EDV)were increased(<i>P</i><0.05). RI in observation group was lower than that in control group, while EDV and PSV were higher than those in control group(<i>P</i><0.001). After treatment, the macular thicknesses and other clinical indexes(hemangioma, bleeding spots, gray value of visual field)in both groups were decreased(<i>P</i><0.05), and they were lower in observation group than control group(<i>P</i><0.001). There was no significant difference in the incidence rate of complications between the two groups(0.8% <i>vs </i>2.6%)(χ2=0.344, <i>P</i>=0.557). <p>CONCLUSION: Compared with 532nm PRP in treatment of DR, curative effect of 532nm PRP combined with calcium dobesilate is better. The latter can improve fundus microcirculation and macular thickness more significantly, with high safety.
ABSTRACT
·AIM: To study the effect of panretinal photocoagulation ( PRP ) combined with calcium dobesilate on fundus microcirculation and the thickness of the retinal nerve fiber layer (RNFL) in patients with diabetic retinopathy (DR). ·METHODS: Totally 166 cases of DR patients in the Department of Ophthalmology of our hospital in October 2015 to October 2017 were selected. According to the random number table method, 166 cases were divided into the control group ( Group A) and the study group (Group B), with 83 cases in each group. Group A was treated with PRP, and Group B was given calcium dobesilate on the basis of Group A. Observation and comparison between the two groups on clinical curative effect, postoperative complication rate and the changes of best corrected visual acuity ( BCVA ), blood rheology index [ hematocrit ( Hct), erythrocyte sedimentation rate ( ESR ), deformation of erythrocyte ( DE ), plasma viscosity (PV), aggregation of erythrocyte (AE)] and the changes of hemodynamic indexes [resistance index (RI), end diastolic velocity (EDV), peak systole velocity (PSV) of central retinal artery ( CRA )] before and after treatment. Besides, the RNFL thickness of the optic disc, the nasal side, the inferior and the superior side, and the average RNFL thickness of the optic disc center were observed and compared. · RESULTS: After treatment, BCVA in both groups decreased significantly compared with that before treatment (P<0. 05), and there was no significant change between Group A and B (P>0. 05), and the effective rate in Group B was significantly higher than that in Group A (P<0. 05 ). There was no significant difference in the incidence of complications and the rate of loss of visits in the two groups of A and B (P>0. 05). Compared with those before treatment, the EDV and PSV values of two groups increased after treatment (P<0. 05), and RI value decreased (P<0. 05). After treatment, the EDV and PSV values of CRA in Group B were significantly higher than those in Group A (P<0. 05), and the values of RI and Hct, ESR, PV, DE and AE were significantly lower than those of Group A ( P<0. 05 ). After treatment, the average, inferior and superior RNFL of the two groups were all thinner than those before the treatment (P<0. 05). The decrease of average, inferior, superior and nasal RNFL of Group A was more than those in the Group B (P<0. 05). ·CONCLUSION: Retinal photocoagulation combined with calcium dobesilate in the treatment of DR is effective and safe. It can effectively improve the fundus microcirculation and reduce the damage of PRP to DR patients' visual acuity and retinal nerve fiber layer thickness.
ABSTRACT
AIM: To analyze the effect of calcium dobesilate combined with hypoglycemics for patients with diabetic retinopathy (DR) and cataract, and the influence on microcirculation of eye fundus, hypoxia inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) level. METHODS: Totally 98 DR patients with cataract (126 eyes) from January 2013 to December 2015 in our hospital were selected as the research objects, and were divided into two groups randomly(treatment group:64 eyes in 49 patients, control group: 62 eyes in 49 patients). The control group was treated with acarbose tablet and metformin, while treatment group was treated with calcium dobesilate additionally. The clinical effect, the glycemic control effect, serum HIF-1α and VEGF level, eye function and fundus microcirculation of two groups after 12mo were compared. RESULTS: After 12mo, the total effective rates of two groups were 87.5%,61.3% respectively, which indicated significantly difference (P<0.05); the vision of treatment group was significantly higher than that of control group (P<0.05). Two groups' blood glucose level decreased significantly, and no significant difference between two groups(P>0.05). After 1-month treatment, the plasma viscosity, erythrocyte aggregation index, erythrocyte deformability index, erythrocyte sedimentation rate and hematocrit in the treatment group were significantly lower than those in the control group (P<0.05). The PSV and EDV of the posterior ciliary artery and central artery in the treatment group were significantly higher than those in the control group (P<0. 05), and RI was significantly lower than that in the control group (P<0.05). After 12-month treatment, the HIF-1α level of two groups were 35 90士11.36mmol/L, 46.75士12.08mmol/L respectively;the VEGF of two groups level were 89.72士13.61mmol/L, 110.30士16.74mmol/L, respectively, the treatment group's HIF- 1α level and VEGF were significantly lower than control group (P<0.05), and both decreased significantly after treatment (P<0.05). CONCLUSION: Calcium dobesilate combined with hypoglycemics can effectively increase the clinical effect in the treatment of retinopathy diabetic cataract, effectively control blood glucose, improve microcirculation of eye fundus, decrease HIF - 1α, VEGF level, inhibit angiogenesis.