scholarly journals Hemophthalmia after surgical treatment of diabetic retinopathy in patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (3) ◽  
pp. 14-20
Author(s):  
S.S. Lytvynenko

Background. In patients with type 2 diabetes mellitus (DM2) and diabetic retinopathy (DR), vitreous hemorrhage is one of the most common complications after pars plana vitrectomy (PPV) and ranges from 12 to 63 %. The study was aimed to analyze the frequency and causes of the development of hemophthalmia after surgical treatment of diabetic retinopathy in patients with type 2 diabetes mellitus. Materials and methods. The study involved 118 patients (118 eyes) with type 2 diabetes mellitus and DR, who were divided into three groups: the first group — with initial non-proliferative DR (NPDR; 28 eyes), the second group — with moderate to severe NPDR (49 eyes) and the third group — with proliferative DR (РDR; 41 eyes). The age of patients ranged from 44 to 84 years, men — 52 (44.1 %), women — 66 (55.9 %). The study did not include the patients with severe PDR and tractional retinal detachment or massive hemorrhage that required silicone oil tamponade of the vitreal cavity. All patients underwent closed subtotal vitrectomy 25G with panretinal laser photocoagulation and tamponade with an air-gas C3F8 mixture or the operation was completed with BSS plus solution injected into the vitreal cavity. Patients were examined based on a standard protocol of clinical and ophthalmological studies. Results. Within three months after vitrectomy, 33.1 % of patients developed postoperative hemophthalmia, which happened more often in РDR (39.0 %). In most cases (71.4 %), the preoperative hemophthalmia in РDR was accompanied by the development of postoperative hemophthalmia. Gender did not significantly impact the incidence of postoperative hemophthalmia. Patients with hemophthalmia were 9.3 years older than patients without hemophthalmia (p < 0.001), which affected both men and women equally. Patients with hemophthalmia had a longer history of type 2 diabetes mellitus compared to those wi­thout it (three years; p = 0.007), which was confirmed for men: men with hemophthalmia had a longer history of type 2diabetes mellitus than those without hemophthalmia (seven years; p = 0.026). Elevated blood levels of glycated hemoglobin (HbA1c) and a high score on the ETDRS scale are the risk factors for the development of postoperative hemophthalmos in patients with РDR. Conclusions. A study within three months after PPV in patients with DR and type 2 diabetes mellitus found that 33.1 % of patients developed postoperative hemophthalmia, which occurred more often in РDR (39.0 %). In most cases (71.4 %), the preoperative hemophthalmos in РDR was accompanied by the development of postoperative hemophthalmia. The risk factors for postoperative hemophthalmia after vitrectomy in type 2 diabetes mellitus and DR were age and diabetes duration, and for РDR — the presence of preoperative hemophthalmia, increased blood glycated hemoglobin, and a high score on the ETDRS scale.

2021 ◽  
Vol 10 (4) ◽  
pp. 3304-3311
Author(s):  
, Kvani

Diabetes Mellitus has an array of micro vascular complications most notably retinopathy, neuropathy and nephropathy of which retinopathy is the most common. Diabetic Retinopathy can cause permanent vision loss due to capillary non-perfusion, macular edema, vitreous hemorrhage, tractinal retinal detachment and neo-vascular glaucoma. This study had been carried out to find out the demographic and biochemical risk factors for Diabetic Retinopathy in unadulterated type 2 Diabetes Mellitus. To assess the presence of retinopathy; to find out the influence of demographic and biochemical variables mainly micro albuminuria, duration of Diabetes Mellitus, glycemic levels on the prevalence and severity of retinopathy in type 2 Diabetes. After ethical approval, two hundred type 2 Diabetes Mellitus patients fitting our criteria were enrolled. History and patient details were recorded. Body mass index was calculated. Clinical examination with slit lamp bio microscopy was done and Diabetic Retinopathy was graded according to the International Classification system. Patients’ blood sugar, HbA1C, cholesterol, urea and creatinine values were recorded. Spot urine sample was tested for micro albuminuria. The data were analysed and compared using appropriate tests. Retinopathy prevalence was 65.5% and was significantly more in insulin users (71.8%). The prevalence of micro albuminuria was 52%. and 93.3% of them had Diabetic Retinopathy. Elevated postprandial blood sugar and HbA1C levels were significantly associated with the prevalence and severity of Retinopathy. Micro albuminuria was identified as the significant variable associated with the development and progression of Retinopathy and can be taken as a marker to prevent avoidable blindness.


2019 ◽  
Vol 19 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Jana Sajovic ◽  
Ines Cilenšek ◽  
Sara Mankoč ◽  
Špela Tajnšek ◽  
Tanja Kunej ◽  
...  

Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and has been investigated as a candidate gene in a number of conditions, including diabetes and its microvascular complications (e.g., retinopathy and nephropathy). Several VEGF-related polymorphisms have been shown to contribute to nearly half of the variability in circulating VEGF levels in healthy individuals. Our aim was to assess the association between VEGF-related rs10738760 and rs6921438 polymorphisms and proliferative diabetic retinopathy (PDR) in Slovenian patients with type 2 diabetes mellitus (T2DM). We also investigated the effect of these polymorphisms on VEGF receptor 2 (VEGFR-2) expression in fibrovascular membranes (FVMs) from patients with PDR. This case-control study enrolled 505 unrelated patients with T2DM: 143 diabetic patients with PDR as a study group, and 362 patients with T2DM of >10 years duration and with no clinical signs of PDR as a control group. Patient clinical and laboratory data were obtained from their medical records. rs10738760 and rs6921438 polymorphisms were genotyped using TaqMan SNP Genotyping assay. VEGFR-2 expression was assessed by immunohistochemistry in 20 FVMs from patients with PDR, and numerical areal density of VEGFR-2-positive cells was calculated. The occurrence of PDR was 1.7 times higher in diabetic patients carrying GA genotype of rs6921438 compared to patients with GG genotype, with a borderline statistical significance (OR = 1.7, 95% CI = 1.00 – 2.86, p = 0.05). In addition, A allele of rs6921438 was associated with increased VEGFR-2 expression in FVMs from PDR patients. However, we observed no association between AA genotype of rs6921438 nor between rs10738760 variants and PDR, indicating that the two polymorphisms are not genetic risk factors for PDR.


Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 177
Author(s):  
Wojciech Matuszewski ◽  
Magdalena M. Stefanowicz-Rutkowska ◽  
Magdalena Szychlińska ◽  
Elżbieta Bandurska-Stankiewicz

Background and Objective: Nowadays, diabetes is one of the main causes of blindness in the world. Identification and differentiation of risk factors for diabetic retinopathy depending on the type of diabetes gives us the opportunity to fight and prevent this complication. Aim of the research: To assess differences in the risk factors for diabetic retinopathy in type 1 and type 2 diabetes mellitus patients in Warmia and Mazury Region, Poland. Materials and Methods: Risk factors for diabetic retinopathy (DR) were assessed on the basis of an original questionnaire, which included: personal data, clinical history of diabetes and eye disease. Elements of clinical examination: blood pressure, BMI, waist circumference. Indicators of diabetes metabolic control: mean glycemia, glycated hemoglobin (HbA1c), total cholesterol and triglycerides, creatinine, glomerular filtration rate (GFR), albumin–creatinine ratio in urine. Results: The study group included 315 (26%) patients with DM1 and 894 (74%) patients with DM2. Risk factors were estimated on the basis of logistic regression and verified with Student’s t-test. Statistically significant dependencies were found in both groups between the occurrence of diabetic retinopathy and diabetes duration, HbA1c, triglyceride concentrations, indicators of kidney function and cigarette smoking status. In the DM2 group, the development of DR was significantly influenced by the implemented models of diabetic treatment. Conclusions: In the whole study group, the risk of DR was associated with the duration of diabetes, HbA1c, triglyceride concentrations and smoking. In DM1 patients, the risk of DR was associated with diabetic kidney disease in the G1A1/A2 stage of chronic kidney disease, and in DM2 patients with the G2 stage of chronic kidney disease. An important risk factor for DR in DM2 patients was associated with late introduction of insulin therapy.


Author(s):  
Fengqi Guo ◽  
Ting Zhou ◽  
Juan Tang ◽  
Mingxia Dong ◽  
Qianping Wei

Abstract Purpose To analyze the clinical features and related risk factors in diabetic retinopathy (DR) and subclinical atherosclerosis, the micro- and macro-vascular diseases in newly diagnosed type 2 diabetes mellitus (T2DM). Methods A retrospective study of 435 cases of inpatients with newly diagnosed T2DM from 2013–2017, and compare the 2 types of T2DM related vascular complications. Results The macro- and microvascular complications are not rare at this stage. Subclinical atherosclerosis was found in 251 subjects (57.7%), which was higher than that of DR (13.1%). In addition, some cases of subclinical atherosclerosis co-existed with DR, suggesting that DR was related with subclinical atherosclerosis (r=0.098, P=0.041). Older age showed a significant association with both subclinical atherosclerosis and DR. Single factor analysis indicated that dyslipidemia was the common risk factor in DR and subclinical atherosclerosis. Conclusions It should be paid attention to the screening of both DR and subclinical atherosclerosis in each age group of newly diagnosed T2DM. Except for the control of blood glucose, the control of the dyslipidemia is important in the prevention and treatment of the micro- and macro-vascular diseases.


2017 ◽  
Vol 20 (4) ◽  
pp. 4-10
Author(s):  
Tatiana Olegovna Yalochkina ◽  
Janna Evgen'evna Belaya ◽  
Lyudmila Yakovlevna Rozhinskaya ◽  
Michail Borisovich Antsiferov ◽  
Larisa Konstantinovna Dzeranova ◽  
...  

Aim. To estimate the prevalence of and risk factors for low-traumatic fractures in patients with type 2 diabetes mellitus (T2DM).Materials and methods. We questioned 214 patients with T2DM from a single outpatient clinic located in Moscow to evaluate the prevalence of and risk factors for low-traumatic fractures, the duration of and complications from TD2M and HbA1c levels.Results. Of 214 patients, 65 reported low-traumatic bone fractures. Patients with a history of low-traumatic fractures reported falls in the previous year (28%), whereas only 13% of patients without fractures reported falls. The difference was statistically significant, with an odds ratio of 2.34 (1,144,76), P=0,022. Men reported fractures more frequently than women (43.3% vs. 24.7%, respectively, P = 0.01). Patients with bone fractures had a lower body mass index (P = 0.022); however, a multivariate analysis revealed that a history of falls and male sex were the most significant risk factors for fracture.Conclusion. Around 30% of patients with T2DM from a Moscow outpatient clinic reported bone fractures. The most significant risk factors for fracture were a history of falls in the previous year and male sex. The article is the RePrint from the original article inDiabetes Mellitus (2016); 19(5) pp. 359-365. doi: 10.14341/DM7796


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