Objective To investigate the effects of Atorvastatin calcium on the incidence of macular edema after phacoemulsification in diabetic patients. Methods Forty two eyes of 42 cataract patients with diabetes and hypercholesterolemia who underwent phacoemulsification surgery were divided into interventional group (23 patients) and non-interventional group (19 patients) by random number table methods. The blood glucose and pressure of patients in two groups was controlled strictly before and after surgery. 10 mg Atorvastatin calcium per day was delivered one day after cataract surgery for the patients of interventional group and used for 24 weeks. No lipid-lowing agent was provided to the patients of non-interventional group. The main outcome measures included the best corrected visual acuity (BCVA), central retina thickness (CRT), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C). No significant difference was shown in the BCVA, CRT, TC, LDL-C and HDL-C in two groups before phacoemulsification surgery (t=1.251, 1.257, 1.031, 1.042, 1.461; P > 0.05). At the end of the 24 weeks after surgery, the efficacy evaluation and comparative analysis were performed. The analysis included the BCVA, the incidence of macular edema, CRT, TC, LDL-C and HDL-C. Results The BCVA was no significantly different between two groups one day after surgery (t=1.523，P > 0.05). But 4, 12, 24 weeks after phacoemulsification surgery, the BCVA in interventional group was better than that in non-interventional group(t=3.920, 3.012, 7.025; P < 0.05). 24 weeks after the operation, macular edema was occurred in 2 eyes (8.69%) in interventional group and 4 eyes (21.05%) in non-interventional group. Significance difference was found between two groups (χ2=4.896，P < 0.05). There was no significance different of the CRT between two groups one day after operation (t=1.501，P > 0.05). Whereas, the significance difference of the CRT was occurred in two groups 4, 12, 24 weeks after surgery(t=4.673, 7.583, 9.035; P < 0.05). Comparing with that in non-interventional group, the level of TC (t=7.043, 7.930, 8.611)and LDL-C (t=9.374, 9.554, 10.856) in interventional group was significantly decreased 4 to 24 weeks after operation (P < 0.05). But no significance different of HDL-C was shown in two groups 4, 12 and 24 weeks after surgery (t=1.057, 1.127, 1.295; P > 0.05). Conclusion The treatment of Atorvastatin calcium effectively reduced the incidence rate of macular edema in hypercholesterolemia patients with good glycemic and hypertension control after phacoemulsification surgery.
Objective To investigate the clinical features and prognosis of acute isolated corpus callosum infarction. Methods The clinical and imaging data of patients with acute isolated corpus callosum infarction diagnosed in the Department of Neurology of Beijing Geriatric Hospital and the Department of Neurology of China-Japan Friendship Hospital from February 2017 to February 2021 were retrospectively selected. Patients were divided into groups according to infarction location, infarction size and prognosis. According to the infarction location, the patients were divided into single-site lesion group and multi-site lesions group. According to the infarction size, the patients were divided into large lesion group and small lesion group. According to the prognosis, the patients were divided into good prognosis group and poor prognosis group. The clinical characteristics, etiology and prognosis of these diseases were observed and analyzed. Results A total of 52 patients were included. Among them, there were 32 males (61.5%) and 20 females (38.5%), with an average age of (65.4±7.1) years. The most common risk factors were hypertension (44 cases, 84.6%), hyperlipidemia (32 cases, 61.5%), and diabetes (28 cases, 53.8%). The most common infarction site was splenium in the single-site lesion group (24 cases, 46.2%). The vast majority of patients (92.3%) had nonspecific clinical symptoms, and only 4 (7.7%) had corpus callosum disconnection syndrome. In the TOAST etiological classification, Large-artery atherosclerosis (LAA) was the most common (25 cases, 48.1%), followed by small-artery occlusion (14 cases, 26.9%), the responsible vascular lesions were the most common in the P1/P2 segment of posterior cerebral artery (10 cases) and the A1/A2 segment of anterior cerebral artery (9 cases). There was no significant difference in etiology between the groups with different infarction location and the groups with different infarction size (P>0.05). Forty-four cases (84.6%) had a good prognosis, and 8 cases (15.4%) had a poor prognosis. Combined with multiple risk factors, multiple involvement of lesions and large infarction size were associated with poor prognosis (P<0.05). Conclusions Acute isolated corpus callosum infarction is a rare type of ischemic stroke, with the most common involvement of splenium. Its clinical manifestations are mostly nonspecific, and a few may be manifested as disconnection syndrome. The etiology is mostly LAA, and the overall prognosis of such patients is good, and the poor prognosis may be related to the combination of multiple risk factors and the wide range of infarcts.