Objective To observe the clinical characteristics of diabetic neovascularization on the disc (DNVD).Methods The clinical data of 526 patients (1052 eyes) who were diagnosed as diabetes in Department of intern medicine, as diabetic retinopathy by ophthalmoscope and fundus fluorescein angiograph (FFA) was retrospectively reviewed. All patients were carried out with best corrected visual acuity(BCVA), slitlamp microscope,ophthalmoscope and FFA after mydriasis. In which, who has neovascularization on the optic disc with ophthalmoscopy and FFA examination were included in this study.The relationship between the occurrence and development of DNVD and phase of DR, disease duration, the level of blood glucose and panretinal photocoagulation were analyzed. Results DNVD was found in167/1052eyes (15.87%). There were 91 eyes (54.49%) with BCVA<0.1, 58 eyes (34.73%) with BCVA<0.4 but ge;0.1,and 18 eyes(19.78%) with BCVAge;0.4. Retinal neovascularization was located in the surface of disc surface or within 1PD from the optic disc;Those vessels filled early and rapidly, and with local b fluorescence due to fluorescence leakage at middle and late stage of FFA examination.All 167 DNVD eyes are proliferative diabetic retinopathy (PDR) with 43 eyes (25.75%) in stage IV,52 eyes (31.14%) in stage V and 72 eyes (43.11%) in stage VI.Of those DNVD eyes,there were 5 eyes (2.99%) with course of diabetes <3 years,12 eyes (7.19%) s<5 years but ge;3 years, 21 eyes (12.57%)<10 butge;5 years, 56 eyes (33.53%)<15 but ge;10 years and 73 eyes (43.71%) ge;15 years. There were 15 eyes (8.98%) with fasting blood glucose (FBG)<7.0 mmol/L,26 eyes (15.57%) with FBG<9.0 but ge;7.0 mmol/L,50 eyes (29.94%) with FBG<12.0 but ge;9.0 mmol/L and 76 eyes (45.51%) with FBG ge;12.0 mmol/L;there were 28 eyes (16.77%) with 2 hour postprandial blood glucose(2hPBG)<10.0 mmol/L, 35 eyes (20.96%) with 2hPBG<12.0 but ge;10.0 mmol/L,42 eyes (25.15%) with 2hPBG <16.0 butge;12.0 mmol/L and 62 eyes (50.30%) with 2hPBG ge;16.0 mmol/L. The occurrence of DNVD and duration of diabetes, FBG and 2hPBG were all positively correlated (r=0.991,0.984,0.960, P=0.001, 0.016, 0.040) by the Person correlation analysis. 15 eyes (5.84%) of DNVD happened in 257 eyes who treated with PRP in severe nonproliferative diabetic retinopathy (NPDR),152 eyes (19.12%) DNVD happened in 795 eyes who untreated with PRP in severe NPDR,the differences were statistically significant (chi;2=25.659,P<0.01) between them.Conclusion DNVD happened commonly in DR, the occurrence of DNVD is intensive related with diabetic retinopathy stage,duration of diabetes,FBG and PBG.
Objective To evaluate the anatomic and visual outcomes of idiopathic macular holes treated with triamcinolone (TA)assisted posterior vitreous detachment (PVD) and then internal limiting membrane (ILM) peeling without any dye. Methods Twenty-three patients (23 eyes) with stage Ⅱ and Ⅲ idiopathic macular holes were enrolled. The best-corrected visual acuity (BCVA), the lens, the duration, stage and size of the macular holes were measured before and after the surgery. The preoperative BCVA was 0.04 to 0.40; the logMAR was 0.398 to 1.398 with the mean of 0.846plusmn;0.310. All surgery involved TAassisted PVD and then ILM peeling without any dye. Combined cataract extraction with vitrectomy was performed on 5 eyes. The follow-up ranged from 6 to 16 months with the mean of 9 months. Results Anatomic macular hole closure was achieved in 22 eyes (95.7%) at the first month after surgery and in 23 eyes (100。0%) finally. At the 6th months after surgery, the BCVA was 0.12 to 0.90, logMAR was 0.046 to 0.921 with the mean of 0.410plusmn;0.209, compared with preoperative BCVA, the difference was statistically significant (t=6.636, P<0.0001). BCVA increased in 21 eyes (91.3%) and kept unchanged in 2 eyes (8.7%). There are 1 -3 spots self-limited bleeding on the retinal surface when the ILM was peeled in 5 eyes. Postoperative complications included progression of cataract in 9 patients and transient intraocular pressure elevation in 6 patients. Conclusions TA-assisted PVD and then ILM peeling without any dye is an effective and safe surgical technique in stage Ⅱ and Ⅲ idiopathic macular hole.