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BACKGROUND: Diabetic macular edema (DME), a chronic microvascular complication of diabetes, is a leading cause of visual impairment and blindness. Pars plana vitrectomy (PPV) can restore the normal macular structure and reduce macular edema, whereas internal limiting membrane (ILM) peeling is used to treat tractional macular diseases. Despite the advantages, there is limited research on the combined effects of PPV with ILM peeling. AIM: To observe the effects of PPV combined with ILM peeling on postoperative central macular thickness (CMT), best-corrected visual acuity (BCVA), cystoid macular edema (CME) volume, and complications in patients with DME. METHODS: Eighty-one patients (92 eyes) diagnosed with DME at the Beijing Shanqu Liangxiang Hospital between January and December 2022 were randomly divided to undergo PPV alone (control group: 41 patients, 47 eyes) or PPV + ILM peeling (stripping group: 40 patients, 45 eyes); a single surgeon performed all surgeries. The two groups were compared preoperatively and 1 and 3 months postoperatively. RESULTS: Preoperatively, both groups had comparable values of CMT, BCVA, and CME volume (P > 0.05). After surgery (both 1 and 3 months), both groups showed significant reductions in CMT, BCVA, and CME volume compared to preoperative levels, with the stripping group showing more significant reductions compared to the control group (P < 0.05). Further repeated-measures ANOVA analysis for within-group differences revealed significant effects of group and time, and interaction effects for CMT, BCVA, and CME volume (P < 0.05). There were no significant differences in the incidence of complications between the groups (retinal detachment: control = 2, stripping = 1; endophthalmitis: Control = 4, stripping = 1; no cases of secondary glaucoma or macular holes; χ 2 = 0.296, P = 0.587). CONCLUSION: PPV with ILM peeling can significantly improve the visual acuity of patients with DME, reduce CMT, and improve CME with fewer complications.
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AIM: To investigate the risk and protective factors associated with the retinal nerve fiber layer defect (RNFLD) in a Chinese adult population. METHODS: This study was a cross-sectional population-based investigation including employees and retirees of a coal mining company in Kailuan City, Hebei Province. All the study participants underwent a comprehensive systemic and ophthalmic examination. RNFLD was diagnosed on fundus photographs. Binary logistic regression was used to investigate the risk and protective factors associated with the RNFLD. RESULTS: The community-based study included 14 440 participants. There were 10 473 participants in our study, including 7120 males (68.0%) and 3353 females (32.0%). The age range was 45-108y, averaging 59.56±8.66y. Totally 568 participants had RNFLD and the prevalence rate was 5.42%. A higher prevalence of RNFLD was associated with older age [P<0.001, odds ratio (OR): 1.032; 95% confidence interval (CI): 1.018-1.046], longer axial length (P=0.010, OR: 1.190; 95%CI: 1.042-1.359), hypertension (P=0.007, OR: 0.639; 95%CI: 0.460-0.887), and diabetes mellitus (P=0.019, OR: 0.684; 95%CI: 0.499-0.939). The protective factors of RNFLD were visual acuity (P=0.038, OR: 0.617; 95%CI: 0.391-0.975), and central anterior chamber depth (P=0.046, OR: 0.595; 95%CI: 0.358-0.990). CONCLUSION: In our cross-sectional community-based study, with an age range of 45-108y, RNFLD is associated with older age, longer axial length, hypertension, and diabetes mellitus. The protective factors of RNFLD are visual acuity and central anterior chamber depth. These can help to predict and evaluate RNFLD related diseases and identify high-risk populations early.
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Objective: To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD. Methods: A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD. Results: The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD. Conclusion: There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.
Sujet(s)
Diabète , Hyperlipidémies , Hypertension artérielle , Dégénérescence maculaire , Études transversales , Diabète/épidémiologie , Humains , Hyperlipidémies/complications , Hyperlipidémies/épidémiologie , Hypertension artérielle/complications , Hypertension artérielle/épidémiologie , Dégénérescence maculaire/épidémiologie , Dégénérescence maculaire/étiologie , Facteurs de risqueRÉSUMÉ
OBJECTIVES: We performed this meta-analysis to assess the correlation of retinal vein occlusion (RVO) and chronic kidney disease (CKD). METHODS: We searched PubMed, Embase, Web of Science and Cochrane Library for population-based studies reporting the CKD as associated factor to RVO, central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Then we pooled the data for analysis. RESULTS: After screening potential literature, 12 eligible studies with 23,656,214 individuals were finally included in quantitative synthesis. The pooled prevalence (95% confidence interval [CI]) of CKD in RVO group was 10.9% (95% CI: 6.6%, 15.1%). The pooled prevalence of any RVO in end stage renal disease (ESRD) group was 1.8% (95% CI: 1.6%, 2.1%). The prevalence of CKD was significantly higher in subjects diagnosed with RVO than non-RVO participants (odds ratio [OR]: 3.30; 95% CI: 2.28, 4.76; p < 0.001). CRVO subjects had a higher prevalence of CKD than BRVO patients (OR: 2.17; 95% CI: 1.28, 4.66; p = 0.004). In a similar manner, compared to non-ESRD subjects, ESRD patients had significantly higher prevalence of RVO (OR: 2.19; 95% CI: 1.97, 2.43; p < 0.001), CRVO (OR: 2.61; 95% CI: 2.17, 3.15; p < 0.001) and BRVO (OR: 2.01; 95% CI: 1.76, 2.30; p < 0.001). CONCLUSION: The prevalence of CKD increases in RVO patients, especially in CRVO. And in turn, the prevalence of RVO also increases in ESRD patients. The data support a correlation of RVO and CKD.
Sujet(s)
Défaillance rénale chronique , Occlusion veineuse rétinienne , Humains , Défaillance rénale chronique/épidémiologie , Odds ratio , Prévalence , Occlusion veineuse rétinienne/épidémiologie , Facteurs de risqueRÉSUMÉ
AIM: To elucidate a simple method for isolating endothelial progenitor cells (EPCs) from human umbilical cord blood mononuclear cells and observe the endothelial cell-specific expression profile during proliferation and differentiation in vitro. METHODS: Human umbilical cord blood were isolated by Percoll density gradient centrifugation from human cord blood and cultured in vitro. The adherent cells were then identified by immunohistochemical staining and flow cytometric analysis. CD(34), vascular endothelial growth factor receptor-2 (VEGFR-2), EPCs specific antigen CD(133), as well as endothelial cell specific markers CD(31) and vWF were used. The cells were characterized by acetylated LDL (acLDL) up-taking and lectin binding by direct fluorescentstaining. RESULTS: During culture, the attached cells exhibited spindle-shape in early stage, and gradually display endothelium-like cobblestone morphology with outgrowth. On day 7, flow cytometric analysis showed that the positive staining rate of attached cells for CD(133), CD(34) and VEGFR-2 were 17.8%±3.7%, 22.1%±4.4% and 81.5%±5.0%, respectively. While, immunohistochemical staining showed that the adherent cells were positive to CD(31) and vWF at the rate of 92.7%±2.2% and 73.3%±4.2%, respectively. By direct fluorescentstaining, we observed that 83.0%±4.3% of the attached cells were double positive for DiI-acLDL and FITC-UEA-I. CONCLUSION: EPCs can be separated from human cord blood under certain conditions in vitro. This observation may provide a basis for study of relationship between EPCs and retinal neovascularization, as well as further clinical application of EPCs in ischemic retinal lesions.