RESUMO
Uveitis is a group of inflammation diseases involving the iris, ciliary body, choroid, vitreous body, retina and retinal vessels, which can lead to visual deterioration and even visual loss. The pathogenesis of uveitis is complex and diverse, including infection, autoimmunity, trauma, physical and chemical injury, immune genetic mechanism and so on. Recent studies have shown that the activation of complement system is one of the pathogenesis of uveitis. Various complement proteins, including CFH, CFB, CFI, MAC, CD59 and so on, regulate host tissue damage through a rigorous mechanism mediated by the complement system. And studies have found that those complement proteins are involved in the occurrence and development of uveitis at the gene level and biological function. In addition, complement components like C2, C3, C4 and C5 can affect the pathogenesis of uveitis in terms of copy number variation, gene polymorphism and the regulation of T-cell-mediated autoimmune response. Therefore, complement inhibition therapy and related gene therapy provide new ideas and targets for the treatment of uveitis.
RESUMO
Objective The purpose of this study was to understand the awareness, prevalence of diabetic retinopathy and treatment status of people aged over 50 and living in the rural areas of Shuangcheng city, Heilongjiang province, China. Methods Cluster sampling was used in randomly selected 5504 survey for ophthalmic clinical examination, in patients with diabetic retinopathy. A questionnaire in the state of knowledge about prevention and treatment was developed. Results Among the 5504 persons entering in the project, 5053 were examined on their eyes (91.8%). In this selected population, 56 persons (112 eyes) were diagnosed as diabetic retinopathy (1.108%), with 95% confidence interval (CI) as: 0.819% to 1.397%. Of 56 patients, 49 cases were non-proliferative diabetic retinopathy, accounting for 87.50% of the total number of patients with diabetic retinopathy;proliferative diabetic retinopathy 7 cases, accounting for 12.50% of the 112 eyes, 6.25% (7/112)having vitreous hemorrhage, 8.04% (9/112) having macular edema. For diabetic retinopathy prevalence rates, there was no significant difference in males and females. Between the per differential 10-year-old division, the difference was significant. Among the 60 to 69 group, a significantly higher prevalence rate was seen. Of the 112 eyes with diabetic retinopathy, 34 eyes(30.4%) were low vision [visual acuity ＜20/60 (0.3) to ≥ 20/400 (0.05) ]; 6 eyes (5.4%) were blind [visual acuity ＜20/400 (0.05) to NLP]. The rate in the patients with PDR and fasting blood glucose was above 11.1 mmol/L was higher than having NPDR and fasting blood glucose below 11.1 mmol/L. Having fasting blood glucose 11.1 mmol/L and above with the course over five years among patients with PDR, the proportion of fasting blood glucose was higher than those with less than 11.1 mmol/L and diabetic retinopathy duration of less than five years. Of 56 patients with diabetic retinopathy, 38 cases (67.9%) did not receive any treatment. Among 18 cases (32.1%) with insulin or oral drug therapy,regularly using insulin or other medication (14.3%), only 1 (1.8%) case was given the treatment for diabetic retinopathy. Results from our survey showed that patients with diabetic retinopathy had a poor understanding about prevention and treatment of the disease. Conclusion Long duration and high blood glucose in patients with diabetic retinopathy seemed to be the important risk factor. Early systematic drug use for prevention and blood glucose control was the key to prevent diabetic retinopathy. Patients with diabetic retinopathy in China had poor understanding about the prevention measures of the disease and lack of knowledge.