Objective To explore the values of different clinical parameters and biochemistry indicators to monitor and predict diabetic retinopathy (DR). Methods The study involved 250 patients with type 2 diabetes mellitus (DM). The patients were divided into DR group (100 patients) with expected sensitivity (Sen) 80％, without DR group (150 patients) with expected specificity (Spe) 60％. DR related clinical and biochemical indicators which including peripheral blood plasma endothelin-1 (ET-1), peripheral vascular endothelial growth factor, plasma magnesium, renal function related indicators, islet function related indicators, blood rheology and blood lipids were detected. Receiver operating characteristic (ROC) was used to analyze accuracy; count the area under a curve (AUC), Sen, Spe and Youden index; develop joint diagnostic testing program. Results The parameters or indicators with clinical value of DR early warning included age, DM duration, plasma ET-1, serum magnesium and urinary albumin (P＜0.05). In the period of mild non-progressive DR, plasma ET-1 had the highest diagnostic validity (AUC=0.742,Spe=72.00%, Sen=72.20%); in moderate and severe non-progressive DR period, urinary albumin had the highest diagnosis validity (AUC=0.742, Spe=56.10%, Sen=87.88%); in the progressive DR period, the diagnostic validity of plasma ET-1 was highest (AUC=0.857, Spe=84.00%, Sen=85.71%). The joint program with the highest Youden index was DM duration combined with plasma ET-1 serial test, and the early warning value was that DM duration exceeded 3.5 years and the tested plasma ET-1 was greater than 160.00 pg/ml. Conclusions Age, DM duration, plasma ET-1, serum magnesium and urinary albumin are the significant parameters or indicators for DR early warning. Joint diagnostic tests can help patients to monitor the progression of DR.
Objective To observe the effects of CXCR4 inhibitor (AMD3100) combined with anti-vascular endothelial growth factor (VEGF) antibody on experimental choroidal neovascularization. Methods Choroidal neovascularization (CNV) was induced in 48 BrownNorway (BN) rats by Krypton red laser photocoagulation, and those rats were randomly divided into AF564 group (group A), AMD3100 group (group B), combined treatment group (group C) and PBS group (group D), 12 rats in each group. Left eyes were the experimental eyes. The rats of group A-D received intravitreal injection of 5mu;l of AF564, AMD3100, AF564/AMD3100 and PBS after laser photocoagulation respectively. Fourteen days after photocoagulation, fundus fluorescein angiography (FFA), pathological section analysis and choroidal vascular wholemount were used to observe the degree of fluorescein leakage, the relative thickness and areas of CNV. Results Fourteen days after photocoagulation, the scores of fluorescein leakage in group A - D were 2.16plusmn;0.91, 2.16plusmn;0.91, 1.92plusmn;1.03, 1.39plusmn;0.93 respectively. Fluorescein leakage in group A - C was obviously reduced compared to group D (F=12.91,P＜0.001), while fluorescein leakage in group C was reduced compared to group A and B (F=9.21,P＜0.05). The CNV relative thicknesses in group A-D were 1.82plusmn;0.11, 1.90plusmn;0.22, 1.12plusmn;0.12, 2.82plusmn;0.29 respectively. Group A -C had thinner CNV compared to group D (F=5.92，P＜0.001), while group C had thinner CNV compared to group A and B (F=5.16, P＜0.05). The CNV areas in group A -D were (8204plusmn;122), (9332plusmn;211), (6533plusmn;101), and (13644plusmn;255) mu;m2 respectively. Group A -C had smaller CNV area compared to group D (F=147.50，P＜0.001), while group C had smaller CNV area compared to group A and B (F=112.60, P＜0.05). Conclusion Combined treatment with CXCR4 inhibitor and anti-VEGF antibody can inhibit laser-induced CNV significantly.
Objective To determine the correlation between central macular thickness (CMT) and the visual function in patients iwht macular edema (ME). Methods The clinical data of 42 eyes of 40 patients with ME which were examined by optical coherence tomography (OCT) and microperimetry (MP-1) were retrospectively analyzed. In 40 patients (42 eyes), diabetic ME (DME) was in 27 eyes，branch retinal vein occlusion was in 11eyes, and central retinal vein occlusion was in 4 eyes. All of the eyes had undergone OCT，MP-1 and best-corrected visual acuity (BCVA) test. Central macular thickness (CMT) was measured by fast macular scans using OCT. Retinal sensitivity (MS) and fixation patterns were evaluated by Mp-1. The position was chosen :2 disc diameters (DD) temporal to the disc and one third of a DD inferior to the centre of the disc. Results The correlation between CMT and BCVA is not significant (r＝－0.429，P=0.069) as well as the correlation between CMT and MS (r＝－0.433，P=0.058). The difference of CMT between the unstable and stable group was significant (F=3.262, P=0.039）. The difference of CMT between the central fixation group and preferred retinal locus (PRL) group was significant (F=3.173, P=0.044). Conclusions BCVA and MS have no significant correlation with CMT. When CMT increases, the fixation stability decreases, fixation location.changes, and PRL occurs.