RESUMO
BACKGROUND: Diabetes is a serious public health concern in China, with 30% of patients developing retinopathy, and diabetic macular edema (DME) having the biggest impact on vision. High blood glucose level can cause retinal cell hypoxia, thus promoting vascular endothelial growth factor (VEGF) formation and increasing vascular permeability, which induces DME. Moreover, cell hypoxia can accelerate the rate of apoptosis, which leads to the aging of patients. In severe cases, optic cell apoptosis or retinal fibrosis and permanent blindness may occur. AIM: To investigate and compare the efficacy, mechanism, and differences between two anti-VEGF drugs (Compaq and ranibizumab) in DME patients. METHODS: Ninety-six patients with DME who attended our hospital from April 2018 to February 2020 were included and randomly divided into two groups (Compaq group and ranibizumab group). The groups received vitreal cavity injections of 0.5 mg Compaq and 0.5 mg ranibizumab, respectively, once a month. The best corrected visual acuity (BCVA), intraocular pressure (IOP), macular retinal thickness (CMT), macular choroidal thickness (SFCT), foveal no perfusion area (FAZ), superficial capillary density, deep capillary density, treatment effect, and adverse reactions were compared before and after treatment and between the two groups. RESULTS: Before treatment and 1-mo post-treatment, there was no statistically significant difference in the estimated BCVA in both groups (P > 0.05). BCVA decreased in the Compaq group 3 mo after treatment, and the difference was statistically significant (P < 0.05). Before treatment, and 1 mo and 3 mo post-treatment, there was no statistically significant difference in the estimated IOP in either group (P > 0.05). Before treatment and 1-mo post-treatment, there was no statistically significant difference in the estimated CMT, SFCT, or FAZ in either group (P > 0.05). CMT and SFCT values decreased in the Compaq group 3 mo post-treatment, and the difference was statistically significant (P < 0.05). Before treatment, and 1 mo and 3 mo post-treatment, there were no statistically significant differences in vascular density in the shallow or deep capillary plexi of the fovea, parafovea, or overall macular area between the two groups (P > 0.05). Marked efficient, effective, and invalid rates were 70.83% and 52.08%, 27.08% and 39.58%, and 2.08% and 8.33% in the Compaq and ranibizumab groups, respectively. The differences between the two groups were statistically significant (P < 0.05). CONCLUSION: Anti-VEGF drugs can effectively improve CMT and SFCT, without affecting microcirculation, thus providing an effective and safe treatment for patients with DME.
RESUMO
AIM: To study the effect of the minocycline (MNC) on expression of bcl-2, bax in retinal nerve cells of rat with diabetes. METHODS: Male SD rats were randomly divided into negative control group, model control group and MNC treated group. Diabetes model was established by intraperitoneal injection of 60 mg/kg streptozotocin (STZ). The protein expressions of bcl-2 and bax in retina were detected by immunohistochemistry method. RESULTS: Compared with the negative control group, bax immunoreactive neurons in retina were increased significantly (P<0.01) in model control group. However, bax immunoreactive neurons in retina in MNC treated group were significantly decreased (P<0.01). Compared with the model control group, bcl-2 immunoreactive neurons in retina were increased significantly(P<0.01) in MNC treated group. CONCLUSION: MNC can obviously decreased expression of bax and increased expression of bcl-2 in retina with DR. It is one of path of inhibiting impairment on retinal nerve cells with DR.