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Abstract：
Introduction: 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. Objective: 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. Methods: 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. Results: 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). Conclusions: 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. Abbreviations: 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.
摘要：
简介：该研究假设，由于严重的炎症和葡萄糖控制不足，一些糖尿病性新生血管性青光眼（NVG）患者对经巩膜（TSC）睫状体光凝（CPC）没有完全反应。目的：该研究旨在确定基线血液中细胞间黏附分子-1（ICAM-1）和糖化血红蛋白（HbA1c）水平对TSCCPC治疗糖尿病NVG患者的影响。方法：这项开放性前瞻性研究包括70名患有疼痛性NVG的糖尿病患者（75只眼；年龄63.0岁）和20名健康个体（年龄61.5岁）作为免疫对照。所有患者均接受二极管激光TSCPC。测定血液样品中的基线HbA1c水平和ICAM-1表达。随访12个月。结果：TSCCPC后一个月，与基线相比,IOP降低了28%。随访12个月后，激光治疗的有效性为63％，眼压降低了46％。在NVG患者中，ICAM-1的初始水平比对照组高2.5倍。对第一次TSCCPC没有完全反应的患者（30只眼），需要额外的激光手术，具有高的初始HbA1c（9.5％）和高的ICAM-1表达值（609.0细胞/μL）。结论：在NVG糖尿病患者中，高IOP的TSCCPC重复操作与外周血中ICAM-1表达的高初始值和高HbA1c相关。糖尿病NVG患者的管理策略应针对强化血糖控制和局部抗炎治疗。缩写：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，TSCCPC=经巩膜睫状体光凝,ICAM-1=细胞间粘附分子-1，HbA1c=糖化血红蛋白，IOP=眼内压。
