scholarly journals Characteristics of secondary epiretinal membrane due to peripheral break

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Geun Woo Lee ◽  
Sang Eun Lee ◽  
Sun Hyup Han ◽  
Sang Jin Kim ◽  
Se Woong Kang
Keyword(s):  
Refractive Error ◽  
Epiretinal Membrane ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Macular Pucker ◽  
Cross Sectional ◽  
En Face ◽  
Retinal Examination ◽  
Fundus Photographs ◽  
Foveal Center

AbstractThis study aimed to investigate morphological differences between idiopathic epiretinal membrane (ERM) and secondary ERM due to peripheral break (SEPB) and to identify clinical characteristics in eyes with SEPB to facilitate peripheral retinal examination. The retrospective cross-sectional study involved 93 consecutive eyes in 91 patients who underwent ERM removal surgery. Eyes were divided into two groups: the macular pucker group and the idiopathic ERM group. En-face Optical Coherence Tomography (OCT) images, fundus photographs, severity of metamorphopsia (M-score) and clinical characteristics of each group were compared. ERM extent and eccentricity (ratio of the shortest and longest distances from the foveal center to the boundary) were obtained through en-face OCT imaging. Fundus photographs were used to judge whether the membrane was turbid or not. Patients with SEPB were younger than patients with idiopathic ERM (61.3 ± 7.5 vs. 66.6 ± 8.3 years; p < 0.05). Preoperative M-score and myopic refractive error, axial length were also significantly higher in the macular pucker group than in the idiopathic ERM group (all p < 0.05). There was no difference in ERM extent between the two groups. The incidence of ERM eccentricity was 23 of the 34 eyes (67.6%) in the SEPB group and 26 of the 59 eyes (44.1%) in the idiopathic ERM group (p < 0.05). The incidence of turbid ERM was 18 of the 34 eyes (52.9%) in the SEPB group and 10 of the 59 eyes (16.9%) in the idiopathic ERM group (p < 0.01). The SEPB group, compared with the idiopathic ERM group, tended to have eccentric, turbid ERM at a younger age and with more severe metamorphopsia and myopic refractive error.

scholarly journals Diabetic maculopathy: multicolour and SD-OCT versus fundus photography

2021 ◽  
Vol 6 (1) ◽  
pp. e000514
Author(s):  
Obaid Kousha ◽  
Martina Maria Delle Fave ◽  
Mariano Cozzi ◽  
Elisa Carini ◽  
Sergio Pagliarini
Keyword(s):  
Macular Oedema ◽  
Cross Sectional Study ◽  
Fundus Photography ◽  
Diabetic Maculopathy ◽  
Perfect Agreement ◽  
Cross Sectional ◽  
Clinically Significant ◽  
Fundus Photographs ◽  
Diabetic Eye Screening ◽  
Sd Oct

ObjectiveThe English Diabetic Eye Screening (DES) programme recommends patients with M1 diabetic maculopathy to be referred to hospital eye services. DES uses flash fundus photography as the reference standard for maculopathy grading. We compared multicolour versus non-stereoscopic fundus photography at identifying M1 maculopathy, with spectral domain optical coherence tomography (SD-OCT) identifying macular thickening.Methods and analysisThis cross-sectional study included 345 patients with R1M1 referred from DES and reviewed in secondary care with fundus photographs, multicolour and SD-OCT. Maculopathy was graded based on DES exudate criteria on both multicolour and fundus photography in a blind fashion by two independent graders. Macular thickness was ascertained on SD-OCT.ResultsIntergrader agreement on grading maculopathy using fundus photography (Cohen’s κ=0.91) and multicolour (Cohen’s κ=0.82) was ‘almost perfect’. Agreement between fundus photography and multicolour on grading maculopathy (Cohen’s κ=0.76) was ‘substantial’. Compared with fundus photography, multicolour had sensitivity of 87% (95% CI 81% to 93%) and specificity of 90% (95% CI 87% to 94%) in detecting M1 maculopathy. SD-OCT identified 84 eyes with macular thickening, 47 of which were graded as M0 by fundus photography. 5 eyes with exudates and severe macular oedema requiring urgent intervention were also missed on fundus photography but not on multicolour. Multicolour, when complemented by SD-OCT, did not miss any clinically significant macular oedema.ConclusionMulticolour integrates synergistically in a single platform with SD-OCT providing effective monitoring of M1 diabetic maculopathy. The need for fundus photography is eliminated by multicolour/SD-OCT in dedicated R1M1 virtual clinics not requiring parallel diabetic retinopathy grading.

Kidney Biopsy in Type 2 Diabetes: A Multicenter Cross-Sectional Study

2021 ◽  
pp. 1-10
Author(s):  
Jonathan M. Chemouny ◽  
Mickaël Bobot ◽  
Aurélie Sannier ◽  
Valentin Maisons ◽  
Noémie Jourde-Chiche ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Total Population ◽  
Cross Sectional Study ◽  
Rapid Progression ◽  
Hypertensive Nephropathy ◽  
Cross Sectional ◽  
Recent Onset ◽  
Atypical Features ◽  
Retinal Examination

<b><i>Introduction:</i></b> Kidney biopsies (KBs) are performed in patients with type 2 diabetes (T2D) to diagnose non-diabetic or hypertensive kidney disease (NDHKD) potentially requiring specific management compared to diabetic and or hypertensive nephropathy (absence of NDHKD). Indications for KB are based on the presence of atypical features compared to the typical course of diabetic nephropathy. In this study, we assessed the association of different patterns of atypical features, or KB indications, with NDHKD. <b><i>Methods:</i></b> Native KBs performed in patients with T2D were analyzed. Data were collected from the patients’ records. KB indications were determined according to the presence of different atypical features considered sequentially: (1) presence of any feature suggesting NDHKD which is not among the following ones, (2) recent onset of nephrotic syndrome, (3) low or rapidly declining estimated glomerular filtration rate (eGFR), (4) rapid increase in proteinuria, (5) short duration of diabetes, (6) presence of hematuria, or (7) normal retinal examination. <b><i>Results:</i></b> Among the 463 KBs analyzed, NDHKD was diagnosed in 40% of the total population and 54, 40, 24, and 7% of the KBs performed for indications 1–4 respectively. Conversely, no patient who underwent KB for indications 5–7 displayed NDHKD. Logistic regression analyses identified eGFR<sub>CKD-EPI</sub> &#x3e;15 mL/min/1.73 m<sup>2</sup>, urinary protein-to-Cr ratio &#x3c;0.3 g/mmol, hematuria, HbA1c &#x3c;7%, and diabetes duration &#x3c;5 years as predictors of NDHKD, independently from the indication group. <b><i>Conclusion:</i></b> NDHKD is frequent in T2D. Despite the association of hematuria with NDHKD, our results suggest that presence of hematuria and absence of DR are insufficient to indicate KB in the absence of concurrent atypical features. Conversely, rapid progression of proteinuria and rapid deterioration of eGFR are major signals of NDHKD.

Visual field defects and myopic macular degeneration in Singapore adults with high myopia

2021 ◽  
pp. bjophthalmol-2020-318674
Author(s):  
Carla Lanca ◽  
Chen Hsin Sun ◽  
Rachel Chong ◽  
Yee Ling Wong ◽  
Monisha Esther Nongpiur ◽  
...  
Keyword(s):  
Visual Field ◽  
Macular Degeneration ◽  
High Myopia ◽  
Cross Sectional Study ◽  
Visual Field Defects ◽  
Mean Deviation ◽  
Cross Sectional ◽  
Sensitivity Loss ◽  
Fundus Photographs ◽  
Generalised Estimating Equations

AimsTo characterise the association between visual field (VF) defects and myopic macular degeneration (MMD) in highly myopic adults without glaucoma.MethodsParticipants (n=106; 181 eyes) with high myopia (HM; spherical equivalent ≤−5.0 D or axial length (AL) ≥26 mm), after excluding glaucoma and glaucoma suspects, from the Singapore Epidemiology of Eye Diseases-HM study were included in this cross-sectional study. Humphrey VF (central 24–2 threshold), cup-disc ratio (CDR) and intraocular pressure (IOP) measurements were performed. Mean deviation (MD) and pattern SD (PSD), VF defects (normal or abnormal; p<0.05 in ≥3 non-edge contiguous locations) and pattern (eg, generalised sensitivity loss) were analysed. MMD presence was diagnosed from fundus photographs. Generalised estimating equations were used for analysing factors (MD, PSD, VF defects, CDR and IOP) associated with MMD.ResultsMean age was 55.4±9.9 years and 51.9% were women (AL=26.7±1.1 mm). MMD eyes had lower MD (−3.8±2.9 dB vs −1.1±1.4 dB) and higher PSD (2.8±1.7 dB vs 1.7±0.6 dB). A higher percentage of MMD eyes (n=48) had abnormal VF (62.5% vs 28.6%; p<0.001) compared with no MMD (n=133 eyes). VF pattern in MMD eyes was significantly different from eyes without MMD (p=0.001) with greater generalised sensitivity loss (53.3% vs 10.5%) and arcuate defects (16.7% vs 10.5%). In multivariate analyses, MD (OR=1.52) and PSD (OR=1.67) were significantly (p=0.003) associated with MMD, but VF defects were not associated with MMD.ConclusionHighly myopic adults with MMD may have VF loss when compared with highly myopic patients without MMD even in adults without glaucoma.

Abstract P354: Circulating Interleukin 17 A In Patients With Acute And Chronic Coronary Syndrome

2021 ◽  
Vol 129 (Suppl_1) ◽  
Author(s):  
Dinaldo C Oliveira ◽  
Edivaldo Mendes Filho ◽  
Mariana Barros ◽  
Carolina Oliveira ◽  
Joao Vitor Cabral ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Healthy Volunteers ◽  
Clinical Characteristics ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Interleukin 17 ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Artery Disease

Introduction: Interleukin L-17 is produced by Th 17 cells and other cells. There is a debate if IL 17 is atherogenic or atheroprotective. The true role of this interleukin during the development and progression of the coronary artery disease is not known. Objective: To evaluate if there are differences between the IL17 A serum levels according to clinical presentation of the coronary artery disease. Methods: This is a cross sectional study which enrolled 101 patients with acute coronary syndrome (ACS), 100 patients with chronic coronary syndrome (CCS) and 100 healthy volunteers. Blood samples were taken from patients ( at admission) and controls to analysis the level of IL17A. Clinical characteristics were collected through questionnaires. This research was approved by ethical committee. Results: Comparisons of the clinical characteristics between patients with ACS and CCS revealed: mean age ( 62 ± 12.4 vs 63.3 ± 9.8, p = 0.4 ), male (63.4% vs 58%, p = 0.4) hypertension (85.1% vs 79%, p = 0.1) , disyipidemia (48% vs 31%, p =0.01), Diabetes Mellitus (47.5% vs 41%, p = 0.3), previous myocardial infarction (57.4% vs 40%, p = 0,01), smoking (29.7% vs 38%, p = 1). The peripheral concentrations of IL17A according to ACS, CCS and controls were: 5.36 ± 8.83 vs 6.69 ± 17.92 vs 6.26 ± 11.13, p = 0.6. Besides, the comparison between ACS and CCS showed: 5.36 ± 8.83 vs 6.69 ± 17.92, p = 0.3. Conclusion: The main finding os this study was that the circulating IL 17 concentrations were similar in patients with ACS, CCS and healthy volunteers). Besides, there was no difference between patients with ACS and CCS. Therefore, our hypothesis is that in patients with ACS and CCS the circulating IL 17 A concentrations are low or undetectable.

scholarly journals Clinical Characteristics of Pigment Dispersion Syndrome and Pigmentary Glaucoma Patients: A Cross-sectional Study

2020 ◽  
Author(s):  
Vijay Pratap Singh Tomar ◽  
Sandeep Sharma ◽  
Rahul Bhardwaj ◽  
Sindhuja Singh ◽  
Virendra Kumar Pal ◽  
...  
Keyword(s):  
Visual Field ◽  
Optic Disc ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Pigment Dispersion ◽  
Pigmentary Glaucoma ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pigment Dispersion Syndrome

Introduction: Pigmentary Glaucoma (PG) and Pigment Dispersion Syndrome (PDS) are two different spectrums of a single disease. Since the disease is seen in younger population and is rapidly progressive blinding disease, therefore early diagnosis and treatment will reduce the burden of the disease and improve the quality of life. Aim: To evaluate clinical characteristics of PDS and PG patients in eastern part of Uttar Pradesh. Materials and Methods: This was a two years (1st January 2018 to 31st December 2019) hospital‑based retrospective cross‑sectional study of patients who attended the glaucoma clinic. Diagnosis of PDS was made when they had normal optic disc, normal visual field {with or without increased Intra Ocular Pressure (IOP)} and at least two of the following three signs were found clinically: Krukenberg spindle, homogenous moderate‑to‑heavy (≥Spaeth 2+) Trabecular Meshwork (TM) pigmentation, and any degree of zonular and/or lenticular pigment granule dusting. Patients with PDS were diagnosed with PG, if they had two or more of the following findings: initial IOP >21 mmHg, glaucomatous optic nerve damage or glaucomatous visual field loss. Various parameters such as influence of demographics, IOP, Best‑Corrected Visual Acuity (BCVA), Central Corneal Thickness (CCT), Mean Deviation (MD), Visual Field Index (VFI %), spherical equivalent and clinical finding of anterior segment of study patients were analysed. Mean, standard deviation and percentage were calculated using GraphPad Instat version 3.0. Results: Among 40 patients, nine eyes of the six patients had myopia of ‑0.5D or greater, with mean refractive error of ‑3.55±4.72 spherical equivalent. The average baseline IOP in study patients (PDS+PG), was 30.21±11.42 mmHg. Twenty four (60%) patients, either in one or both eyes had glaucoma, secondary to PDS at the initial diagnosis. Thirty three (82.5%) patients had Krukenberg spindles. Homogeneous TM pigmentation was seen in all patients. Typical spoke‑like radial Iris Transillumination Defects (ITDs) were not observed in any of the patients except in one patient, who had isolated short slit‑like trans‑illumination defects in iris crypts. Conclusion: PDS patients with normal optic disc and visual field and raised IOP, should be started prophylactic treatment and needs to be monitored more closely. Thus, the finding of PDS in Indians should alert the ophthalmologist to look for glaucoma during the initial examination.

scholarly journals Clinical characteristics and outcome of vasculitides

2016 ◽  
Vol 3 (2) ◽  
pp. 3-9
Author(s):  
Buddhi Prasad Paudyal ◽  
Anjana Education Rajbhandari
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Health Sciences ◽  
Small Vessel ◽  
Small Vessel Vasculitis ◽  
Cross Sectional ◽  
The Mean ◽  
Schonlein Purpura ◽  
Overall Mortality

 Introductions: Vasculitides can cause significant morbidity and mortality if not treated on time. There is lack of data locally. This study aims to define the pattern, clinical characteristics, and outcome of vasculitides.Methods: This was a cross sectional study between January 2011 and December 2015 at Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Nepal. The medical records of patients diagnosed with vasculitides in adults rheumatology service of the hospital were reviewed.Results: Ninety six patients were diagnosed with vasculitides during the study period. The mean age was 42.2 years. Sixty nine (71.8%) patient had small vessel, 20 (20.8%) large vessel and five (5.2%) had variable vessel vasculitides. Seventy five patients (78.1%) had primary and 21 (21.8%) secondary vasculitides. Cutaneous leucocytoclasticangitis was seen in 27 (28.1%), Takayasu arteritis in 17 (17.7), Henoch-Schonlein purpura in 11 (11.4%) and Rheumatoid arthritis associated vasculitis in nine patients. Purpura was present in all 96 (100%). The overall mortality was 9 (9.3%).Conclusions: Primary vasculitides were more common than secondary forms. Small vessel vasculitis was the most common. Cutaneous symptoms were predominant features. The mortality was attributed to active disease, sepsis, and complications of the primary disease. Journal of Patan Academy of Health  Sciences. 2016 Dec;3(2):3-9

scholarly journals The association between serum uric acid and diabetic complications in patients with type 2 diabetes mellitus by gender: a cross-sectional study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e10691
Author(s):  
Yimeng Hu ◽  
Qinge Li ◽  
Rui Min ◽  
Yingfeng Deng ◽  
Yancheng Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Clinical Characteristics ◽  
Independent Risk Factor ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Background The relationship between serum uric acid (SUA) and several diabetic complications or co-morbidities remains a matter of debate. The study aims to explore the association between SUA levels and the prevalence of non-alcoholic fatty liver disease (NAFLD), diabetic retinopathy (DR), diabetic nephropathy (DN) and diabetic peripheral neuropathy (DPN) in patients with type 2 diabetes mellitus (T2DM). Methods A total of 2,809 participants (1,784 males and 1,025 females) were included in this cross-sectional study. Clinical characteristics and the prevalence of each of the four diseases were analyzed based on gender-specific quartiles of SUA levels. The Pearson correlation analysis and linear-regression analysis were used to access the correlation between SUA levels and clinical characteristics. Furthermore, a binary logistic regression analysis was carried out to determine whether SUA was an independent risk factor for each of the four complications. Results SUA levels were positively correlated to BMI, BUN, Scr and TG, but negatively associated with eGFR, HDL, FBG, 2h-PG and HbA1c% for the patients with T2DM. The prevalence of NAFLD and DN, but not DR or DPN, were increased with SUA levels from the first to the fourth quartile. Binary logistic regression further disclosed that SUA was an independent risk factor for NAFLD (ORs Male = 1.002, ∗P = 0.0013; ORs Female = 1.002, ∗P = 0.015) and DN (ORs Male = 1.006, ∗P < 0.001; ORs Female = 1.005, ∗P < 0.001), but not for DR and DPN. After adjustment for the confounders, SUA levels were significantly associated with NAFLD within the 3rd (ORs = 1.829, P = 0.004) and 4th quartile (ORs = 2.064, P = 0.001) for women, but not independently associated with SUA for man. On the other hand, our results revealed increased prevalence of DN for SUA quartile 2 (ORs = 3.643, P = 0.039), quartile 3 (ORs = 3.967, P = 0.024) and quartile 4 (ORs = 9.133, P < 0.001) in men; however, SUA quartiles were significantly associated with DN only for quartile 4 (ORs = 4.083, P = 0.042) in women Conclusion For patients with T2DM, elevated SUA concentration is an independent risk factor for the prevalence of NAFLD and DN after adjustment for other indicators, but not DR or DPN.

scholarly journals Prevalence and risk factors for myopia among school children in Aba, Nigeria

2017 ◽  
Vol 76 (1) ◽  
Author(s):  
Uchenna C. Atowa ◽  
Alvin J. Munsamy ◽  
Samuel O. Wajuihian
Keyword(s):  
School Children ◽  
Refractive Error ◽  
Age Groups ◽  
Public Health Problem ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Level Of Education ◽  
Multi Stage ◽  
Significant Difference

Aim: To study the prevalence of myopia among school children in Aba, Nigeria.Methods: This cross-sectional study was conducted in public and private (primary and secondary) schools. A multi-stage random sampling technique was used for selecting participants aged between 8 and 15 years from 12 schools in Aba, Nigeria. Data were analysed for 1197 children who underwent a comprehensive eye examination. The children were divided according to the following criteria: age groups (group 1 [8–11 years] or group 2 [12–15 years]), gender (male or female), level of education (primary or secondary) and type of school (public or private). Myopia was defined as spherical equivalent refraction (SER) ≤ -0.50 D in the poorer eye.Results: The prevalence of myopia was estimated to be 2.7%. Of the 96 children with refractive error, 78.1% were uncorrected. In using logistic regression analysis, risk of developing myopia was associated with older age groups (odds ratio [OR]: 1.20; 95% confidence interval [CI], 0.16–9.11; p < 0.010) and higher level of education (OR: 1.73; 95% CI, 1.05–2.86; p < 0.030). There was no significant difference in myopia prevalence between male and female children (p = 0.89).Conclusion: Although the prevalence of myopia and overall prevalence of refractive error in school children in Aba were low, the high prevalence of uncorrected refractive error is a significant public health problem. An effective and sustainable children’s vision screening programme is needed to prevent visual impairment and blindness.

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