糖尿病视网膜病变患者视网膜血流动力学观察

糖尿病视网膜病变(Diabetic retinopathy,DR)为糖尿病严重并发症之一,是糖尿病患者致盲的主要原因,早期DR隐匿缓慢,视力无异常表现,常不被患者感觉,一旦出现视力障碍到眼科就诊,DR多处于增生阶段,目前尚无特效的药物和治疗方案逆转病变发展,随着视网膜病变的进展,血流动力     

视网膜光凝治疗糖尿病视网膜病变150例(296眼)的疗效观察

糖尿病视网膜病变(DR)是一种进展性的微血管病变，是四大主要致盲疾病之一，而激光治疗是改善视网膜微循环、维持和保存视力、延缓病变发展的有效手段，全视网膜光凝可以减少严重视力丧失；局部光凝糖尿病视网膜病变黄斑水肿不仅能降低视力丧失的危险，还能增加视力恢复的机会，降低持续黄斑水肿的发生率。本文就激光治疗150例296只眼的疗效及影响作以如下分析。     

糖尿病视网膜病变眼底荧光血管造影分析

日前我国糖尿病患者日趋增多．糖尿病视网膜病变（diabetic retinopathv,DR）是其严重并发症之一,也是主要的致盲眼病之一。早期发现DR微血管异常．控制与减慢DR的发展将有效保存患者中心视力,降低致盲率,提高患者生活质量。眼底荧光血管造影（fundus fluorescence angiography,FFA）对于糖尿病视网膜病变的早期发现．及时治疗有指导意义。我院于2003～2008年对内分泌科确诊为2型糖尿病的72例（141眼）行FFA检查回顾性分析结果分析如下．     

糖尿病视网膜病变激光治疗时机

早在1960年,Meyer Schwickerelth首次使用激光治疗糖尿病视网膜病变（DR）以后,糖尿病视网膜病变研究（DRS）和糖尿病视网膜病变早期治疗研究（ETDRS）均证实：适时的激光光凝治疗使DR患者发生严重视力丧失的危险减少50％以上,有效降低了增殖性糖尿病视网膜病变（PDR）发生黄斑水肿的风险,使DR致盲危险性下降90％。目前,激光光凝治疗仍然是治疗DR、减轻黄斑水肿及防止糖尿病致盲非常有效的方法之一。     

糖尿病视网膜病变患者心理护理干预后生活质量的调查分析

<正>糖尿病视网膜病变(diabetic retinopathy,DR)是糖代谢异常造成的眼部严重并发症,与糖尿病神经病变和糖尿病肾病并称为糖尿病三大微血管并发症。该病具有进行性发展的特征,常可导致不可逆性视力损害,在世界范围内已成为主要的致盲性眼病之一[1]。DR患者视功能受损,使自理能力下降。患者常有不同程度心理障碍,如紧张、焦虑、抑     

影响糖尿病视网膜病变患者生存质量的相关因素及对策

糖尿病视网膜病变(DR)是糖尿病常见的慢性并发症，是现代社会的主要眼病之一。糖尿病是一种常见慢性疾病，其本身就对病人的生存质量造成严重的影响，当并发视网膜病变时，视功能受到损害，可导致病人的生存质量进一步恶化。Brown等(1999)年发现，随(DR)患者的视力下降，其生存质量逐渐降低。于强等比较了不同病变程度及视力与生存质量之间存在明显相关性，     

糖尿病视网膜病变的治疗进展

糖尿病视网膜病变（diabetic retinopathy,DR）是目前主要致盲原因之一,其发病率随着人口老龄化及肥胖比例的增多而快速上升。糖尿病视网膜病变的的发生与糖尿病的病程、血糖、血压、血液等因素密切相关,通过抑制新生血管形成、减轻黄斑水肿和血管渗漏、防止视网膜脱离等手段达到改善或保存视力是治疗DR的主要目标。虽然DR发病机制未完全阐明,治愈目标仍是目前世界难题,但近年来的研究取得许多的成果。本文就此方面研究现状作一综述。     

糖尿病视网膜病变玻璃体切割手术联合硅油填充术后激光治疗的现状与进展

糖尿病视网膜病变(diabetic retinopathy,DR)是一种进展性的微血管病变,而增殖期糖尿病性视网膜病变(prepro liferative diabeticretinopathy,PDR)是糖尿病患者的主要致盲原因.增殖性糖尿病视网膜病变是玻璃体切割手术的常见适应证,玻璃体切割手术常联合硅油填充术.     

糖尿病视网膜病变的治疗及护理

糖尿病视网膜病变(DR)是导致成人致盲的主要原因,严重影响糖尿病患者生存质量。随着激光光凝术技术及方式的日臻完善,对糖尿病视网膜病变进展机制及防治研究的不断深入,相关药物应用及防治措施的实施,糖尿病视网膜病变进展将得到有效控制。     

糖尿病视网膜病变相关危险因素分析

糖尿病视网膜病变(diabetic retinopathy,DR)在欧美国家,糖尿病视网膜病变已经成为人群致盲的第一位或第二位病因因素[1].为此,笔者对我院眼科确诊DR住院及体检中心明确诊断的糖尿病患者230例的全面检查结果进行DR相关危险因素分析,为DR的临床预防干预及治疗提供理论依据.     

EGFR inhibitor,AG1478, inhibits inflammatory infiltration and angiogenesis in mice with diabetic retinopathy

Diabetic retinopathy (DR) is one of the most frequently occurring microvascular complications of diabetes. Recent evidence indicates that epidermal growth factor receptors (EGFRs) are critical pathogenic players in non‐neoplastic diseases, including diabetic cardiomyopathy and DR. However, the precise pathogenic mechanism of EGFR in DR has yet to be fully understood. In this study, we developed a type 1 diabetic early‐stage retinopathy mouse model using injections of streptozotocin and an oxygen‐induced end‐stage diabetic retinopathy (OIR) model characterized by hypoxia‐induced revascularization. We tested the hypothesis that the pathogenesis of DR can be reduced by the classic EGFR inhibitor, AG1478, in the mouse models. Our data indicated that treatment of AG1478 prevented retinal dysfunction, and reduced impairment of retinal structures as well as mitochondrial structures in retinal blood vessels in diabetic mice. Furthermore, AG1478 reduced neovascular tufts formation but had no effects on revascularization at the avascular sites when compared to untreated littermates in the OIR model. Our findings provide strong evidence that EGFR critically promoted retinal dysfunction, retinal structural impairment, and retinal vascular abnormalities in models of DR. We conclude that EGFR can be a potential important therapeutic target for treatment of DR.     

达格列净治疗早期糖尿病视网膜病变研究进展

糖尿病视网膜病变（diabetic retinopathy,DR）是糖尿病最常见的微血管并发症之一。因为该病初期症状不明显,患者对疾病认知不够,导致病情恶化,严重可导致失明。它是全球成年人获得性视力丧失的主要原因。因此延缓糖尿病视网膜并发症降糖药物的研发受到广大学者的关注。研究发现钠-葡萄糖协同转运蛋白2（sodium-glucose cotransporter 2,SGLT2）抑制剂（SGLT2 inhibitor,SGLT2i）在降低血糖的同时能延缓糖尿病视网膜并发症的进展。本文将主要对DR早期改变及SGLT-2i对DR保护作用的临床和实验证据进行综述。     

糖尿病视网膜病变的临床治疗现状及研究进展

糖尿病视网膜病变（DR）为长期高血糖导致的糖尿病患者视网膜局部微血管病变,可造成不同程度的视功能损害,是致盲的主要原因。DR的发生与多种因素有关,其发病机制也十分复杂。目前临床上DR的治疗方式多种多样,但疗效各异。随着DR发病机制研究的不断深入,多种治疗该病的方法被不断提出。本文结合既往的研究报道对DR的发病机制和临床治疗现状进行综述,旨在为临床提供参考。     

糖尿病大鼠视网膜血流动力学与视网膜血管形态学关系的研究

经过严格评估,美国《剑桥科学文摘》(Cambridge Scientific Abstracts,CSA)已决定正式将《现代药物与临床》列为其来源期刊。CSA于30多年前创办,是世界著名的二次文献出版公司美国剑桥科学文摘出版公司出版发行的综合性网络数据库,是国际上具有重要影响力的科学技术文献检索系统之一,是近几年发展最快的、大型的、综合性最强的数据库,覆盖的学科范     

The ethanol extract of Zingiber zerumbet rhizomes mitigates vascular lesions in the diabetic retina

Diabetic retinopathy (DR) is a common diabetic eye disease which is well-known as the result of microvascular retinal changes. Although the ethanol extract from Zingiber zerumbet (L.) Smith rhizome (EEZZR) has been indicated to ameliorate hyperglycemia in diabetes, its protective effect on DR remains unclear. The aim of this study was to determine the effects of EEZZR on DR in streptozotocin (STZ) diabetic rats. Diabetic rats were treated orally with EEZZR (200, 300 mg/kg per day) or calcium dobesilate (CD; 500 mg/kg per day) for 12 weeks. EEZZR displayed similar characteristics to CD in reducing blood–retinal barrier permeability in diabetic rats. Retinal histopathological observation showed that retinal vessels were decreased in EEZZR-treated diabetic rats. EEZZR decreased the increased retinal expression of vascular endothelial growth factor (VEGF) and upregulate the expressions of renal pigment epithelium-derived factor (PEDF) in diabetic rats. Retinal mRNA expression of tumor necrosis factor-α, interleukin (IL)-1, IL-6, monocyte chemotactic proteins-1, intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 were all decreased in EEZZR-treated diabetic rats. Moreover, EEZZR could attenuate phosphorylation of nuclear factor Kappa B (NF-κB) p65 and extracellular signal-regulated kinase (ERK)1/2 as well as inhibit the nuclear translocation of pNF-κB p65 induced by diabetes. In conclusion, restoring the balance between stimulators and inhibitors of angiogenesis may be associated with the protective effect of EEZZR on DR. In addition, EEZZR can ameliorate retinal inflammation via transrepression of NF-κB and inhibition of ERK1/2 signaling pathway.     

Neurodegeneration in Diabetic Retina and Its Potential Drug Targets

Diabetic retinopathy (DR) is one of the major complications of diabetes causing vision loss and blindness worldwide. DR is widely recognized as a neurodegenerative disease as evidenced from early changes at cellular and molecular levels in the neuronal component of the diabetic retina, which is further supported by various retinal functional tests indicating functional deficits in the retina soon after diabetes progression. Diabetes alters the level of a number of neurodegenerative metabolites, which increases influx through several metabolic pathways which in turn induce an increase in oxidative stress and a decrease in neurotrophic factors, thereby damage retinal neurons. Loss of neurons may implicate in vascular pathology, a clinical signs of DR observed at later stages of the disease. Here, we discuss diabetes-induced potential metabolites known to be detrimental to neuronal damage and their mechanism of action. In addition, we highlight important neurotrophic factors, whose level have been found to be dysregulated in diabetic retina and may damage neurons. Furthermore, we discuss potential drugs and strategies based on targeting diabetes-induced metabolites, metabolic pathways, oxidative stress, and neurotrophins to protect retinal neurons, which may ameliorate vision loss and vascular damage in DR.     

波动性高糖对糖尿病视网膜病变的作用研究进展

糖尿病视网膜病变(diabetic retinopathy,DR)是糖尿病微血管严重并发症之一,其发生发展不仅与长期的高血糖水平有关,而且与血糖波动幅度呈现明显正相关。波动性高糖通过启动细胞自噬和细胞凋亡,激活氧化应激,损伤视网膜组织DNA,促进血管内皮生长因子(vascular endothelial growth factor,VEGF)的释放等多种途径参与DR的发生进展。     

复方樟柳碱治疗糖尿病性视网膜病变的疗效观察

目的观察复方樟柳碱穴位注射治疗糖尿病性视网膜病变的临床疗效。方法本研究是前瞻性的对照研究,入选糖尿病性视网膜病变（diabetic retinopathy,DR）Ⅱ期的患者80例80眼,其中治疗组50例50眼,对照组30例30眼。治疗组患者给予复方樟柳碱注射液2 ml作患侧眼的颞浅动脉旁皮下注射,1次/d,共计注射20 d。用药前及用药后30 d分别行Snellen视力表最佳矫正视力（best corrected visual acuity,BCVA）、视网膜振荡电位（oscillatory potenlials,OPS）及对比敏感度（contrastsen sitivity,CS）检查。对照组患者亦给予间隔30 d的上述相同检查。结果 DRⅡ期治疗组患者用药后BCVA有轻度的提高[（0.50±0.16 VS 0.52±0.15）,P〈0.05]。治疗组患者用药前OPS总振幅（96.7±29.4）μV,用药后（119.5±32.8）μV,差异有统计学意义（P〈0.01）。治疗组患者用药后CS检查在低频（1.5 c/d、3.0 c/d）、中频（6.0 c/d）和高频（12.0 c/d、18.0 c/d）均有显著的提高（P〈0.01）。对照组患者的BCVA、OPS、CS在30 d内差异无统计学意义（P〉0.05）。结论复方樟柳碱穴位注射可显著改善DRⅡ期患者的视网膜血液供应,改善患者的视觉质量,值得在DR患者中早期临床应用。     

2型糖尿病视网膜病变与肾脏损害相关性研究

目的探讨2型糖尿病患者视网膜病变（DR）与肾脏损害的关系及尿白蛋白排泄率（UAER）在糖尿病微血管病变（DMAP）诊断中的价值。方法172例2型糖尿病患者根据是否并发DR分为：未并发DR组（NDR组，85例）和并发DR组（DR组，87例）；DR组又分为：单纯型DR组（BDR组，41例）和增殖型DR组（PDR组，46例）。对各组的临床及检验指标进行比较。结果DR组和NDR组的年龄、体质指数、腰围臀围比值、空腹血糖、糖化血红蛋白、胰岛素抵抗指数、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇无统计学意义；2组患者的病程、肌酐和UAER有统计学意义；病程（OR=5．83）、UAER（OR=3．72）与2型糖尿病并发DR呈正相关；PDR组、BDR组和NDR组的病程和UAER两两比较均有统计学意义。结论2型糖尿病患者DR与肾脏损害具有相关一致性，检测UAER对DMAP的早期诊断有重要价值。     

Old and new drug targets in diabetic retinopathy: from biochemical changes to inflammation and neurodegeneration

Diabetic Retinopathy (DR) is a major complication of diabetes and is a leading cause of blindness in western countries. DR has been considered a microvascular disease, and the blood-retinal barrier breakdown is a hallmark of this disease. The available treatments are scarce and not very effective. Despite the attempts to control blood glucose levels and blood pressure, many diabetic patients are affected by DR, which progresses to more severe forms of disease, where laser photocoagulation therapy is needed. DR has a huge psychological impact in patients and tremendous economic and social costs. Taking this into account, the scientific community is committed to find a treatment to DR. Understanding the cellular and molecular mechanisms underlying the pathogenesis of DR will facilitate the development of strategies to prevent, or at least to delay the progression of the disease. The involvement of the polyol pathway, advanced glycation end products, protein kinase C and oxidative stress in the pathogenesis of DR is well-documented, and several clinical trials have been conducted to test the efficacy of various drugs. More recent findings also demonstrate that DR has characteristics of chronic inflammatory disease and neurodegenerative disease, which increases the opportunity of intervention at the pharmacological level. This review presents past and recent evidences demonstrating the involvement of different molecules and processes in DR, and how different approaches and pharmacological tools have been used to prevent retinal cell dysfunction.