蓝莓花青素在眼科疾病的研究进展

蓝莓又名越橘,它还有很多别名,如笃斯,都柿等,是营养价值极高的浆果,在我国主要种植于山东半岛和大小兴安岭等地区。它具有超强的抗氧化活性和清除自由基能力,归根结底是因为蓝莓中富含丰富的花青素。它还有许多优点,例如高效率、低毒和对人体的生物利用率为100%。蓝莓花青素可以降血压、降血脂,对由于糖尿病引起的毛细血管病有治疗作用,抗炎症、抗癌、预防老年痴呆、增强视力,消除眼睛疲劳、促进眼周微血管循环、延缓脑神经衰老,增强心肺功能等功效。本文主要以蓝莓的提取物花青素为代表来综述花青素的性质、药理作用以及在主要眼病如缓解视疲劳、屈光不正、眼表疾病、白内障、青光眼、视网膜病变等方面应用的最新研究进展。在未来发展进程中,如果能更加深入地研究出其药物作用机制,将会为眼科临床应用提供更多既有效又经济的药物,为广大患者带来福音。     

全视网膜光凝术改善PDR患者的视觉相关生活质量及日常视觉功能

目的：评估全视网膜光凝术( PRP )对糖尿病视网膜病变( PDR)患者在视觉相关生活质量及日常视觉功能的影响。方法：研究纳入30例(男13例,女17例)接受全视网膜光凝术治疗糖尿病视网膜病变患者。国家眼科研究所发布的视觉功能量表( VFQ-25)用来评估全视网膜光凝术治疗前后视觉相关生活质量及日常视觉功能。患者在接受全视网膜光凝术治疗前和治疗后6 mo分别填写VFQ-25量表,比较视觉相关生活质量及日常视觉功能差异。运用配对t检验对治疗前后VFQ-25评分对比。结果：全视网膜光凝术治疗前平均VFQ-25综合评分为74.79±15.7,术后平均综合评分为74.08±19.1。术前与术后的平均VFQ-25综合评分无统计学意义( P=0.875)。结论：全视网膜光凝术( PRP)对糖尿病视网膜病变( PDR)患者在视觉相关生活质量及日常视觉功能无不利影响。     

高血压视网膜病变与血脂

高血压视网膜病变是高血压常见的眼部并发症,血脂在高血压视网膜病变的发生发展中发挥一定作用.一方面血脂升高通过增加高血压的严重程度加重高血压视网膜病变;另一方面,血脂紊乱还可以导致血管内皮细胞损伤和微循环障碍.     

糖尿病视网膜病变血-视网膜屏障的损伤机制

糖尿病严重影响了视网膜微循环,从而引起一系列组织结构的病理改变.这些改变最终可导致内皮细胞过度增生,血管通透性改变,异常的视网膜血管形成并发视力减退.本文阐述了高血糖对视网膜微血管系统的影响,从细胞功能和分子生物学的角度阐明高血糖所导致的细胞损伤效应.高血糖可通过影响细胞连接功能、诱导细胞凋亡以及改变细胞间的相互作用等方式对视网膜血管细胞造成损伤.这将为人们了解糖尿病视网膜病变发生发展中的分子及细胞缺陷提供新思路.     

脑红蛋白在眼科的研究现状

脑红蛋白(neuroglobin,NGB)是继血红蛋白和肌红蛋白之后发现的第三类神经系统特异的携氧球蛋白,与氧有很高的亲和力,具有重要的神经保护功能.近来发现NGB在视网膜内的含量是大脑的100倍,高表达的NGB对眼部组织的缺血缺氧、氧化应激损伤有一定的保护作用,在眼科疾病的发生发展中亦具有重要的研究价值.本文主要针对NGB的眼内分布、神经保护机制及其在视网膜光化学损伤、糖尿病视网膜病变、青光眼等眼科疾病中发挥的作用进行综述.     

自噬作用对糖尿病视网膜病变的影响

糖尿病视网膜病变(diabetic retinopathy,DR)发病机制多样,目前尚未完全阐明.自噬可能通过改变细胞内环境、氧化应激、内质网应激、细胞凋亡以及过度自噬等途径对DR的发生发展产生影响.此外,对于DR的治疗,适当提高自噬作用或抑制过度自噬可能具有重要的潜在价值.     

Association of vascular endothelial growth factor -634G/C and receptor for advanced glycation end products G82S gene polymorphisms with diabetic retinopathy

AIM: To investigate the association of receptor for advanced glycation end products (RAGE) G82S and vascular endothelial growth factor (VEGF) -634 G/C gene polymorphisms with diabetic retinopathy (DR). METHODS: Our cross-sectional study included 61 diabetic patients, 12 of them had proliferative diabetic retinopathy (PDR), 15 had non proliferative diabetic retinopathy (NPDR), 34 had no diabetic retinopathy (NDR) and 61 healthy controls. Participants were tested for RAGE G82S and VEGF -634 G/C polymorphisms by polymerase chain reaction-restriction fragment length polymorphism. RESULTS: We found a significant association between VEGF -634 G/C polymorphism and PDR as PDR patients had increased incidence of VEGF -634 CC genotype compared to NDR patients [odds ratio for CC vs (GC+GG)=6.5, 95% CI=1.5-27.8, P=0.021]. Also VEGF -634 CC genotype and C allele were significantly higher in the PDR than in NPDR patients, which is a novel finding in our study (P=0.024, 0.009 respectively). The mean triglycerides level was significantly higher in diabetic patients with CC genotype (P=0.01) as compared to patients with other genotypes. All cases and control subjects were of the same heterozygous RAGE 82G/S genotype. CONCLUSION: Patients carrying VEGF -634 C polymorphism have a higher risk of PDR development, so VEGF -634 G/C polymorphism could be used as a predictive marker for PDR in diabetic patients. We could not find a significant association between RAGE G82S polymorphism and DR.     

Effect of endothelial progenitor cells derived from human umbilical cord blood on oxygen-induced retinopathy in mice by intravitreal transplantation

AIM: To investigate the effect of endothelial progenitor cells (EPCs) labeled by carboxy fluorescein diacetate succinimidyl ester (CFSE) on murine oxygen-induced retinopathy (OIR) by intravitreal transplantation. METHODS: After isolated from human umbilical cord blood mononuclear cells, EPCs were cultivated and then labeled with CFSE in vitro. C57BL/6J mice were placed to 75% hyperoxia chamber from P7 to P12 to establish OIR model. At P12, OIR mice were intravitreally injected with 1 μL suspension contained 2×105 EPCs (EPCs group) or isometric phosphate buffered saline (PBS group). The contralateral eye of each mice received no injection (OIR group). Evans blue angiography and frozen section were examined to track the labeled cells in OIR group at P15 and P19. Using retina paraffin sections and adenosinediphos phatase staining at P12 and P19, the effect of EPCs on OIR mice was evaluated quantitatively and qualitatively. RESULTS: The retinas from EPCs group with less non-perfusion area and fewer peripheral tufts were observed at P19, comparing with that from PBS or OIR group. The retinopathy in EPCs group receded earlier with less non-ganglion cells and neovascular nuclei, together with relatively regular distribution. The counts of the neovascular nuclei at P19 were reduced by 44% or 45%, compared with those of OIR group or PBS group respectively. Three days after EPCs injection, a large number of EPCs appeared in the vitreous cavity and adhered to the retinal surface. While at one week, the cells gathered between the internal plexiform layer and the inner limiting membrane, and some EPCs appeared in retinal vessels. CONCLUSION: EPCs transplantation can participate in the reparative procedure of the neovascularization in OIR.     

血糖、血脂水平与糖尿病视网膜病变患者视力损害的相关性研究

目的探讨血糖、血脂水平与糖尿病视网膜病变患者视力损害的相关性。方法选取2016年1月至2018年1月我院内分泌科收治的250例DR患者进行研究。根据视力分级标准分为三个组:盲组(n=28),低视力组(n=80),低视力以上组(n=142)。比较各组患者FPG、HbAlC、TC、TG、LDL-C、HDL-C、LDL-C/HDL-C、ApoB、ApoA1、ApoB/ApoA1水平,对FPG、HbA1C、LDL-C/HDL-C及ApoB/ApoA1与DR患者视力损害进行Pearman相关性分析和Logistic回归分析。结果三组患者的TC、TG差异均无统计学意义(P>0.05);与低视力以上组相比,盲组和低视力组FPG、HbAlC、LDL-C、LDL-C/HDL-C、ApoB、ApoB/ApoA1更高,HDL-C、ApoA1更低(P<0.05);盲组FPG、HbAlC、LDL-C、LDL-C/HDL-C、ApoB、ApoB/ApoAl显著高于低视力组,HDL-C、ApoA1显著低于低视力组(P<0. 05)。经Spearman相关性分析,FPG、HbAlC、LDL-C/HDL-C、ApoB/ApoA1比值与DR患者视力损害均呈正相关。经Logistic回归分析,FPG、HbAlC、LDL-C/HDL-C、ApoB/ApoA1均是DR患者视力损害的独立危险因素。结论 FPG、HbAlC、LDL-C/HDL-C、ApoB/ApoA1与DR患者的视力损害有密切关系,通过监测这些指标有利于DR患者视力损害的预测,及时采取治疗措施。     

A review on computer-aided recent developments for automatic detection of diabetic retinopathy

Diabetic retinopathy is a serious microvascular disorder that might result in loss of vision and blindness. It seriously damages the retinal blood vessels and reduces the light-sensitive inner layer of the eye. Due to the manual inspection of retinal fundus images on diabetic retinopathy to detect the morphological abnormalities in Microaneurysms (MAs), Exudates (EXs), Haemorrhages (HMs), and Inter retinal microvascular abnormalities (IRMA) is very difficult and time consuming process. In order to avoid this, the regular follow-up screening process, and early automatic Diabetic Retinopathy detection are necessary. This paper discusses various methods of analysing automatic retinopathy detection and classification of different grading based on the severity levels. In addition, retinal blood vessel detection techniques are also discussed for the ultimate detection and diagnostic procedure of proliferative diabetic retinopathy. Furthermore, the paper elaborately discussed the systematic review accessed by authors on various publicly available databases collected from different medical sources. In the survey, meta-analysis of several methods for diabetic feature extraction, segmentation and various types of classifiers have been used to evaluate the system performance metrics for the diagnosis of DR. This survey will be helpful for the technical persons and researchers who want to focus on enhancing the diagnosis of a system that would be more powerful in real life.