Prevalence and risk factors of hypertensive retinopathy in a health-checkup population / 中华健康管理学杂志

Objective:To investigate the prevalence and risk factors of hypertensive retinopathy (HRP) in a non-diabetic population over 30 years old during routine health examinations.Methods:This was a cross-sectional study of a non-diabetic population over 30 years of age. The study was conducted during routine health examinations at the Tongren Hospital, Beijing, from January to December 2020. Fundus photographs were taken, and data including medical history, height, weight, and blood pressure were collected. Routine laboratory examinations were performed. The study population was divided into hypertension, transient hypertension, and non-hypertension groups. The prevalence of HRP was compared among the three groups. OR and 95% CI of HRP risk factors was estimated by binary logistic regression, adjusted for age and gender. Results:The prevalence of HRP was 4.3% in the non-diabetic population over 30 years old. Adjusted for age, gender, and systolic blood pressure, the prevalence of HRP in hypertension and transient hypertension groups, was both higher than in the non-hypertension group [ OR(95% CI) of 3.11(2.25-4.30) and 1.72(1.21-2.45), respectively]. The proportion of grade 1-2 HRP was higher (76.2%). There was no significant difference in the prevalence of grade 3 HRP among the three groups. Adjusted for age and gender, systolic blood pressure and creatinine clearance rate were independent risk factors for HRP in the hypertension group [ OR(95% CI): 1.22(1.01-1.48) and 1.66(1.12-2.46)] and transient hypertension group [ OR(95% CI): 1.48(1.10-2.06) and 1.95(1.03-3.46)]. SBP and DBP were independent risk factors for HRP in the non-hypertension group [ OR(95% CI): 1.68(1.07-2.63) and 1.61(1.06-2.44)]. Conclusions:There was a high prevalence of HRP among the non-diabetic population over the age of 30 and there was still relatively high risk of grade 3 HRP among the normotensive population.

Correlation of cystatin C and diabetic retinopathy in type 2 diabetic patients / 中华内分泌代谢杂志

[Summary] Serum cystatin C levels were measured by microparticle enhanced turbidimetry in 114 type 2diabetic patients without retinopathy (group A) and 105 type 2 diabetic patients with retinopathy (group B),as well as 47 normal healthy individuals as controls (group NC).The results showed that the serum cystatin C level of group B was much higher than those of group NC and group A (P＜0.05).However,there was no difference in serum cystatin C level between group NC and group A.Multivariate logistic regression analysis revealed that serum levels of cystatin C and cholesterol,and systemic blood pressure were independent risk factors of diabetic retinopathy in type 2 diabetic patients (all P＜0.05),suggesting that detection of serum cystatin C level may play an important role in early diagnosis and prevention of diabetic retinopathy.

Manifestações retinianas em pacientes portadores de anemia de células falciformes / Retinal sings in patients with sickle cell disease

A Organização Mundial de Saúde estima que mais de 5 por cento da população mundial seja portadora de algum tipo de hemoglobinopatia. Dentre essas encontramos a anemia de células falciformes, que tem seu principal efeito lesivo sobre a vasculatura periférica. Na retina, as lesões falciformes possuem fisiopatologia e classificação bem definidas. O objetivo é identificar as manifestações retinianas à anemia falciforme em pacientes encaminhados ao Hospital Bettina Ferro de Souza a partir do Hemocentro do Estado do Pará - HEMOPA. MÉTODOS: No Serviço de Oftalmologia do Hospital Universitário Bettina Ferro de Souza realizou-se em cinquenta pacientes portadores de anemia de células falciformes, sendo 37 genótipo SS e 13 genótipo SC, foram acompanhados pelo ambulatório de anemia falciforme do HEMOPA e selecionados aleatoriamente, sendo submetidos à entrevista para registro de sexo; idade; cor; genótipo; alterações oculares; medicamentos utilizados. exame oftalmológico, incluindo angiofluoresceínografia nos casos com alteração retiniana. RESULTADOS: Registro em protocolo de pesquisa e posteriormente submetidos à análise estatística utilizando o teste estatístico Qui-quadrado e p<0,05. Oitenta e oito por cento dos pacientes estudados não possuíam qualquer lesão retiniana falciforme, 3 por cento apresentaram oclusão vascular periférica, em 2 por cento evidenciou-se placa pigmentada, e 7 por cento apresentaram lesões não compatíveis com a doença falciforme; quanto ao sexo houve proporcionalidade de 50 por cento para ambos; faixa etária de maior predominância foi a de 11 e 15 anos com 38 por cento, 74 por cento enquandraram-se no genótipo SS e 26 por cento no SC. Em relação ao uso de medicamentos, notou-se maior prevalência de alterações oculares nos pacientes que faziam uso do ácido fólico isolado com 5 por cento, em contraste com aqueles em uso da associação hidróxiuréia e ácido fólico em que todos (27 por cento) possuíam exame fundoscópico normal. Todos os pacientes (29 por cento) com hemoglobina fetal acima de 10 por cento possuíam retina sem alterações. CONCLUSÃO: Poucos casos de lesões retinianas foram observados no grupo estudado, ainda assim esta pesquisa reafirma a importância da realização do exame oftalmológico de maneira precoce e periódica, visto que, a retinopatia falciforme é fato bem documentado e suas complicações podem resultar em amaurose.

The World Health Organization counts that more than 5 percent of the world's population carry some type of hemoglobinopathy. Among them we find the sickle cell aneamia that presents its main harmful effect on the peripheral vasculature. In the retina, the falciform lesions have a well defined physiopathology and classification. To identify the retinal manifestations caused by the falciform aneamia in patients directed to the Bettina Ferro de Souza Hospital from the Hemocenter of the State of Pará - HEMOPA, in the months of September through December of 2006. METHODS: Ophthalmologic examination was performed in the Department of Ophthalmology of the Bettina Ferro de Souza Hospital. and fifty patients with sickle cell aneamia (SS or SC) followed by the department of falciform aneamia of the Hematologia e Hemoterapia do Pará - HEMOPA have been randomly selected and submitted to interview in order to register their: sex; age; color; genotype; ocular alterations; medicines taken. Ophthalmologic examination was performed in the Department of Ophthalmology of the Bettina Ferro de Souza Hospital. It consisted of: evaluation of the acuity of vision with and without correction, indirect biomicroscopy, indirect binocular ophthalmoscopy, and, in case the latter presented alterations, a complementary study with angiofluoresceinography would be carried through. RESULTS: The outcomes have been registered in research protocol and later submitted to the statistic analysis using the Qui-square test, adopting, as level of significance, p<0,05. Eighty-eight percent of the patients did not present any falciform retinal sign, 3 percent presented peripheral vascular occlusion; in 2 percent, pigmented plate was shown, and 7 percent presented injuries which were not compatible with the falciform disease; there was a proportionality of 50 percent for males and females; there was a higher predominance (38 percent) of people aged from 11 and 15; 74 percent had SS genotype and 26 percent SC genotype; in relation to the use of medicines there was a higher prevalence of ocular alterations in patients who had made use of the folic acid isolated, with 5 percent, in contrast with those who had used the hidroxyurea association and folic acid, when all (27 percent) presented normal fundoscopic examination; all the patients (29 percent) that showed fetal hemoglobin rate above 10 percent had retina without alterations. CONCLUSION: Few cases of retinal signs have been observed in the studied group, however this research does not diminish the importance of early and periodic ophthalmologic examination, since falciform retinopathy is largely registered and its complications can lead to amaurosis.

Prevalence of diabetic retinopathy and macular edema in type 2 diabetes patients in the endocrinology department of Tianjin / 中华内分泌代谢杂志

According to the analysis of 9 237 hospitalized type 2 diabetic patients, the prevalence of diabetic retinopathy ( DR )was 32.9％ , with the prevalence of mild, moderate, and serious non-proliferative DR and proliferative DR being 10. 1％, 18. 3％, 3.2％, and 1.3％ respectively. The prevalence of diabetic macular edema ( DME ) was 3.56％ in type 2 diabetics and i 0. 8％ in patients with DR. Diabetes duration and proteinuria were the common risk factors of DR and DME.

Protein kinase Cβ_2 mediated high glucose-induced human umbilical vein endothelial cells injury via regulation of peroxisome proliferator-activated receptor α / 中华内分泌代谢杂志

Objective To investigate the roles of protein kinase C(PKC)β_2 and PPARα in the mRNA expression of vascular endothelial growth factor(VEGF)and vascular cell adhesion molecule-1(VCAM-1)in human umbilical vein endothelial cells(HUVECs)exposed to high glucose,and to explore their relationship.Methods The HUVECs were divided into eight groups:normal glucose(NG,5 mmoL/L D-glucose)group,high glucose(HG,25 mmol/L D-ucose)group,osmotic control(L,NG+20 mmol/L L-glucose)group,normal glucose transfected with empty vector(NN,NG+AdS-null)group,high glucose transfected with PKCβ_2(HB,HG+Ad5-PKCβ_2)group,high glucose plus fenofibrate(HF,HG+40 μmol/L fenofibrate)group,and HB plus fenofibrate (HBF,HB+40μmol/L fenofibrate)group.HUVECs were incubated with fenofibrate for 20 minutes as HF20 group.All cells in various groups were cultured for 6 days.The expressions of VEGF and VCAM-1 mRNA were detected by RT-PCR.PPARα protein expression was tested by Western blot.The expression and traaslocation of PKCβ_2 protein were observed by confocal laser scanning microscopo.Results (1)HG increased VEGF and VCAM-1 mRNA expressions,with 1.91 and 1.56 folds of NG group,respectively(both P<0.05).VEGF and VCAM-1 mRNA expressions in HB group further increased,with 2.59 and 2.07 folds of NG group,respectively(both P<0.05).Fenofibrate significantly decreased VEGF and VCAM-1 mRNA expressions,with 68%and 74%of HG group,respectively(both P<0.05).There were no significant difierences in the expressiong of VEGF,VCAM-1 mRNA between HF20 and HG groups.(2)The protein expression of PPARα decreased by 20%in HG group compared with NG group,and further decreased in HB group,being 78%of HG group.Compared with HG group,PPARαexpression increased by 13%in HF group(P<0.05).(3)HG induced PKCβ_2 translocation from cytosol to nucleus and quantitative analysis showed the ratio of plasma/nuclear fluorescence intensity in HG group decreased by 37% compared with NG group(P<0.05).The PKCβ_2 translocation was more obvious in HB group than in HG group.Conclusion Hiigll glucose stimulates VEGF and VCAM-1 mRNA expressions in HUVECs via PKCβ_2 activationdependent PPARα pathway.

Effect of pigment epithelium-derived factor on rat retinal Müller cells under high glucose conditions / 中华内分泌代谢杂志

Objective To investigate the effect of pigment epithelium-derived factor (PEDF) on rat retinal Müller cells under high glucose conditions. Methods Müller cells cultured in 25 mmoL/L glncose were incubated with 100 ng/ml PEDF or 10 ng/ml interleukin-1β(IL-1β) for 24 h. The expression of IL-1β or PEDF in Müller cells was measured by indirect immunofluorescence, Western blot or realtime RT-PCR. The survival of Müller cells was detected by MTT assay. Results Under high glucose conditions, expression of IL-1β or PEDF was decreased after treated with 100 ng/ml PEDF or 10 ng/ml IL-1β for 24 hours by the methods of immunocytochemistry, Western blot or realtime PCR (P ＜ 0.05). Activity of Müller cells was increased significantly by PEDF (0.48±0.09 vs 0.64±0.17, P＜0.05). Conclusion In mimic diabetic conditions, PEDF decreases expression of IL-1β in rat retinal Müller cells and enhances the cell activity. To some degree, PEDF may block the process of inflammation in diabetic retinopathy.

Factors influencing the therapeutic efficacy of Argon laser photocoagulation on proliferative diabetic retinopathy / 眼科

108 eyes of proliferative diabetic retinopathy were treated with Argon laser panretinal photocoagulation. Three months after treatment, The systemic and local factors influencing the therapeutic effecacy were treated by "stepwise discriminations analysis" to tind that the relevant factors included the severity and location of neovascularization and the total doses of laser irradiation. For eyes with papillar or mutiple and low dosage of laser irradiation, the therapeutic efficacy was poor.