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 o observe the expression of Notch1 and Delta-like ligand 4 (Dll4) on the fibrovascular membranes in proliferative diabetic retinopathy (PDR), and investigate its relationship with vascular endothelial growth factor receptor 2 (VEGFR2). Methods Fifty-seven PDR patients (60 eyes) who underwent vitrectomy were enrolled in this study. The PDR patients were divided into non-injection group (30 patients, 32 eyes) and injection group (27 patients, 28 eyes). The eyes in injection group received intravitreal injection with ranibizumab at 2 to 7 days before surgery. The preretinal fibrovascular membranes were obtained from the PDR patients during vitrectomy. Eighteen epiretinal membranes were obtained from the non-diabetic patients was served as controls. The real-time polymerase chain reaction (RT-PCR) and immunohistochemical methods were used to detecting the expression of Notch1, Dll4 and VEGFR2. In the meantime, the numbers of the nucleus of vascular endothelial cells in the membranes stained with hematoxylin were counted. Results The immunohistochemical staining revealed that there were positive expression of Notch1, Dll4 and VEGFR2 in all PDR membranes, regardless of the injection of the ranibizumab. The levels of Notch1, Dll4 and VEGFR2 protein in non-injection group were higher than those of injection group (t=3.45, 6.01, 4.08;P=0.030, 0.008, 0.023). In injection group, the number of endothelial cells in the membranes reduced (17.17±2.48) compared with that of the non-injection group (41.50±5.57). There was significant difference in the number of endothelial cells in the membranes between the two groups (t=9.58,P＜0.05). RT-PCR showed that the differences of the mRNA expression of Notch1, Dll4 and VEGFR2 were all statistically significant among the PDR group and control group (H=12.50, 12.50, 12.02;P＜0.05).The expression of Notch1, Dll4 and VEGFR2 in the PDR membranes was higher than that of epiretinal membranes from non-diabetic patients. In the PDR group, the expression of Notch1, Dll4 and VEGFR2 of non-injection group was higher than that of injection group. Spearman correlation analysis showed that the expression of mRNA between VEGFR2 and Dll4 (r=0.83), VEGFR2 and Notch1 (r=0.81), Notch1 and Dll4 (r=0.87) were all significantly correlated (P＜0.05). Conclusions The expression of Notch1 and Dll4 in the PDR membranes are higher than that of the control group, and it is positively correlated with the expression of the VEGFR2. Notch1 and Dll4 play a regulatory rule in the neovascularization in PDR, the acting way may be correlated with VEGFR2.
ObjectiveTo analyze the expression of miRNA involved in regulating retinal neovascularizationin in retinal tissue of oxygen-induced retinopathy (OIR) mice.MethodsEighty healthy C57BL/6J mice were randomly divided into control group and OIR group at postnatal day 7(P7). Control group were not received any treatment and then exposed to room air. The OIR group was exposed to (75±2)% oxygen and then under room air at P12. Mice of all groups were euthanized at P17. Retinal neovasculation (RNV) was evaluated by counting the number of pre-retinal neovascular cells and analysing no perfusion area by immunofluorescent staining of the mouse retina.Total RNA was extracted from retinal tissue,and miRNA microarrays was performed to identify differentially expressed miRNA in the two groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed differential microRNA.ResultsCompared with the control group,the retinal neovascular tufts and the no perfusion area were both significantly smaller than those in OIR group. The number of pre-retinal neovascular cell nuclei in retinas from control group were obviously lower than those in the retinas from OIR group (t=9.025, P＜0.05). MiRNA microarray analysis showed that 54 miRNA in OIR group showed statistically different expression in control group, 47 miRNA were up-regulated and 7 miRNA were down-regulated. The results of PCR were consistent with the trend of microarray. In GO analysis, 1112 items were significantly different (P＜0.05), and 65 items were significantly different in KEGG analysis of expression profile (P＜0.05).ConclusionsThe miRNA expression in retinal tissue of OIR mice is different from that of normal mice, and these miRNA may be involved in the development of RNV. There are 54 miRNA expression differences in retinal tissue of OIR compared with normal mouse retinal tissue.