scholarly journals Prognostic factors affecting macular hole closure types

2021 ◽  
Vol 13 ◽  
pp. 251584142110090
Author(s):  
Gülşah Gümüş ◽  
Gökhan Demir ◽  
Beril Tülü Aygün ◽  
Ali Demircan ◽  
Zeynep Alkın ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Duration Of Symptoms ◽  
Significant Difference ◽  
Neurosensory Retina ◽  
Closure Group ◽  
Hole Closure

Purpose: In this study, we aimed to evaluate the relationship between macular hole closure types assessed by optical coherence tomography (OCT) and the preoperative prognostic factors. Materials and methods: In total, 183 patients who underwent pars plana vitrectomy and internal limiting membrane peeling for idiopathic macular hole between August 2014 and August 2019 were reviewed retrospectively. The preoperative measurements of the macular hole including minimum linear diameter (MLD), basal hole diameter (BHD) and hole height (HH) were measured on OCT images. The patients were divided into two closure types on the basis of postoperative OCT findings (type 1 closure: retinal edges were flat and there was no defect of the neurosensory retina on the fovea; type 2 closure: retinal edges were flat and there was a defect of the neurosensory retina on the fovea). The difference of prognostic factors such as age; duration of symptoms; preoperative best-corrected visual acuity (BCVA); preoperative macular hole measurements, including MLD, BHD and HH; and rate of reopening between two types were statistically analysed. Results: The mean age of patients was 66.33 ± 8.09 years (range: 48–88 years). According to OCT imaging, 117 eyes (63.9%) were classified into the type 1 closure group, and 66 eyes (36.1%) were classified into the type 2 closure group. There were no significant differences between two groups in age, duration of symptoms and preoperative BCVA ( p = 0.694, p = 0.092 and p = 0.15). MLD and BHD were significantly larger, and reopening was significantly more common in type 2 group ( p < 0.05, p = 0.04 and p < 0.005); however, there was no significant difference in HH between two groups ( p = 0.239). Conclusion: Preoperative horizontal measurements of macular hole may help to determine postoperative visual expectations and anatomical success, and predict the possibility of reopening.

scholarly journals Role of intraretinal cysts in the prediction of postoperative closure and photoreceptor damages of the idiopathic full-thickness macular hole

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jin-Ho Joo ◽  
Woo Ho Nam ◽  
Taesung Joo ◽  
Sang Woong Moon
Keyword(s):  
Macular Hole ◽  
Internal Limiting Membrane ◽  
Full Thickness ◽  
Base Diameter ◽  
Full Thickness Macular Hole ◽  
Significant Difference ◽  
Two Factors ◽  
Pars Plana ◽  
Hole Closure

Abstract Background To determine whether it would be effective in predicting the results of the postoperative full-thickness macular hole (FTMH) closure when intraretinal cyst (IRC) is present. Methods Case-control study. Patients with idiopathic FTMH who underwent pars plana vitrectomy with internal limiting membrane peeling were retrospectively reviewed. Preoperative spectral-domain optical coherence tomography was undertaken in all patients. The new parameter, macular hole closing factor (MHCF) was defined as the base diameter - (arm length + IRC height) by adding IRC to the existing parameter. After surgery, patients were classified and analyzed according to the type of hole closure and the damage of photoreceptor. Results Of the 35 patients, 28 (80.00%) had type 1 closure and seven (20.00%) had type 2 closure. There was a significant difference in postoperative BCVA (P < 0.01), base diameter (P = 0.037), arm length (P = 0.045), and IRC height (P = 0.011) between the two groups. In the type 1 closure, they were further divided into two subgroups according to photoreceptor damage, and it was confirmed that there were significant differences in postoperative BCVA (P = 0.045), hole height (P = 0.048), and IRC height (P = 0.046) in the two subgroups. As for the new parameters, a significant difference between the three groups was confirmed (P < 0.01). Conclusion IRC may help predict hole closure along with the known horizontal parameters. Therefore, the new parameter containing both two factors can help predict not only hole closure but also damage to photoreceptors that affects postoperative visual prognosis.

scholarly journals Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.

2020 ◽  
Author(s):  
Diana Catarino ◽  
Diana Silva ◽  
Joana Guiomar ◽  
Cristina Ribeiro ◽  
Luísa Ruas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Ldl Cholesterol ◽  
Β Cell ◽  
Duration Of Symptoms ◽  
Immune Mediated ◽  
Significant Difference

Abstract Background: The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods: Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results: 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion: Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.

scholarly journals Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.

2020 ◽  
Author(s):  
Diana Catarino ◽  
Diana Silva ◽  
Joana Guiomar ◽  
Cristina Ribeiro ◽  
Luísa Ruas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Ldl Cholesterol ◽  
Β Cell ◽  
Duration Of Symptoms ◽  
Immune Mediated ◽  
Significant Difference

Abstract Background The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.

scholarly journals Surgical Outcomes in Macular Telangiectasia Type 2-Related Macular Holes: A Report on Four Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Kinza T. Ahmad ◽  
Joseph Chacko ◽  
Ahmed B. Sallam ◽  
David B. Warner ◽  
Sami H. Uwaydat
Keyword(s):  
Macular Hole ◽  
Surgical Outcomes ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Imaging Data ◽  
Closure Rate ◽  
Macular Telangiectasia ◽  
Macular Holes ◽  
Hole Closure

Introduction. The few published studies that exist on the surgical outcomes of full-thickness macular hole (FTMH) repair in Macular Telangiectasia (MacTel) Type 2 report poor rates of hole closure of around 30%. This study is the largest case series of patients with FTMH in MacTel Type 2 and describes an 80% hole closure rate. Purpose/Aim. To describe the outcomes of four patients who underwent surgery for FTMH associated with MacTel Type 2. Methods. A retrospective review of clinical, surgical, and imaging data of five eyes in four patients with MacTel Type 2 FTMH who underwent pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and 30% SF6 or 15% C3F8 gas tamponade within 3-9 months of initial vision decline. Results. Visual acuity (VA) at the time of surgery ranged from 20/50 to 20/200. Successful hole closure was achieved in four out of five eyes, and final VA ranged from 20/20 to 20/40 at follow-up visits greater than 20 months postoperatively. The single eye that did not achieve hole closure had a final VA of 20/60. Conclusion. Our case series describes higher hole closure rates and better final VA than previously published reports for macular hole surgery in patients with MacTel Type 2 FTMH.

Conversion from type 2 to type 1 macular hole closure after surgery in high myopia

2021 ◽  
Vol 14 (8) ◽  
pp. e243551
Author(s):  
Ramesh Venkatesh ◽  
Arpitha Pereira ◽  
Nikitha Gurram Reddy ◽  
Naresh Kumar Yadav
Keyword(s):  
Macular Hole ◽  
High Myopia ◽  
Silicone Oil ◽  
Internal Limiting Membrane ◽  
Final Visit ◽  
Closed Type ◽  
The Right ◽  
Spontaneous Conversion

We describe a case of spontaneous conversion from type 2 macular hole (MH) closure to type 1 closure following MH surgery in high myopia. A 42-year-old male patient with myopia was diagnosed with full-thickness MH and localised neurosensory detachment. His best-corrected vision in the right eye was 20/120, N18. He underwent pars plana vitrectomy with internal limiting membrane peeling and silicone oil tamponade. Nine days after surgery, optical coherence tomography (OCT) showed type 2 MH closure and presence of epiretinal tissue. At 6 weeks of follow-up, there was spontaneous conversion from type 2 to type 1 closure of MH with a thin epimacular tissue bridging across the fovea and vision improving to 20/80. At 3 months after surgery, silicon oil removal was done. OCT showed a closed type 1 MH and visual acuity of 20/80 at the final visit. Early spontaneous conversion in closure can occur over time, leading to better anatomical and visual outcomes.

scholarly journals Non-immune-mediated versus immune-mediated type 1 diabetes diagnosis and long-term differences. Retrospective analysis.

2020 ◽  
Author(s):  
Diana Catarino ◽  
Diana Silva ◽  
Joana Guiomar ◽  
Cristina Ribeiro ◽  
Luísa Ruas ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Blood Glucose ◽  
Ldl Cholesterol ◽  
Β Cell ◽  
Duration Of Symptoms ◽  
Immune Mediated ◽  
Significant Difference

Abstract Background The American Diabetes Association proposed two subcategories for type 1 diabetes mellitus : type 1A or immune-mediated diabetes (IDM) and type 1B or idiopathic diabetes. The absence of β-cell autoimmune markers, permanent insulinopenia and prone to ketoacidosis define the second category, whose pathogenesis remains unclear. Only a minority of patients fall into this category, also designated non-immune-mediated (NIDM), which is considered by several authors similar to type 2 diabetes. The aim of this study is to evaluate differences at the diagnosis and ten years later of two categories. Methods Retrospective cohort study of patients with β-cell autoimmune markers performed at diagnosis and undetectable c-peptide. Were excluded patients with suspicion of another specific type of diabetes. We obtained two groups: IDM (≥ 1 positive antibody) and NIDM (negative antibodies). Age, family history, anthropometry, duration of symptoms, clinical presentation, blood glucose at admission, A1C, lipid profile, arterial hypertension, total diary dose of insulin (TDDI), microvascular and macrovascular complications were evaluated. Results were considered statistically significant with p<0.05. Results 37 patients, 29 with IDM and 8 patients with NIDM. The age of diagnosis of IDM group (23 years) was significantly different (p=0.004) from the NIDM group (38.1). The body mass index (BMI) at the diagnosis did not differ significantly (p=0.435). The duration of symptoms was longer in the NIDM (p=0.003). The disease presentation (p=0.744), blood glucose (p=0.482) and HbA1C (p=0.794) at admission and TDID at discharge (p=0.301) did not differ significantly. Total and LDL cholesterol levels were higher in NIDM group but did not differ significantly (p=0.585 and p=0.579, respectively). After ten years BMI did not differ between groups(p=0.079). Patients with IDM showed a significantly higher HbA1C (p=0,008) and TDID (p=0.017). Relative to the lipid profile, there was no significant difference, however the LDL cholesterol and triglycerides were higher on the NIDM group, as the percentage of hypertension. Microvascular complications were higher in the IDM group, but no significant difference was found. Conclusion Patients with IDM had a poor metabolic control and higher insulin requirement. Patients with NIDM were older and showed higher cardiovascular risk, resembling a clinical phenotype of type 2 diabetes.

scholarly journals CNNM2-Related Disorders: Phenotype and Its Severity Were Associated With the Mode of Inheritance

2021 ◽  
Vol 9 ◽  
Author(s):  
Han Zhang ◽  
Ye Wu ◽  
Yuwu Jiang
Keyword(s):  
De Novo ◽  
Serum Magnesium ◽  
Brain Magnetic Resonance Imaging ◽  
Functional Studies ◽  
Pathogenic Variants ◽  
Significant Difference ◽  
Domain Variations ◽  
Type 3

CNNM2 (Cystathionine-β-synthase-pair Domain Divalent Metal Cation Transport Mediator 2) pathogenic variants have been reported to cause hypomagnesemia, epilepsy, and intellectual disability/developmental delay (ID/DD). We identified two new cases with CNNM2 novel de novo pathogenic variants, c.814T&gt;C and c.976G&gt;C. They both presented with infantile-onset epilepsy with DD and hypomagnesemia refractory to magnesium supplementation. To date, 21 cases with CNNM2-related disorders have been reported. We combined all 23 cases to analyze the features of CNNM2-related disorders. The phenotypes can be classified into three types: type 1, autosomal dominant (AD) inherited simple hypomagnesemia; type 2, AD inherited hypomagnesemia with epilepsy and ID/DD; and type 3, autosomal recessive (AR) inherited hypomagnesemia with epilepsy and ID/DD. All five type 1 cases had no epilepsy or ID/DD; they all had hypomagnesemia, and three of them presented with symptoms secondary to hypomagnesemia. Fifteen type 2 patients could have ID/DD and seizures, which can be controlled with antiseizure medications (ASMs); their variations clustered in the DUF21 domain of CNNM2. All three type 3 patients had seizures from 1 to 6 days after birth; the seizures were refractory, and 1/3 had status epilepticus; ID/DD in these AR-inherited cases was more severe than that of AD-inherited cases; they all had abnormalities of brain magnetic resonance imaging (MRI). Except for one patient whose serum magnesium was the lower limit of normal, others had definite hypomagnesemia. Hypomagnesemia could be improved after magnesium supplement but could not return to the normal level. Variations in the CBS2 domain may be related to lower serum magnesium. However, there was no significant difference in the level of serum magnesium among the patients with three different types of CNNM2-related disorders. The severity of different phenotypes was therefore not explained by decreased serum magnesium. We expanded the spectrum of CNNM2 variants and classified the phenotypes of CNNM2-related disorders into three types. We found that DUF21 domain variations were most associated with CNNM2-related central nervous system phenotypes, whereas hypomagnesemia was more pronounced in patients with CBS2 domain variations, and AR-inherited CNNM2-related disorders had the most severe phenotype. These results provide important clues for further functional studies of CNNM2 and provide basic foundations for more accurate genetic counseling.

scholarly journals Clinical significance of intramammary arterial calcifications in diabetic women

2004 ◽  
Vol 61 (2) ◽  
pp. 163-167 ◽  
Author(s):  
Zorica Milosevic ◽  
Jelica Bjekic ◽  
Stanko Radulovic ◽  
Branislav Goldner
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Control Group ◽  
Duration Of Diabetes ◽  
Diabetic Macroangiopathy ◽  
Indirect Sign ◽  
Significant Difference

Background. It is well known that intramammary arterial calcifications diagnosed by mammography as a part of generalized diabetic macroangiopathy may be an indirect sign of diabetes mellitus. Hence, the aim of this study was to determine the incidence of intramammary arterial calcifications, the patient?s age when the calcifications occur, as well as to observe the influence of diabetic polineuropathy, type, and the duration of diabetes on the onset of calcifications, in comparison with nondiabetic women. Methods. Mammographic findings of 113 diabetic female patients (21 with type 1 diabetes and 92 with type 2), as well as of 208 nondiabetic women (the control group) were analyzed in the prospective study. The data about the type of diabetes, its duration, and polineuropathy were obtained using the questionnaire. Statistical differences were determined by Mann-Whitney test. Results. Intramammary arterial calcifications were identified in 33.3% of the women with type 1 diabetes, in 40.2% with type 2, and in 8.2% of the women from the control group, respectively. The differences comparing the women with type 1, as well as type 2 diabetes and the controls were statistically significant (p=0.0001). Women with intramammary arterial calcifications and type 1 diabetes were younger comparing to the control group (median age 52 years, comparing to 67 years of age, p=0.001), while there was no statistically significant difference in age between the women with calcifications and type 2 diabetes (61 years of age) in relation to the control group (p=0.176). The incidence of polineuropathy in diabetic women was higher in the group with intramammary arterial calcifications (52.3%) in comparison to the group without calcifications (26.1%), (p=0.005). The association between intramammary arterial calcifications and the duration of diabetes was not found. Conclusion. The obtained results supported the theory that intramammary arterial calcifications, detected by mammography could serve as markers of co-existing diabetes mellitus and therefore should be specified in radiologic report in case of their early development.

scholarly journals Aggregation activity of blood formed elements in patients with type 1 and type 2 diabetes mellitus

2012 ◽  
Vol 15 (2) ◽  
pp. 49-53
Author(s):  
Boris Il'ich Kuznik ◽  
Yury Antonovich Vitkovskiy ◽  
Marina Yur'evna Zakharova ◽  
Natalya Nikolaevna Klyuchereva ◽  
Olga Sergeevna Rodnina ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Platelet Aggregation ◽  
Blood Samples ◽  
Significant Difference ◽  
Erythrocyte Adhesion ◽  
T1 And T2 ◽  
Aggregation Activity ◽  
Spontaneous Platelet Aggregation

Aims. To assess differences in blood formed elements aggregation activity in patients with type 1 (T1) and type 2 (T2) diabetes mellitus(DM). Materials and methods. We studied blood samples from 88 patients with T1 and T2 DM. Platelet aggregation activity was assessed bymeans of ?Biola? aggregometer; we also determined platelet-lymphocyte and leucocyte-erythrocyte adhesion intensity. Results. We show that spontaneous platelet aggregation is markedly increased in patients with T1DM but remains normal or slightlyelevated in case of T2DM. In blood from patients with T2DM platelet aggregation in response to ADP, epinephrine, ristomycineand contact with collagen was generally increased, whereas in T1DM we often observed its secondary reduction. Data on plateletlymphocyteadhesion in T1DM is controversial, but in T2DM this process seems to be significantly suppressed. Quantity of leucocyteerythrocyteaggregates was sharply increased in both T1DM and T2DM. Conclusion. We've determined significant difference in blood formed elements aggregation activity between patients with T1 and T2 DM.

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