PURPOSE: To compare the pain scale and time necessary for panretinal photocoagulation (PRP) between Navilas(R) (OD-OS, Teltow, Germany) and conventional laser in diabetic retinopathy. METHODS: Fifteen patients who required PRP for diabetic retinopathy were enrolled in the present study. PRP was performed using Navilas(R) (5 x 5 array patterned system) in the superior, nasal and inferior areas, and using conventional laser at the temporal area 1 week later. Total time of laser application and number of laser shots were counted for calculating required time per 100 spots of each laser system. Immediately after the laser photocoagulation, patients were asked to quantify their pain on a visual analog pain scale (0 = no pain; 10 = worst pain). RESULTS: PRP using Navilas(R) required shorter time per 100 laser spots (27.7 sec vs. 102.0 sec, p < 0.001) and subjects had lower treatment-related pain than with the conventional laser system (3.3 vs. 6.9, p < 0.001). CONCLUSIONS: PRP using Navilas(R) can be considered as an efficient method for improving patient and operator's comfort with faster laser application and lower treatment-related pain.
Diabetic Retinopathy* ; Humans ; Laser Therapy* ; Light Coagulation* ; Pain Measurement

Acupuncture Therapy ; Adult ; Aged ; Diabetic Retinopathy ; therapy ; Female ; Humans ; Middle Aged ; Retinal Hemorrhage ; therapy

Cataract ; genetics ; Diabetic Retinopathy ; genetics ; Eye Diseases ; genetics ; therapy ; Genetic Therapy ; Glaucoma, Open-Angle ; genetics ; Humans ; Macular Degeneration ; genetics

PURPOSE: To identify the association between hormone replacement therapy and eye diseases. METHODS: The fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) is a nationwide survey. The study included 5,808 females who completed the KNHANES IV. The prevalence of eye disease of adjusted mean using linear regression analysis between the subjects who had hormone replacement therapy and those who did not have the therapy was analyzed. RESULTS: Among the 5,808 females, 480 (8.3%) received hormone replacement therapy. The adjusted prevalence of myopia was 44.5% (95% CI, 38.1-51.2) in the subjects who received hormone replacement therapy, and 54.4% (95% CI, 52.6-56.1) in those who did not have the therapy. The adjusted prevalence of hyperopia was 7.7% (95% CI, 5.5-10.6) in subjects who received hormone replacement therapy and 4.5% (95% CI, 3.8-5.3) in those who did not have the therapy. The adjusted prevalence of pterygium was 2.1% (95% CI, 1.3-3.3) in the subjects who received hormone replacement therapy and 3.3% (95% CI, 2.7-4.0) in those who did not have the therapy. All the results were statistically significant with a p-value <0.05. The adjusted prevalence of diabetic retinopathy was 5.6% (95% CI, 1.4-19.8) in the subjects who received hormone replacement therapy and 16.7% (95% CI, 13.0-21.2) in those who did have the therapy. The p-value was 0.053, which is marginally statistically significant. CONCLUSIONS: The adjusted prevalence of myopia, pterygium, and diabetic retinopathy in the subjects who received hormone replacement therapy was low, although hyperopia was statistically significantly high.
Diabetic Retinopathy ; Eye ; Eye Diseases ; Female ; Hormone Replacement Therapy ; Humans ; Hyperopia ; Korea ; Linear Models ; Myopia ; Nutrition Surveys ; Prevalence ; Pterygium

OBJECTIVETo probe clinical therapeutic effect of acupuncture on diabetic retinopathy and the mechanism.

METHODSOne hundred and twenty cases of diabetic retinopathy were randomly divided into an observed group and a control group, 60 cases in each group. On the basis of routine diabetic treatment, the observation group were treated with the acupoints for regulating the spleen and stomach, and the control group with the acupoints around eye mainly. Clinical therapeutic effect was evaluated by eye fundus condition, blood glucose, blood lipids, nitric oxide (NO) and endothelin (ET) levels.

RESULTSThe needling method for regulating the spleen and stomach not only can improve the eye fundus condition, but also has benign regulative action on metabolism of blood glucose and blood lipids, and NO and ET levels, with significant differences as compared with those in the control group (P < 0.05, P < 0.01).

CONCLUSIONThe needling method for regulating the spleen and stomach is an effective therapy for diabetic retinopathy, and the mechanism is possibly related with the regulation of levels of vascular active substances, NO and ET.

Acupuncture Therapy ; methods ; Blood Glucose ; analysis ; Diabetic Retinopathy ; blood ; physiopathology ; therapy ; Endothelins ; blood ; Humans ; Lipids ; blood ; Nitric Oxide ; blood ; Spleen ; physiopathology ; Stomach ; physiopathology

OBJECTIVETo study the effects of Huoxue Jiedu Recipe (HJR) on the hemodynamics of central retinal artery (CRA) and central retinal vena, as well as the morphology of blood vessels of diabetic rats.

METHODSSixty SD rats were selected and fasted for 12 h. Streptozotocin (STZ, 65 mg/kg) was intraperitoneally injected to induce diabetic rat models. The modeled rats were randomly divided into the model group, the high dose HJR group (15.4 g/kg), the middle dose HJR group (7.70 g/kg), the low dose HJR group (3.85 g/kg), and the Doxium Capsule group (the Western medicine group, 0. 167 g/kg), 10 in each group. Another 10 rats were recruited as the normal control group. Equal volume of distilled water was given to rats in the normal control group. The intervention was carried out once daily in each group, totally for 20 weeks. The peak systolic velocity (PSV), the end diastolic velocity (EDV), the mean velocity (MV), the pulsatile index (PI), the resistive index (RI), and the central retinal vena velocity (CRV) were detected in each group. The retinal vascular morphologies were observed and compared using trypsin digestion.

RESULTSCompared with the normal control group, the PSV, EDV, MV, and CRV decreased, PI, RI, and capillary density increased in the model group with statistical difference (P<0.01). The retinal capillaries rowed disorderly. The calibers of capillaries were not even. The hyperplasia of endothelial cells and less pericytes could be seen. Compared with the model group, PSV, EDV, MV, and CRV all increased, PI and RI decreased in the high and middle dose HJR groups with statistical difference (P<0.01). There was no statistical difference among all the medication groups (P>0.05). The distributions of capillaries in the 3 HJR groups were even. The vascular morphous was comparatively regular, without obvious twisting and dilation. The hyperplasia of endothelial cells was not obvious. Compared with the model group, the capillary density significantly decreased (P<0.01). There was no statistical difference among the 3 HJR groups. Compared with the model group, the capillary density significantly decreased in the Western medicine group (P<0.01).

CONCLUSIONHJR could obviously improve the retinal hemodynamics parameters of diabetic rats, increase the retinal capillary blood flow and reperfusion, and restrain the hyperplasia of endothelial cells in the capillary.

Animals ; Diabetes Mellitus, Experimental ; drug therapy ; pathology ; physiopathology ; Diabetic Retinopathy ; drug therapy ; pathology ; physiopathology ; Drugs, Chinese Herbal ; therapeutic use ; Hemodynamics ; Male ; Phytotherapy ; Rats ; Rats, Sprague-Dawley

INTRODUCTIONWe assessed awareness of diabetes and diabetic retinopathy in a Singaporean Malay population. We hypothesised that poor awareness is associated with poorer control of diabetic retinopathy risk factors (glycaemic and blood pressure levels) and suboptimal treatment with laser therapy.

MATERIALS AND METHODSA population-based survey of 3280 (78.7% response rate) persons among Singaporean Malays aged between 40 and 80 years old. Diabetes was defined in persons with random glucose >or=11.1mmoL/L, use of diabetic medication, or a previous physician diagnosis. Diabetic retinopathy was graded from retinal photographs following the modified Airlie House classification. Patient awareness was assessed via structured interviews. Glycosylated haemoglobin was measured from venous blood.

RESULTSOf the 3280 study participants, 768 had diabetes, of whom 13.2% (n = 101) were unaware of their diabetes status. Participants unaware of their diabetes status had significantly higher mean glycosylated haemoglobin (9.7% vs 8.2%, P <0.001), systolic blood pressure (160.0 mmHg vs 153.7 mmHg, P = 0.01) and diastolic blood pressure (83.5 mmHg vs 78.5 mmHg, P <0.001), compared to participants who were aware. Of the 272 (35.4%) participants detected to have diabetic retinopathy, 83.4% (n = 227) were unaware of having retinopathy. Of the 77 with vision-threatening retinopathy, laser treatment had been performed in only 55.6% of those unaware of having retinopathy.

CONCLUSIONIn a sample of Malays with diabetes, high proportions were unaware of their disease. Unawareness was associated with poorer control of diabetic retinopathy risk factors. Only half of persons who were unaware that they had vision-threatening diabetic retinopathy had received laser treatment. These data highlight room for improvement in diabetic retinopathy prevention through better patient education and screening.

Adult ; Aged ; Aged, 80 and over ; Diabetes Mellitus ; therapy ; Diabetic Retinopathy ; therapy ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires

BACKGROUNDDiabetic retinopathy (DR) is one of the most common complications of diabetes. Angiotensin-converting enzyme inhibitor is thought to play an important role in preventing and treating retinal diseases in animal models of DR. The aim of the present study was to investigate the role of angiotensin-converting enzyme inhibitor (ACEI, captopril) in the treatment of patients with non-proliferative DR.

METHODSThree hundred and seventeen type 2 diabetic patients (88.05% of participants) without or with mild to moderate non-proliferative retinopathy were randomly divided into captopril group (n = 202) and placebo group (n = 115). All subjects received 24-month follow-up. General clinical examinations, including blood pressure and glycated hemoglobin, as well as comprehensive standardized ophthalmic examinations were performed. Color fundus photography and optical coherence tomography (OCT) were used to grade diabetic retinopathy and detect macular edema respectively.

RESULTSThe levels of blood pressure and glycated hemoglobin in the two groups of patients remained within the normal range during the entire follow-up and no significant difference was found between the initial and last visits, suggesting that ACEI drugs play a protective role on the DR patients independent of its anti-blood pressure role. DR classification showed that 169 eyes (83.66%) remained unchanged and the DR grade of 33 eyes (16.34%) increased in captopril group, while 84 eyes (73.04%) remained unchanged and the grade of 31 eyes (26.96%) increased in placebo group (P = 0.024). Captopril treatment improved macular edema in 55.45% eyes, which was significantly higher than the 37.39% improvement in placebo group (P = 0.002). No significant difference was found in the visual acuity between the two groups (P = 0.271).

CONCLUSIONCaptopril can improve or delay the development of DR and macular edema, which can be used in the early treatment of DR patients with type 2 diabetic mellitus.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Angiotensin-Converting Enzyme Inhibitors ; therapeutic use ; Captopril ; therapeutic use ; Diabetic Retinopathy ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

All cells in human body receive oxygen and nutrients and remove metabolic wastes through the vascular network. New vessel formation in a human body is significantly decreased in adults compared with fetus. New vessel formation is a critical process in pathogenesis, thus, it is a therapeutic target in several diseases, such as cancer, diabetic retinopathy, myocardial infarction and cerebral ischemia. Angiogenesis initiates through the interaction of several factors. For the increment of angiogenesis, new vessel promoting factors, such as vascular endothelial growth factor, or their genes have been directly injected to patients in the past. However, in recent studies, direct injection of cells promoting blood flow to patients has been attempted. In this paper, I will focus on cell therapy and its application in promoting blood flow in patients with impaired vessel such as myocardial infarction, cerebral ischemia and limb ischemia.
Adult ; Brain Ischemia ; Diabetic Retinopathy ; Endothelial Cells ; Extremities ; Fetus ; Glycosaminoglycans ; Human Body ; Humans ; Ischemia ; Myocardial Infarction ; Oxygen ; Tissue Therapy ; Vascular Endothelial Growth Factor A

OBJECTIVETo observe the prevention and clinical efficacy of combination of Liuwei Dihuang Pill (LDP) and Ginkgo Leaf Tablet (GLT) for early diabetic retinopathy (DR).

METHODSUsing randomized, double-blind, double simulation, parallel controlled clinical trial, 140 type 2 diabetes mellitus (T2DM) outpatients were recruited and assigned to the treatment group and the control group, 70 in each group. All patients received basic Western medicine treatment (such as blood glucose and pressure control). Patients in the treatment group took LDP (8 pills each time, 3 times per day) and GLT (19.2 mg each time, 3 times per day), while those in the control group took LDP placebos and GLT placebos. All treatment lasted for 24 consecutive months. All subjects were followed-up every month. The general clinical data as sex, age, and metabolic data such as blood glucose, blood pressure, blood lipid, and DR prevalence rate were collected and statistically analyzed.

RESULTSThere was no significant difference in levels of blood glucose, blood pressure, or blood lipid between the two groups (P > 0.05). After treatment the DR incidence rate was significantly lower in the treatment group than in the control group [3.1% (2/64) vs 18.6% (11/59), P < 0.05)]. Meanwhile, the DR prevalence rate of the treatment group was also significantly lower than that of the control group [6.3% (4/64) vs 20.0% (13/59), P < 0.05].

CONCLUSIONCombination of LDP and GLT could effectively prevent and treat the development of DR in T2DM patients.

Blood Glucose ; analysis ; Blood Pressure ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; drug therapy ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Ginkgo biloba ; chemistry ; Humans ; Phytotherapy ; Tablets