The Effect Of Retinal Photocoagulation On Ocular Surface In Different Traditional Chinese Medical Constitution Of Patients With Diabetic Retinopathy

ObjectiveBefore and after retinal photocoagulation,collected the ocular surface of patients with diabetic retinopathy.Analyse the correlation between the retinal photocoagulation and TCM constitution and the damage of ocular surface after retinal photocoagulation as the treatment for diabetic retinopathy.MethodsFrom February 2018 to December 2018 in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,55 patients(55 eyes)with diabetic retinopathy,who were receive treatment of retinal photocoagulation and met the inclusion and exclusion criteria,was selected into observation group.Before and after retinal photocoagulation,NIBUTf、NIBUTav、LTMH、meibomian gland morphology、grading of eyes were observed and evaluated by using Keratograph 5M。By the same time,using the form of TCM constitution to collect information.Comparing the difference between the data and analysing the effects of retinal photocoagulatio and ocular surface.Results①A total of 55 DR patients were investigated in this clinical observation,including 29males(29 eyes);26females(26 eyes).Their average age is 53.1±8.6 years old,average disease duration is 8.158±2.433 years,average intraocular pressure is 14.684±1.572mmh.②In the observed cases,the frequency at TCM constitution is:qi deficiency constitution(19.3%)>yin deficiency constitution(15.8%)>yang deficiency constitution(15.8%)>damp-heat constitution(12.3%)>normal-constition and qi-stagnation constitution(10.5%)>blood-stasis constitution(8.8%)>phlegm dampness phlegm-dampness constitution(7%)>special constitution(1.8%)③Compare different indicators between different TCM constitution of patients,there was significant difference in meibomian gland morphology(P<0.05).④Analyzing changes in date about different TCM constitution patients after treatment,there was significant difference in NIBUTf、NIBUTav(P<0.05).About the change of NIBUTav,qi-stagnation constitution,qi deficiency constitution and blood-stasis constitution become the top three.About the change of NIBUTf,special constitution,normal-constition and phlegm dampness phlegm-dampness constitution become the top three④Analyzing changes in date about different TCM constitution patients after treatment,there was no significant difference in the LTMH and grading of eyes(P>0.05).⑤There was negative correlation between the course of disease of patients with diabetic retinopathy and LTMH.(r<0,P<0.05).⑥After retinal photocoagulation,there was significant difference in the date about ocular surface(P<0.05).⑦There was positive correlation between the Laser energy and ocular surface after first treatmen(r>0.05,P<0.05).There was positive correlation between the number of times of Laser and NIBUTf(r>0.05,P<0.05).After the second treatmen,there was negative correlation between the Laser energy and grading of eyes(r<0.05,P<0.05).After the third treatmen,there was positive correlation between the Laser energy and NIBUTav(r>0.05,P<0.05).ConclusionAfter retinal photocoagulation,the ocular surface of patients with diabetic retinopathy will make the following changes:NIBUTf、NIBUTav has decreased、meibomian gland morphology has go up、LTMH become lower.In addition,there is a relationship between the TCM constitution、the course of disease of patients with diabetic retinopathy and ocular surface.