血清和房水中miR-377-3p和miR-365-3p表达水平与糖尿病性黄斑水肿程度的相关性

目的:探讨血清和房水中miR-377-3p和miR-365-3p表达水平与糖尿病性黄斑水肿(DME)程度的相关性。方法:前瞻性研究。选取2021-02/2022-02三六三医院收治的初诊为DME患者60例60眼(如双眼发病取严重眼入组,若两眼程度一致取右眼),其中轻度24眼,中度21眼,重度15眼;另选同期本院收治的未发生DME的2型糖尿病患者60例60眼作为对照组。收集所有患者基本临床资料,包括BMI、吸烟史、饮酒史、高血压、高血脂、糖尿病病程、糖化血红蛋白、空腹血糖、Hcy;实时荧光定量PCR(qRT-PCR)法检测血清和房水中miR-377-3p和miR-365-3p表达水平。结果:DME组患者糖尿病病程、糖化血红蛋白、空腹血糖、同型半胱氨酸(Hcy)均显著高于对照组(均P<0.05);DME组患者血清中miR-377-3p和miR-365-3p表达水平均低于对照组(均P<0.05);重度组患者血清和房水中miR-377-3p和miR-365-3p表达水平显著低于中度组和轻度组,中度组显著低于轻度组(均P<0.05);血清中miR-377-3p和miR-365-...     

康柏西普对DME患者黄斑部微循环的影响

目的:观察糖尿病性黄斑水肿(DME)患者注射康柏西普前后黄斑部视网膜浅层毛细血管密度及房水因子的变化,初步探讨康柏西普对DME患者黄斑部微循环的影响.方法:前瞻性病例对照研究.收集2019-12/2020-12就诊于我院眼科的DME患者10例11眼作为DME组,收集15例无全身系统疾病和眼底疾病的白内障患者作为白内障组...     

糖尿病性白内障患者血清与房水中细胞因子表达的变化

目的：分析糖尿病性白内障患者血清和房水中维生素C、氧化应激产物、炎症因子及血管内皮生长因子(VEGF)水平变化。

方法：选取2018-01/2019-12我院收治的糖尿病性白内障患者40例40眼作为观察组,单纯白内障患者40例40眼作为对照组。分析两组患者血液和房水样本中维生素C、氧化应激产物(丙二醛)、炎症因子(IL-6和IL-8)及VEGF水平的差异。

结果：两组患者血清维生素C水平无差异(P>0.05),但观察组房水维生素C水平明显低于对照组(20.6±13.6mg/L vs 27.2±9.9mg/L,P<0.05); 两组患者血清丙二醛水平无差异(P>0.05),但观察组房水丙二醛水平明显高于对照组(12.6±4.6nmol/mL vs 8.0±3.1nmol/mL,P<0.001); 观察组血清和房水IL-6、IL-8水平均明显高于对照组(P<0.001); 两组患者血清VEGF水平无差异(P>0.05),但观察组房水VEGF水平明显高于对照组(45.6±20.6pg/mL vs 16.5±4.5pg/mL,P<0.001)。

结论：糖尿病性白内障患者与单纯白内障患者相比,虽然血清维生素C、氧化应激产物及VEGF水平相似,但其房水中维生素C、氧化应激产物及VEGF水平存在较大的差异,同时糖尿病性白内障患者血清和房水炎症因子水平相比单纯白内障患者更高。     

Enhanced Depth Imaging of Central Laminar Thickness in Optic Neuropathy: Comparison with Normal Eyes

Abstract

The purpose of this study was to compare central laminar thickness (LT) among patients with glaucomatous optic neuropathy (GON), patients with non-GON, and normal subjects using enhanced-depth imaging optical coherence tomography (EDI-OCT). Enrolled were 57 patients (n?=?64 eyes), including 30 women and 27 men. Three groups were identified: GON (n?=?18 eyes), non-GON (n?=?16 eyes), and control (n?=?30 eyes). The GON group comprised eyes with primary open-angle glaucoma (POAG) (n?=?9) and normal-tension glaucoma (NTG) (n?=?9). The non-GON group comprised eyes with demyelinating optic neuritis (n?=?9), anterior ischemic optic neuropathy (AION) (n?=?2), compressive ON (n?=?2), Leber hereditary ON (n?=?2), and traumatic ON (n?=?1). GON and non-GON groups were further divided into mild, moderate, and severe subgroups. Inclusion in the GON group was based on mean deviations (MDs) of visual fields; inclusion in the non-GON group was based on critical flicker frequency (CFF) responses. Intraclass correlation coefficients (ICCs) were used to verify reproducibility of measurements. LTs of GON and non-GON group eyes were thinner than those of control group eyes (p?<?0.01); LTs of GON group eyes were thinner than those of non-GON group eyes (p?=?0.01). LTs of severe GON subgroup eyes were thinner than those of moderate and mild GON subgroup eyes (p?<?0.001; p?=?0.024, respectively). LTs of severe non-GON subgroup eyes were thinner than those of mild non-GON subgroup eyes (p?=?0.002). These results show that EDI-OCT is valuable for documenting structural abnormalities in optic neuropathy (ON).     

Evaluation of Neopterin Levels in an Endotoxin-Induced Experimental Uveitis Model

Background: In this study, NP levels of intraocular fluids and serum were analyzed in the endotoxin-induced uveitis model. Methods: Intravitreal injection of 0.05?ml E. Coli lipopolysaccharide (IVT LPS) has been performed into the right eyes of 14 rabbits. Animals were divided into two groups. Group 1 (n?=?7) sacrificed 24 hours after the intravitreal injection, and group 2 (n?=?7) 72 hours after the intravitreal injection. Aqueous fluid, vitreous and serum samples were drawn at the time of sacrifice; histopathological changes were also examined. Results: Significantly elevated aqueous and vitreous NP levels were observed in IVT LPS injected eyes. In IVT LPS injected eyes, aqueous NP levels showed a significant decrease in 72 hours (p?p?). Both aqueous and vitreous protein concentrations were significantly higher in IVT LPS injected eyes. Histopathologic evaluation revealed that, in the first 24 hours, inflammation was significant in choroid and ciliary body. Retinal histopathological changes were observed mainly at 72 hours. Conclusions: This study demonstrates that neopterin levels correlate with early intraocular inflammatory response in an endotoxin-induced uveitis model.     

Choroidal Changes and Duration of Diabetes

Abstract

Purpose: We investigate changes in macular choroidal thickness in eyes without diabetic retinopathy of patients with various durations of diabetes, using enhanced depth imaging optical coherence tomography (EDI OCT). Methods: The 134 Type-2 diabetic patients who presented without diabetic retinopathy were prospectively imaged using EDI OCT on Heidelberg Spectralis (Heidelberg Engineering, Heidelberg, Germany) sd-OCT. The patients with diabetes were classified into three groups, according to the duration of diabetes: Group I (5–9 years, n?=?63); Group II (10–14 years, n?=?37); Group III (15–40 years, n?=?34). The retinal and choroidal thickness was evaluated between these groups at central fovea and at the regions at 500-mm intervals up to 1500?mm temporal and nasal to the fovea. Results: The central foveal retinal thickness was significantly different between groups (group I: 273.05?±?19.51?µ, group II: 267.12?±?20.78?µ, group III: 261.34?±?22.27?µ; p?=?0.04). The choroidal thickness measurements at central fovea, at 500, 1000, and 1500 micron intervals temporal and nasal to the center of the fovea were not significantly different between groups. The duration of diabetes was weakly correlated with choroidal thickness in all measured distances and they were not statistically significant. The central foveal choroidal thickness was weakly correlated with serum creatinine (r?=??0.18, p?=?0.03). Conclus?on: Foveal retinal thickness was significantly decreased in patients with longer duration of diabetes. Duration of diabetes does not seem to be related to foveal chorodial thickness. On the other hand, the weak relation between creatinine and choroidal thickness may be evaluated further. The choroidal thickness changes that may be an early sign of nephropathy can be submitted to an easy, noninvasive scanning test at the same time.     

Effects of Fenofibric Acid on Diabetic Macular Edema: The MacuFen study

Purpose: Fenofibrate reduced progression of diabetic retinopathy in two large randomized studies. The effect of 135?mg fenofibric acid on diabetic macular edema (DME) was evaluated in subjects with existing DME.

Methods: In this double-blind, randomized, placebo-controlled study, 110 subjects with DME not requiring immediate photocoagulation or intraocular treatment with adequate diabetes and blood pressure control received either fenofibric acid or placebo once daily for 1 year. Total macula volume (TMV) and thickness were measured in the worse eye and all eligible eyes with time-domain optical coherence tomography at baseline and quarterly thereafter.

Results: TMV decreased by ?0.35?mm³ (within-group difference) after fenofibric acid treatment and by ?0.11?mm³ after placebo. The between-group comparison of the change was ?0.25?mm³ (95% confidence interval, CI, ?0.645–0.155; p?=?0.227, worse eye analysis). Weighted inner zone thickness and volume decreased by ?18.7?µm and ?0.13?mm³, respectively, for within group difference after fenofibric acid and by ?3.1?µm and ?0.02?mm³, respectively, after placebo. Considering all eligible eyes, thicknesses at central zone, mean inner zone, and entire retina decreased by ?21.3?µm, ?19.8?µm, and ?20.4?µm, respectively, after fenofibric acid. No between-group difference in changes of these measurements was observed. Triglycerides decreased by 23% after fenofibric acid (vs 4% after placebo, p?=?0.001) and high-density lipoprotein cholesterol increased by 8% (vs 0.3%, p?=?0.014). No safety concern was identified.

Conclusion: Subjects treated with fenofibric acid had a modest improvement in TMV, although the study was probably underpowered to detect a benefit over placebo after 1 year.     

正元芸生滴丸治疗非增生期糖尿病性黄斑水肿的临床观察

目的:探讨正元芸生滴丸治疗非增生期糖尿病性黄斑水肿(diabetic macular edema,DME)的临床疗效。方法:运用眼底荧光血管造影和光学相干断层扫描确诊非增生期DME患者共40例76眼,随机分为对照组和观察组,其中对照组20例40眼,给予常规治疗;观察组20例36眼,在对照组基础上采用口服正元芸生滴丸进行治疗。于治疗后3mo检查黄斑区视网膜厚度和最佳矫正视力情况。结果:对照组和观察组黄斑水肿消退率分别为13眼(32.5%)和24眼(66.7%),差异均有统计学意义(P<0.05)。视力改善情况观察组优于对照组(P<0.01)。结论:正元芸生滴丸对非增生期DME消退及视力提高方面有明显治疗作用。     

2型糖尿病患者血清唾液酸浓度与糖尿病性黄斑水肿的相关性

目的:探讨2型糖尿病患者血清唾液酸浓度与糖尿病性黄斑水肿的相关性.方法:选取65例2型糖尿病患者,以及54例正常对照,采取外周静脉血后用比色法测量血清唾液酸浓度.对于糖尿病患者采用视网膜血管荧光造影方法判断黄斑区水肿程度.结果:糖尿病患者65例中黄斑水肿22例,无黄斑水肿43例,其中1级水肿10例,2级水肿5例,3级水肿7例.糖尿病患者血清唾液酸浓度为96.56±14.29mmol/L,对照组的血清唾液酸浓度为42.44±17.68mmol/L,两组比较有显著统计学差异(P＜0.05).在糖尿病患者组,无黄斑水肿的患者血清唾液酸浓度为86.53±13.39mmol/L,有黄斑水肿的患者中血清唾液酸浓度为110.09±18.81 mmol/L,两者差异具有统计学意义(P＜0.05).血清唾液酸浓度与黄斑水肿严重程度有显著正相关(r=0.62,P＜O.05).结论:血清唾液酸浓度在2型糖尿病患者并发黄斑水肿时明显升高,并且血清唾液酸浓度越高,黄斑水肿越严重.     

糖尿病黄斑水肿相关因素分析

目的:探讨糖尿病黄斑水肿(diabetic macular edema,DME)与糖尿病病程和视力之间的关系。方法: 回顾性分析40例40眼荧光素眼底血管造影(fluorescence fundus angiography,FFA)及光学相干断层扫描(optical coherence tomography,OCT)确诊的DME患者的检查结果、糖尿病病程和视力等临床资料。分析各种类型DME与以上相关因素的关系。结果: DME患者40例40眼中,局限型DME14眼(35%),弥漫型20眼(50%),囊样水肿6眼(15%)。患者的视力与DME的类型具有显著相关性(r=-0.835,P=0.000),黄斑囊样水肿较局限型水肿对视力的损害更严重。糖尿病病程与DME的类型具有显著相关性(r=0.472,P=0.002)。结论: DME与糖尿病病程、视力均存在显著相关性。     

糖尿病性黄斑水肿与血清E-选择素的相关性分析

目的：探讨糖尿病性黄斑水肿(DME)与血清E-选择素的关系。

方法：观察2009-10/2013-10本院90例确诊为糖尿病性视网膜病变患者,回顾性分析患者黄斑水肿程度与血清可溶性E-选择素(sE-sel)水平相关性。按是否发生糖尿病黄斑水肿将诊断为糖尿病视网膜病变患者分为两组,糖尿病黄斑水肿组和非糖尿病黄斑水肿组,比较两组血清sE-sel、尿微量蛋白(MA)水平。

结果：组间比较MA,sE-sel差异有统计学意义(P<0.05),DME患者sE-sel水平与MA、空腹血糖(FBG)成正相关(r=0.728,P<0.05; r=0.651,P<0.05)。

结论：血清可溶性E-选择素水平升高是糖尿病性黄斑水肿的危险因素,参与了糖尿病微血管病变的发病机制。     

康柏西普对糖尿病性黄斑水肿患者血清中lncRNA MALAT1水平及黄斑中央区厚度的影响

目的：探讨康柏西普对糖尿病性黄斑水肿(DME)患者血清lncRNA MALAT1水平、黄斑中央区厚度(CMT)及最佳矫正视力(BCVA)的影响，观察其治疗的有效性与安全性。

方法：纳入DME患者300例300眼，均为单眼病变。按照随机数字表法进行分组：非注射组100例100眼，对照组100例100眼给予雷珠单抗治疗，研究组100例100眼给予康柏西普治疗。

结果：治疗前与治疗后1、2、3mo测定患者BCVA、血清lncRNA MALAT1水平及CMT，同时对比临床疗效，并对患者进行随访，记录不良反应发生情况。非注射组患者的BCVA(LogMAR)、血清lncRNA MALAT1水平与CMT均无明显变化(P>0.05)。对照组、研究组患者治疗后1、2、3mo的BCVA(LogMAR)与治疗前相比明显提高(均P<0.05)，但研究组与对照组相比，差异无统计学意义。对照组患者治疗后1、2、3mo血清lncRNA MALAT1水平降低，研究组患者治疗后1、2、3mo血清lncRNA MALAT1水平降低更明显，研究组治疗后血清lncRNA MALAT1水平明显低于对照组(均P<0.05)。对照组患者治疗后1、2、3mo CMT降低，研究组患者治疗后1、2、3mo CMT降低更明显，研究组治疗后CMT明显低于对照组(均P<0.05)。研究组不良反应发生率(2.0%)明显低于对照组(11.0%)。

结论：康柏西普能够显著降低DME患者血清lncRNA MALAT1水平，降低CMT、减轻黄斑水肿，改善视力，其治疗有效性与安全性明显优于雷珠单抗。     

Aqueous angiopoietin-like levels correlate with optical coherence tomography angiography metrics in diabetic macular edema

AIM: To quantitatively detect aqueous levels of angiopoietin-like (ANGPTL)3, ANGPTL4, and ANGPTL6 and investigate their correlation with optical coherence tomography angiography (OCTA) findings in patients with diabetic macular edema (DME). METHODS: This cross-sectional study included 23 patients (27 eyes) with type 2 diabetes and 16 control subjects (20 eyes). All patients underwent OCTA imaging and ultra-wide field fundus photography. Diabetic patients were categorized into two groups according to the presence or absence of diabetic retinopathy (DME group, 14 patients, 16 eyes); and non-diabetic retinopathy (NDR) group, 9 patients, 11 eyes, respectively. Aqueous levels of ANGPTL3, ANGPTL4, and ANGPTL6 were assessed using suspension array technology, and foveal-centered 3×3 mm2 OCTA scans were automatically graded to determine the central, inner, and full vessel density (CVD, IVD, FVD); central, inner, and full perfusion density (CPD, IPD, FPD), foveal avascular zone (FAZ) area, FAZ perimeter, and FAZ circularity index (FAZ-CI) on superficial capillary plexuses. Additionally, central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were measured in a model of macular cube 512×128. RESULTS: Aqueous ANGPTL3 levels were not significantly different among the three groups (P>0.05). ANGPTL4 levels were significantly higher in the DME group than the control and NDR groups (P<0.0001 and P<0.001), while ANGPTL6 levels were significantly higher in the DME group than the control group (P<0.05). In the whole cohort, the aqueous ANGPTL3 levels correlated negatively with the IVD, FVD, IPD, and FPD, and positively with the CV and CAT. The aqueous ANGPTL4 levels correlated negatively with the CVD, IVD, FVD, CPD, IPD, and FPD, and positively with the FAZ perimeter, CST, CV, and CAT. The aqueous ANGPTL6 levels correlated negatively with the IVD, FVD, IPD, FPD, FAZ-CI and positively with CST, CV, CAT. CONCLUSION: ANGPTL4 and ANGPTL6 may be associated with vascular leakage in DME and may represent good targets for DME therapy. In addition, OCTA metrics may be useful for evaluating macular ischemia in DME.     

糖尿病黄斑水肿对抗VEGF药物治疗的不同反应与糖尿病视网膜病变程度的相关性

目的：通过观察糖尿病黄斑水肿(diabetic macular edema,DME)患者对于玻璃体腔注射抗VEGF治疗的不同反应和糖尿病视网膜病变(diabetic retinopathy,DR)的不同程度之间的相关性,进一步阐释糖尿病黄伴水肿的发病机制和治疗策略。

方法：选择非增生性糖尿病视网膜病变(non proliferative diabetic retinopathy,NPDR)伴发DME的患者27例33眼,增生性糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)伴发DME的患者32例34眼。均给予玻璃体腔注射抗VEGF药雷珠单抗,观察两组患者对该药的不同反应,并进行统计学比较。

结果：分别把患者治疗3、6mo时的最佳矫正视力(best corrected visual acuity,BCVA)和黄斑中心视网膜厚度(central macular thickness,CMT)和治疗前的BCVA、CMT作比较,NPDR组有统计学差异(P<0.05),PDR组无统计学差异(P>0.05)。NPDR组和PDR组比较,3、6mo时的BCVR和CMT均有统计学差异(P<0.05)。

结论：糖尿病视网膜病变的不同程度影响着糖尿病黄斑水肿对抗VEGF治疗的反应。     

兔眼超声乳化吸出术后非手术眼房水及血清中TNF-α、IL-1β表达变化与该眼角膜知觉敏感度变化之间的关系

目的探讨超声乳化吸出术后不同时间点兔非手术眼房水及血清中肿瘤坏死因子α(TNF-α)和白细胞介素-1β(IL-1β)表达变化与该眼角膜知觉敏感度变化之间的关系。方法选取健康成年新西兰大白兔40只作为实验对象。采用随机数字表法将大白兔分为实验组与空白对照组,实验组25只,空白对照组15只。实验组:一眼行晶状体超声乳化吸出术,根据术后取材时间分为术后1 d、3 d、7 d、14 d、21 d共5组,每组5只动物。空白对照组:按照对应取材时间也分为5组,每组3只动物。术后观察并记录各组兔双眼的结膜充血、角膜混浊及前房炎症反应情况。实时定量PCR检测各组兔血清TNF-αmRNA和IL-1βmRNA表达水平,ELISA法检测房水中TNF-α、IL-1β蛋白浓度,角膜知觉计测量角膜知觉敏感度。结果实验组非手术眼与空白对照组双眼在不同时间点,结膜充血、角膜混浊及前房炎症反应级别均为0级。术后1 d、3 d、7 d、14 d,实验组兔血清TNF-αmRNA和IL-1βmRNA表达水平均较基线值升高,术后7 d达高峰(TNF-αmRNA相对表达量为14.95±0.89,IL-1βmRNA相对表达量为7....     

抗血管内皮生长因子药物联合激光治疗糖尿病黄斑水肿

目的:探讨抗血管内皮生长因子药物联合激光治疗糖尿病黄斑水肿(diabetic macular edema,DME)的临床效果.方法:选取2015-06/12在我院接受治疗的94例141眼DME患者,采用随机数字表法分为联合组47例68眼(雷珠单抗联合激光治疗)、对照组47例73眼(激光治疗),对比两组患者治疗后不同时间的最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心视网膜厚度(macular central retinal thickness,CRT)、黄斑总体积(total macular volume,TMV)、黄斑水肿分级.结果:治疗2、6、12wk联合组的BCVA平均值均大于对照组,差异有统计学意义(P<0.05),治疗2、6、12wk联合组的CRT、TMV平均值均小于对照组,差异有统计学意义(P<0.05);治疗12wk后,联合组黄斑水肿轻度80.9%、中度17.7%、重度1.5%,对照组轻度60.0%、中度31.5%、重度5.5%,两组比较差异有统计学意义(P<0.05).结论:抗血管内皮生长因子药物联合激光治疗DME患者的效果优于单用激光治疗.     

Choroidal Thickness in Turkish Children with Anisometric Amblyopia

Purpose: To assess macular choroidal thickness (CT) and axial length measurements in children with anisometropic amblyopia and to compare the measurements with that of fellow non-amblyopic eyes and age-sex matched controls. Methods: Forty patients with anisometropic amblyopia and 40 age-/sex-matched controls were evaluated in this study. Eyes were classified into three groups as follows: amblyopic eyes (n?=?40), fellow non-amblyopic eyes, and healthy eyes (n?=?40). All subjects underwent complete ophthalmic examination and macular choroidal thickness measurements by enhanced depth imaging method of the Spectralis optical coherence tomography system. CT was measured at the fovea and at 1000-μm intervals from the foveal center in both temporal and nasal directions. The statistical assessment was performed with the assistance of one-way analysis of variance (ANOVA) and Pearson’s correlation test. Results: The mean subfoveal CT was 389.35, 349.07, and 315.8?μm in the amblyopic, fellow non-amblyopic and healthy eyes, respectively. Choroid was thickest in subfoveal and thinnest in nasal regions among all groups. Both amblyopic and fellow non-amblopic eyes were more hyperopic than healthy eyes. While the subfoveal and nasal CT in amblyopic eyes and fellow eyes were significantly higher than healthy eyes, the temporal CT in amblyopic eyes was significantly higher than in healthy eyes. There was a significant positive correlation between the CT of the subfoveal, nasal, and temporal regions and the refractive state (r?=?0.432 p?=?0.001; r?=?0.324 p?=?0.001; r?=?0.215 p?=?0.01, respectively). Conclusion: The macular choroidal thickness—not only in amblyopic eyes but also in non-amblyopic fellow eyes—was significantly thicker than in the healthy subjects. The thick choroid in amblyopic and non-amblyopic fellow eyes may indicate bilateral delay of emmetropization, which probably means amblyopia affecting the visual feedback of both eyes.     

血清TLR4和VEGFA表达对糖尿病视网膜病变的临床诊断及预后价值评估

目的：探讨Toll样受体4(TLR4)、血管内皮生长因子A(VEGFA)在糖尿病视网膜病变(DR)患者血清中的表达情况及临床意义。

方法：选取2021-01/2022-01本院收治的183例2型糖尿病(T2DM)患者为研究对象，分为非糖尿病视网膜病变(NDR)组(54例)，增殖性糖尿病视网膜病变(PDR)组(68例)和非增殖性糖尿病视网膜病变(NPDR)组(61例)。同期按照年龄、性别分层随机选择70例于本院进行健康体检志愿者作为对照组。出院后随访1a，根据DR患者是否发生视力残疾，分为预后不良组(40例)与预后良好组(89例)。采用酶联免疫吸附法(ELISA)检测血清中TLR4、VEGFA水平； 通过Logistic回归分析DR发生的影响因素； 利用受试者工作特征曲线(ROC)分析血清TLR4、VEGFA水平诊断DR及预测预后的临床价值。

结果：对照组、NDR组、PDR组和NPDR组间TLR4、VEGFA水平比较均具有差异(F=935.753、516.936，均P<0.05)，各组两两比较均具有差异(P<0.05)。预后不良组患者血清中TLR4、VEGFA表达水平均高于预后良好组(P<0.01)。Logistic回归分析结果显示，TLR4、VEGFA、病程、HbA1c均是DR发生的危险因素(P<0.05)； ROC结果显示，血清TLR4、VEGFA水平及二者联合预测DR的AUC分别为0.869、0.862、0.931，血清TLR4、VEGFA水平及二者联合预测DR患者视力残疾的AUC分别为0.864、0.863、0.938。

结论：DR患者血清中TLR4、VEGFA表达均上调，二者联合检测可作为评估DR发生及预后不良的潜在指标。     

芪明颗粒联合格栅样激光光凝治疗糖尿病视网膜病变合并黄斑水肿

目的：研究芪明颗粒联合格栅样激光光凝治疗糖尿病视网膜病变(diabetic retinopathy,DR)合并黄斑水肿(diabetic macular edema,DME)的临床疗效。

方法：本研究对象为2014-03/2017-03于我院治疗的50例98眼DR合并DME患者,按照治疗方式不同分为两组,对照组患者25例48眼采用格栅样激光光凝治疗,观察组患者25例50眼在此基础上联合芪明颗粒治疗。光学相干断层扫描(optical coherence tomography,OCT)及眼底血管造影(fundus fluorescein angiography,FFA)评价两组患者DME消退情况并比较治疗前、治疗7d,1、3mo黄斑中心凹厚度(central macular thickness,CMT)和最佳矫正视力(best corrected visual acuity,BCVA)。

结果：观察组总有效47眼,总有效率为94%,对照组治疗总有效40眼,总有效率为83%,观察组总有效率显著高于对照组,差异具有统计学意义(P<0.05)。两组治疗后BCVA均显著改善,观察组治疗7d,1、3mo均显著优于对照组,差异均有统计学意义(P<0.05)。两组治疗后CMT均显著降低,观察组治疗7d,1、3mo均显著低于对照组,差异均有统计学意义(P<0.05)。观察组和对照组分别出现高眼压2例2眼和1例1眼,给予降眼压药物后迅速缓解,其余无明显不良反应出现。

结论：芪明颗粒联合格栅样激光光凝治疗能显著改善DR合并DME症状,降低CMT,改善视力。     

The Effect of Intravitreal Anti-VEGF on the Pigment Epithelial Detachment in Eyes with the Exudative Type of Age-Related Macular Degeneration

Abstract

Purpose: To evaluate the effect of anti-VEGF treatment on pigment epithelial detachment (PED) secondary to the exudative type of age-related macular degeneration (AMD). Methods: Retrospective analysis of 30 eyes (28 patients) with exudative AMD accompanied by PED (receiving anti-VEGF injections). Alterations of the PED morphology were qualitatively assessed with optical coherence tomography (OCT). Changes in best-corrected visual acuity (BCVA) and number of injections were compared to 30 control eyes (30 patients) exhibiting exudative AMD without PED. Results: Mean follow-up was 19.8 months. Changes of the extent of PED were as follows: unchanged: 11 eyes (36.7%); reduced: 12 (40%); significantly reduced: 7 (23.3%). Mean paired difference in BCVA was ?0.08 logMAR (p?=?0.46) and in the number of injections was 2.1 injections (p?=?0.04). Conclusions: A substantial number of the studied patients showed reduction of the extent of the PED after anti-VEGF treatment. The PED group required a higher number of injections.