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The joint and blood of laser eyesight tablets treatment of diabetic retinopathy_2618

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The joint and blood of laser eyesight tablets treatment of diabetic retinopathy_2618

    The joint and blood of laser eyesight tablets treatment of diabetic retinopathy

     Author: Ma Jian-Ping Wang Xuan-Yi Wang Li-Feng

    Zhang Jian car

     Abstract Objective: To observe the laser photocoagulation with the blood and eyesight tablets in treatment of diabetic retinopathy. Methods: 126 patients (180 eyes) with diabetic retinopathy, of which 60 cases (84 eyes) of retinal photocoagulation, 66 patients (96 eyes) photocoagulation in treatment of joint and blood of eyesight. Results:

    Photocoagulation in treatment of joint and blood group of visual acuity was improved eyesight is better than photocoagulation group, vision improved more than patients with photocoagulation group, ERG Oscillatory potentials to reduce the total amplitude range is also lower than pure photocoagulation group, retinal hemorrhage , edema, exudate absorption time, neovascular back fuller. Conclusion: Photocoagulation treatment of joint and blood of diabetic retinopathy eyesight tablets good effect.

     Key words Diabetic retinopathy; laser; and blood eyesight film

     0 Introduction

     Near 20a, diabetes mellitus (DM) prevalence rate rising, diabetic retinopathy (diabetic retinopathy, DR) is a severe complication of DM, according to statistics, DM duration of

    more than 20a of the patients, almost all will appear background diabetic retinopathy (background diabetic retinopathy); more than 30a later, there will be 2 / 3 of I-DR

    patients with proliferative diabetic retinopathy

(proliferative diabetic retinopathy, PDR) [1], DR is the

    current ability to work in many countries the age group (20 ~ 64 years old ) is the primary blinding eye disease. Laser photocoagulation surgery can effectively control the development of DR will help preserve the original vision, is

    an important means of treatment of DR, but photocoagulation have certain side effects and limitations. We use photocoagulation combined with traditional Chinese medicines and blood eyesight films, applications syndrome

    differentiation and treatment methods, reduce eye

    complications caused by laser photocoagulation is reported as follows.

     An object and method

     1.1 The object according to the National Conference on the Third Eye provisions of DR typing, staging criteria, confirmed my out-patient and hospitalization in patients with DR, ? ~ ? period, 126 cases of 180, 92 male and 75 cases, female 51 cases of 88 , aged 30 ~ 85 (mean 62.5) years, duration of diabetes 1 ~ 28a, DR 1 ~ 10a. Exclude refractive interstitial opacity, such as: moderate or severe cataract,

    vitreous hemorrhage, corneal optical zone spot. There is a history of glaucoma care. Group: The case of the treated, according to DR's staging classification, and evenly to the two treatment sub-groups, so that simple photocoagulation

    group, 60 cases (84), including the background model 31 and proliferation of type 44, with Macular edema 9. The combination group, 66 cases (96), in which the background model 37 and proliferation of type 48, with macular edema 11. Laser treatment group before treatment was given and blood eyesight 15d tablets, 3 times / d, each time 5.

    Photocoagulation after continued use, 15d for a course of treatment, while vitamin B1, C, E. Simple postoperative photocoagulation only vitamin B1, C, E. Routine examination:

    All patients in the retinal photocoagulation before surgery, for visual acuity, intraocular pressure, slit lamp, fundus color photos, fundus fluorescein angiography, visual field, depending on the electrophysiological and other tests, and do detailed record.

     1.2 method two groups by the same physician using the same approach to retinal photocoagulation. Preoperative multi-

    Korea-P with the United States fully dilated to 7 ~ 8mm, with

France BIV-Viridis harmonic Nd: YAG532nm laser spot 200 ~ 500

    μm, exposure time 0.1 ~ 0.2s, power 200 ~ 450mW, multiple retinal non-perfusion areas and (or) neovascularization underwent panretinal photocoagulation, energy up to Grade ?

    spot (Tso's classification method), total photocoagulation Points 1 400 ~ 1 600, divided into 3 ~ 5 times to complete. All patients were followed up for more than 3 times, the time from 3 to 24 (average 9.6) mo.

     2 Results

     Seen as a barometer rose 2.1 visual acuity ? 1 behavior

    of visual acuity was improved, no change in those for

    stability, decreased visual acuity of ? 1 Walker declined

    (Table 1). Vision inspection, the existing field of vision is enlarged compared with photocoagulation ? 10 ? are to

    improve visual field changes in the 5 ? within a stable

    person, reduce ? 10 ? were narrow. Using fundus color photos and FFA inspection record retinal exudation, edema, hemorrhage and non-perfusion zones. Visual electrophysiology

    electroretinogram (ERG) b-wave amplitude, vibration amplitude changes in the total potential, and changes in the incubation

    period.

     2.2 Effect analysis of changes in visual acuity after treatment groups shown in Table 1, both groups were improved visual acuity, photocoagulation combined and blood eyesight tablets group (combination group) visual acuity was improved

    by a big margin decline was lower, with simple light Ning group (referred to simply group) compared with P ? 0.05.

    Vision changes were observed, the joint group to improve eye vision is more than simply the number of groups, number of

    eyes, two fairly stable vision, while the number of eyes, reduced vision surgery is significantly more than simply a joint group. The fundus color photos and FFA examination neovascularization in decline: The number of eyes, a joint group of regression more than a mere group of nine, without the eyes of a few was quite faded. Combination group Fundus hemorrhage, exudation, edema absorption time was significantly

    faster than the pure (P ? 0.001).

     3 Discussion

     At present, retinal photocoagulation is the only

effective treatment of DR measures [2], whose pre-treatment of

    proliferative and proliferative DR The mechanism is mainly

    through the destruction of part of the retinal photoreceptor cells with high oxygen consumption reduced retinal oxygen consumption, and by increasing the choroid to the retina's oxygen supply, reduce production of new blood vessel growth factors such as the role of improving the retina hypoxia, inhibit the formation of retinal neovascularization and promote regression of neovascularization. Photocoagulation treatment in the DR with the wide range of applications, no doubt about the ocular complications are increasingly

    attracted the concern of ophthalmologists. As a destructive treatment, photocoagulation treatment in fulfilling its role, is also on the normal structure and function of the retina caused some impact. Reposted elsewhere in the paper for free

    download http://

     Laser damage mechanism of the human eye is very complex, now that there are three kinds of damaging effects: heat, light pressure, electromagnetic effects. Even if the correct photocoagulation for the treatment itself is a pathological

    process, would be vision, vision and dark adaptation to a certain extent of damage [3].

     Recently, Leibu, etc. [4] using conventional full field ERG in retinal photocoagulation in rabbit retinal function before and after surgery were studied after the first 1d,

    photocoagulation spot between the performance of a wide range of retinal edema and serous Xing off. Changes in retinal function after laser photocoagulation, in part, the direct damage caused by laser photocoagulation of retinal function of

    the damage, the other part by the photocoagulation spots after photocoagulation of the retina between the edema, serous retinal detachment caused by a decline in function. There is blood - retinal barrier damage, inflammation, free radical toxicity and other factors. So that each part of the retina of the organizational structure and physiological function are subject to varying degrees, resulting in a decline in overall function of the retina. DR laser treatment complications include: bleeding, glaucoma (concurrent choroidal detachment caused by secondary glaucoma), Bruch's membrane rupture, persistent macular edema, decreased dark adaptation, and vision to narrow, traction retinal detachment and so on.

     Shixue Tao et al [5] on 33 DR Shi photocoagulation after

    the first 2d, ciliary body was found with the ophthalmoscope choroidal detachment, but the UBM examination revealed 31 appeared in the ciliary body and choroidal detachment preceding paragraph, accounting for 93.9%. Ciliary body after photocoagulation, choroidal detachment prone to have their anatomic basis of the first, second, photocoagulation of choroidal and retinal capillary damage, so that a large number of serous leakage of intravascular and photocoagulation of pigment epithelial damage, so that the blood - retina barrier

    both inside and outside the been damaged and that the accumulation of slurry in the ciliary body and choroid and the sclera preceding the anatomy between the weak areas - the

    ciliary body suprachoroidal space, which took place choroidal

    detachment.

     Yu Qiang, etc. [6] application of the multifocal visual evoked response imaging system (VERIS) to the DR before and after retinal photocoagulation in patients with posterior pole changes in retinal function of several parts of a quantitative

    study, suggesting that early postoperative macular photocoagulation for retinal function has been relatively severe damage, and its damage and decreased vision in patients with symptoms directly related to the other.

     To find an effective drug intervention to prevent or reduce the incidence of these complications will have a positive clinical significance. And blood eyesight film is Xi'an Forest of Stone Tablets Pharmaceutical production, follow the traditional Chinese medicine "Eye Body-wen, blood

    stasis Act" theory, application syndrome differentiation and treatment methods, from the etiology, pathogenesis start with pure research and development of traditional Chinese medicine preparations. With Puhuang, to yellow, red sage root, Eclipta

    prostrata, chrysanthemum, Astragalus, charge-Wei son, cassia

    seed, etc. 19 flavor agents, are righting agent. Major components of the chrysanthemum, containing the human body can not be synthesized "plant progesterone", also known as lutein (lutein), belonging to carotenoids. The distribution of the body intake of lutein to the eye two parts: (1) the retina and macular area; (2) lens, macular up. These lutein are thought to help filter out damaging blue light on the eye, with antioxidants to inhibit free radical generation, scavenging free radicals to fight against membrane lipid peroxidation and

    malondialdehyde generation so that they are to protect the integrity of cell membrane structure and function, reduced postoperative macular photocoagulation damage. Eclipta

    prostrata has a cooling blood to stop bleeding, Ziyin kidney function. In 1998, the Beijing Military General Hospital, Institute of clinical pharmacology pharmacist Mei, in a report that immune activity of Eclipta prostrata, indicating that

    there is increasing human humoral immunity, cellular immunity and antibody formation capacity, which was then In Chinese herbal medicine has not yet been found. Astragalus Qingre Xiehuo detoxification, has a certain antioxidant free radical damage, protect the role of the optic nerve. Puhuang, Rehmannia are sweet-ping, there are cooling blood to stop

    bleeding, the effectiveness of Quyu Blood Circulation. Danshen can improve the blood flow change, improve microcirculation, with effective scavenging of oxygen free radicals, a good

    production with calcium channel blocking and membrane stabilizing effect.

     The observation of randomized control study method, eyesight and blood tablets to prevent and treat postoperative complications of photocoagulation, the effects were studied.

    The results showed that the combination treatment group were better than photocoagulation alone group, to improve and stabilize visual acuity accounted for a ratio greater than a simple group, vision improved in patients with more than a

    simple group, as compared electrophysiological examination, ERGb wave amplitude reduction ranges from significantly lower in the pure group, ERG Oscillatory potentials to reduce the total amplitude is also lower than a simple group, the incubation period shorter than a mere group or the same. There are 12 cases of severe macular edema in patients (6 cases of simple groups, the joint group of 4 cases), shock and graphics evoked potential amplitude decreased, the incubation period be extended.

     DR laser photocoagulation is an important means of effective prevention and treatment [7], it can be closed retinal vascular leakage, reducing edema, exudation, and hemorrhage; closure of capillary non-perfusion areas, ease the

    retinal hypoxia, reduction and eradication of new vascular

    growth factor synthesis and release, but also can be directly closed retinal neovascularization, preventing massive bleeding [8]. Supplemented and blood before and after photocoagulation

in treatment of eyesight, reducing retinal light damage to the

    retina to improve blood circulation, helping to preserve and enhance vision.

     References

     1 National Diabetes Research Coordination Group. 300,000 population of the country's 14 provinces and cities in diabetes, the investigation report. Chinese Journal of

    Internal Medicine, 1981; (11) :678-683

     2 Zhengyu Xiang, LI Rui-feng. Photocoagulation treatment of

    diabetic retinopathy indications and methods. Chinese Journal of Practical Ophthalmology, 1999; 17 (1) :6-11

     3 Infeld DA, O'Shea JG. Diabetic retinopathy. Postgrad Med J, 1998; 74:129-133

     4 Leibu R, Davaila E, Zemel E, Bitterman N, Miller B, Perlman I. Development of laser-induced retinal damage in the rabbit. Grafe's Arch Clin Exp Ophthalmol, 1999; 237:991-1000

     5 Shixue Tao, Yuan Yuan-sheng, Cheng Yuxia, tea Xue-ping, Li

    Yan, Bin Cai. Diabetic retinopathy after laser

    photocoagulation of ultrasound bio-microscopy. China Ocular

    Fundus Diseases, 2003; 6 (19) :355-356

     6, strong, and Zhang Xin, Liu-Qing, Chen Xiuqi, Zhong

    Xiaojing. Tanakan diabetic retinopathy retinal

    photocoagulation anterior segment due to the intervention effects of early changes. China Ocular Fundus Diseases, 2001; 3 (17): 187 -- 189

     7 Hui-ling, Shuai Xiaoli, Wang Yu-sheng, ZHANG Zi-feng.

    Frequency-doubling 532nm laser treatment of 50 patients with diabetic retinopathy. International Ophthalmology, 2003; 3 (4) :46-48

     8 FU Yong-Yan, Sun Wenzhuo, Byung Hwa. SHG 532nm laser treatment of diabetic macular edema. International Ophthalmology, 2004; 4 (5) :947-948 reposted elsewhere in the paper for free download http://www.hi138. com

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