Diabetic Retinopathy. Morphofunctional State of the Retina in Pancreas Recipients

Diabetes mellitus (DM) is one of the most common and rapidly progressing diseases worldwide. Diabetic retinopathy (DR) is a common complication of diabetes and the main cause of vision loss in middle-aged and elderly people. The development and progression of DR is closely related to the duration of diabetes, hyperglycemia, and arterial hypertension. There is growing evidence that inflammation is one of the key links in the pathogenesis of diabetic retinal damage, but the exact molecular mechanisms remain to be known. Pancreas transplantation (PT) is currently the only effective treatment for diabetes that restores normal physiological glucose metabolism. Due to the limited number of PT surgeries associated with the severity of intra- and postoperative complications and the acute issue of organ donation, studies on the assessment of DR after PT are few and contradictory. There is a need for further studies of the DR state after PT with the study of the influence of risk factors, determination of the level of immunological markers and the use of modern instrumental research methods to create effective patient management regimens in the postoperative period.

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Hubungan tekanan intraocular dengan diabetes retinopati proliferatif

e-CliniC ◽

10.35790/ecl.4.2.2016.14470 ◽

2016 ◽

Vol 4 (2) ◽

Author(s):

Felix Martua ◽

Laya Rares ◽

Yamin Tongku

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Intraocular Pressure ◽

Proliferative Diabetic Retinopathy ◽

Vital Sign ◽

Vision Loss ◽

Severe Form ◽

Common Complication ◽

Dummy Variable ◽

Period Data

Abstrak: Diabetes Mellitus (DM) adalah penyakit tidak menular yang diderita lebih dari 170 juta orang di seluruh dunia, salah satu komplikasi dari DM adalah diabetes retinopati dimana salah satu bentuknya adalah proliferatif (PDR). Jika PDR tidak ditangani dengan cepat maka akan menimbulkan penurunan tajam penglihatan dan disertai peningkatan tekanan intraokular (TIO). Penelitian ini dilakukan untuk menemukan hubungan antara PDR dengan peningkatan TIO. Penelitian dilakukan dengan metode analitik retrospektif, dengan menggunakan data rekam medik dari pasien yang berobat di Poliklinik Mata RSUP Prof. R.D. Kandou Manado periode Januari 2015-September 2016. Data yang diambil antara lain status tekanan intraocular dan tanda vital pasien sebelum menerima tindakan terapi. Dari 24 data rekam medik pasien yang memenuhi kriteria didapat 15 pasien jenis kelamin perempuan (62,5%) dan 9 pasien jenis kelamin laki-laki (37,5%). Rentang usia paling banyak terkena PDR adalah 55-64 tahun sebanyak 10 orang (41,7%). Hasil analisis menggunakan metode analisis regresi dengan variabel dummy terdapat tingkat hubungan sebesar 29,7% yang berarti PDR sedikit berpengaruh pada TIO, dengan p=0,03 yang menunjukkan hubungan yang kurang signifikan antara PDR dan TIO (p<0,05). Simpulan: didapat hubungan yang kurang signifikan antara PDR dan TIO.Kata kunci: diabetes retinopati proliferatif, tekanan intraokular Abstract: Diabetes Mellitus (DM) is an uninfectious disease that affect more than 170 million persons worldwide. Diabetic retinopathy is one of the most common complication on people with diabetes, and Proliferative Diabetic Retinopathy (PDR) is the most severe form of diabetic retinopathy. PDR will cause vision loss if not treated quickly and causing elevation of intraocular pressure (IOP). PDR and its association with elevation of IOP is the main focus of this study. This study was an analytic-retrospective, using the data from medical record of patients that visits Polyclinic of Opthalmology in Prof. R.D. Kandou Hospital from January 2015 until September 2016 period. Data used for this study is IOP, vision status, and vital sign, and the IOP was measured before patient taking any medication. From 24 samples were used for this study, 15 of them is females (62,5%), based on age span, most patients with PDR are between 55-64 y.o. by 10 people (41,7%). Analytic result using dummy variable shows PDR has little effect to IOP, by 29,7% and shows little signifancy (p=0,03; p<0,05). Conclusion: PDR has little significant correlation to IOP. Keywords: proliferative diabetic retinopathy, intraocular pressure

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In-depth transcriptomic analysis of human retina reveals molecular mechanisms underlying diabetic retinopathy

Scientific Reports ◽

10.1038/s41598-021-88698-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kolja Becker ◽

Holger Klein ◽

Eric Simon ◽

Coralie Viollet ◽

Christian Haslinger ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Rna Sequencing ◽

Molecular Mechanisms ◽

Vision Loss ◽

Ganglion Cells ◽

Expression Profiles ◽

Cell Types ◽

Sequencing Data ◽

Disease Stages ◽

Post Transcriptional Regulation

AbstractDiabetic Retinopathy (DR) is among the major global causes for vision loss. With the rise in diabetes prevalence, an increase in DR incidence is expected. Current understanding of both the molecular etiology and pathways involved in the initiation and progression of DR is limited. Via RNA-Sequencing, we analyzed mRNA and miRNA expression profiles of 80 human post-mortem retinal samples from 43 patients diagnosed with various stages of DR. We found differentially expressed transcripts to be predominantly associated with late stage DR and pathways such as hippo and gap junction signaling. A multivariate regression model identified transcripts with progressive changes throughout disease stages, which in turn displayed significant overlap with sphingolipid and cGMP–PKG signaling. Combined analysis of miRNA and mRNA expression further uncovered disease-relevant miRNA/mRNA associations as potential mechanisms of post-transcriptional regulation. Finally, integrating human retinal single cell RNA-Sequencing data revealed a continuous loss of retinal ganglion cells, and Müller cell mediated changes in histidine and β-alanine signaling. While previously considered primarily a vascular disease, attention in DR has shifted to additional mechanisms and cell-types. Our findings offer an unprecedented and unbiased insight into molecular pathways and cell-specific changes in the development of DR, and provide potential avenues for future therapeutic intervention.

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Progression of Diabetic Retinopathy after Pancreas Transplantation for Insulin-Dependent Diabetes Mellitus

New England Journal of Medicine ◽

10.1056/nejm198801283180403 ◽

1988 ◽

Vol 318 (4) ◽

pp. 208-214 ◽

Cited By ~ 266

Author(s):

Robert C. Ramsay ◽

Frederick C. Goetz ◽

David E.R. Sutherland ◽

S. Michael Mauer ◽

Leslie L. Robison ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Pancreas Transplantation ◽

Insulin Dependent Diabetes Mellitus ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Insulin Dependent

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Molecular Mechanisms of Diabetic Retinopathy, General Preventive Strategies, and Novel Therapeutic Targets

BioMed Research International ◽

10.1155/2014/801269 ◽

2014 ◽

Vol 2014 ◽

pp. 1-18 ◽

Cited By ~ 67

Author(s):

Sher Zaman Safi ◽

Rajes Qvist ◽

Selva Kumar ◽

Kalaivani Batumalaie ◽

Ikram Shah Bin Ismail

Keyword(s):

Diabetic Retinopathy ◽

Structural Damage ◽

Molecular Mechanisms ◽

Vision Loss ◽

Therapeutic Targets ◽

Polyol Pathway ◽

Preventive Strategies ◽

Retinal Cells ◽

Hexosamine Pathway ◽

Pathway Flux

The growing number of people with diabetes worldwide suggests that diabetic retinopathy (DR) and diabetic macular edema (DME) will continue to be sight threatening factors. The pathogenesis of diabetic retinopathy is a widespread cause of visual impairment in the world and a range of hyperglycemia-linked pathways have been implicated in the initiation and progression of this condition. Despite understanding the polyol pathway flux, activation of protein kinase C (KPC) isoforms, increased hexosamine pathway flux, and increased advanced glycation end-product (AGE) formation, pathogenic mechanisms underlying diabetes induced vision loss are not fully understood. The purpose of this paper is to review molecular mechanisms that regulate cell survival and apoptosis of retinal cells and discuss new and exciting therapeutic targets with comparison to the old and inefficient preventive strategies. This review highlights the recent advancements in understanding hyperglycemia-induced biochemical and molecular alterations, systemic metabolic factors, and aberrant activation of signaling cascades that ultimately lead to activation of a number of transcription factors causing functional and structural damage to retinal cells. It also reviews the established interventions and emerging molecular targets to avert diabetic retinopathy and its associated risk factors.

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The vasomotor function of endothelium and elasticity of the arterial wall in the patients with type 1 diabetes mellitus at different stages of diabetic retinopathy

Problems of Endocrinology ◽

10.14341/probl201258422-26 ◽

2012 ◽

Vol 58 (4) ◽

pp. 22-26

Author(s):

E P Kosobian ◽

I Ia Iarek-Martynova ◽

A S Parfenov ◽

M V Shestakova

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Type 1 Diabetes Mellitus ◽

Healthy Subjects ◽

Reactive Hyperemia ◽

Signal Amplitude ◽

Stiffness Index ◽

Retinal Damage

The objective of the present work was to estimate the degree of rigidity of the vascular wall and endothelial function in the patients with type 1 diabetes mellitus at different stages of diabetic retinopathy and in its absence. The study included 118 patients at the age from 18 to 40 years presenting with type 1 diabetes mellitus more than 5 years in duration. The patients were divided into several groups based on the stage of diabetic retinopathy (DR). The control group was comprised of 23 healthy subjects. The contour pulsed wave analysis and the reactive hyperemia test were performed with the use of an Angioscan device. All the patients gave the informed consent to participate in the study. The aortic stiffness index (SI) in all groups of the patents with DM1 and DR was higher than in the healthy subjects. However, the SI values remained normal in the DM1 patients without DR. An increase of SI values was unrelated to the presence of arterial hypertension. The analysis of RI values revealed no statistically significant differences between the groups. The reactive hyperemia test has demonstrated a decrease in the increment of the post-occlusive signal amplitude in a large number of patients suggesting endothelial dysfunction. This decrease was apparent even in the patients exhibiting no signs of retinal damage. However, despite the overall decrease of this parameter, many patients showed its paradoxically high values that probably reflected the elevated baseline level of nitric oxide. The increase of aortic stiffness index with the progression of diabetic retinopathy may be used as an early marker of macrovascular complications even in the patients without arterial hypertension. The lowering of the increment of the post-occlusive signal amplitude in the patients having no signs of retinal damage is indicative of endothelial dysfunction as early as the preclinical stage of DR development. The paradoxically high increment of the signal amplitude is supposed to be associated with the elevation of the baseline level of nitric oxide that in its turn reflects the severity of inflammation and is a factor of high risk of progression of angiopathies.

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RECURRENCE OF IMMUNOLOGICAL MARKERS FOR TYPE 1 (INSULIN-DEPENDENT) DIABETES MELLITUS IN IMMUNOSUPPRESSED PATIENTS AFTER PANCREAS TRANSPLANTATION

Transplantation Journal ◽

10.1097/00007890-199807150-00022 ◽

1998 ◽

Vol 66 (1) ◽

pp. 128-131 ◽

Cited By ~ 27

Author(s):

Enric Esmatjes ◽

Camino Rodr??guez-Villar ◽

Maria J. Ricart ◽

Roser Casamitjana ◽

Jaume Martorell ◽

...

Keyword(s):

Diabetes Mellitus ◽

Pancreas Transplantation ◽

Insulin Dependent Diabetes Mellitus ◽

Insulin Dependent Diabetes ◽

Dependent Diabetes Mellitus ◽

Immunological Markers ◽

Immunosuppressed Patients ◽

Insulin Dependent

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Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17010310 ◽

2020 ◽

Vol 17 (1) ◽

pp. 310

Author(s):

Abdah Khairiah Che Md Noor ◽

Evelyn Li Min Tai ◽

Yee Cheng Kueh ◽

Ab Hamid Siti-Azrin ◽

Zamri Noordin ◽

...

Keyword(s):

Diabetes Mellitus ◽

Visual Acuity ◽

Diabetic Retinopathy ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Survival Time ◽

Proliferative Diabetic Retinopathy ◽

Vision Loss ◽

Ischemic Heart ◽

Vitrectomy Surgery

Vitrectomy surgery in proliferative diabetic retinopathy improves the vision-related quality of life. However, there is lack of data on the duration of maintenance of visual gains post vitrectomy. This study thus aimed to determine the survival time of visual gains and the prognostic factors of vision loss after vitrectomy surgery for complications of proliferative diabetic retinopathy. A retrospective cohort study was conducted in an ophthalmology clinic in Malaysia. We included 134 patients with type 2 diabetes mellitus on follow-up after vitrectomy for proliferative diabetic retinopathy. Visual acuity was measured using the log of minimum angle of resolution (LogMar). A gain of ≥0.3 LogMar sustained on two subsequent visits was considered evidence of visual improvement post vitrectomy. Subjects were considered to have vision loss when their post-operative visual acuity subsequently dropped by ≥0.3 LogMar. Kaplan–Meier analysis was used to determine the survival time of visual gains. Cox Proportional Hazard regression was used to determine the prognostic factors of vision loss. The median age of patients was 56.00 years (IQR ± 10.00). The median duration of diabetes mellitus was 14.00 years (IQR ± 10.00). Approximately 50% of patients with initial improvement post vitrectomy subsequently experienced vision loss. The survival time, i.e., the median time from surgery until the number of patients with vision loss formed half of the original cohort, was 14.63 months (95% CI: 9.95, 19.32). Ischemic heart disease was a significant prognostic factor of vision loss. Patients with underlying ischemic heart disease (adjusted HR: 1.97, 95% CI: 1.18, 3.33) had a higher risk of vision loss post vitrectomy, after adjusting for other factors. Approximately half the patients with initial visual gains post vitrectomy maintained their vision for at least one year. Ischemic heart disease was a poor prognostic factor for preservation of visual gains post vitrectomy.

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Harnessing Feature Extraction Techniques alongside CNN for Diabetic Retinopathy Detection

International Journal of Recent Technology and Engineering - 2 ◽

10.35940/ijrte.b3569.079220 ◽

2020 ◽

Vol 9 (2) ◽

pp. 422-425

Keyword(s):

Diabetes Mellitus ◽

Feature Extraction ◽

Diabetic Retinopathy ◽

Vision Loss ◽

Medical Condition ◽

Machine Learning Algorithms ◽

Extraction Techniques ◽

Energy Deficiency ◽

Automated Screening ◽

Processing Techniques

Diabetes mellitus is a disorder that inhibits your body from properly using the energy from the food you consume. The blood vessels and blood are responsible for the transport of sugar. A hormone called insulin helps cells to take in sugar to be used as energy. Deficiency in insulin causes the disease of diabetes mellitus. One of the side effect of diabetes mellitus is diabetic retinopathy. Diabetic retinopathy is the medical condition that causes the principal vision or in rare cases entire vision loss. Diabetic retinopathy has frequent occurrences in people among 20 to 60 years. Addressing this problem, we have developed an application that saves time and gives the result of the stage of the disease. This research paper presents a CNN based system that classifies the patients in four classes as 0-no DR, 1-Mild DR, 2-Moderate DR, 3-Severe DR. The system takes the input as an image taken from a fundus camera. Image processing techniques and machine learning algorithms are used for feature extraction. The Automated screening of the retinal images would assist the doctors to easily identify the patient's condition more precisely. With this we can easily distinguish between normal and abnormal images of the retina, this will reduce the number of inspections for the doctors.

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PREVALENCE, PATHOGENESIS, CLASSIFICATION, IMAGING, SCREENING AND MANAGE-MENT OF DIABETIC RETINOPATHY- A CRITICAL REVIEW

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj1709072021 ◽

2021 ◽

Vol 9 (7) ◽

pp. 1433-1442

Author(s):

Narender Chanchal ◽

Kushagra Goyal ◽

Divya Vij ◽

Rajesh Kumar Mishra

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Vision Loss ◽

International Diabetes Federation ◽

Pathological Process ◽

Heterogeneous Cluster ◽

Keywords Diabetic Retinopathy ◽

Screening And Surveillance ◽

Working Age ◽

Microvascular Alterations

Diabetic retinopathy is that the leading reason for sightlessness among people between twenty-five and seventyfour years older within the industrialised world. Diabetes mellitus (DM) includes a heterogeneous cluster of disorders of carbohydrate, protein, and metastasis manifesting hyperglycemia. Diabetic retinopathy could be microangiopathy ensuing from the chronic effects of the disease, and shares similarities with the microvascular alterations that occur in different tissues at risk of DM equivalent to the kidneys and also the peripheral nerves. Diabetic retinopathy is assessed into nonproliferative and proliferative stages. Nonproliferative diabetic retinopathy (NPDR) involves progressive intraretinal microvascular alterations that may result in, and a lot of advanced proliferative stages outlined by extraretinal neovascularization. Imaging modalities in common clinical use for the management of NPDR and DME embrace structure photography, fluorescein angiography (FA), and optical coherence tomography (OCT). The suggested schedule for screening and surveillance for NPDR reflects data concerning the epidemiology and natural history of the disease. Diabetic retinopathy could be a leading explanationfor vision loss in working-age Americans and a major cause of sightlessness worldwide. The International Diabetes Federation estimates that as several as 592 million individuals worldwide can have DM in 2035, a rise from or so 387 million people calculable to possess the disease in 2014. Here, we tend to present a review of the presentunderstanding and new insights into biochemical mechanisms within the pathological process in DR, classification, furthermore as clinical treatments for DR patients. Keywords: Diabetic retinopathy, diabetes mellitus, retinal degeneration, fluoresces in angiography, optical coher- ence tomography, VEGF, focal/grid laser photocoagulation.

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