scholarly journals Reproducibility of Fixed-luminance and Multi-luminance Flicker Electroretinography in Patients With Diabetic Retinopathy Using an Office-based Testing Paradigm

2019 ◽  
Vol 14 (6) ◽  
pp. 1095-1103 ◽  
Author(s):  
John J. Wroblewski ◽  
Christa McChancy ◽  
Kassandra Pickel ◽  
Hunter Buterbaugh ◽  
Tyler Wieland ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Correlation Coefficients ◽  
Significant Negative Correlation ◽  
Fundus Photography ◽  
University Of Wisconsin ◽  
Coefficients Of Variation ◽  
Department Of Ophthalmology ◽  
Patients With Diabetes ◽  
Pearson Correlations ◽  
Reading Center

Background: We evaluated the reproducibility of office-based flicker electroretinography (ERG) in patients with nonproliferative diabetic retinopathy (NPDR). Methods: An observational study was conducted in which ultra-widefield fluorescein angiography (UWF-FA) was performed on 20 patients with mild-to-moderate NPDR; images were graded by the Fundus Photography Reading Center (Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA). Fixed- and multi-luminance flicker ERG was repeated four times (greater than or equal to seven days apart). Recording consistency was assessed using intra-class correlation coefficients (ICCs), coefficients of variation, and Pearson correlations. Results: 82.5% and 17.5% of eyes had mild and moderate NPDR using UWF-FA; 90% of the angiograms were given a high confidence grade. Fixed-luminance phase values were highly reproducible (ICC: 0.949; P < .001). There was a significant negative correlation between fixed-luminance phase and log-corrected ischemic index values (−0.426; P = .015). Conclusions: Office-based, fixed-luminance phase values are highly reproducible and negatively correlate with retinal ischemia in NPDR, suggesting that global retinal dysfunction may be reliably quantified early in patients with diabetes.

scholarly journals Flavoprotein Fluorescence Correlation with Visual Acuity Response in Patients Receiving Anti-VEGF Injection for Diabetic Macular Edema

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Jorge S. Andrade Romo ◽  
Giselle Lynch ◽  
Kevin Liu ◽  
Daniel Kim ◽  
Michael Jansen ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Therapeutic Response ◽  
Diagnostic Methods ◽  
Fundus Photography ◽  
Additional Information ◽  
Structural Improvement ◽  
Anti Vegf ◽  
Patients With Diabetes

Anti-VEGF treatment of diabetic macular edema (DME) complicating diabetic retinopathy (DR) has greatly improved structural and visual outcomes for patients with diabetes mellitus. However, up to 50% of patients are either nonresponsive or refractory to anti-VEGF treatment (no improvement in BCVA or central macular thickness (CMT)). It is believed that factors such as mitochondrial structural and functional damage, due to oxidative stress, are partially responsible for this lack of improvement. Flavoprotein fluorescence (FPF) has been shown to be a sensitive marker of mitochondrial function and has been found to correlate with the degree of diabetic retinopathy. FPF may also provide additional information regarding therapeutic response of patients receiving anti-VEGF treatment for DME. Eight patients with DR and DME with clinically significant DME (CSDME) who underwent anti-VEGF (bevacizumab) treatment were imaged before injection and at follow-up visit using FPF in addition to standard color fundus photography and OCT CMT. A strong correlation r=0.98 (p=0.000015) between the FPF decrease and the BCVA improvement was observed; BCVA improved as FPF values decreased. Notably, in the same patients, the correlation between OCT CMT decrease and BCVA improvement (r=0.688) was not found to be significant (p=0.13). These findings suggest that FPF can detect improvement in metabolic function preceding structural improvement and even with small changes in edema. Additionally, FPF may be supplementary to current diagnostic methods for earlier detection of therapeutic response to anti-VEGF treatment in patients with DME.

“A Cross Sectional Study to Evaluate Association Between the Duration of Diabetes and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients in A Tertiary Care Centre”

2021 ◽  
Vol 8 (2) ◽  
pp. 62-66
Author(s):  
Dr. Sneha Murade ◽  
Dr. Amrut Swami ◽  
Dr. Anil Singh ◽  
Dr. Vikas Khamkar ◽  
Dr. Shruti Swami
Keyword(s):  
Diabetic Retinopathy ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Department Of Ophthalmology ◽  
Patients With Diabetes ◽  
Lifestyle Related Diseases

Introduction: The numbers of people affected with lifestyle related diseases are increasing every day, diabetes being one of the major contributors to the increasing morbidity and mortality in the world. Diabetic retinopathy is one the complications of diabetes which is thought to be associated with the duration of diabetes, we conducted this study to evaluate the same. Methods: This study was conducted at Department of Ophthalmology. Total 100 cases were selected for the study and patient data was collected and analysed. Duration of diabetes and its association with diabetic retinopathy was studied. Results: There were 62 males (62%), most of the participants were more than 60 years of age (54%). Majority of the patients had diabetes for 5 to 10 years (44%) followed by 1 to 5 years (34%) and 0 – 1 year (22%). On FFA examination, majority of the patients had no any diabetic retinopathy (52%) while rest 48 patients had retinopathy (48%). Significant association was seen between the duration of diabetes and presence of diabetic retinopathy. (p=0.002). Conclusion: We found a significant association between the duration of diabetes and diabetic retinopathy. It is important that in patients with diabetes who are not diagnosed as retinopathy by ophthalmoscopy, FFA should be done.

scholarly journals Central Macular Thickness: a Comparative Study of Diabetics Vs Healthy

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Beenish Khan, Muhammad Muneer Quraishy, Asma Shams
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Thickness ◽  
Diabetic Group ◽  
Central Macular Thickness ◽  
Optical Coherence ◽  
Healthy Group ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
Patients With Diabetes

Purpose: To compare the central macular thickness amongst diabetics with that of healthy population by using Optical Coherence Tomography. Study Design: Case control study. Place and Duration of Study: Department of Ophthalmology Unit I, Civil Hospital Karachi from 5th March 2012 to 4th September 2012. Material and Methods: We randomly selected patients with diabetes (cases) and healthy patients (control) with clinically normal macula and no diabetic retinopathy. Detailed relevant history was acquired. Best corrected visual acuity (BCVA) was measured with standard Snellen’s chart. Detailed dilated fundus examination was done using +90D and +78D lens. Central macular thickness within an area of 1000 µm was measured using Optical Coherence Tomography. Results: There were 68 patients in each group. The mean age of patients in the Diabetic group was 47.94 ± 14 (20-80) years and in the healthy group it was found to be 39.53 ± 14.93 (20-80) years. Out of these 26 were male and 42 were female in the diabetic group whereas 27 were male and 41 were female in the healthy group. Mean central macular thickness of Diabetic eyes were 214.48 ± 31.41 µm and that of healthy eyes were 236.79 ± 19.38 µm with mean difference of 22.31 ± 4 µm (p value = 0.000).. A statistically significant difference in the central macular thickness of Diabetics and healthy patients was observed. Conclusion: The central macular thickness is significantly decreased in eyes of patients with Diabetes. Keywords: Central macular thickness, Optical Coherence Tomography, OCT, Diabetic Retinopathy, Diabetic Maculopathy.

Does patient education improve compliance to routine diabetic retinopathy screening?

2018 ◽  
Vol 26 (3) ◽  
pp. 161-173
Author(s):  
Prima Moinul ◽  
Joshua Barbosa ◽  
Jenny Qian ◽  
Mei Lin Chen ◽  
Mohammad Mohaghegh ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Patient Education ◽  
Fundus Photography ◽  
Diabetic Retinopathy Screening ◽  
Patients With Diabetes ◽  
Chi Squared ◽  
Improve Compliance ◽  
Hba1c Levels

Introduction Diabetic retinopathy (DR) screening relies on adherence to follow-up eye care. This article assesses if a model of patient education and tele-retina screening among high-risk patients with DR can achieve increased rates of compliance within a one-year follow-up. Methods Between May 2014 and May 2016, DR screening was conducted in a cohort of 101 patients with diabetes in Southern Ontario. Optical coherence tomography and fundus photography images were used to visualize the retina remotely. Enrolled patients participated in an educational seminar at the screening site with the expressed purpose of enhancing patient understanding of DR. A chi-squared test was used to assess patient compliance to follow-up examinations within 6–12 months, while pre-to post-screening HbA1c levels were compared using a dependent t-test. Results Of 101 patients who completed the study, 33 patients (32.6%) have never previously been screened for DR. Baseline compliance to annual screening increased from 36 patients (35.6%) to 51 patients (50.5%) after the tele-retina programme ( p = 0.03). Eighty-nine patients (88%) were referred to an optometrist for ongoing care compared with 12 patients (11.9%) to an ophthalmologist for management of DR. Overall, 100 patients (99.0%) were satisfied with the tele-retina screening. There was no significant change in pre- to-post screening HbA1c levels ( p = 0.91). Discussion Patient education-focused tele-retina screening for DR significantly increased compliance to follow-up in a high-risk, non-compliant patient population. Management of diabetes as captured by HbA1c levels remain unchanged in the cohort indicating a need for ongoing inter-professional collaboration in education and vision screening.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

scholarly journals Retinal vascular findings in patients with COVID-19

2021 ◽  
Vol 13 ◽  
pp. 251584142110304
Author(s):  
Emre Aydemir ◽  
Alper Halil Bayat ◽  
Burak Ören ◽  
Halil Ibrahim Atesoglu ◽  
Yasin Şakir Göker ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Fundus Photography ◽  
Control Group ◽  
Fundus Fluorescein Angiography ◽  
University Of Wisconsin ◽  
Retinal Vascular Caliber ◽  
Retinal Artery ◽  
The Mean ◽  
And Gender ◽  
College Of Engineering

Purpose: The purpose of this study was to compare the retinal vascular caliber of COVID-19 patients with that of healthy subjects. Methods: This was a prospective case–control study. Forty-six patients who had COVID-19 were successfully treated, and 38 age- and gender-matched healthy subjects were enrolled in this study. Fundus photography was taken using fundus fluorescein angiography (FA; Visucam 500; Carl Zeiss Meditec, Jena, Germany). Retinal vascular caliber was analyzed with IVAN, a semi-automated retinal vascular analyzer (Nicole J. Ferrier, College of Engineering, Fundus Photography Reading Center, University of Wisconsin, Madison, WI, USA). Central retinal artery equivalent (CRAE), central retinal vein equivalent (CRVE), and artery–vein ratio (AVR) were compared between groups. Results: The mean age was 37.8 ± 9.5 years in the COVID-19 group ( n = 46) and 40 ± 8 years in the control group ( n = 38) ( p = 0.45). The mean CRAE was 181.56 ± 6.40 in the COVID-19 group and 171.29 ± 15.06 in the control group ( p = 0.006). The mean CRVE was 226.34 ± 23.83 in the COVID-19 group and 210.94 ± 22.22 in the control group ( p = 0.044). AVR was 0.81 ± 0.09 in the COVID-19 group and 0.82 ± 0.13 in the control group ( p = 0.712). Conclusion: Patients who had COVID-19 have vasodilation in the retinal vascular structure after recovery. As they may be at risk of retinal vascular disease, COVID-19 patients must be followed after recovery.

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