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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<0.05); there were significant differences in visual acuity, FAZ area and SSP and DSP levels in different degrees of NPDR(P<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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【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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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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@#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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Diabetic retinopathy (DR) is a major microvascular complication of diabetes. It is the most common cause of blindness in the working-age population in developed countries. We wanted to analyse the correlation between risk factors of blindness like duration of diabetes, dyslipidaemia, hypertension, HbA1c with severity of diabetic retinopathy in order to design appropriate strategies for prevention and treatment of diabetic retinopathy.METHODSThis was a retrospective study of all diabetic patients with diabetic retinopathy who presented to the eye OPD at KS Hegde Medical Academy from April 1st 2018 to March 31st 2019 that fulfilled the inclusion criteria. A dilated fundus examination was done to note the grade of diabetic retinopathy. The demographic data along with the duration of diabetes, HbA1c values, Cholesterol levels and Blood pressure were documented and correlated with the severity of diabetic retinopathy.RESULTSThe study included 92 patients, of which 63 were males and 29 were females with a mean age of 54.5±2.8 years. We found that there was statistically significant association between the duration of diabetes and HbA1c levels with severity of diabetic retinopathy (p= 0.022 and 0.034 association), whereas there was no statistically significant correlation between blood pressure and cholesterol levels with severity of diabetic retinopathy (p= 0.52 and 0.456 respectively)CONCLUSIONSDiabetic retinopathy showed a male preponderance, with risk factors like duration of diabetes and HbA1c levels having a significant association with the severity of diabetic retinopathy. Therefore, it is essential to have a good systemic control of diabetes with diet and suitable medications. Diabetic retinopathy is a preventable cause of blindness when diagnosed early and screening of diabetic retinopathy must be done in all diabetics to prevent the progression of the disease.
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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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@#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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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 further investigate the etiology and treatment strategies of diabetic macular edema(DME)by studying the correlation between responses to intravitreal injection of Ranibizumab(IVR)and diabetic retinopathy(DR)extent in DME patients. <p>METHODS: This study comprised 33 eyes of 27 non proliferative diabetic retinopathy(NPDR)patients with DME and 34 eyes of 32 PDR patients with DME, who had been followed for at least 6mo after IVR. We compared the responses to the anti-VEGF treatment between the two groups. <p>RESULTS: NPDR patients had strong statistical improvement in best corrected visual acuity(BCVA)and central macular thickness(CMT)after both 3-month treatment and 6-month treatment(<i>P</i><0.05), While PDR patients had not(<i>P</i>>0.05). There were also statistical differences(<i>P</i><0.05)in BCVA and CMT between NPDR group and PDR at a time when the patients had received both 3-month treatment and 6-month treatment. <p>CONCLUSION: Different extents of DR have influence on DME responses to anti-VEGF.
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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 study the clinical efficacy of integrative therapy in the treatment of non-proliferative diabetic retinopathy.·METHODS: Ninety patients ( 90 eyes ) in our hospital with non - proliferative diabetic retinopathy were randomly divided into three groups. All three groups were treated with diabetes drugs to control blood sugar. The first group was treated with western medicine, the second group was treated with Chinese medicine decoction Traditional Chinese Medicine ( TCM ) treatment, and the third group was treated with the combination of those two methods. All patients were recorded and analyzed changes of clinical effects after 6 courses of treatment.·RESULTS: After 6 courses of treatment, the total efficacy rate of the third group was 86%, markedly higher than that of the first group (57%, P<0. 05) as well as the second group (60%, P<0. 05). The integrative group improved more markedly in terms of vision, macular edema absorption, and ERG b-wave amplitude restoration, the difference being statistically significant (P<0. 05) when compared to the first and the second group.· CONCLUSION: Integrative treatment of diabetic retinopathy could effectively improve the therapeutic effect in patients with non-proliferative retinopathy.
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AIM:To investigate the changes of choroidal thickness in patients with severe non-proliferative diabetic retinopathy (NPDR) after vitreous injection of ranibizumab,and to analyze the relationship between the thickness of choroid and the visual acuity of the patients.METHODS:Eighty patients with severe non-proliferative diabetic retinopathy were selected from January 1,2014 to January 1,2017.All patients were divided into observation group and control group according to the random number table,40 cases in each group.The control group was treated in a conventional manner,and the observation group was injected with ranibizumab in the vitreous.The thickness of the choroid in the macular area and the thickness of the retinal neuroepithelium in the macular area were compared between the two groups before and after treatment.The changes of the corrected visual acuity were analyzed at 1mo before and after treatment.The relationship between the thickness of the choroid and the thickness of the retinal neuroepithelium and the best corrected visual acuity were compared.The complications and adverse events were compared between the two groups after 6wk of treatment.RESULTS:The thickness of the choroid and the retinal neuroepithelium in the macular area before were 219.57± 51.24μm and 474.76 ± 95.56μm,respectively,in the observation group and the control group,217.56± 50.36μm and 473.27 ± 96.48μm,respectively.The thickness of the choroid and the thickness of the retinal neuroepithelium in the macular area after treatment were 180.15±42.06μm and 382.18±84.26,202.48±48.28μm and 407.88± 44.25μm,respectively.The difference between the two groups was statistically significant (P＜0.05).The best corrected visual acuity in the observation group and the control group were 0.47±0.19 and 0.53±0.25 respectively (P＜0.05).There was a positive correlation between the choroidal thickness and the best corrected visual acuity in the macular fovea (regression coefficient=1.12,S=0.48,OR=1.376,P＜ 0.05).There was a positive correlation between retinal neuroepithelial thickness and best corrected visual acuity in the macular area (regression coefficient =0.95,S=0.27,OR=1.020,P＜ 0.05).There were 2 eyes (5％) with subconjunctival hemorrhage,1 eyes (2.5％) of glaucoma,1 eyes (2.5％) of vitreous hemorrhage,0 of choroidal detachment,retinal detachment in 0 in observation group at 6wk after treatment.There were 4 eyes (10％) with subconjunctival hemorrhage,2 eyes (5％) of glaucoma,2 eyes of vitreous hemorrhage (5％),2 eyes of choroidal detachment (5％),retinal detachment in 2 eyes (5％) in the control group,and the difference between the two groups on the complications and adverse reactions was statistically significant (P＜0.05).CONCLUSION:The choroidal thickness of patients with macular edema in severe non-proliferative diabetic retinopathy is correlated with the best corrected visual acuity.Intravitreal injection of ranibizumab can effectively reduce the macular fovea choroidal thickness,reduce macular edema and improve vision,and less complications.
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AIM:To observe the effect of panretinal photocoagulation (PRP) combined with anti-vascular endothelial growth factor (VEGF) drugs in the treatment of severe non proliferative diabetic retinopathy (NPDR),and to investigate the influence of the treatment on the prognosis of NPDR patients.METHODS:Totally 120 patients (227 eyes) with NPDR diagnosed by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT) were randomly divided into observation group (60 cases,112 eyes) and control group (60 cases,115 eyes).Patients in the observation group were treated by PRP combined with anti-VEGF drugs,while patients the control group were treated with PRP alone.The clinical efficacy and complications of the two groups were compared.Before and after treatment,the best corrected visual acuity (BCVA),central macular thickness (CMT),levels of serum VEGF and angiopoietin 2 (Ang-2) in the two groups were analyzed.RESULTS:The total effective rate of the observation group was significantly higher than that of the control group (P＜0.05).Compared with before treatment,BCVA of the two groups in the time of 2wk,1,3 and 6mo after treatment improved significantly (P＜0.05).And the BCVA of the observation group at each time point after treatment was better than that of the control group (P＜0.05).Compared with before treatment,the CMT and the levels of VEGF and Ang-2 in the observation group decreased significantly starting at 2wk after treatment (P＜ 0.05).While those in the control group decreased significantly starting at 1mo after treatment (P＜ 0.05).The levels of VEGF and Ang-2 in the observation group at each time point after treatment was lower than that of the control group (P＜0.05).CMT of the observation group were significantly lower than that of the control group in the time of 1,3 and 6mo after treatment (P＜0.05).There was no significant difference in the total complication rate between the two groups (P＞0.05).CONCLUSION:PRP combined with anti-VEGF drugs could effectively improve vision of NPDR patients,alleviate macular edema,and improve the clinical efficacy.
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Objective To explore the clinical efficacy of compound Xueshuantong capsule combined with compound anisodine injection in the treatment of non-proliferative diabetic retinopathy.MethodsSixty patients with non-proliferative diabetic retinopathy were enrolled in this study.All patients were enrolled from March 2014 to May 2016 and were divided into two groups by simple randomization.The control group were treated with salvia miltiorrhiza injection, and the patients were treated with compound Xueshuantong capsule combined with compound anisodine injection.The clinical efficacy and the level of hemorheology were compared.ResultsThe clinical improvement rate was 93.33% in the observation group, which was significantly higher than that in the control group (P<0.05).The PV, HCT, KAI and Fg levels in the observation group were significantly lower than those in the control group (P<0.05).ConclusionCompound Xueshuantong Capsule combined with compound anisodine injection for local injection of non-proliferative diabetic retinopathy has a significant clinical effect and is widely used.
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Objective To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with panretinal photocoagulation for severe non-proliferative diabetic retinopathy.Methods Sixty-four cases (90 eyes) with severe non-proliferative diabetic retinopathy from July 2014 to June 2016 in our hospital were randomly divided into two groups according to the digital table.The observation group (32 cases,46 eyes) underwent intravitreal injection of reizumab combined with panretinal photocoagulation,and the control group (32 cases,44 eyes) were treated with only panretinal photocoagulation.The visual acuity,fundus,fundus fluorescein angiography and macnlar thickness postoperative 1 month,3 months,6 months were observed and detected.The mean thickness of the retinal neuroepithelium in the macular region and total volume of the 6 mm diameter neuroepithelium in the macular area were compared and statistically analyzed.The laser energy,number of spots and energy density were calculated and recorded.Results BCVA at postoperative 1 month,3 months,6 months in the observation and the control group were better than that before treatment(all P ＜ 0.05),and the observation group was better than the control group (all P ＜ 0.05).In the control group,BCVA had no statistically significant difference between 3 months and 6 months (P ＞ 0.05),and the differences were statistically significant among other time points (all P ＜ 0.05).In the observation group,the differences were statistically significant among all time points after treatment (all P ＜ O.05).In the comparison of mean thickness of the retinal neuroepithelium in the macular region and total volume of the 6 mm diameter neuroepithelium in the macular area in the control group and the observation group before and after treatment,there were statistically significant differences at different time points between the two groups (all P ＜ 0.05).Moreover,the average thickness of the retinal neuroepithelium and total volume of 6 mm diameter neuroepithelium in the macular region at postoperative 1 month,3 months,6 months were better than those in the control group (all P ＜ 0.05).The laser energy,spot number and energy density of the observation group were significantly lower than those of the control group (all P ＜ 0.05).Conclusion Intravitreal injection of ranibizumab combined with panretinal photocoagulation for severe non-proliferative diabetic retinopathy can accelerate retinal neovascularization in a short period of time,reduce macular edema and improve the visual function of patients with less laser energy,the curative effect is better than application of retinal laser photocoagulation alone,is worthy of clinical promotion.
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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.
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Objective To observe the changes of choroidal thickness after ranibizumab treatment for non-proliferative diabetic retinopathy (NPDR) with macular edema,and determine the association between choroidal thickness and visual acuity.Methods Twenty-three eyes from 23 patients diagnosed with NPDR and diabetic macuiar edema were treated with 3 monthly intravitreal injections of ranibizumab.The subfoveal choroidal thickness and central macular thickness were measured,and the best corrected visual acuity was recorded.Changes of subfoveal choroidal thickness,correlation between subfoveal choroidal thickness and best corrected visual acuity were assessed at 3 months follow-up.Results After 3 monthly anti-VEGF treatments,subfoveal choroidal thickness and central macular thickness decreased significantly,there was no statistical difference at 1 month and 2 months compared with pre-treatment (all P ＞ 0.05),but there was statistical differences at 3 months compared with pre-treatment (P =0.04,0.01).In the treatment,the best corrected visual acuity increased gradually,there was no statistical difference at 1 month and 2 months compared with pre-treatment (all P ＞ 0.05),but there was statistical differences at 3 months compared with pre-treatment (P =0.04).Before the treatment,the subfoveal choroidal thickness was positive correlated with macuiar retinal thickness (R2 =0.94,P =0.00);And the best corrected visual acuity before treatment and 3 months after treatment had a positive correlation (R2 =0.93,P =0.00;R2 =0.82,P =0.00).There was a positive correlation between central macular thickness and best corrected visual acuity at 3 months after treatment (R2 =0.83,P =0.00).There was a positive correlation in the best corrected visual acuity between before treatment and 3 months after treatment (R2 =0.84,P =0.00).Conclusion The subfoveal choroidal thickness is a clinical index to evaluate the efficacy of anti-VEGF in the treatment of diabetic macuiar edema.Baseline subfoveal choroidal thickness can be considered as one of the indicators of clinical efficacy in the short term.