scholarly journals Delay in seeking medical care after the onset of symptoms in patients with sight-threatening diabetic retinopathy

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110132
Author(s):  
Yan Wei ◽  
Fenghua Mi ◽  
Yan Cui ◽  
Ying Li ◽  
Xinyi Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Medical Care ◽  
Diabetic Complications ◽  
Multivariate Logistic Regression Analysis ◽  
Routine Examination ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant ◽  
Poor Outcomes ◽  
Associated Risk Factors

Objective To investigate the reasons for delays in seeking medical care in patients with diabetic retinopathy and associated risk factors. Methods We retrospectively reviewed data for patients with sight-threatening diabetic retinopathy (STDR) who attended a hospital in China. Various forms of STDR were identified, including severe non-proliferative DR, clinically significant macular edema and proliferative DR. Demographic, clinical and socioeconomic information was collected and the associated risk factors were evaluated. Results Of the 127 patients with STDR, 89.2% sought medical care within 1 month of developing symptoms. Those who sought treatment ≥6 months after symptoms developed had significantly lower income and less knowledge of diabetic complications than those who attended earlier. Multivariate logistic regression analysis showed that no or infrequent routine examination for diabetic complications were associated with long delays in seeking medical care (odds ratio (OR) 3.06, 95% confidence interval (CI) 1.05–9.19; and OR 2.91, 95% CI 1.04–8.40, respectively). Conclusions Most patients with STDR sought medical care within 1 month of symptoms developing, but no or infrequent routine examination for diabetic complications was associated with long delays. These results stress the importance of educational programs regarding diabetic complications to encourage timely medical care and prevent poor outcomes.

scholarly journals Delay in seeking medical care after the onset of symptoms in patients with sight-threatening diabetic retinopathy

2020 ◽  
Author(s):  
Yan Wei ◽  
Fenghua Mi ◽  
Yan Cui ◽  
Ying Li ◽  
Xinyi Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Diabetic Retinopathy ◽  
Regression Analysis ◽  
Medical Care ◽  
Logistic Regression Analysis ◽  
Diabetic Complications ◽  
Odds Ratio ◽  
Routine Examination ◽  
Factors Associated

Abstract Background Diabetic retinopathy (DR) is a common diabetes-associated complication and a primary cause of blindness. One of the critical factors affecting timely and effectual therapy for DR is the delay in treatment after the onset of symptoms. The present study aimed to investigate the reasons for the delay in the treatment of the condition and the risk factors associated with the delay. Methods We retrospectively reviewed data from 127 patients with sight-threatening diabetic retinopathy (STDR) treated at Qilu Hospital of Shandong University in China. Various forms of STDR were identified including severe non-proliferative DR, clinically significant macular edema (CSME) and proliferative DR(PDR). Information concerning demography, clinical, and socioeconomic status of the patients was gathered. Risk factors associated with the delay was evaluated using logistic regression analysis. Results Among 127 patients with STDR, 89.2% sought medical care one month after the onset of symptoms. Patients who sought for treatment 6 months post-symptom onset had significantly lower income and less knowledge about diabetic eye complications than those presenting within 6 months. Multivariate logistic regression analysis showed that never or infrequent routine examination for diabetic complications was associated with a long delay in seeking medical care (odds ratio 3.06, 95% CI 1.05-9.19, p <0.05; odds ratio 2.91, 95% CI 1.04-8.40, p <0.05). Conclusions Most STDR patients sought medical care one month after the onset of symptoms. Never or infrequent routine examination for diabetic complications was associated with a long delay. The results of the present study stress the necessity to implement educational programs on diabetic complications to encourage early medical care and prevent disastrous outcomes.

scholarly journals CATARACT SURGERY AND PROGRESSION OF DIABETIC RETINOPATHY

2003 ◽  
Vol 41 (143) ◽  
pp. 433-437
Author(s):  
Sudesh Subedi
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Cataract Extraction ◽  
Extracapsular Cataract Extraction ◽  
Vitreous Loss ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant ◽  
Form Type

Patient with diabetes mellitus have a higher prevalence of lens opacity 1and cataractdevelopment at an earlier age than non diabetic.2Cataract in diabetes mellitus decreasesthe visual acuity, makes posterior segment evaluation and laser treatment difficult.Several studies have shown that there is progression of diabetic retinopathy after cataractsurgery. In all studies, criteria for progression of diabetic retinopathy are:a) progression of any form/type or stage of diabetic eye (DE), nonproliferative diabeticretinopathy (NPDR) or proliferative diabetic retinopathy (PDR) to any advanced,recurrent form/ type or stage of NPDR or PDR andb) development of new clinically significant macular edema (CSME) and/or worsening/recurrent of preexisting CSME defined by Early Treatment Diabetic RetinopathyStudy (ETDRS).• More severe the preexisting diabetic retinopathy (DR), much worse the DR aftercataract extraction. The progression of DR after cataract extraction is severe inIntracapsular Cataract Extraction (ICCE) than Extracapsular Cataract Extraction(ECCE) with Intraocular Lens (IOL) and Sutureless Small Incision CataractSurgery (SICS) and Phacoemulcification.• Progression of DR increases with complicated cataract surgery, like posteriorcapsular rupture (PCR), vitreous loss and prolonged surgery.• The first 6 months period is crucial as a minimum period of follow up to detectprogression of DR.• There are other several local and systemic risk factors for the progression of DR,like hypertension, renal failure, ischemic heart disease, high cholesterol andtriglyceride level, pregnancy etc.Key Words: Diabetic retinopathy, cataract surgery, risk factors

scholarly journals Cross Talk between Lipid Metabolism and Inflammatory Markers in Patients with Diabetic Retinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Roxanne Crosby-Nwaobi ◽  
Irini Chatziralli ◽  
Theodoros Sergentanis ◽  
Tracy Dew ◽  
Angus Forbes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Inflammatory Markers ◽  
Multinomial Logistic Regression ◽  
Significant Risk ◽  
Metabolic Markers ◽  
Apo B ◽  
Multinomial Logistic Regression Analysis ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Purpose. The purpose of this study was to examine the relationship between metabolic and inflammatory markers in patients with diabetic retinopathy (DR).Methods. 208 adult patients with type 2 diabetes participated in this study and were categorized into (1) mild nonproliferative diabetic retinopathy (NPDR) without clinically significant macular edema (CSME), (2) NPDR with CSME, (3) proliferative diabetic retinopathy (PDR) without CSME, and (4) PDR with CSME. Variable serum metabolic markers were assessed using immunoassays. Multinomial logistic regression analysis was performed.Results. Diabetes duration and hypertension are the most significant risk factors for DR. Serum Apo-B and Apo-B/Apo-A ratio were the most significant metabolic risk factors for PDR and CSME. For every 0.1 g/L increase in Apo-B concentration, the risk of PDR and CSME increased by about 1.20 times. We also found that 10 pg/mL increase in serum TNF-αwas associated with approximately 2-fold risk of PDR/CSME while an increase by 100 pg/mL in serum VEGF concentration correlated with CSME.Conclusions. In conclusion, it seems that there is a link between metabolic and inflammatory markers. Apo-B/Apo-A ratio should be evaluated as a reliable risk factor for PDR and CSME, while the role of increased systemic TNF-αand VEGF should be explored in CSME.

scholarly journals Risk factors associated with progression of diabetic retinopathy in eyes treated with panretinal photocoagulation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sung Uk Baek ◽  
Min Seon Park ◽  
Bum-Joo Cho ◽  
In Won Park ◽  
Soonil Kwon
Keyword(s):  
Risk Factors ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Platelet Count ◽  
Multivariate Logistic Regression Analysis ◽  
Panretinal Photocoagulation ◽  
Lower Baseline ◽  
Uncontrolled Diabetes ◽  
High Platelet Count ◽  
Baseline Visual Acuity

AbstractUncontrolled diabetes has been associated with progression of diabetic retinopathy (DR) in several studies. Therefore, we aimed to investigate systemic and ophthalmic factors related to worsening of DR even after completion of panretinal photocoagulation (PRP). We retrospectively reviewed DR patients who had completed PRP in at least one eye with a 3-year follow-up. A total of 243 eyes of 243 subjects (mean age 52.6 ± 11.6 years) were enrolled. Among them, 52 patients (21.4%) showed progression of DR after PRP (progression group), and the other 191 (78.6%) patients had stable DR (non-progression group). The progression group had higher proportion of proliferative DR (P = 0.019); lower baseline visual acuity (P < 0.001); and higher platelet count (P = 0.048), hemoglobin (P = 0.044), and hematocrit, (P = 0.042) than the non-progression group. In the multivariate logistic regression analysis for progression of DR, baseline visual acuity (HR: 0.053, P < 0.001) and platelet count (HR: 1.215, P = 0.031) were identified as risk factors for progression. Consequently, we propose that patients with low visual acuity or high platelet count are more likely to have progressive DR despite PRP and require careful observation. Also, the evaluation of hemorheological factors including platelet counts before PRP can be considered useful in predicting the prognosis of DR.

scholarly journals Diabetic retinopathy with or without clinically significant macular edema: The influencing factors

2016 ◽  
Vol 7 (2) ◽  
pp. 142-147
Author(s):  
Barsha Suwal ◽  
Jeevan Kumar Shrestha ◽  
Sagun Narayan Joshi ◽  
Ananda Kumar Sharma
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Macular Edema ◽  
Total Cholesterol ◽  
Cholesterol Level ◽  
Total Cholesterol Level ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Introduction: Diabetic retinopathy is the commonest micro vascular complication in patients with diabetes and remains a leading cause of blindness in people of working age group. Objective: to determine the prevalence of clinically significant macular edema (CSME) and the influence of systemic risk factors Materials and methods: It is a hospital based comparative study conducted in 220 eyes of 110 diabetic patients. DR was graded according to International Clinical Diabetic Retinopathy Severity Scale and CSME was defined according to Early Treatment Diabetic Retinopathy Study (ETDRS) system. The patients were grouped as 1) CSME group (DR and CSME in one or both eyes) and 2) Non- CSME group(CSME in none of the eyes but with any grade of DR).Level of glycosylated hemoglobin (HbA1C), serum total cholesterol, triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and urine for albumin were studied in both groups. Results: CSME was present in 36% of 110 patients. Poor glycemic control and high total cholesterol level showed positive association with CSME (p<0.05). LDL and TG levels were higher and HDL lower in CSME group. However, no statistical significance was found. Conclusion: The CSME is significantly associated with poorer glycemic control and elevated total cholesterol level.

scholarly journals 945. Prevalence of HIV Associated Non-AIDS Conditions and Associated Risk Factors among Hospitalized HIV-infected Patients in India

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S504-S505
Author(s):  
Amyeo A Jereen ◽  
Celia Kucera ◽  
Saniya Pervin ◽  
Muralidhar Varma ◽  
Radhakrishnan Rajesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Transmitted Disease ◽  
Multivariate Logistic Regression Analysis ◽  
Patient Risk ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
History Of ◽  
Artery Disease ◽  
Associated Risk Factors

Abstract Background HIV-associated non-AIDS (HANA) conditions are becoming common as People Living with Human Immunodeficiency Virus (PLWHIV) age. However, data estimating the prevalence of HANA conditions and associated risk factors is lacking in developing countries. This study evaluates reasons for hospitalizations among PLWHIV in Udupi, India in the antiretroviral era, and describes associated risk factors. Methods Demographic and clinical data were extracted from medical charts of 1280 HIV-infected patients 18 years and older who were admitted to Kasturba Hospital, Manipal, India between January 1, 2013 and December 31, 2017, for a total of 2157 hospitalizations. Primary reasons for hospitalization were categorized into AIDS-defining vs Non-AIDS-defining and HANA vs Non-HANA conditions (Fig 1). Multivariate logistic regression analysis was performed to estimate demographic and clinical factors associated with hospitalizations due to AIDS-defining illness and HANA conditions. Categorization of Reasons for Hospitalization Results Patients’ median age was 45 (18-80) years; 70% male. Median age of patients with AIDS-defining illness (45% of hospitalizations) was lower at 44 (18-75) years compared with HANA (15% of hospitalizations) at 48 (21-80) years. Age (OR, 95% CI) (0.985, 0.974-0.995), admission CD4 (0.998, 0.997 - 0.998), history of hypertension (HTN) (0.59, 0.42-0.82), stroke (0.49, 0.24 - 0.93), diabetes (1.56, 1.10 - 2.19), and AIDS-defining cancers (1.74, 1.05 - 2.89) were associated with AIDS-defining hospitalizations (Fig 2). Additionally, age (1.016, 1.001 - 1.031), history of HTN (1.70, 1.16 - 2.46), coronary artery disease (CAD) (4.02, 1.87- 9.02), chronic kidney disease (CKD) (2.30, 1.15 - 4.61), stroke (2.93, 1.46 - 5.96), Hepatitis B (3.32, 1.66- 6.72), Hepatitis C (16.1, 2.84 - 314), sexually transmitted disease (STD) (3.76, 1.38- 10.8), and HANA-associated cancer (2.44, 1.28- 6.42) were associated with HANA hospitalizations (Fig 3). Patient Risk Factors for AIDS-related Hospitalization Patient Risk Factors for HANA-related Hospitalization Conclusion Prevalence of HANA conditions was lower than AIDS-defining illnesses possibly because of a younger population. Patients with AIDS-defining illnesses were also likely to have HANA conditions. Early detection and effective treatment of both HIV and HANA conditions is essential to decrease hospitalizations in low-resource settings. Disclosures All Authors: No reported disclosures

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