Objective To evaluate nitric oxide(NO)and vascular endothelial growth factor(VEGF)in vitreous humor and blood samples in patients with proliferative diabetic retinopathy(PDR)and in patients with branch retinal vein occlusion(BRVO).Methods NO concentrations were determined by using the Greiss reaction in plasma and vitreous humor samples.VEGF levels were assayed by ELISA.The patients in the studies were divided into four groups:16 patients with PDR,5 patients with BRVO,11 patients with rhegmatogenous retinal detachment(RRD),and 10 patients with idiopathic macular hole(IMH).Results The vitreous fluid levels of NO were significantly higher in patients with PDR(15.2μmol/L,4.6-50.9μmol/L)than those in the other three groups(F=5.13,P=0.005).The concentrations of VEGF were significantly higher in patients with PDR and BRVO(1507.2 μg/mL,50.71-3722.0μg/ml;838.8μg/mL,159.6-3328.0μg/mL)than those in the other two groups(F=6.84,P=0.0008),but highest in PDR(T=3.92,P=0.001).There was no significant difference between NO and VEGF in serum in four groups.There was no correlation between concentrations of NO and VEGF in four groups whatever in vitreous or plasma(all P>0.05).Conclusion The results suggest that higher levels of NO and VEGF may be related to the angiogenesis in DR.
AIM: To evaluate the effects of intensive control of blood glucose and blood pressure on microvascular complications in patients with type Ⅱ diabetes by comparing the therapeutic effects of intensive and standard treatment in patients with type Ⅱ diabetes. METHODS: A total of 107 patients with type Ⅱ diabetes were randomly assigned into intensive and standard treatment groups. Patients in the intensive treatment group received preterax (perindopril/ indapamide) to control blood pressure, and gliclazide (diamicron) MR to control blood glucose. Patients in the standard treatment group received routine medications or placebo. Urinary microalbumin (UMA), urinary creatinine (UCR), the UMA/ UCR ratio, and visual acuity were monitored according to the study design of the ADVANCE trial. Direct ophthalmoscopy and seven-field stereoscopic retinal photography were used to examine the fundi at baseline,and repeated after 5 years of treatment. RESULTS: The characteristics of patients in both groups were well balanced at baseline. After 5 years of treatment, visual acuity was found to be decreased in the standard group (P=0.04), but remained stable in the intensive group. The severity of diabetic retinopathy had not progressed in patients in the intensive group, but had deteriorated in the standard group (P=0.0006). The UMA/UCR ratio was not obviously changed in patients in the intensive group, whereas it was significantly increased in the standard group (P=0.00). CONCLUSION: Intensive control of blood glucose and blood pressure can decrease the incidence or slow the progression of microvascular complications in patients with type Ⅱ diabetes, and maintain stable vision.
