Systematic Review and Meta-analysis of Hexue Mingmu Tablets in Treatment of Diabetic Retinopathy and Retinal Vein Obstruction / 中国实验方剂学杂志

In order to evaluate the efficacy and safety of Hexue Mingmu tablets in the treatment of diabetic retinopathy（DR） and retinal vein obstruction（RVO）， and to provide a basis for the clinical treatment of ophthalmic diseases， this paper obtained randomized controlled trials（RCTs） of Hexue Mingmu tablets in the treatment of DR and RVO by searching Chinese and English electronic databases and trial registration platforms（up to September 13， 2022）. The risk of bias in the included studies was assessed using RoB2.0， and Meta-analysis was performed using RevMan5.4. A total of 35 RCTs involving a total sample size of 3 261 patients were included. Meta-analysis results showed that compared with conventional western medical treatment alone， the combination of Hexue Mingmu tablets with conventional western medical treatment improved patients' macular thickness｛mean difference（MD） =-39.83， 95% confidence interval（CI） ［-51.60， -28.06］， P<0.000 01｝， improved corrected visual acuity｛risk ratio（RR）dichotomous=1.09， 95% CI ［1.00， 1.18］， P=0.04； MDcontinuous variable=0.15， 95% CI ［0.13， 0.17］， P<0.000 01｝， increased effective rate of fundus symptom improvement（RR=1.26， 95% CI ［1.22， 1.30］， P<0.000 01）， improved hemorheology index｛standard mean difference（SMD）=-1.53， 95% CI ［-2.04， -1.01］， P<0.000 01｝， shortened improvement time of fundus symptoms（MD=-5.53， 95% CI ［-5.96， -5.09］， P<0.000 01）， and there was no significant difference on adverse events between the two groups. The results show that treatment of DR and RVO with Hexue Mingmu tablets may improve the macular thickness and hemorheology index of patients， which can significantly enhance the effect of corrected visual acuity and clinical efficiency， and shorten the time to symptom improvement. However， the original literature is of low quality and the pooled results have some limitations. Subsequent studies should try to use uniform standard assessment criteria and testing methods， focus on the rigor of study design and implementation， and pay attention to the key outcomes of this disease and the clinical safety of medication， so as to provide more reliable evidence to support this kind of clinical problems.

Comparison of abnormal blood lipid between patients with renal vein occlusion and hyperlipidemia / 心血管康复医学杂志

Objective :To explore difference of blood lipid levels among patients with retinal vein occlusion (RVO) from department of ophthalmology , those with hyperlipidemia from department of cardiology and healthy people .Methods :Blood lipid levels were compared among 35 RVO patients who visited department of ophthalmology for the first time ,35 patients with hyperlipidemia who visited department of cardiology for the first time and 35 healthy people undergoing physi—cal examination from Jun 2017 to Jan 2018. Results : (1) Compared with healthy group ,there were significant rise in blood levels of total cholesterol (TC) and triglyceride (TG) ,and significant reduction in blood level of high density lipoprotein cholesterol (HDL—C) in RVO group and hyperlipidemia group (P＜0.05 or ＜0.01) ,and significant rise in blood level of low density lipoprotein cholesterol (LDL—C) in hyperlipidemia group , P＝ 0.001 ; (2 ) Compared with hyperlipidemia group ,there were significant reductions in levels of TC [ (5.73 ± 0.91) mmol／L vs.(5.09 ± 0.83) mmol／L] ,TG [ (2.31 ± 1.37) mmol／L vs.(1.81 ± 1.89) mmol／L] and LDL—C [ (3.11 ± 0.79) mmol／L vs.(2.55 ± 0.42) mmol／L] in RVO group , P＜0.01 all.Conclusion : Blood lipid levels of RVO patients are significantly higher than those of healthy people , but those were reduced than hyperlipidemia group indicated that blood lipid levels rise is a pathogenic factor ,but not only one ,its other pathogenic factor should be investigate .

Epidemical survey of relative factors of retinal vessels disease of the native Tibetan among the people aged 40 and above in Maqin county, Qinghai province / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To investigate the prevalence and related high risk factors of retinal vessels disease of native Tibetan among the aged 40 and above in Maqin county, Qinghai province, China. METHODS:The cluster sampling method was used to investigate the visual acuity and retinal vessel diseases of the native Tibetan among the aged 40 and above in Maqin county. RESULTS:Totally 2 511 individuals were underwent the survey, among them, 29 cases (37 eyes) were of retinal vessel diseases, the prevalence was 1. 15%, 21 cases (23 eyes) were retinal vein obstruction (0. 84%), 5 cases (10 eyes) were diabetic retinopathy ( 0. 20%), 3 cases ( 4 eyes) were retinal vasculitis (0. 12%). The blindness and low vision of retinal vessels disease were 23 eyes (0. 92%). CONCLUSlON:All the hypertension, hyperglycemia, erythrocytosis, high altitude and weight are the high risk factors of retinal vessel diseases which are the main eyes fundus disease could grow blind.

Bilateral Central Retinal Vein Occlusion in Patient with Disseminated Intravascular Coagulation

PURPOSE: To report a case of bilateral central retinal vein occlusion (CRVO) as one of the initial signs of disseminated intravascular coagulation (DIC). CASE SUMMARY: A 33-year-old woman with a history of pregnancy-induced thrombotic thrombocytopenic purpura presented to our hospital with bilateral visual loss. On her initial visit, visual acuity was counting fingers at 30 cm in both eyes. Based on the findings of a funduscopic examination, the patient was diagnosed with bilateral CRVO. Laboratory tests confirmed the diagnosis of DIC combined with thrombotic thrombocytopenic purpura (TTP). Plasma exchange and transfusion of cryoprecipitate with fresh frozen plasma was performed. The ocular fundus findings did not improve. Despite medical treatment, the patient's systemic condition deteriorated and she died of metabolic acidosis two weeks later. CONCLUSIONS: Bilateral central retinal vein occlusion occurred as a sign of aggravation of preexisting TTP and progression to DIC in the presented case. In patients with severe bilateral retinal venous changes, there should be a very high level of suspicion for presence or progression of systemic disease, with the possibility of effective early systemic evaluation and therapy.

Clinical Course after Intravitreal Bevacizumab Injection in Ischemic Central Retinal Vein Obstruction

PURPOSE: To determine the clinical outcome of intravitreal bevacizumab injection in patients with ischemic central retinal vein obstruction (CRVO). METHODS: The present study was conducted retrospectively on 56 eyes of 56 patients who were diagnosed with CRVO and classified according to ischemic and non-ischemic type and underwent an intravitreal bevacizumab injection. The present study measured changes in visual acuity and central macular thickness, neovascularization in the anterior segment, development of neovascular glaucoma and other clinical complications. RESULTS: The average number of bevacizumab injections in both groups was 2.07 and 1.62 in the ischemic type. No patients developed neovascular glaucoma in the non-ischemic type group, 14 of 26 eyes in the ischemic type group developed neovascular glaucoma and the mean time to diagnosis was 28.75 weeks. log MAR visual acuity of the ischemic type group prior to injection was 1.56 +/- 0.65 on average which improved to 1.44 +/- 0.97 (p = 0.45). CONCLUSIONS: Intravitreal bevacizumab injection improves the condition of cystic macular edema clinically, but does not affect the development of neovascular glaucoma and improvement of visual acuity in ischemic type CRVO.

Intravitreal Bevacizumab Injection for Macular Edema Secondary to Branch Retinal Vein Occlusion

PURPOSE: To examine the clinical effects of intravitreal bevacizumab injections for patients with macular edema secondary to branched retinal vein occlusion (BRVO). METHODS: Nineteen patients (19 eyes) diagnosed with BRVO within the three month study window, having visual acuities under 0.5 and significant macular edema within two-disc diameters of the fovea were included in the present study. The author evaluated the patients' responses to bevacizumab (1.25 mg/0.05 mL) treatment using visual acuity and central macular edema measurements. RESULTS: The mean visual acuity improved from 1.06 (+/-0.10 logMAR unit) at baseline to 0.68 (+/-0.09 logMAR unit), 0.279 (+/-0.049) at one month, 0.67 (+/-0.9 logMAR unit) at two months, 0.61 (+/-0.09 logMAR unit) at three months and 0.54 (+/-0.10 logMAR unit) at six months. The mean central macular thickness decreased from 552.9 micrometer (+/-41.0) at baseline to 290.0 micrometer (+/-36.7) at one month, 290.0 micrometer (+/-36.7) at three months and 281.3 micrometer (+/-30.1) at six months. No adverse side effects were observed following injections. CONCLUSIONS: The observed macular edema and visual acuity improvements, as well as lack of serious adverse side effects after intravitreal bevacizumab injection, demonstrated that intravitreal bevacizumab injection may be useful for treating patients with macular edema secondary to BRVO.

Observations of argon laser on retinal vein obstruction / 中国康复理论与实践

@# ObjectiveTo discuss the effect of argon laser on retinal vein obstruction (RVO) . Methods428 eyes of 422 patients with RVO were treated by argon laser.Among them, there were 386 eyes with ischemic RVO,42 eyes with no-ischemic RVO, and 129 eyes with macular vesicular edema(MVE).ResultsThe vision acuity of 207 eyes is improved, and not changed in 138 eyes. The disappearing rate of MVE is 84.45%(82/97). ConclusionUsing argon laser to treat RVO can curb new vascular of retina building, lighten MVE and protect vision function.

Crossing and distance between the disc and obstruct site in super-temporal branch retinal vein obstruction / 眼科新进展

Objective　The retrospective case-control study was applied to investigate the crossing characteristics and the distance between the disc and the first crossing site in super-temporal branch retinal vein obstruction.Methods　Fifty-three cases of branch retinal vein obstruction and 53 cases of controls were collected to observe the artery-vein crossing characteristics and to measure the distance between the disc and the first crossing site.Results　The average distances of super-temporal and infer-temporal branch in case group were significantly different. The distance of the super-temporal branch in case group was significantly different from that in the control group. The distances of the super-temporal branch and infer-temporal branch were not significantly different in control group. The numbers of the arteries over the veins in the super-temporal branch in case and control group were significantly different. Conclusion　The mechanism of super-temporal branch retinal vein obstruction is related with the near distance between the disc and the first crossing, and is also related with the numbers of the arteries over the veins in the crossing site.

Comparison of Risk Factors Associated with Central and Branch Retinal Vein Obstruction

Central retinal vein occlusion(CRVO) and branch retinal vein occlusion(BRVO) are the most common retinal vascular diseases. Althouht the pathogenesis of these two dieseases are different, the clinical features are similiar. In this paper, we studied on several factors such as sex, age, laterality, refractive error, intraocular pressure(IOP) and, systemic diseases(56 eyes of CRVO group and 128 eyes of BRVO group). In BRVO hroup, female, above 50 years old, bilaterality and hyperopia(above +3.0D) are more frequent than in CRVO group. In CRVO group, high IOP and below 40 years old are more frequent than in BRVO group. The hing incidence of female in BRVO group(P=0.034) and the high incidence of high IOP in CRVO group(P=0.011) are statistically significant. Diabetes melitus, glucose intolerance, tuberculosis, and syphilis are more frequently associated in CRVO group than in BRVO group, whereas hypertension and heart disease are more frequently associated in BRVO group. An abnormal level in CRP, VDRL and PTT are higher in CRVO group than in BRVO. On the other hand, the incidences of abnormal lipid profile, Hb A2 fraction and RA are higher in BRVO group than in CRVO. In cases of CRVO, the incidence of hypertension is higher in patients of 50 years old or older than in patients do 49 years old or younger, In cases of BRVO, the incidence of heart disease in patients of 50 years old or older is higher than in patients of 49 years old or younger, which both diseases are statistically significant(P<0.05).