Correlation between blood biochemical parameters and choroidal thickness in patients with nonproliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the relationship between blood biochemical parameters and choroidal thickness(CT)in naïve-treatment of patients with nonproliferative diabetic retinopathy(NPDR).METHODS: Prospective cross-sectional study. A total of 92 patients(92 eyes)with naïve-treated NPDR were selected in the Affiliated Eye Hospital of Nanchang University from July 2021 to July 2022. All of the patients included in this study were subjected to ophthalmologic examination including enhanced depth imaging optical coherence tomography(EDI-OCT), best corrected visual acuity(BCVA), fundus fluorescence angiography, intraocular pressure, slit lamp and fundus examination. At the same time, they were also underwent hematological examination including blood glucose, glycosylated hemoglobin(HbA1c), serum creatinine, uric acid, urea, β2 microglobulin, high density lipoprotein(HDL), low density lipoprotein(LDL), serum calcium, serum potassium and other tests. According to the glomerular filtration rate(eGFR)and CT, the patients were divided into normal, mild and moderate to severe renal function group, pachychoroid group and the leptochoroid group. The blood biochemical indexes, CT differences and theirs correlation were analyzed in naïve-treated NPDR patients.RESULTS: A total of 92 cases(92 eyes)were included in this study, with 51 males(51 eyes), 41 females(41 eyes), 45 right eyes and 47 left eyes. There was no significant difference in age, axial length and disease duration among the three groups(all P>0.05). There were significant differences in nasal 0.5, 1.5mm, subfoveal and temporal 0.5, 1.5mm CT among three groups(all P<0.05). There was no statistical significance in age, axial length and the course of disease between the pachychoroid and leptochoroid groups(all P>0.05). There were significant differences in creatinine, eGFR, uric acid, urea, potassium and β2-microglobulin between the pachychoroid group and the leptochoroid group(all P<0.05). There were no significant differences in total cholesterol, triglyceride, HDL, LDL, HbA1c, serum calcium and glucose between the two groups(all P>0.05). CT was negatively correlated with creatinine, urea, uric acid and β2-microglobulin, and positively correlated with eGFR. Multiple regression analysis showed that the thicker the nasal 0.5mm CT, the higher the eGFR(B=0.292, P<0.001). CT affected creatinine, eGFR, urea, uric acid and β2-microglobulin(B=16.5, 64.6, 24.1, 18.1, 20.3; P=0.008, <0.001, <0.001, 0.004, 0.001), while there were no significant effects on total cholesterol, triglyceride, glucose, serum calcium, HDL and LDL(all P>0.05).CONCLUSION: In patients with naïve-treated NPDR, the thicker the CT, the better the renal function. The decrease of CT in newly diagnosed NPDR patients is an important hint to pay attention to the renal function.

Optical coherence tomography angiography quantitative analysis of the effect of modified Buyang Huanwu Decoction on blood flow to the optic disc in patients with non-proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the clinical efficacy of modified Buyang Huanwu Decoction in treating non-proliferative diabetic retinopathy(NPDR)of qi and yin deficiency and stagnation of collaterals, and to quantitatively analyze the changes in peripapillary vessel density before and after treatment using optical coherence tomography angiography(OCTA).METHODS:A randomized controlled trial was used to collect a total of 58 patients(99 eyes)with qi and yin deficiency and stagnation of collaterals NPDR who visited our hospital from June 2022 to November 2022, and patients were randomly divided into an observation group(n=29, 51 eyes)and a control group(n=29, 48 eyes). The control group received basic treatment according to the recommendations for DR published by the American Academy of Ophthalmology in 2019(blood glucose control, diabetes health education, and regular follow-up for patients with mild NPDR; and add local/grid-like laser photocoagulation if necessary for patients with moderate NPDR), while the observation group received modified Buyang Huanwu Decoction in addition to the basic treatment for 1mo. The best-corrected visual acuity(BCVA), traditional Chinese medicine(TCM)efficacy, peripapillary telangiectasia vessel density(ppVD), and changes in peripapillary retinal nerve fiber layer(pRNFL)thickness were compared between the two groups before and after treatment.RESULTS:The BCVA(LogMAR)of the observation group was 0.20(0.10, 0.30)after 1mo of treatment, which was significantly improved compared with that of the control group of 0.30(0.20, 0.40; P<0.05). The TCM efficacy in the observation group after 1mo of treatment was better than that in the control group(P<0.05). The ppVD in all quadrants of the observation group showed a significant improvement at 1mo after treatment, and the ppVD in all quadrants of the observation group was higher than that of the control group(P<0.05). The pRNFL thickness in the superior, temporal, and average peripapillary areas of the observation group increased after 1mo of treatment, and the pRNFL thickness in the superior, temporal, inferior quadrants, and average peripapillary area of the observation group was higher than that of the control group(P<0.05).CONCLUSION:Modified Buyang Huanwu Decoction can improve visual acuity and enhance TCM efficacy in patients with NPDR of qi and yin deficiency and stagnation of collaterals. It may be related to its ability to improve ppVD and reduce damage to the pRNFL.

Combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection in treatment of patients with nonproliferative diabetic retinopathy / 中华内分泌外科杂志

Objective:To investigate the combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection in treatment of patients with nonproliferative diabetic retinopathy.Methods:106 cases were randomly selected from the patients with nonproliferative diabetic retinopathy admitted in Traditional Chinese and Western Hospital of Dazhou City from Jan. 2019 to Dec. 2019. Based on the random numbers table, the cases were divided into control group and intervention group, with each group 53 patients. They were respectively treated with the therapy of calcium dobesilate capsules alone and the combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules and intravenous drip of Danhong injection, and the therapeutic effects were compared.Results:After treatment, the visual acuity of patients in both groups significantly improved ( P<0.05) , and the visual acuity of patients in the intervention group was higher than that of patients in the control group ( P<0.05) ; after treatment, the peak systolic velocity (PSV) and end diastolic velocity (EDV) of the central retinal artery (CRA) and posterior ciliary artery (PCA) of the patients in both groups significantly increased ( P<0.05) , while RI significantly reduced ( P<0.05) , and PSV and EDV of CRA and PCA in the intervention group were significantly higher than those of the control group ( P<0.05) , while RI was significantly lower than that of the control group ( P<0.05) . After treatment, the therapeutic efficiency of the intervention group was 96.23%, significantly higher than 79.25% in the control group ( χ2=7.102, P<0.05) . The incidence of adverse reactions in the intervention group was 9.43%, which had no significant difference with 3.78% in the control group ( χ2=1.377, P>0.05) . After targeted treatment was given, the adverse reactions disappeared. Conclusion:The combined therapy of calcium dobesilate capsules, oral administration of Dahuoluo capsules, and intravenous drip of Danhong injection was significantly effective in treatment of patients with nonproliferative diabetic retinopathy.

Choroidal thickness in diabetic patients of Indian ethnicity.

Purpose: To evaluate choroidal thickness (CT) change in various grades of diabetic retinopathy (DR) in comparison to age‑matched healthy subjects. Methods: This prospective observational study included 227 eyes of 125 subjects with diabetes (study group: 58 females) and 197 eyes of 110 age‑matched healthy subjects (control group: 66 females). Collected data included age, gender, duration of diabetes, glycemic control, comprehensive ocular examination, fundus photography, and CT measurement on spectral domain ocular coherence tomography using enhanced depth imaging. Results: Mean age in the study group was 57.0 ± 9.37 years (43–73 years). The mean age was 41.48 ± 5.43 years in the control group. Subjects with diabetes with (252.8 ± 55.6 microns) and without (261.71 ± 51.8 microns) retinopathy had significantly thinner choroids when compared to the control group (281.7 ± 47.7 microns; P = 0.032). Seventy‑four of 227 eyes did not have any evidence of DR, 89 eyes had features of nonproliferative diabetic retinopathy (NPDR), and 33 eyes had treatment naïve proliferative diabetic retinopathy (PDR). Thirty‑one PDR eyes had received previous laser photocoagulation. Subjects with diabetes without retinopathy had a greater subfoveal choroidal thickness (SFCT) than subjects with diabetes with retinopathy (P < 0.001). Eyes with PDR (243.9 ± 56.2 microns) had thinner SFCT than those with NPDR (238.98 ± 111.23 microns). There was no difference in the SFCT between treated (laser photocoagulation done; 251.784 ± 103.72 microns) and treatment naïve PDR (258.405 ± 89.47 microns, P = 0.23). Conclusions: Control eyes had greater SFCT compared to subjects with diabetes, with and without retinopathy. The thinning progressed with increasing severity of DR. Choroidal thinning may contribute to DR pathogenesis.

Antioxidative stress effect of probucol for nonproliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

To study the antioxidative stress effect of probucol for nonproliferative diabetic retinopathy. METHODS: Sixty - eight clinic patients with nonproliferative diabetic retinopathy were selected from January, 2012 to August, 2013. According to the random number table, the patients were divided into control group and observation group, the control group was received conventional medicine for hypoglycemic therapy, and the observation group was given probucol (0. 375g, twice daily) on the basis of control group. All patients were followed up for average 11. 58 ± 0. 17mo. At the same time 16 healthy volunteers matched with baseline were collected as normal control group. Changes in fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, the staging progress rate and the remission rate of diabetic retinopathy, and indicators related to oxidative stress, such as, total antioxide capacity ( TAOC ) , superoxide dismutase ( SOD ) , and methane dicarboxy aldehyde ( MDA ) , of two groups of patients before and after therapy were observed.RESULTS: Fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin of patients in two groups before and after therapy showed no significant changes, and the differences had no statistical significance. The staging remission rate and the progress rate of diabetic retinopathy of the control group after therapy were 3% and 19% respectively. The staging remission rate and the progress rate of diabetic retinopathy of the observation group after probucol therapy were 18% and 5% respectively. ln comparison with the control group, the difference had statistical significance (P<0. 05). TAOC, SOD, MDA of the control group before and after therapy had no obvious change, but TAOC, SOD of the observation group after therapy had significantly increased, and MDA had significantly decreased ( P < 0. 05 ), with statistical significance in comparison with the changes of the patients in the control group after therapy (P<0. 05).CONCLUSlON:Probucol can improve the antioxidative stress status of the patients with nonproliferative diabetic retinopathy, and enhance the therapeutic effect of the patients with diabetic retinopathy.

Retinal hemodynamic influence of compound xueshuantong capsule on nonproliferative diabetic retinopathy after laser photocoagulation / 国际眼科杂志(Guoji Yanke Zazhi)

AlM: To observe retinal hemodynamic influence of compound xueshuantong capsule on nonproliferative diabetic retinopathy ( NPDR) after laser photocoagulation.METHODS:A total of 41 patients (72 eyes) with NPDR after laser photocoagulation were enrolled in this study. They were all given compound xueshuantong capsule, and used color Doppler flow imaging for detection of retinal hemodynamics. RESULTS: After treatment, patients with retinal blood perfusion significantly improved; central retinal arterial peak systolic velocity ( PSV ) , end - diastolic velocity (EDV) and medial velocity (Vm) were increased, while the resistance index ( Rl) decreased. The difference have statistical significance (P CONCLUSlON: Compound xueshuantong capsule can improve retinal blood perfusion for nonproliferative diabetic retinopathy after laser photocoagulation, which is related to improvement of visual prognosis.

Visual Outcome and Complications of Vitrectomy for Diabetic Macular Edema at One-Year Follow-up / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the surgical efficacy of vitrectomy for diabetic macular edema (DME) at one year's follow-up.METHODS: The surgical outcomes in 116 consecutive eyes of 89 patients who had vitrectomy for diabetic macular edema were retrospectively reviewed and analyzed. All the patients were followed up for one year or longer postoperatively.RESULTS: The one year postoperative mean best-corrected visual acuity (BCVA) (0.428± 0.387) was significantly better than the mean preoperative BCVA (0.285±0.249;Wilcoxon signed-rank test, P＜0.0001). In 41 eyes with nonproliferative diabetic retinopathy (NPDR), mean BCVA improved significantly from 0.291± 0.201 preoperatively to 0.45± 0.41 at one year of follow-up (Wilcoxon signed-rank test, P=0.0171). In 75 eyes with proliferative diabetic retinopathy (PDR), mean BCVA improved significantly from 0.282± 0.272 preoperatively to 0.416± 0.376at one year of follow-up (Wilcoxon signed-rank test, P＜0.0001). The stage of diabetic retinopathy did not influence final visual acuity. Macular edema resolved in 74 of 116 eyes (63.8%) after the surgery. BCVA improved by 2 or more lines in 53 eyes (45.7%), remained unchanged in 39 eyes (33.6%), and exacerbated by 2 or more lines after the surgery in 24 eyes (20.7%). The intraoperative and postoperative complications included iatrogenic retinal tears (9 eyes), vitreous hemorrhage (10 eyes), neovascular glaucoma (6 eyes), hard exudates deposition in the center of macula (18 eyes), macular atrophy (19 eyes) and epiretinal membrane (3 eyes). Among these complications,exacerbation of BCVA by 2 or more lines occurred due to neovascular glaucoma (4 eyes), macular atrophy (10 eyes), hard exudates deposition (9 eyes) and epiretinal membrane (1 eyes).CONCLUSIONS: Vitrectomy is an effective procedure for improving visual acuity and reducing macular edema in eyes with DME. However, careful preoperative examinations and adequate surgical techniques are imperative to avoid severe complications of this treatment.

Clinical Efficacy of Compound Jianghuang Decoction for Preventing Nonproliferate Diabetic Retinopathy from Developing into Proliferate Diabetic Retinopathy / 中国药房

OBJECTIVE:To observe the clinical efficacy of Compound jianghuang decoction in preventing nonproliferate diabetic retinopathy(NPDR) from developing into proliferate diabetic retinopathy(PDR).METHODS:The clinical data of 123 patients(208 eyes) with NPDR receiving Compound jianghuang decoction(n = 64 cases,treatment group) or low dose of enteric - coated aspirin(n = 59,control group) in addition to hypoglycemic drugs administered in both groups to control blood sugar level were analyzed retrospectively.The clinical efficacy in the two groups was observed by fundus examination and fundus fluorescein angiography.RESULTS:The proportion of developing into PDR in the treatment group was significantly lower than in the control group.CONCLUSION:Compound jianghuang decoction is effective in suppressing retinal neovascularization and preventing NPDR from developing into PDR.