Features of clinical and functional indicators of the eye with diabetic retinopathy

The stages of DR were determined according to the severity scale of the Early Treatment Diabetic Retinopathy Study (ETDRS). Before treatment, increased blood flow in the central retinal artery (CRA), was detected in the initial Ia stage of NPDR and a progressive decrease in blood flow in the second Ib and third Ic stage of NPDR. Also, a progressive decrease in blood flow by stages was detected in the short posterior ciliary artery (SPCA). The staging of changes in the blood flow velocity in the central retinal vein (CRV) from 6.5 cm/sec in the Ia stage to 3.5 cm/sec in the Ic stage was revealed, which indicates dilatation of the vein, increasing as retinopathy progresses In the correlation analysis, a moderate negative correlation was found in all groups between peak systolic velocity (PSV) of CRA and severity of diabetic retinopathy (SDR) (r = -0.68;-0.70;-0.45) Analysis of the dynamics of the severity of DR in groups showed a decrease in SDR in the 3rd group, received a solution of tanakan (EGb 761, Beaufour Ipsen Industrie, Paris, France) in the form of endonasal electrophoresis, by 24.1%, while in the 1st and 2nd groups the decrease in SDR was 8.2% and 16.9%, respectively. The results of hemodynamic studies, carried out at different times after treatment, showed significantly increase (p<0.05) in the peak systolic blood flow velocity of the CRA the 3rd group by 42,3%, while in the 1st and 2nd groups, by 6,6% and30,8% respectively. The deviations of retinal photosensitivity from the age norm after 10 days of treatment in the 3rd group statistically significant (p<0.05) decreased by 25% (from 8,03 to 6,0 dB), while in the 1st and 2nd groups only by 16,7% (from 7,8 to 6,5dB) and 21% (from 8,1 to 6,4dB), respectively.本研究中糖尿病视网膜病变（Diabetic Retinopathy, DR）的分期依据早期糖尿病视网膜病变治疗研究（Early Treatment Diabetic Retinopathy Study, ETDRS）的严重程度分级标准确定。治疗前，在非增殖性糖尿病视网膜病变（Non-Proliferative Diabetic Retinopathy, NPDR）的初始Ia期，可检测到视网膜中央动脉（central retinal artery, CRA）血流升高；而在NPDR的第IIb期与第IIIc期，其血流呈进行性下降。同时，在后短睫状动脉（short posterior ciliary artery, SPCA）中也观察到血流随分期进展而进行性降低的现象。此外，视网膜中央静脉（central retinal vein, CRV）的血流速度变化分期特征明确：从Ia期的6.5 cm/s逐步降至Ic期的3.5 cm/s，这一结果提示随着视网膜病变进展，静脉扩张程度逐渐加重。 相关性分析显示，所有组别中视网膜中央动脉收缩期峰值流速（peak systolic velocity, PSV）与糖尿病视网膜病变严重程度（severity of diabetic retinopathy, SDR）均呈中度负相关（相关系数r分别为-0.68、-0.70、-0.45）。 对各组糖尿病视网膜病变严重程度的动态变化分析结果表明：第3组患者接受鼻内电泳剂型的他拉科坦（EGb 761，法国巴黎博福-益普生制药公司（Beaufour Ipsen Industrie）生产）治疗后，其SDR下降了24.1%；而第1组与第2组的SDR降幅分别仅为8.2%与16.9%。 在治疗后不同时间点开展的血流动力学研究结果显示：第3组患者的视网膜中央动脉收缩期峰值流速显著提升（p<0.05），增幅达42.3%；第1组与第2组的增幅则分别为6.6%与30.8%。 治疗10天后，第3组患者的视网膜光敏感度与年龄正常参考值的偏差较基线显著降低（p<0.05），降幅达25%（从8.03 dB降至6.0 dB）；而第1组与第2组的降幅分别仅为16.7%（从7.8 dB降至6.5 dB）与21%（从8.1 dB降至6.4 dB）。