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.

scholarly journals The Effect of HbA1c Variability as a Risk Measure for Microangiopathy in Type 1 Diabetes Mellitus

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1151
Author(s):  
Pedro Romero-Aroca ◽  
Raul Navarro-Gil ◽  
Albert Feliu ◽  
Aida Valls ◽  
Antonio Moreno ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Type 1 Diabetes Mellitus ◽  
Risk Measure ◽  
Case Series ◽  
Multivariate Statistical ◽  
Case Series Study ◽  
Prospective Case Series

Background: To measure the relationship between variability in HbA1c and microalbuminuria (MA) and diabetic retinopathy (DR) in the long term. Methods: A prospective case-series study, was conducted on 366 Type 1 Diabetes Mellitus patients with normoalbuminuria and without diabetic retinopathy at inclusion. The cohort was followed for a period of 12 years. The Cox survival analysis was used for the multivariate statistical study. The effect of variability in microangiopathy (retinopathy and nephropathy) was evaluated by calculating the standard deviation of HbA1c (SD-HbA1c), the coefficient of variation of HbA1c (CV-HbA1c), average real variability (ARV-HbA1c) and variability irrespective of the mean (VIM-HbA1c) adjusted for the other known variables. Results: A total of 106 patients developed diabetic retinopathy (29%) and 73 microalbuminuria (19.9%). Overt diabetic nephropathy, by our definition, affected only five patients (1.36%). Statistical results show that the current age, mean HbA1c, SD-HbA1c and ARV-HbA1c are significant in the development of diabetic retinopathy. Microalbuminuria was significant for current age, mean HbA1c, CV-HbA1c and ARV-HbA1c. Conclusions: By measuring the variability in HbA1c, we can use SD-HbA1c and ARV-HbA1c as possible targets for judging which patients are at risk of developing DR and MA, and CV-HbA1c as the target for severe DR.

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