scholarly journals Incidence of diabetic eye disease in accordance with duration, glycemic control, blood and ocular pressure

2017 ◽  
Vol 70 (11-12) ◽  
pp. 353-358
Author(s):  
Vladimir Canadanovic ◽  
Sandra Jovanovic ◽  
Sofija Davidovic ◽  
Ana Oros ◽  
Vladislav Dzinic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Group I

Introduction. Diabetic retinopathy remains the leading cause of visual disability and blindness among professionally active adults in economically developed societies, which is of particular concern because the prevalence and incidence of diabetes mellitus is expected to increase sharply during the next decade. There are several known factors responsible for the development of diabetic retinopathy, duration of disease and blood sugar level being the most important ones. Material and Methods. Prospective study of 280 diabetic patients (diabetes mellitus type 2) divided into 3 groups according to the duration of diabetes mellitus. All diabetic patients underwent complete ophthalmological examination in artificial mydriasis and optic coherence tomography. A full medical history included patient age, the time elapsed from diabetes diagnosis, current treatment of diabetes, presence of hypertension and glycemic control assessed by glycosylated hemoglobin measurement. Results. The mean age of patients was 63.5 years (SD?6.5, range 57-70 years). Mean duration of diabetes was 7.3 years in group I, 12.4 years in group II and 17.2 years in group III. The average value of glycosylated hemoglobin was 6.58% in the group I, 7.64% in the group II and 8.29% in the third group of patients. No statistically significant difference in intraocular pressure and the level of blood pressure were found among groups. Cataract was present in 104 patients (37.1%). Complications related to diabetes among all patients included in our study were: nonproliferative diabetic retinopathy in 48.5%, proliferative diabetic retinopathy in 25.7% and diabetic macular edema in 22.5% of patients. Conclusion. The duration of diabetes is one of the most significant factors for the development of diabetic maculopathy and the progression from nonproliferative to its proliferative stage. There is significantly higher incidence of proliferative diabetic retinopathy and diabetic macular edema in patients with increased serum level of glycosylated hemoglobin. Diabetes accompanied by hypertension is related to worsening of the clinical course of diabetic eye diseases and developing diabetic macular edema and proliferative diabetic retinopathy.

scholarly journals Effect of glycemic control on diabetic retinopathy and diabetic macular edema: a prospective observational study

2021 ◽  
Author(s):  
Kajal Seema S. ◽  
Jayalekshmi T. ◽  
Manasa S. ◽  
Prasenna M.
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Observational Study ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Hba1c Levels

Background: The objective of the study was to examine the effect of long-term glycemic control, as measured by glycated hemoglobin levels (HbA1C), on the onset and progression of diabetic retinopathy (DR) and diabetic macular edema (DME) over a period of 10 years.Methods: Patients who were diagnosed to have type 2 diabetes mellitus participated in this cross-sectional observational study. Duration of onset of diabetes and the glycemic control status were analyzed. Fasting and postprandial blood sugar levels and HbA1C levels were tested for every participant. Diabetic retinopathy was graded as per the ETDRS guidelines using stereoscopic fundus photographs. In addition to the clinical evaluation, optical coherence tomography was done to confirm the presence of DME.Results: A total of 212 diabetic patients were enrolled in this study. One sixty-four patients (78.1%) had DR, out of which 71 patients (43.3%) had mild non proliferative diabetic retinopathy (NPDR), 42 patients (25.6%) had moderate NPDR, 31 patients (18.9%) had severe NPDR, and 20 (12.2%) had proliferative diabetic retinopathy (PDR). Fifty-nine patients with DR (36%) had DME. Duration of diabetes (14.62±6.18 vs 9.72±3.68 years, p<0.001), higher fasting blood glucose (176.79±59.13 vs 138.46±49.44 mg/dl, p<0.001) and higher HbA1c levels (8.21±1.38 vs 7.48±1.25 %, p=0.002) were significantly associated with DR.Conclusions: The stage of diabetic retinopathy rather than metabolic status is a strong predictive factor for the development of diabetic macular edema.

scholarly journals Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal

2015 ◽  
Vol 7 (1) ◽  
pp. 26-32
Author(s):  
R Thapa ◽  
S Bajimaya ◽  
S Sharma ◽  
B B Rai ◽  
G Paudyal
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Proliferative Diabetic Retinopathy ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Duration Of Diabetes ◽  
Case Series Study

Introduction: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. Objective: to study the systemic association of proliferative diabetic retinopathy. Materials and methods: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classi¿ed using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid pro¿le, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.Results: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.Conclusion: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.

scholarly journals Multifocal Electroretinogram, Central Macula Thickness and Visual Acuity in Diabetic Macular Edema Following Intravitreal Injection of anti-VEGF

2021 ◽  
Vol 4 (2) ◽  
pp. 150
Author(s):  
Syntia Nusanti ◽  
Kirana Sampurna ◽  
Ari Djatikusumo ◽  
Anggun Rama Yudantha ◽  
Joedo Prihartono
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Post Injection ◽  
Anti Vegf ◽  
Sd Oct

Introduction :  Diabetic Retinopathy (DR) is one of the major cause of visual acuity deterioration in diabetic patients. The loss of central visual acuity in diabetic patients are mainly due to macula edema, which is found in 29% diabetic patients with the over 20 years duration of disease. The aim of this study is to evaluate and investigate the possible correlation among changes of visual acuity (VA), central macular thickness (CMT) using Spectral Domain Optical Coherence Tomography (SD-OCT). Electrophysiological responses using multifocal electroretinography (MfERG) in diabetic macular edema (DME) following intravitreal injection of bevacizumab. Methods: Single arm clinical trial. Thirty-three eyes of 33 DME patients (16 non-proliferative diabetic retinopathy and 17 non-high-risk proliferative diabetic retinopathy), receives intravitreal bevacizumab 1,25mg. All patients underwent complete ophthalmic examination including ETDRS VA testing, Sixty-one scaled hexagon MfERG and SD-OCT scan at baseline, 1-week and 1-month post-injection. Components of the first order kernel (N1, N2 and P1) in central 2o were measured. Result : MfERG showed reduced P1 amplitude (P<0.05) at 1-week after injection followed by increased P1 amplitude (P>0.05) at 1-month after treatment as compared to the baseline in all subjects. There was 19% improvement CMT and 0.2Logmar VA improvement in 1-month post-injection compared to the baseline (P<005). This study showed no serious ocular adverse effects. There was no significant correlation between changes in visual acuity with changes in CMT or other MfERG parameters. Conclusion: Intravitreal injection bevacizumab resulting in improved VA, reduction in CMT and mild improvement in the MfERG responses. Although VA changes did not correlate with reduced CMT nor with improved responses of MfERG, the combined use of SD-OCT and MfERG may be used to evaluate macular function in DME patient with worsened visual acuity post anti-VEGF injection.

scholarly journals Pattern and Risk Factors of Diabetic Retinopathy among Type 2 Diabetic Patients: Experience in a Tertiary Care Hospital

2016 ◽  
Vol 17 (1) ◽  
pp. 17-20
Author(s):  
Md Mostarshid Billah ◽  
Muhammad Abdur Rahim ◽  
Md Anisur Rahman ◽  
Palash Mitra ◽  
Tufayel Ahmed Chowdhury ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Proliferative Diabetic Retinopathy ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Duration Of Diabetes ◽  
Type 2 Diabetic

Background: Diabetic retinopathy is the commonest cause of blindness in the working age group of both developed and developing countries. It is the indicator of all micro-vascular complications of diabetes mellitus. This study was aimed to find out the frequency and pattern of diabetic retinopathy among hospitalized adult type 2 diabetic patients.Methodology: This cross-sectional study was carried out in the Department of Medicine and Endocrinology of BIRDEM General Hospital, Dhaka over a period of six months. Retinopathy was determined by fundoscopic examination in dilated pupil. Data were collected in preformed questionnaire including demographic characteristics, fundoscopic findings, and laboratory investigation reports with prior informed consent of the patients.Results: Total patients were 94, male were 52 and female were 42. Mean age of the patients was 52.2 ± 11.12 years. Hypertension was the most common (42.8%) co-morbid condition followed by dyslipidemia (33%), nephropathy (34%), neuropathy (21.3%), ischemic heart disease (9.6%) and stroke (5.3%). Study showed 37.23% Patient had good glycemic control (HbA1C <7%) and 62.77% had poor glycemic control. The frequency of retinopathy of any form was present in 36.2% patients. Among them, non-proliferative diabetic retinopathy (NPDR) was present in 78.79%, proliferative diabetic retinopathy (PDR) 6.06%, maculopathy 6.06%, both maculopathy and PDR in 9.09% diabetic patients. Among NPDR, 46.15 % was mild, 26.92% was moderate and 26.92% was severe NPDR. This study also revealed retinopathy was more with increase in duration of diabetes (66.6% vs. 17.3% p=0.01), in poorly controlled diabetic than good control (52.54% vs. 8.5%, p=0.01), those with hypertension (55% vs. 22%, p=0.02), and those having diabetic nephropathy (78.12% vs. 14.51%, p=0.01).Conclusion: This study showed frequency of diabetic retinopathy was 36.2% and among retinopathy NPDR was predominate. Poor glycemic control, increase duration of diabetes, presence of other microvascular complication i.e. nephropathy found to be significant risk factors for developing retinopathy.J MEDICINE January 2016; 17 (1) : 17-20

scholarly journals Bevacizumab and Treatment Regimes in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 155-159
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Intravitreal Bevacizumab ◽  
Retinal Neovascularization ◽  
Diabetic Patients ◽  
Treatment Regimes ◽  
Endothelial Growth Factor

Diabetic macular edema and proliferative diabetic retinopathy is the most important cause of vision loss in diabetic patients. Vascular endothelial growth factor has been shown to play a major role in retinal neovascularization and vascular hyperpermeability in eyes with diabetic patients. Recent studies have demonstrated the usefulness of an intravitreal injection of bevacizumab in the reduction of diabetic macular edema, vascular permeability, and fibrovascular proliferation in retinal neovascularization secondary to proliferative diabetic retinopathy. This review aimed to evaluate the intravitreal bevacizumab in diabetic retinopathy and diabetic macular edema.

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 Stringent glycemic control is still the key to evade diabetic retinopathy.

2020 ◽  
Vol 27 (05) ◽  
pp. 1011-1016
Author(s):  
Syed Munawar Alam ◽  
Sagheer Ahmed ◽  
Shazia Bano ◽  
Shahneela Perveen
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Proliferative Diabetic Retinopathy ◽  
Study Groups ◽  
Hplc Method ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Institutional Review

Objectives: The aim of this study was to evaluate the major determinants of diabetic retinopathy. Study Design: Cross sectional, case control study. Setting: Department of Biochemistry, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi. Period: March 2015 to April 2016. Material & Methods: Ethical approval was taken from the Institutional Review Board of JPMC. A total of 208 people including type 2 diabetic patients and healthy control subjects; of male gender, aged between ≥30 years and ≤ 60 years were recruited and assigned to four study groups. Each group comprise of 52 individuals, depending on the ophthalmoscopy findings, i.e. healthy controls, diabetic without retinopathy (NDR), diabetic with non-proliferative diabetic retinopathy (NPDR) and diabetic with proliferative diabetic retinopathy (PDR). Fasting blood sugar was estimated using GOD-PAP method, while HbA1c was estimated by HPLC method. Data was analyzed on SPSS software version 16. Results: Diabetics with Diabetic Retinopathy had a poor glycemic control as compare to Diabetics without Diabetic Retinopathy (FBS; 109.12 ± 13.81 vs. 184.29 ± 40.07 vs. 188.6 ± 47.68 vs. 217.06 ± 62.33; p-value = 0.001) (HbA1c; 6.73 ± 0.56 vs. 8.40 ± 1.77 vs. 9.71 ± 1.85 vs. 14.91 ± 3.87; p-value = 0.001). For Diabetic Retinopathy the odds ratio of glycemic control i.e. FBS was observed as 1.019 & HbA1c was recorded as 1.561; which was statistically significant. Conclusion: Glycemic indicators; including FBS and HbA1c, are found to be the major determinants of Diabetic Retinopathy in our study.

scholarly journals Histopathological evaluation of kidney disease in patients with diabetes mellitus

2021 ◽  
Vol 8 (2) ◽  
pp. 112-119
Author(s):  
Juju Raj Shrestha ◽  
Kashyap Dahal ◽  
Anil Baral ◽  
Rajani Hada
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Rapid Rise ◽  
Class Iii ◽  
Diabetic Kidney ◽  
Duration Of Diabetes

Introduction: Non diabetic kidney disease (NDKD), a treatable condition, is common in diabetic patients with atypical clinical presentations. Present study aimed to find out histopathological diagnosis of kidney disease in type 2 Diabetes mellitus with such presentations. Method: This was a hospital based cross sectional study conducted in Nephrology department, Bir hospital, Nepal from Aug 2019 to January 2021. Total 29 diabetic patients with atypical presentations, rapid rise of proteinuria alone (n=5), with microscopic hematuria (n=6), with impaired renal function (n=8) and rapid rise of creatinine with (n=8) or without (n=2) microscopic hematuria were included. The baseline information was recorded and kidney biopsy was performed. Result: The mean age of patients was 52.6±10.4 y and 22(75.9%) were male. Diabetic retinopathy (DR) was absent in 24(82.8%) patients. Presence of NDKD alone was in 6(20.7%) and superimposed on diabetic kidney disease (DKD) in 10(34.5%) with total NDKD in 16(55.2%) and isolated DKD in 13(44.8%) patients. Non diabetic kidney disease were glomerulonephritis 12(75%) with membranous nephropathy 4(25%) and IgA nephropathy 4(25%) patients. The significant difference between NDKD and isolated DKD was only the duration of diabetes < 5 y in 8(61.5%) of isolated DKD and ≥5 y in 13(81.2%) patients with NDKD (p=0.018). Diabetic retinopathy was absent in 6(100%) patients with isolated NDKD, 8(80%) of class III and 5(62.5%) of class IV DKD. Conclusion: Glomerulonephritis is the commonest NDKD in type 2 DM with atypical presentation and advance DKD (Class III & IV) is present even in absence of diabetic retinopathy and short duration of diabetes.

scholarly journals Study of aerobic bacterial conjunctival flora in patients with diabetes mellitus

2013 ◽  
Vol 5 (1) ◽  
pp. 28-32 ◽  
Author(s):  
D Karimsab ◽  
SK Razak
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Bacterial Flora ◽  
Diabetic Patients ◽  
Coagulase Negative Staphylococci ◽  
Ocular Infections ◽  
Patients With Diabetes ◽  
Conjunctival Flora ◽  
Normal Bacterial Flora

Introduction: Normal bacterial flora may be altered by a variety of factors. Objective: To study the aerobic bacterial conjunctival flora in patients with diabetes mellitus and to find its clinical significance by comparing the results to the conjunctival flora of non-diabetic subjects. Materials and methods: A total of 75 diabetic patients were included as cases and 25 nondiabetics as controls to compare the results. Specimens for the study of conjunctival flora were taken by rubbing sterile cotton-tipped swabs to the inferior palbebral conjunctiva. The conjunctival culture report of the patients with diabetic mellitus was compared to that of nondiabetic subjects. Results: Positive conjunctival cultures were seen in a higher percentage of patients with diabetes (unilateral and bilateral positive conjunctival cultures 34.66 % and 58.66 % respectively) compared to that in non-diabetic controls (unilateral and bilateral positive conjunctival cultures 24 % and 16 % respectively). Diabetics showed a higher proportion of coagulase negative staphylococci (45.33 %), compared to the non-diabetic group (16 %). Among the diabetic patients, positive conjunctival cultures were detected more frequently in those with diabetic retinopathy compared to those without retinopathy. A higher proportions of bilateral positive conjunctival cultures were seen in cases with proliferative diabetic retinopathy (38.63 %) in comparison to patients with no retinopathy and different stages of non-proliferative diabetic retinopathy. Conclusion: The conjunctival floral pattern with increased bacteria in diabetics is a predominant cause of many diabetes-related ocular infections. The presence of diabetic retinopathy is an indicator for increased colonization of conjunctiva, and its severity correlates with the severity of diabetic retinopathy. Nepal J Ophthalmol 2013; 5(9):28-32 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7818

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