scholarly journals Influence of serum lipids on clinically significant macular edema in type 2 diabetic retinopathy cases

2021 ◽  
Vol 7 (1) ◽  
pp. 82-88
Author(s):  
Deepa C K ◽  
Dinesh P ◽  
Nagalakshmi C S ◽  
Nidhi Pandey
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Serum Lipids ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant ◽  
Type 2 Diabetic ◽  
Type 2 Diabetic Retinopathy

scholarly journals Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy

2020 ◽  
Vol 9 (5) ◽  
pp. 1433 ◽  
Author(s):  
Ines P. Marques ◽  
Maria H. Madeira ◽  
Ana L. Messias ◽  
Torcato Santos ◽  
António C-V. Martinho ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Odds Ratio ◽  
Retinal Thickness ◽  
Proliferative Retinopathy ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications.

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 Management of Diabetic Retinopathy

2021 ◽  
pp. 95-103
Author(s):  
Marieta Dumitrache ◽  
Rodica Lascu
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Effective Treatment ◽  
Prophylactic Treatment ◽  
Vision Loss ◽  
Vitreous Hemorrhage ◽  
Tractional Retinal Detachment ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant ◽  
Photocoagulation Laser

Management in D.R. through prophylactic treatment (maintaining a glycemic level as close as possible to normal, control hypertension <150/85 mmHg, hyperlipidemia) and curative treatment of D.R. does not cure the disease, but may slow the evolution of D.M. and D.R. AntiVEGF agents are indicated as adjuvant therapy in pan-photocoagulation laser and / or vitrectomy in patients with DR to block angiogenesis by inhibiting VEGF. All antiVEGF agents are an effective treatment for the clinically significant macular edema. Photocoagulation laser is a treatment of choice in preproliferative and proliferative DR and an effective treatment of diabetic macular edema. The indications for laser treatment in diabetic retinopathy are related to the incidence, evolution of neovessels, duration of diabetes, HbA1c level, presence of macular edema, stage of DR. The laser for macular lesions reduces the risk of vision loss in the eyes with incipient and moderate non-proliferative DR and macular edema concomitant; the laser should be applied to all patients with clinically significant macular edema. Vitrectomy in proliferative DR is indicated in vitreous hemorrhage, tractional retinal detachment in order to remove the vitreous hermorrhage and excision of tractional preretinal membranes.

Elevation in Circulating Soluble CD40 Ligand Concentrations in Type 2 Diabetic Retinopathy and Association with its Severity

2018 ◽  
Vol 128 (05) ◽  
pp. 319-324 ◽  
Author(s):  
Laila Ben Lamine ◽  
Amira Turki ◽  
Ghada Al-Khateeb ◽  
Nejla Sellami ◽  
Hagger B. Amor ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Linear Regression Analysis ◽  
Plasma Concentrations ◽  
Cd40 Ligand ◽  
Significant Finding ◽  
Characteristic Analysis ◽  
Soluble Cd40 Ligand ◽  
Type 2 Diabetic ◽  
Type 2 Diabetic Retinopathy

Abstract Background To investigate the relationship between changes in circulating soluble CD40 ligand (sCD40L) levels and the presence and severity of type 2 diabetic retinopathy (DR). Subjects and methods sCD40L plasma concentrations were measured in 205 type 2 diabetes (T2DM) patients without DR (DWR; n=50) and with DR (n=155), the latter subdivided into non-proliferative diabetic retinopathy [NPDR; n=98 (63.2%)], or proliferative retinopathy [PDR; n=57 (36.8%)] patients. Results Receiver operating characteristic analysis provided good discriminatory power for sCD40L as predictor of DR presence, with high sensitivity and specificity. Categorizing DWR and DR patients into sCD40L quartiles, based on sCD40L concentrations in T2DM without DR, demonstrated statistically significant gradual increase in DR risk with increasing sCD40L levels. sCD40L levels were significantly higher in DR compared to DWR patients. Plasma sCD40L levels differed significantly according to DR severity, and correlated with diabetes duration, dyslipedimea, nephropathy, and presence of DR, but not with gender, age, SBP, DBP, FPG, HbA1c, T2DM medications. Linear regression analysis confirmed the association of increased sCD40L levels with DR, independent of others parameters; mean plasma sCD40L levels differing significantly according to DR severity. Conclusion Plasma sCD40L levels were positively associated with DR. The significant finding here is that sCD40L levels can be predictors of DR severity.

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