Choroidal Changes of Long-Term Type 1 Diabetic Patients without Retinopathy

The aim of the study is to assess choroidal thickness (CT) and choroidal volume (CV) in 90 type 1 diabetes mellitus (DM1) patients with no diabetic retinopathy (DR) and 60 control eyes using spectral domain optical coherence tomography (SD-OCT) and swept source (SS)-OCT in the areas of the Early Treatment Diabetic Retinopathy Study (ETDRS). Mean ages were 42.93 ± 13.62 and 41.52 ± 13.05 years in the diabetic and control groups, respectively. Significant differences were obtained between both groups with Spectralis SD-OCT in all ETDRS areas and in the total CV, excluding the temporal perifoveal one. With Triton SS-OCT, statistically significant differences were obtained in the subfoveal CT and in the vertical areas. CT showed the same tendency with both OCTs, with greater CT and CV in the DM1 group than the mean values of the control group. To assess the influence of DM1 evolution in the CT modifications, DM1 patients were divided into Group 1, with less than 24 years of diagnosis, and Group 2, with ≥24 years of DM1 evolution. Using both OCTs, seven of the nine ETDRS areas and the CV had lower values in Group 2. CT and CV measured by OCT were higher in DM1 without DR. There is a choroidal thinning related to disease evolution in DM1. In patients with DM evolution greater than 24 years, the CT is statistically lower than in patients with less evolution of the disease.

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Volume rendered 3D OCTA assessment of macular ischemia in patients with type 1 diabetes and without diabetic retinopathy

Scientific Reports ◽

10.1038/s41598-021-99297-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Enrico Borrelli ◽

Domenico Grosso ◽

Mariacristina Parravano ◽

Eliana Costanzo ◽

Maria Brambati ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Healthy Subjects ◽

Diabetic Group ◽

Control Group ◽

Diabetic Patients ◽

Vascular Volume ◽

Patients With Diabetes ◽

Perfusion Density

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.

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Ocular Rigidity and Outflow Facility in Nonproliferative Diabetic Retinopathy

Journal of Diabetes Research ◽

10.1155/2015/141598 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Theonitsa Panagiotoglou ◽

Miltiadis Tsilimbaris ◽

Harilaos Ginis ◽

Nikos Karyotakis ◽

Vaggelis Georgiou ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Intraocular Pressure ◽

Cataract Surgery ◽

Anterior Chamber ◽

Control Group ◽

Diabetic Patients ◽

Outflow Facility ◽

Nonproliferative Diabetic Retinopathy ◽

Computer Controlled ◽

And Control

Purpose.To compare ocular rigidity (OR) and outflow facility (C) in patients with nonproliferative diabetic retinopathy (NPDR) and control subjects.Methods. Twenty-four patients with NPDR (NPDR group) and 24 controls (control group) undergoing cataract surgery were enrolled. NPDR group was further divided into patients with mild NPDR (NPDR1-group) and patients with moderate and/or severe NPDR (NPDR2-group). After cannulation of the anterior chamber, a computer-controlled device was used to infuse saline and increase the intraocular pressure (IOP) in a stepping procedure from 15 to 40 mmHg. Ocular rigidity and outflow facility coefficients were estimated from IOP and volume recordings.Results. Ocular rigidity was 0.0205 μL−1in NPDR group and 0.0202 μL−1in control group (P=0.942). In NPDR1-group, OR was 0.017 μL−1and in NPDR2-group it was 0.025μL−1(P=0.192). Outflow facility was 0.120 μL/min/mmHg in NPDR-group compared to 0.153 μL/min/mmHg in the control group at an IOP of 35 mmHg (P=0.151). There was no difference in C between NPDR1-group and NPDR2-group (P=0.709).Conclusions. No statistically significant differences in ocular rigidity and outflow facility could be documented between diabetic patients and controls. No difference in OR and C was detected between mild NPDR and severe NPDR.

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Distribution of DD Genotype of Angiotensin-Converting Enzyme Gene and Its Correlation with Diabetic Retinopathy

Trends in Medical Sciences ◽

10.5812/tms.115489 ◽

2021 ◽

Vol 1 (2) ◽

Author(s):

Hamid Ali-Bahar ◽

Maysam Mard-Soltani ◽

Yousef Paridar ◽

Zahra Nasirbaghban ◽

Zahra Sadat Hashemi ◽

...

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Angiotensin Converting Enzyme ◽

Microvascular Complications ◽

Control Group ◽

Case Group ◽

Diabetic Patients ◽

Converting Enzyme ◽

Ace Gene ◽

And Control

Background: One of the major microvascular complications of diabetes mellitus (DM) is diabetic retinopathy (DR). Studies have shown that angiotensin-converting enzyme (ACE) gene polymorphisms are correlated with DR progression. Accordingly, the elucidation of the association between ACE gene polymorphism and the risk of DR development seems to be highly crucial. Methods: In this study, 195 individuals with type 2 diabetes mellitus (T2DM) were classified as the case group with retinopathy (99 people) and control group without retinopathy (96 people). Screening for DR was performed by ophthalmologists using clinical examination and fluorescein angiography. Different ACE genotypes (II, ID, and DD) were identified by the collection of blood samples, extraction of DNA, and PCR amplification using specific primers. Results: The frequency distribution of genotypes was significantly different between the case and control groups (P = 0.009). Interestingly, possessing a DD genotype made diabetic patients approximately 2.5 folds (95% CI = 1.271 - 4.840, P = 0.007) and 3.25 folds (95% CI = 1.312 - 8.051, P = 0.01) more susceptible to DR when compared to having DI and II genotypes, respectively. Moreover, having a D allele made diabetic individuals nearly 1.75 folds (95% CI = 1.167 - 2.623, P = 0.007) more susceptible to DR than possessing an I allele. Conclusions: Our results potentiate the hypothesis that the DD genotype and D allele of the ACE gene might play a role in the pathogenesis of DR.

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Changes in retinal layers in type 1 diabetes mellitus without retinopathy measured by spectral domain and swept source OCTs

Scientific Reports ◽

10.1038/s41598-021-89992-w ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Elvira Orduna-Hospital ◽

Ana Sanchez-Cano ◽

Lorena Perdices ◽

Javier Acha ◽

Elena María Lopez-Alaminos ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Diabetic Retinopathy ◽

Type 1 Diabetes Mellitus ◽

Color Vision ◽

Spectral Domain ◽

Retinal Layer ◽

Swept Source ◽

Sd Oct

AbstractTo evaluate changes in inner retinal layer (IRL) thicknesses in patients with type 1 diabetes mellitus (DM1) with no diabetic retinopathy (DR) using two different optical coherence tomography (OCT) devices. Ninety DM1 and 60 healthy eyes were evaluated using spectral domain (SD)-OCT and swept source (SS)-OCT to measure changes in the retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL) and inner nuclear layer (INL) thicknesses in all Early Treatment of Diabetic Retinopathy Study (ETDRS) macular areas. Functional tests were performed in both groups, including ETDRS with 100, 2.5 and 1.25% contrast, and color vision. The mean ages were 42.93 ± 13.62 and 41.52 ± 13.05 years in the diabetic and control groups, respectively. Visual acuity (VA) with ETDRS 1.25% was lower in the DM1 patients. Both ETDRS 2.5% and color vision were lower in the DM1 group but did not reach statistical significance. Retinal thicknesses in the central area and in the vertical outer areas were higher in the DM1 group. Differences were found in the IRL with no changes in the outer ones. Long-term DM1 patients with no DR maintained visual function, with a decrease in VA with 1.25% ETDRS contrast. Macular thickness measurements were higher using Spectralis SD-OCT than DRI Triton SS-OCT, and DM1 patients had a decrease in IRL thickness, especially in the GCL at the parafoveal level, generating thinning of the RNFL in the peripheral areas. There were no differences in outer retinal layer (ORL) thickness.

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Multimodal Imaging Assessment of Vascular and Neurodegenerative Retinal Alterations in Type 1 Diabetic Patients without Fundoscopic Signs of Diabetic Retinopathy

Journal of Clinical Medicine ◽

10.3390/jcm8091409 ◽

2019 ◽

Vol 8 (9) ◽

pp. 1409 ◽

Cited By ~ 11

Author(s):

Riccardo Sacconi ◽

Marco Casaluci ◽

Enrico Borrelli ◽

Giacomo Mulinacci ◽

Francesca Lamanna ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Multimodal Imaging ◽

Foveal Avascular Zone ◽

Control Group ◽

Diabetic Patients ◽

Ganglion Cell Complex ◽

Fiber Layer ◽

Imaging Evaluation ◽

Significant Difference

The aim of this cross-sectional case-control study is to investigate the possible presence of vascular/neurodegenerative alterations in the retina of type 1 diabetes mellitus (T1DM) patients without diabetic retinopathy (DR). Thirty-four eyes of 34 consecutive T1DM without DR (mean age 21 ± 2 years) were included. Another cohort of 27 eyes (27 healthy control subjects matched with age and sex) was also recruited. All patients underwent multimodal imaging evaluation using structural optical coherence tomography (OCT), OCT-angiography (OCT-A), dynamic vessel analyzer (DVA) and microperimetry. No significant differences were disclosed comparing diabetics and controls for visual acuity, central macular thickness, and subfoveal choroidal thickness. On retinal nerve fiber layer and ganglion cell complex thickness, no significant differences were disclosed comparing each 3-mm-diameter macular and peripapillary subfield between two groups. Using OCT-A, deep capillary plexus perfusion density (PD) of diabetics was significantly lower compared to control group, whereas PD of other retinal/choriocapillaris plexuses and foveal avascular zone area did not show any significant difference. Using DVA, diabetic eyes revealed a significantly decreased vessel response to flicker light in comparison to controls. No differences were disclosed using microperimetry analysis. Taken together, these results suggest that vascular alterations could be the first detectable retinal change in the development of DR.

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Clinical Analysis of Targeted Navel Drops in the Treatment of Diabetes Mellitus

Journal of Clinical and Nursing Research ◽

10.26689/jcnr.v5i5.2574 ◽

2021 ◽

Vol 5 (5) ◽

pp. 194-198

Author(s):

Yueping Zhu

Keyword(s):

Blood Glucose ◽

Research Group ◽

Fasting Blood Glucose ◽

Effective Rate ◽

Postprandial Blood Glucose ◽

Control Group ◽

Diabetic Patients ◽

Group 2 ◽

And Control ◽

Group 1

Objective: To analyze and evaluate the clinical efficacy of targeted navel drops in the treatment of diabetes mellitus. Methods: The time span of the study was from September 2020 to April 2021, and 288 diabetic patients were selected from our hospital. The patients were divided into research group (n = 96) group, control group 1 (n = 96) and control group 2 (n = 96) by random number table. Control group 1 was managed with diet and exercise alone, control group 2 was treated with metformin on the basis of control group 1, and based on the treatment plan of the two control groups, the research group was treated with targeted navel drops. The relevant indexes of the three groups were compared and analyzed. Results: There was no significant difference in the fasting blood glucose and 2-hour postprandial blood glucose among the three groups (p > 0.05) before the treatment. After treatment, the fasting blood glucose and 2-hour postprandial blood glucose of the research group were significantly lower than those of control group 1 and control group 2 (p < 0.05). The total effective rate of the research group was 95.8%, that of control group 1 was 85.4%, and that of control group 2 was 79.2%. The total effective rate of the research group was significantly higher than that of control group 1 and control group 2 (p < 0.05). Conclusion: There is a significant effect of targeted navel drops on diabetic patients in reducing their blood sugar levels, and its curative effect is better than using a single hypoglycemic therapy belonging to western medicine. It can be widely promoted at all levels in medical institutions.

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Structural and functional findings in patients with moderate diabetic retinopathy

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05277-y ◽

2021 ◽

Author(s):

A. Boned-Murillo ◽

M. D. Diaz-Barreda ◽

A. Ferreras ◽

I. Bartolomé-Sesé ◽

E. Orduna-Hospital ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Control Group ◽

Ganglion Cell Complex ◽

Retinal Sensitivity ◽

Exclusion Criteria ◽

Cross Sectional ◽

Swept Source ◽

Swept Source Oct ◽

And Control

Abstract Purpose To evaluate structural and functional ocular changes in patients with type 2 diabetes mellitus (DM2) and moderate diabetic retinopathy (DR) without apparent diabetic macular edema (DME) assessed by optical coherence tomography (OCT) and microperimetry. Methods This was a single-center cross-sectional descriptive study for which 75 healthy controls and 48 DM2 patients with moderate DR were included after applying exclusion criteria (one eye per patient was included). All eyes underwent a complete ophthalmic examination (axial length, macular imaging with swept-source OCT, and MAIA microperimetry). Macular thicknesses, ganglion cell complex (GCC) thicknesses, and central retinal sensitivity were compared between groups, and the relationships between the OCT and microperimetry parameters were evaluated. Results Macular thickness was similar in both groups (242.17 ± 35.0 in the DM2 group vs 260.64 ± 73.9 in the control group). There was a diminution in the parafoveal area thickness in the DM2 group in the GCC complex. Retinal sensitivity was reduced in all sectors in the DM2 group. The central global value was 24.01 ± 5.7 in the DM2 group and 27.31 ± 2.7 in the control group (p < 0.001). Macular integrity was 80.89 ± 26.4 vs 64.70 ± 28.3 (p < 0.001) and total mean threshold was 23.90 ± 4.9 vs 26.48 ± 2.6 (p < 0.001) in the DM2 and control group, respectively. Moderate correlations were detected between the central sector of MAIA microperimetry and retina total central thickness (− 0.347; p = 0.0035). Age, visual acuity, and hemoglobin A1c levels also correlated with retinal sensitivity. Conclusion Macular GCC thickness and central retinal sensitivity were reduced in patients with moderate DR without DME, suggesting the presence of macular neurodegeneration.

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Proteomic Analysis of the Vitreous Body in Proliferative and Non-Proliferative Diabetic Retinopathy

Current Proteomics ◽

10.2174/1570164617666200302101442 ◽

2020 ◽

Vol 17 ◽

Cited By ~ 1

Author(s):

Van-An Duong ◽

Jeeyun Ahn ◽

Na-Young Han ◽

Jong-Moon Park ◽

Jeong-Hun Mok ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Proliferative Diabetic Retinopathy ◽

Microvascular Complications ◽

Treatment Options ◽

Vitreous Body ◽

Control Group ◽

Diabetic Patients ◽

Protein Protein Interaction ◽

Alpha Beta ◽

New Treatment

Background: Diabetic Retinopathy (DR), one of the major microvascular complications commonly occurring in diabetic patients, can be classified into Proliferative Diabetic Retinopathy (PDR) and Non-Proliferative Diabetic Retinopathy (NPDR). Currently available therapies are only targeted for later stages of the disease in which some pathologic changes may be irreversible. Thus, there is a need to develop new treatment options for earlier stages of DR through revealing pathological mechanisms of PDR and NPDR. Objective: The purpose of this study was to characterize proteomes of diabetic through quantitative analysis of PDR and NPDR. Methods: Vitreous body was collected from three groups: control (non-diabetes mellitus), NPDR, and PDR. Vitreous proteins were digested to peptide mixtures and analyzed using LC-MS/MS. MaxQuant was used to search against the database and statistical analyses were performed using Perseus. Gene ontology analysis, related-disease identification, and protein-protein interaction were performed using the differential expressed proteins. Results: Twenty proteins were identified as critical in PDR and NPDR. The NPDR group showed different expressions of kininogen-1, serotransferrin, ribonuclease pancreatic, osteopontin, keratin type II cytoskeletal 2 epidermal, and transthyretin. Also, prothrombin, signal transducer and activator of transcription 4, hemoglobin subunit alpha, beta, and delta were particularly up-regulated proteins for PDR group. The up-regulated proteins related to complement and coagulation cascades. Statherin was down-regulated in PDR and NPDR compared with the control group. Transthyretin was the unique protein that increased its abundance in NPDR compared with the PDR and control group. Conclusion: This study confirmed the different expressions of some proteins in PDR and NPDR. Additionally, we revealed uniquely expressed proteins of PDR and NPDR, which would be differential biomarkers: prothrombin, alpha-2-HS-glycoprotein, hemoglobin subunit alpha, beta, and transthyretin.

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Investigation of TAGAP gene polymorphism (rs1738074) in Turkish pediatric celiac patients

Turkish Journal of Biochemistry ◽

10.1515/tjb-2020-0419 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Melek Pehlivan ◽

Tülay K. Ayna ◽

Maşallah Baran ◽

Mustafa Soyöz ◽

Aslı Ö. Koçyiğit ◽

...

Keyword(s):

Pediatric Patients ◽

Disease Risk ◽

Polymerase Chain Reaction Method ◽

Control Group ◽

Healthy Children ◽

Single Nucleotide ◽

Significant Difference ◽

Allele Specific ◽

And Control

Abstract Objectives There are several hypotheses on the effects of the rs1738074 T/C single nucleotide polymorphism in the TAGAP gene; however, there has been no study on Turkish pediatric patients. We aimed to investigate the association of celiac disease (CD) and type 1 diabetes mellitus (T1DM) comorbidity with the polymorphism in the TAGAP gene of Turkish pediatric patients. Methods Totally, 127 pediatric CD patients and 100 healthy children were included. We determined the polymorphism by the allele-specific polymerase chain reaction method. We used IBM SPSS Statistics version 25.0 and Arlequin 3.5.2 for the statistical analyses. The authors have no conflict of interest. Results It was determined that 72% (n=154) of only CD patients had C allele, whereas 28% (n=60) had T allele. Of the patients with celiac and T1DM, 42.5% (n=17) and 57.5% (n=23) had T and C alleles, respectively. Of the individuals in control group, 67% (n=134) had C allele, whereas 33% (n=66) had T allele. Conclusions There was no significant difference in the genotype and allele frequencies between the patient and control groups (p>0.05). There was no significant association between the disease risk and the polymorphism in our study group.

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The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients

European Journal of Ophthalmology ◽

10.1177/1120672121990576 ◽

2021 ◽

pp. 112067212199057

Author(s):

Tomás de Oliveira Loureiro ◽

João Nobre Cardoso ◽

Carlos Diogo Pinheiro Lima Lopes ◽

Ana Rita Carreira ◽

Sandra Rodrigues-Barros ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Metabolic Control ◽

Insulin Pump Therapy ◽

Vascular Density ◽

Diabetic Patients ◽

Retinal Vasculature ◽

Increased Risk ◽

The Mean ◽

Type 1 Diabetic Patients

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.

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