SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine", Odesa, Ukraine.
"Nicolae Testemiţanu" State University of Medicine and Pharmacy, Chişinău, Republic of Moldova.
Rom J Ophthalmol. 2024 Apr-Jun;68(2):135-142. doi: 10.22336/rjo.2024.25.
The study hypothesizes that some patients with diabetic neovascular glaucoma (NVG) do not fully respond to transscleral (TSC) cyclophotocoagulation (CPC) due to significant inflammation and insufficient glucose control. The study aimed to determine the effect of baseline blood levels of intercellular adhesion molecule-1 (ICAM-1) and glycated haemoglobin (HbA1c) on the management of patients with diabetic NVG by TSC CPC. This open prospective study included 70 diabetic patients (75 eyes; aged Ме 63.0 years) with painful NVG and 20 healthy individuals (aged Ме 61.5 years) as an immunological control. All patients underwent TSC СPC with a diode laser. Baseline HbA1c levels and ICAM-1 expression in blood samples were determined. Follow-up was 12 months. One month after TSC CPC, IOP decreased by 28% compared to baseline. The effectiveness of laser treatment after 12 months of follow-up was 63% with IOP decrease by 46%. In patients with NVG, the initial level of ICAM-1 was 2.5 times higher than in the control group. Patients who did not fully respond to the first TSC CPC (30 eyes) and required additional laser procedure, had high initial HbA1c (9.5%) and high expression values of the ICAM-1 (609.0 cells/μL). Repeated procedures of TSC CPC at high IOP in diabetic patients with NVG are associated with high initial values of expression of ICAM-1 in peripheral blood and high HbA1c. The strategy of management of patients with diabetic NVG should be aimed at intensive glucose control and local anti-inflammatory treatment. PDR = proliferative diabetic retinopathy, DR = diabetic retinopathy, NVG = neovascular glaucoma, TSC CPC = transscleral cyclophotocoagulation, ICAM-1 = intercellular adhesion molecule-1, HbA1c = glycated haemoglobin, IOP = intraocular pressure.
该研究假设，由于炎症明显和血糖控制不足，一些糖尿病新生血管性青光眼 (NVG) 患者对经巩膜（TSC）睫状体光凝术（CPC）不能完全反应。该研究旨在确定白细胞间黏附分子-1（ICAM-1）和糖化血红蛋白（HbA1c）的基线血液水平对 TSC CPC 治疗糖尿病性 NVG 患者的影响。这项开放前瞻性研究包括 70 例（75 只眼；年龄均为 63.0 岁）患有疼痛性 NVG 的糖尿病患者和 20 例作为免疫对照的健康个体（年龄均为 61.5 岁）。所有患者均接受二极管激光 TSC CPC。测定基线 HbA1c 水平和血液样本中 ICAM-1 的表达。随访 12 个月。TSC CPC 后 1 个月，与基线相比，IOP 下降了 28%。12 个月随访时激光治疗的有效率为 63%，IOP 下降了 46%。在 NVG 患者中，ICAM-1 的初始水平比对照组高 2.5 倍。对首次 TSC CPC 无完全反应（30 只眼）且需要额外激光治疗的患者，初始 HbA1c（9.5%）较高，ICAM-1 的表达值较高（609.0 个细胞/μL）。在患有 NVG 的糖尿病患者中，高眼压下重复 TSC CPC 与外周血中 ICAM-1 的初始高表达和高 HbA1c 相关。糖尿病性 NVG 患者的管理策略应旨在强化血糖控制和局部抗炎治疗。PDR = 增殖性糖尿病视网膜病变，DR = 糖尿病视网膜病变，NVG = 新生血管性青光眼，TSC CPC = 经巩膜睫状体光凝术，ICAM-1 = 细胞间黏附分子-1，HbA1c = 糖化血红蛋白，IOP = 眼内压。
