The method of viscodissection with contrast enhancement of posterior hyaloid membrane for proliferative diabetic retinopathy surgery

2021 ◽  
pp. 127-129
Author(s):  
D.V. Petrachkov ◽  
◽  
A.G. Matyuschenko ◽  
L. Alkharki ◽  
A.L. Sidamonidze ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Contrast Enhancement ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreoretinal Surgery ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Posterior Hyaloid ◽  
Retinal Breaks

Purpose. Study is to evaluate the efficacy of the method of viscodissection with contrast enhancement of posterior hyaloid membrane in PDR surgery. Material and methods. The study involved 26 patients with type 1 diabetes mellitus and severe PDR with the presence of tractional retinal detachment (TRD). All patients received treatment in the volume of lensectomy and IOL implantation, microinvasive vitrectomy, viscodissection with contrasting of epiretinal structures was performed, followed by segmentation and removal of membranes, endolaser coagulation followed by tamponade with sterile air of the vitreous cavity. Results. In all patients included in the study, with dynamic observation, there was a positive dynamics of morphofunctional indicators - best corrected visual acuity (BCVA) from 32.5-16.1 to 62.2-15.7 and central retinal thickness (CRT) according to optical coherence tomography (OCT) from 775.9-78.4 to 492.1-73.8 µm. Conclusion. The method of viscodissection with simultaneous contrast of the posterior hyaloid membrane facilitates the assessment of the quality of the separation of pathological membranes and improves the quality of visual control over the process of their separation, which reduces the risks of iatrogenic retinal breaks. Key words: diabetes mellitus, proliferative diabetic retinopathy, vitreoretinal surgery, viscodissection.

Evaluation of complications of the late postoperative period in patients with diabetes mellitus after drainage surgery of neovascular glaucoma

2021 ◽  
pp. 10-12
Author(s):  
V.A. Biletskaya ◽  
◽  
D.V. Lipatov ◽  
M.A. Frolov ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Neovascular Glaucoma ◽  
Research Centre ◽  
Federal State ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Surgical Methods

Today diabetes mellitus (DM) is one of the leading medical and social problems. Its complications lead to terrible concomitant pathologies that qualitatively affect the lives of patients. At the end of 2019, there were more than 463 million people with diabetes in the world and this number is increasing every year. Diabetic retinopathy (DR) is one of the most severe complications of DM on the organ of vision. Secondary neovascular glaucoma (NG) is a manifestation of the end-stage proliferative DR. This is a relatively rare but difficult-to-treat pathology that often leads working-age patients to disability and impaired social adaptation. The main objective of treatment for NG is to compensate for intraocular pressure (IOP), but conservative (drug) therapy is often ineffective. Therefore, doctors are forced to use surgical methods of treatment. At the same time, do not forget about the multiple complications during the operation, as well as in the early and late postoperative periods. A special feature of the course of NG in patients with DM is its combination with the failure of the ligamentous-capsular apparatus of the lens, iris bombage, anterior and posterior synechiae, traction retinal detachment and various hemorrhagic complications. All this allows us to talk about the so-called diabetic glaucoma (DG). Currently, drainage devices have become the standard in the treatment of refractory NG. The effectiveness of such operations according to various sources is about 70-80% of success. Purpose. To assess the condition of patients with DM in the late (10-15 years) postoperative period after performing NG drainage surgery, to analyze the effectiveness of the intervention by studying the dynamics of IOP, the presence or absence of pain syndrome and various intraocular complications. Material and methods. During the period 2006-2020, 150 patients with NG and DM were operated on in the Department of Diabetic Retinopathy of the Federal State Budgetary Institution «Endocrinology Research Centre» of the Ministry of Health of the Russian Federation. Results. In 100% of the postoperative period, the pain syndrome was stopped. And also, in 59.7% of cases, the presence of late complications: vascular thorn, EED, subatrophy and anophthalmos. Conclusion. Despite the presence of complications, drainage surgery in patients with DM continues to be an effective method of choosing surgical treatment for patients with uncompensated NG. Key words: diabetes mellitus; diabetic retinopathy; neovascular glaucoma; drainage surgery.

scholarly journals The Role of Hypertension and Dyslipidaemia in the Progression of Diabetic Retinopathy in Type 2 Diabetes

2019 ◽  
Vol 4 (4) ◽  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Vitreoretinal Surgery ◽  
Additional Burden

Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic retinopathy (DR) remains a significant source of sight disorders and blindness amongst individuals with Type 2 Diabetes Mellitus (T2DM) [1]. Visual impairment and blindness can add an additional burden to individuals with T2DM, thereby, affecting their quality of life and ability to self-manage their diabetes [2]. The number of people registered blind and those with moderate to severe sight complications due to DR rose from 0.2 million to 0.4 and 1.4 million to 2.6 million respectively between 1990 to 2015 [3].

scholarly journals Effects of Intra-vitreal Injection of Bevacizumab as an Adjunct during Phacoemulsification in Diabetic Maculopathy

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Ali Afzal Bodla ◽  
Syeda Minahil Kazmi ◽  
Noor Tariq ◽  
Ayema Moazzam ◽  
Muhammad Muneeb Aman
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Macular Thickness ◽  
Control Group ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Post Surgery ◽  
Significant Difference

Purpose:  To study the effects of Intra-vitreal injection of Bevacizumab as an adjunct during phacoemulsification in patients with diabetic retinopathy. Study Design:  Quasi experimental study. Methods:  Hundred diabetic patients who were scheduled to undergo phacoemulsification were included in the study. They were equally divided into two groups; Bevacizumab and control group. Complete ocular examination and macular thickness and volume were determined using an OPTOVUE-OCT machine. The patients in the Bevacizumab group were given intra-vitreal injection of 1.25 mg/0.05ml of Bevacizumab at the time of Phacoemulsification. A written ethical approval was obtained and the study was conducted according to principles of declaration of Helsinki. Results:  The bevacizumab group manifested low value of CMT one month post-surgery as compared to the control group (262.2 ± 32.2 and 288.5 ± 54.1, respectively) with P = 0.01. The Total Macular volume, and Best-corrected visual acuity in the two groups showed no significant difference one month after surgery. Amongst the patients who developed postsurgical macular edema, four patients did not possess a positive history for diabetic retinopathy and 3 of them had Non Proliferative Diabetic Retinopathy. We found no significant relationship between the post-surgical macula edema with the presence of mild Non Proliferative Diabetic Retinopathy. (Fisher's test, P = 0.321). Conclusion:  The ocular anti-VEGF therapy substantially reduces macular edema secondary to post-surgical inflammation in diabetic patients. It effectively reduces the central macular thickness although the results are not found to be statistically significant when compared with the control group. Key Words:  Diabetes mellitus; diabetic macular edema; diabetic retinopathy: Bevacizumab.

scholarly journals Perbedaan Kualitas Hidup Pada Pasien Retinopati Diabetik Non-Proliferatif Berat dan Retinopati Diabetik Proliferatif di Poliklinik Vitreoretina Instalasi Rawat Jalan Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

2019 ◽  
Vol 13 (2) ◽  
pp. 87-99
Author(s):  
Melan Nurhayati ◽  
Irma Nur Amalia ◽  
Hafsa .
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Proliferative Diabetic Retinopathy ◽  
Chi Square ◽  
Eye Health ◽  
Regular Control ◽  
Chi Square Test

Diabetic retinopathy (RD) is a specific microvascular complication of Diabetes Mellitus (DM) that causes visual impairement. Visual impairment that occurs in DR patients can affect the quality of life related to eye health. The latest data about DR patients from National Eye Center (NEC) Cicendo Eye Hospital Bandung was 2035 patients with Severe Non-proliferative Diabetic Retinopathy (Severe NPDR) and Proliferative Diabetic Retinopathy (PDR) are the most happened. The purpose of this study was to determine quality of life differences in patients with severe NPDR and PDR at the Vitreoretina Polyclinic Outpatient Departement NEC Cicendo Eye Hospital Bandung. This Research is a quantitative non-experimental with a comparative descriptive design. The sample was divided into two groups, they are Severe NPDR and PDR group, with 30 respondents each. The instrument that used in this study is the National Eye Institute Visual Function Questionaire-25 (NEI VFQ-25). Data analized by Chi Square test. The results showed that no differences in qualityof life in patients with severe NPDR and PDR in the Vitreoretina Polyclinic Outpatient Departement NEC Cicendo Eye Hospital Bandung (p = 1,000). This study illustrates the importance of providing education and encouragement to the patients with Severe NPDR and PDR for regular control about their visual impairment and their diabetes, so the patients will spared from decressing in their quality of life.

Evaluation of the technical features of vitreoretinal surgery for proliferative diabetic retinopathy in young patients

Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 36-42
Author(s):  
O.V. Kolenko ◽  
◽  
Y.B. Lebedev ◽  
A.Y. Khudyakov ◽  
E.L. Sorokin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Type 1 Diabetes Mellitus ◽  
Proliferative Diabetic Retinopathy ◽  
Young Patients ◽  
Vitreoretinal Surgery ◽  
High Tendency ◽  
Type 1 Dm

Aim. To investigate the technical difficulties of performing the stages of vitreoretinal surgery, the peculiarities of the surgical technique in young patients with the proliferative stage of diabetic retinopathy (DR). Methods. Twelve patients (12 eyes) with type 1 diabetes mellitus (DM) were selected. Their average age was 26±2 years (from 19 to 30 years). There were 4 men and 8 women. All patients had DM since childhood. Selection criteria: presence of indications for vitreoretinal surgery for proliferative DR, age of patients with type 1 DM not more than 30 years, onset of DM in childhood. Results. Initially, the clinical manifestations of proliferative DR in young people with type 1 DM were distinguished by the severity of neovascular and fibrous growths, a tendency to hemorrhages, and the complexity of preoperative preparation in the form of panretinal laser coagulation, at least partial. Surgical removal of vitreoretinal adhesions and elimination of neovascularization zones differed in technical difficulties associated with their higher density and the area of retinal tissue lesion. Conclusion. Surgical treatment of proliferative DR in young patients has a number of technical difficulties associated with the density and length of fibrovascular vitreoretinal growths, the difficulty of separating them due to the high tendency of newly formed vessels to hemorrhages. Key words: proliferative diabetic retinopathy; endovitreal surgery; type 1 diabetes mellitus; young age.

Features of surgery for proliferative diabetic retinopathy in young patients

2021 ◽  
pp. 113-116
Author(s):  
Y.B. Lebedev ◽  
◽  
A.Y. Khudyakov ◽  
E.L. Sorokin ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Young Patients ◽  
Vitreoretinal Surgery ◽  
Dense Adhesion ◽  
Varying Length ◽  
Technical Features

Purpose. To investigate the technical features and difficulties of performing vitreoretinal surgery in proliferative diabetic retinopathy (DR) in young patients. Material and methods. 12 patients (12 eyes) aged 19 to 30 years, averaging 26±2 years. There were 4 men and 8 women. All patients had diabetes mellitus (DM) in childhood. The duration of type 1 diabetes ranged from 12 to 18 years. Results. Initially, 8 eyes showed combined retinal and peripapillary neovascularization with gliza on the vascular arcades. In 4 eyes, there was both diffuse hemophthalmos and preretinal clots of varying length and volume. In 8 eyes, dense adhesion of the altered posterior hyaloid membrane and the inner border membrane was revealed. In 4 eyes, vasoproliferative membranes were determined, which contributed to the development of traction effects on the retina. The most dangerous was the traction component on the macular retina. Conclusion. Surgical treatment of proliferative DR in young patients has a number of technical difficulties associated with the anatomical features of the macular interface and the features of the proliferative response to surgery. Noteworthy is the minimum time for the transition of DR to the proliferative stage. Key words: proliferative diabetic retinopathy, endovitreal surgery, type 1 diabetes mellitus.

Analisis Hubungan Lama Menderita Diabetes Mellitus Dengan Kualitas Hidup Penderita Diabetes Mellitus

2017 ◽  
Vol 4 (2) ◽  
pp. 7
Author(s):  
Ifa Roifah
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Systematic Sampling ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Cross Sectional ◽  
The Family ◽  
Long Time ◽  
Independent Variable

Diabetes mellitus if doesn’t treated properly can cause various complications in organs such as the eyes, kidneys, nerves and blood vessels of the heart that will harm the soul or affect a person's quality of life. The purpose of this research was to know relationship long suffering diabetes mellitus with the quality of life of people with diabetes mellitus. The design of the study was analytic corelasional with cross sectional approach. Research of variable that is long suffering diabetes mellitus as the independent variable and the dependent variable as a quality of life. Population research namely whole sufferers of diabetes Mellitus at internist disease room in the Wahidin Sudiro Husodo Hospital  Mojokerto as much as 103 patients. The samples were taken with the techniques of systematic sampling as much as 81 respondents. Data collected by questionnaire WHOQOL instruments, then the result of pengunpulan data processing data is done editing, coding, scoring and tabulating and tested with test speaman rho. Spearman rho test results retrieved data ρ value = 0,027 <α = 0.05 so that H1 is accepted so there is a connection between the long suffering with kualits life of sufferers of diabetes mellitus in internist disease room in the Wahidin Sudiro Husodo Hospital  Mojokerto. Low quality of life occur because respondents are already feeling tired and tired with the treatment process has already lived in a long time, so they feel resigned to the situation that is happening will they be healed or not of disease processes that affect them. Especially the Family expected to have family members suffering from diabetes mellitus to always provide good family support in the form of encouragement, communicating medical treatment to keep his health and direct when got health information.; Key Words : Diabetes Mellitus, Qualiity Of Life, long suffering

scholarly journals Study of Retinal Nerve Fibre Layer Thickness in Diabetics - with and without Diabetic Retinopathy

2021 ◽  
Vol 10 (31) ◽  
pp. 2427-2432
Author(s):  
Pranaykumar Shinde
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Nerve Fibre ◽  
Proliferative Diabetic Retinopathy ◽  
Retinal Nerve Fibre Layer ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Rnfl Thickness ◽  
Fibre Layer ◽  
Nerve Fibre Layer

BACKGROUND Diabetes mellitus is a heterogeneous group of diseases, characterized by a state of chronic hyperglycemia, resulting from varied aetiologies. Diabetic retinopathy (DR) is the most common ocular complication of diabetes with 5 % of diabetics, progressing to severe visual loss of 5/200 or less. 3 Very few studies have been conducted on optical coherence tomography (OCT) changes in diabetic retinopathy in Indian scenario. We wanted to evaluate the association of retinal nerve fibre layer (RNFL) thickness with diabetic retinopathy and assess the possibility of RNFL thickness changes being a precursor to diabetic retinal changes. METHODS A cross sectional study was conducted at the Department of Ophthalmology, Acharya Vinobha Bhave Rural Hospital. A total of 120 patients were enrolled for the study and divided into four groups of equal population as controls / non-diabetics (NDM), diabetics without retinopathy (NDR), diabetics with non-proliferative diabetic retinopathy (NPDR) and diabetics with proliferative retinopathy (PDR). Patients were evaluated for visual acuity, RNFL thickness, intraocular pressure(IOP), cup disc ratio in each case and data was statistically analysed. RESULTS Mean temporal RNFL thickness in PDR group was 73.72 ± 15.22 and was statistically significant (P = 0.0001) than temporal RNFL thickness in controls (60.41 ± 7.56), NDR (61.06 ± 6.51) and NPDR (59.01 ± 5.51). Mean cup-disc disc ratio was 0.26 ± 0.08 in controls, was 0.28 ± 0.11 in NDR group, 0.32 ± 0.08 in NPDR group and 0.36 ± 0.11 in PDR group and was statistically significant (P = 0.026). However no statistically significant difference was seen in global average RNFL thickness across groups though it was more in NPDR and PDR when compared to NDM group, and was least in NDR group. CONCLUSIONS There was statistically significant increase in temporal RNFL thickness in diabetic group which worsens with the disease. Hence temporal RNFL thickness may be estimated in diabetic patients to predict transformation to diabetic retinopathy and intervene at an early stage. KEY WORDS Diabetes Mellitus, Retinal Nerve Fibre Layer, Proliferative Diabetic Retinopathy, Non Proliferative Diabetic Retinopathy

Glucose Control

2020 ◽  
Author(s):  
Timothy P. Graham ◽  
Erich N. Marks ◽  
Joshua J. Sebranek ◽  
Douglas B. Coursin
Keyword(s):  
Diabetes Mellitus ◽  
Critically Ill ◽  
Glucose Control ◽  
Cost Of Care ◽  
Hospital Length Of Stay ◽  
Glucose Measurement ◽  
Key Words Diabetes Mellitus ◽  
Key Words Diabetes ◽  
Adult Intensive Care Unit ◽  
Patients With Diabetes

Patients with diabetes mellitus routinely require management in the adult intensive care unit (ICU). These patients have increased morbidity, mortality, hospital length of stay, cost of care, and frequency of hospital and ICU admission. Glucose control in these patients presents challenges for the clinician. In the critically ill, hyperglycemia does not occur exclusively in patients with diabetes or prediabetes but may be related to stress-induced hyperglycemia or iatrogenic causes. Hyperglycemia can contribute to decreased wound healing and immune function and a host of cellular and molecular dysfunctions and has been linked to increased hospital mortality. Hypoglycemia in the ICU is associated with patients with preexisting diabetes, those receiving insulin and other medications, and septic individuals, among others. Insulin therapy is the mainstay of glucose management in the critically ill. ICU practitioners should be aware that point-of-care glucose meters are not as accurate as core laboratory results. Finally, both hypoglycemia and wide fluctuations in blood glucose during critical illness are also associated with increased mortality, although clear cause-and-effect relationships have not been established. This review contains 1 figure, 8 tables, and 71 references. Key words: Diabetes mellitus, glucose measurement, glucose targets, hyperglycemia, hypoglycemia, insulin

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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