ObjectiveTo observe the effect and complications of vitrectomy combined with intraocular silicon oil or C3F8 filling for proliferative diabetic retinopathy (PDR). MethodsEighty-six consecutive patients (101 eyes) with PDR-related vitreous hemorrhage who underwent primary standard three-port vitrectomy and intraocular tamponade of silicone oil or C3F8 were included in this retrospective study. They were divided into silicone oil group and C3F8 groups. There was no statistically significant difference between these two groups of patients for gender, age, duration of diabetes, fasting glucose, history of hypertension, diabetic kidney disease history, history of cardiac and vascular diseases, body mass index and smoking history. There was statistically significant difference between these two groups of patients for visual acuity (Z=-2.604, P=0.009). There was no statistically significant difference between these two groups of patients for intraocular pressure before surgery (Z=0.064, P=0.949). The mean follow-up was (20.3±16.4) months with a range from 1 to 47 months. The patients were followed up for visual acuity, intraocular pressure, neovascular glaucoma (NVG), the incidence of retinal detachment, recurrent vitreous hemorrhage, and repeated operation for complications. ResultsVisual acuity (t=-3.932, -8.326; P=0.000, 0.000) and intraocular pressure (t=-3.159, -2.703; P=0.006, 0.009) were changed significantly after surgery for both groups. Between these two groups after surgery, there were significant differences of visual acuity (Z=-1.879, P=0.040), intraocular pressure (Z=-3.593, P=0.000), and complications (revision operation, retinal detachment, recurrent vitreous hemorrhage and NVG) (t=-2.777, -2.102, -2.308, -2.013; P < 0.05). ConclusionIntraocular silicone oil tamponade can reduce the postoperative complications of PDR, especially for severe retinal neovascularization, exudation associated with retinal edema.
ObjectiveTo observe the effect of interleukin (IL) 10 modified endothelial progenitor cells (EPC) in diabetic retinopathy (DR). MethodsEPC cells were collected and cultivated from the bone marrow of rats and identified by immuno-fluorescence staining. EPC cells were infected with lentivirus (LV) of EPC-LV-IL10-GFP (EPC-LV-IL10-GFP group) or EPC-LV-NC-GFP (GFP group). EPC cells without lentivirus infection was the EPC group. Enzyme-linked immuno sorbent assay (ELISA) was used to measure the concentrations of tumor necrosis factor (TNF)-α, IL10, IL8 and vascular endothelial growth factor (VEGF) in the supernatant of these three groups. 168 male Wistar rats were divided into normal control group (28 rats), diabetes mellitus (DM) group (28 rats), DM-blank control group (56 rats) and DM-intervention group (56 rats). DM was introduced in the latter 3 groups by streptozotocin intravenous injection. Three months later, the rats in the DM-blank control group and DM-intervention group were injected with EPC-LV-NC-GFP or EPC-LV-IL10-GFP by tail vein, respectively. Immunohistochemistry was used to observe the GFP expression in rat retinas. The blood-retinal barrier breakdown was detected by Evans blue (EB) dye. The retinal histopathologic changes were observed by transmission electron microscope. The mRNA level of VEGF, matrix metallproteinases-9 (MMP-9), angiopoietin-1 (Ang-1), inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) in retina were measured by reverse transcription-polymerase chain reaction (RT-PCR). ResultsELISA showed that the levels of TNF-αand IL8 in the supernatant significantly decreased, while the levels of IL10 and VEGF increased (P < 0.05) in EPC-LV-IL10-GFP group. GFP expressed in the retina of blank control group and intervention group, mainly in the ganglion cell layer, inner nuclear layer and outer plexiform layer. The retinal blood vessel pathological change and EB permeability significantly decreased in intervention group compared with DM group (P < 0.05), and blank control group (P < 0.05). RT-PCR revealed that the mRNA level of VEGF, MMP-9 and Ang-1 significantly increased, and eNOS decreased in DM group compared to the normal control group (P < 0.05). The mRNA level of VEGF and iNOS decreased, eNOS increased while Ang-1 and MMP-9 had not changed in DM-blank control group and DM-intervention group compared with DM group (P < 0.05). ConclusionsIL10 modified EPC can improve the inflammative microenvironment and suppressed the pathogenesis of DR. Furthermore, EPC transplantation can increase the number of EPC and exerted their effect.
ObjectiveTo study the prevalence of age-related macular degeneration (AMD) in the population aged 50 and over in Qidong County of Jangsu Province. Methods3644 individuals from 4 villages were randomly selected by clustering sampling method, according to the household registration information and door to door visits. Visual acuity was measured by modified Bailey-Lovie E logMAR chart. The examination of eyelids, cornea, lens and fundus were also carried out. The diagnosis of AMD was made according to the clinical hierarchy system by Age-Related Eye Diseases Study. χ2 test was used to analyze the prevalence of AMD and its related factors. ResultsAmong 3644 selected individuals, 2985 individuals received examination with a participating rate of 81.92%. In total 97 patients (136 eyes) had AMD with a prevalence rate of 3.25%. Among them, 71 patients (105 eyes) had early stage of AMD (2.38%); 26 patients (31 eyes) had late stage of AMD (0.87%). In these late stage patients, there were 9 patients (13 eyes) of exudative lesions (0.30%). There were 32 male (3.11%) and 65 female (3.32%) patients. There was no statistically significant difference between male and female prevalence (χ2=0.29, P > 0.05). Correlation analysis results showed that the long-term smoking (χ2=15.19) and heart cerebrovascular disease (χ2=81.50) was associated with AMD (P < 0.05). ConclusionsThe prevalence rate of AMD is 3.25% in the residents aged 50 and above in the rural area of Qidong County, Jangsu Province. Long-term smoking, high blood pressure and cardiovascular disease are the risk factors of AMD.
Objective To observe the hemodynamic changes of posterior polar and peripheral retina and choroid in patients with rheogenic retinal detachment （RRD） after scleral buckling surgery. MethodsA prospective clinical observational study. A total of 25 eyes of 25 patients with RRD who underwent scleral buckle surgery in Tianjin Eye Hospital from February to April 2024 were included in the study. Among them, 10 were male and 15 were female. Age was 17-68 years old. All cases were monocular. The surgical eye and the contralateral healthy eye were divided into the affected eye group and the contralateral healthy eye group respectively. Best corrected visual acuity （BCVA）, scanning source optical coherence tomography angiography （SS-OCTA）, and axial length （AL） measurements were performed 3 months after surgery. SS-OCTA examination of macular area was performed by VG200 of Visual Microimaging （Henan） Technology Co., LTD. Scanning range 21 mm×26 mm. According to the partitioning method of the early treatment group of glycosuria retinopathy, the retina within 21 mm of the macular fovea was divided into concentric circles with the macular fovea as the center and diameters of 1-3, 3-6, 6-12, 12-21 mm, respectively. The built-in software of the device was used to record the central area （12 mm×12 mm in the fovea of the macula） and the peripheral area （12-21 mm range） retinal superficial capillary plexus （SCP）, deep capillary plexus （DCP）, radial peripapillary capillaries （RPC） blood density and choroidal vascular index （CVI）, choroidal vascular volume （CVV）, and 1-3, 3-6, 6-12, 12-21 mm above concentric circles （S）, nasal side （N）, temporal side （T）, and lower side （I） SCP, DCP, and RPC blood flow density. Quantitative data between the two groups were compared by independent sample t test or Wilcoxon signed rank test. The correlation between retinal and choroid blood flow parameters and postoperative BCVA was analyzed by Spearman correlation analysis. ResultsCompared with the opposite healthy eye group, SCP blood density in the central area （Z=－4.372）, DCP blood density in the central area （Z=－2.829）, and CVI in the peripheral area （Z=－2.138） were decreased in the affected eye group, and the differences were statistically significant （P＜0.05）. SCP: in the affected eye group, the blood flow density in T3-6 mm, T6-12 mm, N6-12 mm and T12-21 mm regions decreased, while the blood flow density in I6-12 mm regions increased, with statistical significance （P＜0.05）. DCP: blood flow density in S6-12 mm, I6-12 mm, S12-21 mm and I12-21 mm regions decreased significantly, and the differences were statistically significant （P＜0.05）. RPC: blood flow density decreased significantly in T6-12 mm and I12-21 mm, and the differences were statistically significant （P＜0.05）. CVI: T6-12 mm, S12-21 mm, T12-21 mm, I12-21 mm significantly decreased, and T1-3 mm, S12-21 mm significantly increased, the differences were statistically significant （P＜0.05）. Correlation analysis showed that AL growth was positively correlated with CVV in central region （r=0.408, P=0.040）. The number of pad pressure was negatively correlated with the blood density of central DCP （r=－0.422, P=0.030）. ConclusionsAfter scleral buckling operation, the blood flow density and choroidal blood flow parameters in RRD affected eyes were lower than those in contralateral healthy eyes in some areas. The increase of AL was positively correlated with CVV in the central region, and the wider the range of pad pressure, the worse the recovery of DCP blood density.
ObjectiveTo study the tolerance of Ice Gardenia Pain Aerosol with single and multiple dosing in healthy Chinese volunteers, evaluate the safe dosing range and the highest tolerance dose of human body, and supply proof for the dose amount in Phase-Ⅱ study. MethodsForty subjects enrolled in Ward I of a national medicine clinical experiment institute between May and September 2014 were included in this study. For single dosing experiment, 28 eligible subjects were enrolled and assigned into 5 groups to receive a single dose of 2, 6, 10, 14 and 18 puffs per time, respectively. The patient number for each group was 4, 6, 6, 6 and 6, respectively with equal number of male and female patients in each group. For the multiple dosing treatment, 12 eligible subjects were enrolled and assigned into 2 groups to receive multiple dosing of 6 and 10 puffs per time per day, respectively, for 14 days. Both the two groups had 6 male and female patients. Tolerability was evaluated by monitoring adverse events, physical examinations, laboratory tests and electrocardiogram. ResultsTotally, 40 subjects were enrolled and all of them completed the study. No adverse events or severe adverse events were observed or reported. No abnormal laboratory test was reported 1 hour, 2, 4, 8, 12 and 24 hours after the treatment of single dosing, and multiple dosing group had no abnormal indexes or adverse events, either. The maximum single tolerance dose was 18 puffs per time, and a single dose of 2-18 puffs per time was well tolerated; Multiple dosing of 6 and 10 puffs per day, once a day for 14 days was well tolerated. ConclusionsSingle and multiple dosing of Ice Gardenia Pain Aerosol are considered to be well tolerated by healthy Chinese volunteers. The maximum single tolerance dose is 18 puffs per time; multiple dosing of 6 and 10 puffs per day, once a day for 14 days is well tolerated. We suggest that the above dosing range can be chosen in the following Phase-Ⅱ study.