scholarly journals Multiple factors in the prediction of risk of recurrent vitreous haemorrhage after sutureless vitrectomy for non-clearing vitreous haemorrhage in patients with diabetic retinopathy

2020 ◽  
Author(s):  
YUHUA DING ◽  
BANGTAO YAO ◽  
HUI HANG ◽  
HUI YE
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Case Series ◽  
Tertiary Hospital ◽  
Vitreous Haemorrhage ◽  
Fluid Exchange ◽  
Duration Of Diabetes ◽  
Multiple Factors ◽  
Sugar Levels ◽  
Sutureless Vitrectomy

Abstract Background We aimed to analyse multiple factors in the prediction of risk of postoperative recurrent vitreous haemorrhage (RVH) for non-clearing vitreous haemorrhage in patients with diabetic retinopathy (DR) who underwent sutureless vitrectomy with 23- (23G) or 25-gauge (25G) narrow-gauge systems. Methods A retrospective consecutive case series design was used. DR patients who underwent sutureless vitrectomy for non-clearing vitreous haemorrhage between June 2017 and October 2019 were enrolled. All operations were performed at a tertiary hospital. Patient demographics and risk factors, including age, gender, duration of diabetes, preoperative fasting blood sugar levels (FBSL), systolic blood pressure (SBP), serum creatinine (Cr), urea, triamcinolone acetonide (TA), electrical coagulation, air-fluid exchange, pan‑retinal photocoagulation status (PRP), anti-vascular endothelial growth factor drug (anti-VEGF), and other factors, were recorded. Patients were divided into two groups based on the timing of their postoperative RVH: immediate postoperative RVH (within 2 weeks after operation) and delayed postoperative RVH (beyond 2–4 weeks after operation). Results Overall, 167 eyes (167patients) were enrolled. Seventy eyes were underwent 23G and 25G sutureless vitrectomy performed in 97 eyes, respectively. Postoperative RVH developed in 18 eyes (25.7%) in Group 23G and in 20 eyes (21.6%) in Group 25G (P = 0.540). Of these, 3 eyes (4.3%) had severed RVH in Group 23G compared with 5 eyes (5.2%) in Group 25G (P = 0.584). Delayed postoperative RVH occurred in 6 eyes (8.6%) in Group 23G and 8 eyes (8.2%) in Group 25G (P = 0.789). A binomial logistic regression analysis revealed that age, duration of diabetes, and Cr level were significantly associated with RVH in both Group 23G (P < 0.05) and Group 25G (P < 0.05). Conclusions The incidence and severity of RVH were 25.7% and 4.3%, respectively, in Group 23G and 21.6% and 5.15%, respectively, in Group 25G. Thus, the 23G sutureless vitrectomy approach was as safe as the 25G sutureless vitrectomy approach for treating vitreous haemorrhage in patients with DR. A younger age, shorter duration of diabetes, and higher Cr levels were risk factors for postoperative RVH in sutureless vitrectomy.

scholarly journals Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu

2014 ◽  
Vol 6 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Raba Thapa ◽  
Deepak Man Joshi ◽  
Aparna Rizyal ◽  
Nhukesh Maharjan ◽  
Rajesh Dhoj Joshi
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Case Series ◽  
Systemic Hypertension ◽  
P Value ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Case Series Study ◽  
Systemic Problems ◽  
Clinically Significant

Introduction: Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal. Objectives: The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients. Materials and methods: A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients’ detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria. Main outcome measures: The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed. Results: A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004). Conclusion: The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.   DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10760   Nepal J Ophthalmol 2014; 6 (2): 24-30

scholarly journals Evaluation of HbA1c Level and Other Risk Factors in Diabetic Retinopathy: A Study of Type 2 Diabetic Patients Attending in a Tertiary Level Hospital

KYAMC Journal ◽  
2017 ◽  
Vol 6 (2) ◽  
pp. 614-619 ◽  
Author(s):  
Sayama Hoque ◽  
MA Muttalib ◽  
Md Imtiajul Islam ◽  
Parvin Akter Khanam ◽  
Subhagata Choudhury
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Diabetic Retinopathy ◽  
Blood Glucose ◽  
Advanced Age ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Duration Of Diabetes ◽  
Type 2 Diabetic

Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels.Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c.Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%;c2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (OR = 3.22; 95% CI: 1.12-9.25) and the risk was strongly increased at the HbA1c categories 8% (OR = 5.07; 95% CI: 1.90-13.50). Advanced age (OR = 2.92; 95% CI: 1.44-5.91), longer duration of diabetes (OR = 3.08; 95% CI: 1.49-6.37), presence of hypertension (OR = 2.42; 95% CI: 1.14-5.16), FBG (OR = 1.139; 95% CI: 1.036-1.251), blood glucose 2 hours ABF (OR = 1.124; 95% CI: 1.046-1.207) and SBP (OR = 1.033; 95% CI: 1.011-1.056) had significant association with retinopathy.Conclusions: HbA1c categories >7.0% is an important risk factor for the development of retinopathy. Poor glycaemic control, advanced age, longer duration of diabetes, hypertension are other significant risk factors of diabetic retinopathy.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 614-619

scholarly journals Prevalence and Associated Factors of Diabetic Retinopathy in Quzhou, China: A Cross-Sectional Study

2021 ◽  
Author(s):  
Zian Cheng ◽  
Xianchen Jiang ◽  
Weifen Zhu ◽  
Xinxin Zhang ◽  
Xiaofang Ying ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Zhejiang Province ◽  
Sectional Study ◽  
Good Glycemic Control ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
High Risk Factors

Abstract Objectives To assess the prevalence and risk factors for fundus status among patients with type 2 diabetes mellitus (T2DM) using fundus screening in four towns of Quzhou city, Zhejiang province of China. Methods This cross-sectional study included 230 T2DM patients of four towns in Quzhou city, Zhejiang province of China. Participants were examined for the diabetes related fundus abnormalities and possible risk factors. Results Almost half of the T2DM patients (53.04%) reported with diabetic retinopathy (DR). Patients with diabetic retinopathy had longer duration of diabetes (P < 0.001) and higher HbA1c (P < 0.01). Risk factors for development of diabetic retinopathy included duration of diabetes and HbA1c. The prevalence of DR increased with the prolongation of the disease duration. The prevalence of DR was 28.79% in the group of disease duration < 5 years, 46.25% in the group of disease duration 5–10 years, 72.92% in the group of disease duration 10–15 years and 88.57% in the group of disease duration ≥ 15 years. What’s more, the prevalence of DR also increased with the increment of HbA1c levels. The prevalence of DR was 44.62% in the group of HbA1c < 7%, 53.13% in the group of HbA1c 7%-8%, 62.92% in the group of HbA1c ≥ 8%. Conclusion The prevalence of DR was disturbingly high. Risk factors for DR were similar to other studies and included duration of diabetes and HbA1c. Thus, good glycemic control remains the core foundation of managing DR.

scholarly journals RISK FACTORS FOR THE OCCURRENCE OF PRIMARY OPEN-ANGLE GLAUCOMA IN PATIENTS WITH DIABETIC RETINOPATHY AND TYPE 2 DIABETES

2021 ◽  
Vol 77 (3) ◽  
pp. 37-46
Author(s):  
K. A. Gudzenko ◽  
S. Yu. Mogilevskyy ◽  
М. L. Kyryliuk ◽  
D. S. Ziablitsev
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Open Angle ◽  
Duration Of Diabetes

The aim of this work was to identify risk factors for the occurrence of primary open-angle glaucoma in patients with diabetic retinopathy and type 2 diabetes mellitus by conducting a regression analysis of the mutual influence of these diseases. We examined 649 patients (649 eyes), among whom 301 patients (301 eyes) had diabetic retinopathy and glaucoma; 164 patients (164 eyes) had diabetic retinopathy only; 81 patients (81 eyes) had only glaucoma and 103 patients (103 eyes) did not have these diseases (control). The construction of logistic regression models was carried out in the GLZ module of the Statistica 10 software (StatSoft, Inc. USA). It was found that the development of primary open-angle glaucoma directly depended on the duration of diabetes and the intraocular pressure level, and vice versa — on visual acuity (p < 0.001). The development of diabetic retinopathy did not depend on the presence of glaucoma, but it was directly dependent on the blood content of glucose and glycated hemoglobin. Men had a lower risk of developing diabetic retinopathy than women(OR = 0.800; 95% CI 0.76-0.84). Also, men had a lower risk of glaucoma (OR = 0.95; 95% CI 0.94–0.96). Stratification by stages of diabetic retinopathy showed the effect of intraocular pressure, decreased visual acuity and glaucoma stages on the development of proliferative diabetic retinopathy (p < 0.001). Increased intraocular pressure was an independent factor in the development of retinopathy. The development of glaucoma of the initial stage was directly influenced by an increase of blood glycated hemoglobin and by the stage of diabetic retinopathy. The occurrence of stage 2 glaucoma was influenced by the duration of diabetes and visual acuity, stage 3 glaucoma — by visual acuity, and stage 4 glaucoma – by the age and duration of diabetes. Independent risk factors for glaucoma were duration of diabetes, increased intraocular pressure, and low visual acuity. When stratified by stage, there was no evidence of a reduction in the risk of developing diabetic retinopathy and glaucoma in men. Thus, the features of the mutual influence of the development of diabetic retinopathy and primary open-angle glaucoma in type 2 diabetes mellitus have been established.

scholarly journals Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Syeda Birjees Anwar ◽  
Naveed Asif ◽  
Syed Abid Hassan Naqvi ◽  
Sidra Malik
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Family History ◽  
Positive Family History ◽  
Family History Of Diabetes ◽  
Duration Of Diabetes ◽  
Multiple Risk Factors ◽  
History Of ◽  
The Mean ◽  
The Difference

Objective: To determine the role of hypertension, hyperlipidemia, smoking and positive family history of diabetes and hypertension in the development of diabetic retinopathy. Methods: This prospective cohort study was conducted at the Department of Chemical Pathology, Armed Forces Institute of Pathology, Rawalpindi over 2 years period from June 2014 to June 2016. One hundred consecutive diabetic patients with no signs of diabetic retinopathy and good glycemic control (HbA1c<6.5%) were registered by non-probability convenient sampling after taking written informed consent. They were evaluated for hypertension, hyperlipidemia and smoking status. These patients were then followed 6 monthly for 2 years to look for the development of diabetic retinopathy. Results: The mean age of the patients was 50.72±9.29 years and there were 57 (57%) male and 43 (43%) female patients. Majority (82%) of the patients had NIDDM. The mean duration of diabetes was 8.31±6.83 years. 11% of the patients were smoker, 37% were hypertensive, 6% had hyperlipidaemia, 62% had family history of diabetes and 30% had family history of hypertension. At the end of follow-up, 9 (9.0%) patients had diabetic retinopathy. The frequency of diabetic retinopathy increased with increasing age of the patient; however, the difference was statistically insignificant. A comparatively higher frequency of diabetic retinopathy was also seen in patients with IDDM and those with positive family history of diabetes and hypertension yet again, the difference was statistically insignificant. Also, no significant difference was noted among male and female genders and smokers vs. non-smoker. However, the frequency of diabetic retinopathy increased significantly with increasing duration of diabetes. It was also higher among those with hypertension and hyperlipidemia. Conclusion: Higher patient age (≥50 years), increasing duration of diabetes (≥20 years), insulin dependent diabetes mellitus, hypertension, hyperlipidemia, and positive family history of diabetes and hypertension were found to be associated with increased frequency of diabetic retinopathy. How to cite this:Anwar SB, Asif N, Naqvi SAH, Malik S. Evaluation of multiple risk factors involved in the development of Diabetic Retinopathy. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.279 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Correlation of Ankle-Brachial Index with Diabetic Retinopathy in Patients of Type 2 Diabetes

2020 ◽  
Vol 35 (4) ◽  
Author(s):  
Abdullah Mazhar ◽  
Tayyaba gul Malik ◽  
Aalia Ali ◽  
Hina Nadeem
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Blood Sugar ◽  
Teaching Hospital ◽  
Ankle Brachial Index ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Sugar Levels ◽  
Relationship Of

Objectives: To find out a relationship of diabetic retinopathy with ankle-brachial (ABI) in patients of type 2 diabetes. Material and Methods It was a cross-sectional observational study carried out in Arif Memorial Teaching hospital and Rashid Latif Medical College from January 2019 to June 2019. 120 patients were selected by purposive convenient sampling from outpatient department of Arif Memorial Teaching hospital. After clinical history, complete ocular examination was performed. Random blood sugar levels were measured using Glucometer. Ankle-brachial index was calculated by dividing the systolic pressure at ankle by the systolic blood pressure at arm. Statistical analysis was done using SPSS 25. Independent sample t test and chi square tests were used to find out the significance of the results. Results: In this study of 120 diabetic patients, 80 (66.7%) were female and 40 (33.3%) were males. Mean Ankle Branchial Index (ABI) of Males was 0.96±0.11 and for females was 0.97±0.14. Among 120 participants of this study, 73 (60.83 %) patients had no signs of diabetic retinopathy, 35 (29.16 %) patients had NPDR and 12 (10%) patients had PDR. ABI was not associated with gender and duration of diabetes. However, there was negative and weak linear relationship between BSR and ABI (r= -0.221). This correlation was higher in diabetics of less than 5 year duration (r=-0.286) than in patients of more than 5 years duration of diabetes (r=-0.129).  Conclusion: Our study indicates that ABI is not significantly related with diabetic retinopathy. However, there is a positive relationship of ABI with high blood sugar levels.

scholarly journals Prevalence and associated risk factors for diabetic retinopathy at first ophthalmological contact

2021 ◽  
Vol 12 (8) ◽  
pp. 118-124
Author(s):  
Bhavkaran Singh ◽  
Prempal Kaur ◽  
Jaspreet Singh ◽  
Parveen Grang
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Observational Study ◽  
Health Concern ◽  
Accurate Estimation ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Screening Programs ◽  
Duration Of Diabetes ◽  
Associated Risk Factors

Background: Type 2 diabetes mellitus (DM) is now considered as a growing global public health concern due to cost associated with diabetic micro and macrovascular complications. Diabetic retinopathy (DR) is one of the leading causes of vision loss. Accurate estimation of prevalence of DR among diabetic patients and associated risk factors are of crucial importance to plan and execute preventive strategies in the community. Aims and Objectives: The present cross sectional hospital based observational study was undertaken to determine the prevalence of DR in diabetic patients at their first ophthalmological contact and toevaluate associated risk factors. Materials and Methods: In this cross sectional hospital based observational study, all diabetic patients visiting ophthalmology clinic for the first time after being diagnosed as diabetic were enrolled. After recording demographic data and biochemical findings, each patient was investigated for DR and correlated with associated risk factors. Results: Of 1699 patients, majority (68.9%) of them had come to ophthalmology clinic with complaint of decreased vision. Only 16.12 % (274) patients had been referred for retinal exam by treating physician. DR was prevalent in 242(16.98%) non-referred and 31(11.31%) referred patients. Mean age and mean duration of diabetes was significantly higher in non-referred patients. Vision threatening DR was also significantly higher in nonreferred patients. Prevalence of DR was significantly correlated with age at presentation, duration of diabetes, rural background, uncontrolled diabetes, systolic blood pressure and high BMI. Conclusion: Low referral by treating physician and lack of awareness among patient accounts for late presentation of diabetic patients to ophthalmologist. Beyond just developing strategies to promote screening programs for early detection and management of DR, education of the patients,comprehensive planning and coordination between ophthalmologist and physician can go a long way to decrease the economic and social burden of preventable blindness due to diabetic retinopathy.

scholarly journals Prevalence and Associated Risk Factors for Diabetic Retinopathy among in-patients Diagnosed with Diabetes Mellitus: A Retrospective Study Conducted in Nobel Medical College and Teaching Hospital, Biratnagar

2018 ◽  
Vol 7 (1) ◽  
pp. 50-55
Author(s):  
Bishwa Nath Adhikari ◽  
Pramod Sharma Gautam ◽  
Binod Bekoju ◽  
Sadhana Basnet ◽  
Himlal Bhandari
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Retrospective Study ◽  
Modern World ◽  
P Value ◽  
Significant Relation ◽  
Duration Of Diabetes ◽  
Medical College ◽  
Associated Risk Factors

Background: Diabetes mellitus (DM) being disease of modern world occurrence of Diabetic retinopathy (DR) has become more frequent. Knowledge on the prevalence and associated risk factors of diabetic retinopathy helps to detect the disease in its early course. The objective of the study was to establish the prevalence and to analyze the associated risk factors and help to screen the disease as early as possible so as to prevent and /or to delay the onset as well as progression of DR. Materials and Methods: A hospital based retrospective study conducted among 213 in-patients of Nobel Medical College, Biratnagar diagnosed with DM. Result: The prevalence of diabetic retinopathy was 32.39% and prevalence of mild NPDR, moderate NPDR, severe NPDR, very severe NPDR, proliferative diabetic retinopathy and clinically significant macular edema was 12.7%, 8.9%, 6.1%, 5%, 1.9% & 2.3% respectively. There was statistically significant relation of diabetic retinopathy with duration of diabetes (p value 0.004) and the mean duration was 8.704 years. Conclusions: The prevalence of diabetic retinopathy among in-patients was 32.39%. Though there was no significant relation with occurrence of DR with type of diabetes, age, sex, alcoholism, smoking and drug intake history, the duration of diabetes and hyperlipidemia, poor hyperglycemic control were highly significantly associated with DR while high BP showed marginally insignificant relation with the same.   Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 50-55 

Clinical Characteristics of Elizabethkingia meningoseptica Ophthalmic infections

2020 ◽  
Author(s):  
KAI CHING PETER LEUNG ◽  
TAK CHUEN SIMON KO
Keyword(s):  
Risk Factors ◽  
Contact Lens ◽  
Ocular Surface ◽  
Treatment Duration ◽  
Case Series ◽  
Tertiary Hospital ◽  
Surface Barrier ◽  
Ocular Prosthesis ◽  
First Case ◽  
Elizabethkingia Meningoseptica

Abstract Background: Elizabethkingia is a Gram-negative, obligate aerobic, oxidase positive bacillus that is known to cause a variety of nosocomial infections and has emerged as an important pathogen because of multiple anti-microbial resistance. We present the first case series of Elizabethkingia ophthalmic infections, with specific emphasis on its clinical spectrum, risk factors, treatment and outcome.Method: Microbiological specimens growing Elizabethkingia were reviewed retrospectively at a regional tertiary hospital from 2005-2019. Clinical manifestation, risk factors, treatment including types of antibiotics, treatment duration and clinical outcome were documented. Results: Ten cases of culture positive Elizabethkingia ophthalmic infection were identified, which all cultured E. meningoseptica. Four cases of keratitis, three cases of conjunctivitis, two cases of blepharitis and one case of blepharitis-conjunctivitis were observed. Four cases were found to be associated with contact lens use and were discovered to colonize E. meningoseptica. One case of blepharitis was associated with an ocular prosthesis (scleral shell) in an eviscerated eye. Fluoroquinolone and chloramphenicol were most commonly used topical antibiotics for treatment. The mean treatment duration for all infections were averaged at 6.5 weeks. Conclusion: E. meningoseptica is the predominant species that causes ophthalmological related Elizabethkingia infections and is found most frequently manifested on the ocular surface. Contact lens use and ocular prosthesis appears to be a risk factor for infection due to ocular surface barrier disruption and bacteria colonization. Combination of fluroquinolone and chloramphenicol is a safe and effective treatment against Elizabethkingia ocular infections. Further studies are required to determine the susceptibility of commonly used topical anti-microbial agents to Elizabethkingia species.

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