Clinical Characteristics Of Non-proliferative Diabetic Retinopathy And Clinical Efficacy Of An Aqueous Extract Of Radix Astragali,Radix Angelica Sinensis And Panax Notoginseng(RRP) In Treating Non-proliferative Diabetic Retinopathy Patients

PART I Clinical characteristics of non-proliferative diabetic retinopathy(NPDR)in different stagesPurpose To investigate the clinical characteristics of non-proliferative diabetic retinopathy(NPDR)in different stages.Methods It is a cross sectional observational study.113 patients with non-proliferative diabetic retinopathy participated in this study,of which 21 with mild NPDR,75 with moderate NPDR and 17 with severe NPDR.Demographic and clinical variables including age,BMI,diabetic duration,fasting blood glucose,fundus colorized photography,fundus fluorescein angiography,best corrected visual acuity,ocular pressure,visual field and multifocal electroretinogram were evaluated.Results(1)Diabetic duration of severe NPDR is longer than mild NPDR(P<0.05);(2)With the NPDR grading increasing,the area of hemorrhage and hard exudates took on enlarging trends.NPDR grading were independently associated with hemorrhage,NPDR grading and diabetic duration were independently associated with hard exudates;(3)With the NPDR grading increasing,the mean sensitivity of visual field showed a decreasing trend(P<0.05)and mean defect showed an increasing trend;(4)With the NPDR grading increasing,the response density of Mf ERG showed a decreasing trend(P<0.05)and latency of Mf ERG showed a delaying trend(P<0.05).Conclusion Along with the NPDR grading increasing,the area of hemorrhage and hard exudates took on enlarging trends,and the results of visual field and Mf ERG showed a degradation trend.NPDR grading were independently associated with hemorrhage,NPDR grading and diabetic duration were independently associated with hard exudates.PART II Clinical efficacy of an aqueous extract of Radix Astragali,Radix Angelica sinensis and Panax notoginseng(RRP)in treating non-proliferative diabetic retinopathy(NPDR)patientsPurpose To investigate the clinical efficacy of RRP in the treatment of NPDR patients.Methods It is a randomized,open-labeled,controlled clinical trial.113 eligible participant were randomly allocated to two groups,103 completed the trial(56 in treatment group and 47 in control group).RRP was given to treatment group and calcium dobesilate capsules was given to control group for 3 months.Demographic variables and blood glucose were evaluated and ophthalmologic examination including fundus colorized photography,fundus fluorescein angiography,best corrected visual acuity,ocular pressure,visual field and multifocal electroretinogram were performed and compared before and after treatment.Results Patients treated with RRP showed improvements of mean sensitivity,mean defect,response density of Mf ERG and hemoglobin A1c.Between-group comparisons of PI response density of 1 ring and hemoglobin A1c have statistically significant differences.Good tolerance with no severe adverse events was found in both groups.Diabetic duration were independently associated with the changes of hemorrhage after treatment,NPDR grading and diabetic duration were independently associated with the changes of hard exudates after treatment.Conclusion The application of RRP was well tolerated and benefited to patients with NPDR,and the protection of visual function was non-inferior to calcium dobesilate capsules.The underlying mechanism of its efficacy may be associated with improved microcirculation,reduction of oxidative stress and anti-inflammatory due to RRP treatment.