scholarly journals Evaluation of the prevalence of non-diabetic eye disease detected at first screen from a single region diabetic retinopathy screening program: a cross-sectional cohort study in Auckland, New Zealand

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e054225
Author(s):  
Nishanthan Ramachandran ◽  
Ole Schmiedel ◽  
Ehsan Vaghefi ◽  
Sophie Hill ◽  
Graham Wilson ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Cohort Study ◽  
New Zealand ◽  
Screening Programme ◽  
Screening Program ◽  
Age Related Macular Degeneration ◽  
Posterior Capsular Opacification ◽  
Hypertensive Retinopathy ◽  
Cross Sectional ◽  
Age Related

ObjectivesTo evaluate the prevalence of incidental non-diabetic ocular comorbidities detected at first screen in a large diabetic retinopathy (DR) screening programme.DesignCross-sectional cohort study.SettingSingle large metropolitan diabetic eye screening programme in Auckland, New Zealand.ParticipantsTwenty-two thousand seven hundred and seventy-one participants who attended screening from September 2008 to August 2018.ResultsHypertensive retinopathy (HTR) was observed in 14.2% (3236/22 771) participants. Drusen were present in 14.0% participants under the age of 55 years, increasing to 20.5% in those 55 years and older. The prevalence of neovascular age-related macular degeneration (AMD) was 0.5% in participants aged<55 years, 2.4% in participants aged 55–75 years and 16% in participants aged>75 years. Retinal vein occlusion and retinal arterial embolus were prevalent in 0.7% and 0.02%, respectively, in participants aged<55 years, increasing to 2.2% and 0.4%, respectively, in those >75 years. Cataracts were common being present in 37.1% of participants over the age of 75 years. Only 386 individuals (1.7%) were labelled as glaucoma suspects. Geographic atrophy, epiretinal membrane, choroidal nevi and posterior capsular opacification had an increased prevalence in older individuals.ConclusionsOur data suggest that AMD, HTR and cataracts are routinely detected during DR screening. The incorporation of the detection of these ocular comorbidities during DR screening provide opportunities for patients to modify risk factors (smoking cessation and diet for AMD, blood pressure for HTR) and allow access to cataract surgery.

Medical retina

2012 ◽  
Author(s):  
Bheema Patil ◽  
Pankaj Puri
Keyword(s):  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Visual Loss ◽  
Clinical Skills ◽  
Night Vision ◽  
Age Related Macular Degeneration ◽  
Hypertensive Retinopathy ◽  
Fundus Fluorescein Angiography ◽  
Macular Lesion ◽  
Age Related

The chapter begins by discussing key clinical skills, namely fundus fluorescein angiography, abnormal fluorescein angiography, indocyanine green angiography, and electrophysiology. The following areas of clinical knowledge are then discussed: diabetic retinopathy, hypertensive retinopathy, retinal vein occlusion, retinal artery occlusions, age-related macular degeneration, intravitreal anti-VEGF injections, central serous chorioretinopathy, retinal vascular anomalies, retinal dystrophies, and choroidal dystrophies. The chapter concludes with eight case-based discussions, on gradual visual loss, central visual loss, visual loss in a hypertensive patient, sudden, painless visual loss, diabetic retinopathy, difficult night vision, visual loss in child, and macular lesion.

scholarly journals Plasma carotenoids and diabetic retinopathy

2008 ◽  
Vol 101 (2) ◽  
pp. 270-277 ◽  
Author(s):  
Laima Brazionis ◽  
Kevin Rowley ◽  
Catherine Itsiopoulos ◽  
Kerin O'Dea
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Vitamin A ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Carotenoid Concentration ◽  
Age Related ◽  
Lifestyle Questionnaire ◽  
The Relationship

Diabetic retinopathy increases with duration of diabetes and may be associated with carotenoid status. Carotenoids alter the pro-oxidation/antioxidation balance, and circulating levels depend largely on dietary intake. Lower levels have been reported in diabetes and age-related macular degeneration; however, little is known of the relationship between carotenoids and diabetic complications. Consequently, the purpose of the present study was to evaluate the relationship between plasma carotenoids and diabetic retinopathy. We assessed the carotenoid–retinopathy relationship in 111 individuals with type 2 diabetes in a community-based, cross-sectional study. We photodocumented retinal status and used HPLC to measure plasma carotenoid concentrations. Data for clinical and demographic variables and risk factors for diabetic retinopathy were obtained from 24 h urine and fasting blood samples, and an interviewer-assisted lifestyle questionnaire. We found that the combined lycopene and lutein/zeaxanthin (non-pro-vitamin A (non-PVA) carotenoid) concentration when compared with the pro-vitamin A (PVA) carotenoids (α-carotene, β-carotene and β-cryptoxanthin) was significantly lower in the retinopathy than non-retinopathy group (OR 1·2 (95 % CI 1·0, 1·4)v.1·6 (95 % CI 1·4, 1·7), respectively;P = 0·009). A higher non-PVA:PVA ratio also predicted a lower risk of diabetic retinopathy, after adjustment for potential confounders (OR 0·33 (95 % CI 0·12, 0·95);P = 0·039). Finally, a higher concentration of PVA carotenoids was associated with greater odds of diabetic retinopathy, after adjustment for risk factors (P = 0·049). We suggest synergies between carotenoids are implicated in diabetic retinopathy, independent of established risk factors. Importantly, our observations indicate dietary modulation of retinopathy risk may be possible by increasing intakes of lutein- and lycopene-rich foods.

A population-based study of visual impairment in the Lower Tugela health district in KZN, SA

2013 ◽  
Vol 72 (3) ◽  
Author(s):  
K.S. Naidoo ◽  
D Sweeney ◽  
J Jaggernath ◽  
B. Holden
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Refractive Error ◽  
Vision Loss ◽  
Population Based ◽  
Age Related Macular Degeneration ◽  
Health District ◽  
Hypertensive Retinopathy ◽  
Age Related ◽  
Kwazulu Natal

A cross-sectional, population-based, epidemiological study of blindness and visual impairment was conducted to evaluate the prevalence of vision loss and various sight-threatening conditions in the Lower Tugela health district of the KwaZulu-Natal province, South Africa. This study was conducted on a randomly selected sample of 3444 individuals from the district. This number represented 84% of those who were visited and 80.1% of the total sample selected. The participants ranged in age from 5 to 93 years (mean of 29.2 years and a median of 20.0 years). The proportion of men to women differed between participants aged <30 years and those aged >30 years. In both age groups, women represented the majority of participants (66.5%), but the number of women to men in the older age group was approximately twice that found in the group aged less than 30 years. The difference in age between the men and women in the study was not statistically significant (p >0.5). The study revealed that 6.4% of the population studied were visually impaired. The distribution of uncorrected visual acuity was better for women than for men for both OD and OS (p = 0.000 for OD and OS). The main causes of visual impairment were refractive error (44.5%), cataract (31.2%), glaucoma (6.0%), hypertensive retinopathy (4.1%) and diabetic retinopathy (4.1%). Unilateral blindness (OD) was present in 0.78% (95% Confidence interval (CI): 0.42%-1.14%) of participants and unilateral blindness (OS) was present in 1.1% (95% CI: 0.70%-1.50%). Thirty-one participants (0.9%) were bilaterally blind with the main causes being cataracts (54.8%) and refractive error (12.9%). Glaucoma and hypertensive retinopathy were responsible for 6.4% of ..bilateral blindness. Diabetic retinopathy, other retinal conditions (coloboma) and corneal scarring were each responsible for 3.2% of bilateral blindness. Albinism, coloboma and age-related macular degeneration accounted for 9.7% of bilateral blindness. The data provides much needed information to support the planning of eye care programs in KwaZulu-Natal.  (S Afr Optom 2013 72(3) 110-118)

Other ophthalmic lesions in the fundus

2020 ◽  
pp. 71-88
Author(s):  
Jonathan M. Gibson
Keyword(s):  
Pattern Recognition ◽  
Diabetic Retinopathy ◽  
Artery Occlusion ◽  
Age Related Macular Degeneration ◽  
Hypertensive Retinopathy ◽  
Blood Disorders ◽  
Age Related ◽  
Ophthalmic Pathology ◽  
Diabetic Population ◽  
Medical Teams

When screening the diabetic population for diabetic retinopathy (DR), many other retinal conditions can be identified, which may represent harmless variations of normality or serious ophthalmic pathology. The most important conditions that may be detected are retinal vein and artery occlusion, hypertensive retinopathy, arterial emboli, and retinal changes due to blood disorders, for example, anaemia. These conditions need local protocols for management, which are best obtained by input and advice from the relevant medical teams. Overall, familiarity with fundal appearance and pattern recognition are important in order to recognize common abnormalities, for example, drusen, chorioretinitis, asteroides hyalosis, choroidal naevi, and age-related macular degeneration.

Eyes

2019 ◽  
pp. 239-260
Author(s):  
Tanya M. Monaghan ◽  
James D. Thomas
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Optic Atrophy ◽  
Central Retinal Vein Occlusion ◽  
Age Related Macular Degeneration ◽  
Hypertensive Retinopathy ◽  
Vein Occlusion ◽  
Age Related ◽  
Optic Disc Swelling ◽  
Central Retinal Vein

This chapter concerns ophthalmology, and covers red eye, diabetic retinopathy, hypertensive retinopathy, optic disc swelling, glaucoma, optic atrophy, cataracts, central retinal vein occlusion, retinal detachment, age-related macular degeneration, and cytomegalovirus retinitis.

scholarly journals Use of Intravitreal Bevacizumab Injection among Patients Undergoing Surgical Retinal Interventions at Tertiary Eye Hospital: A Descriptive Cross-sectional Study

2021 ◽  
Vol 59 (241) ◽  
pp. 858-861
Author(s):  
Arjun Shrestha ◽  
Rinkal Suwal ◽  
Rajan Shrestha ◽  
Barsha Suwal ◽  
Deepak Khadka
Keyword(s):  
Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Sectional Study ◽  
Cross Sectional ◽  
Intravitreal Bevacizumab Injection ◽  
Age Related ◽  
Bevacizumab Injection

Introduction: Intravitreal Bevacizumab injection has now become a routine procedure for retina specialists throughout the world. Easy availability of this monoclonal antibody molecule even in Nepal has brought a revolution in the management of various retinal diseases. This study aims to find out the prevalence of the use of intravitreal Bevacizumab for retinal diseases at the tertiary eye hospital. Methods: This descriptive cross-sectional study was carried out in the retina department at a tertiary care hospital from January 2017 to December 2019 after obtaining ethical clearance from Nepal Health Research Council (Ref: 125/2020P). The sample size was calculated and the study enrolled all patients who received intravitreal Bevacizumab for retinal diseases using convenience sampling technique. Data were analyzed using Statistical Package for Social Science Version 21. Point estimate at 95% Confidence Interval was calculated, along with frequency and percentage for binary data. Results: Out of 959 total surgical retinal interventions done 296 (30.86%) at 95% Confidence Interval (27.93-33.78) patients received intravitreal Bevacizumab. Out of total intravitreal Bevacizumab injections, 143 (36.7%) injections were given to retinal vein occlusions patients, 127 (32.6%) injections were given to diabetic retinopathy patients and 66 (17%) injections was given to age-related macular degeneration patients. Males 176 (59.5%) outnumbered the females 120 (40.5%) in receiving intravitreal Bevacizumab. Mean baseline Logarithm of the Minimal Angle of Resolution visual acuity, 1.1, improved to, 0.75, after 3 months of intravitreal Bevacizumab. Conclusions: Intravitreal Bevacizumab was one of the commonest retinal interventions used. Retinal vein occlusion, diabetic retinopathy, and age-related macular degeneration were the commonest retinal diseases needing intravitreal Bevacizumab.

scholarly journals Intravitreal injections during the COVID-19 pandemic era

2021 ◽  
Vol 2 (2) ◽  
pp. 50-55
Author(s):  
Selda Celik Dulger ◽  
Mehmet Citirik ◽  
Esra Bahadir Camgoz ◽  
Mehmet Yasin Teke
Keyword(s):  
Diabetic Retinopathy ◽  
Demographic Data ◽  
Retinal Disease ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Intravitreal Injections ◽  
Cross Sectional ◽  
Age Related ◽  
Number Of Patients

Background: This study aimed to evaluate the clinical characteristics and changes in the number of patients receiving intravitreal injections (IVIs) at a tertiary hospital during the coronavirus disease 2019 (COVID-19) pandemic as compared to the pre-pandemic period. Methods: This retrospective, cross-sectional study included 3,211 patients with retinal disease, who received IVIs of anti-vascular endothelial growth factor (anti-VEGF) between January and May 2020. This 5-month period was divided into a pre-pandemic and a pandemic period. Clinical and demographic data were collected and were compared between the patients in each period. All COVID-19 infection precautions were implemented to minimize the potential transmission of COVID-19 to both healthcare workers and patients. Results: A total of 3,211 IVIs were administered to patients with diabetic retinopathy, age-related macular degeneration, retinal vein occlusion, and other retinal conditions. Diabetic retinopathy was the most common indication for treatment in the pre-pandemic as well as pandemic periods. Bevacizumab (Avastin, Roche) was the most common IVI type, followed by aflibercept (Eylea, Bayer). Of 3,211 IVIs, 2,943 (91.7%) were administered during the pre-pandemic period and 268 (8.3%) during the pandemic period. There was a statistically significant decrease in injections between the pre-pandemic and pandemic periods, with an overall reduction of 90.8% in IVIs (P < 0.05). No cases of confirmed transmission of COVID-19 orcomplications associated with IVIs were recorded. Conclusions: This study showed that the number of IVIs and patient visits decreased significantly, by more than 10-fold, during the lockdown period. These findings show that COVID-19 has turned the management of sight-threatening eye diseases into a challenging process and must be addressed if future healthcarerestrictions are imposed.

scholarly journals Visual Impairment, Eye Diseases, and Dementia Risk: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-15
Author(s):  
Elżbieta Kuźma ◽  
Thomas J. Littlejohns ◽  
Anthony P. Khawaja ◽  
David J. Llewellyn ◽  
Obioha C. Ukoumunne ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Meta Analysis ◽  
Eye Diseases ◽  
Age Related Macular Degeneration ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Age Related ◽  
Dementia Risk ◽  
Increased Risk

Background: Visual impairment and eye diseases have been associated with dementia, though with mixed findings and often in cross-sectional studies. Objective: To identify prospective studies investigating associations between visual impairment or common eye diseases and risk of all-cause dementia or key dementia subtypes. Methods: We searched Medline, PsycINFO, and Embase from inception to January 2020. We also conducted backward and forward citation searches of included studies and set up alerts to identify studies published after the search date. Random-effects meta-analysis was used to combine adjusted estimates across studies. Results: Thirty studies met our eligibility criteria. For visual impairment, pooled estimates indicated an increased risk of all-cause dementia (37,705 participants, 3,415 cases, risk ratio [RR] = 1.38, 95%confidence interval [CI]: 1.19–1.59, I2 = 28.6%). Pooled estimates also suggested an increased dementia risk associated with cataract (6,659 participants, 1,312 cases, hazard ratio [HR] = 1.17, 95%CI 1.00–1.38, I2 = 0.0%) and diabetic retinopathy (43,658 participants, 7,060 cases, HR = 1.34, 95%CI 1.11–1.61, I2 = 63.9%), respectively. There was no evidence of an association between glaucoma (175,357 participants, 44,144 cases, HR = 0.97, 95%CI 0.90–1.04, I2 = 51.5%) or age-related macular degeneration (7,800,692 participants, >  2,559 cases, HR = 1.15, 95%CI 0.88–1.50, I2 = 91.0%) and risk of dementia, respectively. Conclusion: As visual impairment, cataract, and diabetic retinopathy are associated with an increased likelihood of developing dementia, early diagnosis may help identify those at risk of dementia. Given most causes of visual impairment are treatable or preventable, the potential for dementia prevention warrants further investigation.

Patient Use of Dietary Supplements, Home Monitoring, or Genetic Testing for Nonneovascular Age-Related Macular Degeneration

2021 ◽  
pp. 247412642198922
Author(s):  
Brittany C. Tsou ◽  
T.Y. Alvin Liu ◽  
Jun Kong ◽  
Susan B. Bressler ◽  
J. Fernando Arevalo ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Macular Degeneration ◽  
Dietary Supplements ◽  
Home Monitoring ◽  
Cross Sectional Study ◽  
Age Related Macular Degeneration ◽  
Cross Sectional ◽  
Supplement Use ◽  
Age Related ◽  
Disease Study

Purpose: This work evaluated the use and type of dietary supplements and home monitoring for nonneovascular age-related macular degeneration (AMD), as well as the prevalence of genetic testing among patients with AMD. Methods: A cross-sectional study was conducted of 129 participants older than 50 years who completed self-administered questionnaires regarding usage and type of dietary supplements and home monitoring, as well as the participants’ use of genetic testing for AMD. Results: Of 91 participants with AMD, 83 (91.2%) took vitamins, including 55 (60.4%) who used an Age-Related Eye Disease Study (AREDS) or AREDS2 formulation. Of 38 without AMD, 31 (81.6%) took vitamins (difference from participants with AMD = 9.6% [95% CI, 0%-23.2%]), including 2 on an AREDS formulation. Among 82 participants with AMD who were AREDS candidates (intermediate or advanced AMD in 1 or both eyes), 51 (62.2%; 95% CI, 51.7%-72.7%) took an AREDS or AREDS2 formulation, and 31 (37.8%) did not (5 were unsure). Additionally, 50 (61.0%; 95% CI, 50.4%-71.6%) AREDS candidates did some type of home monitoring. Only 1 (1.2%; 95% CI, 0%-3.6%) underwent genetic testing for AMD. Among 9 with AMD who were not AREDS candidates, 4 (44.4%) used an AREDS formulation, 4 (44.4%) did not, and 1 (11.1%) was unsure; only 1 (11.1%) of these 9 performed home monitoring. Conclusions: Despite similar results from past surveys and AREDS2 data supporting supplement use in 2013 and home monitoring in 2014, these findings suggest about one-third of AREDS candidates do not do so, providing further support for improving education regarding appropriate supplement and home monitoring usage. Genetic testing for AMD also appears infrequent.

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