scholarly journals Retinopathy Phenotypes in Type 2 Diabetes with Different Risks for Macular Edema and Proliferative Retinopathy

2020 ◽  
Vol 9 (5) ◽  
pp. 1433 ◽  
Author(s):  
Ines P. Marques ◽  
Maria H. Madeira ◽  
Ana L. Messias ◽  
Torcato Santos ◽  
António C-V. Martinho ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Odds Ratio ◽  
Retinal Thickness ◽  
Proliferative Retinopathy ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Our group reported that three diabetic retinopathy (DR) phenotypes: A, characterized by low microaneurysm turnover (MAT < 6) and normal central retinal thickness (CRT); B, low MAT (<6) and increased CRT, and C, high MAT (≥6), present different risks for development of macular edema (DME) and proliferative retinopathy (PDR). To test these findings, 212 persons with type 2 diabetes (T2D) and mild nonproliferative retinopathy (NPDR), one eye per person, were followed for five years with annual visits. Of these, 172 completed the follow-up or developed an outcome: PDR or DME (considering both clinically significant macular edema (CSME) and center-involved macular edema (CIME)). Twenty-seven eyes (16%) developed either CSME (14), CIME (10), or PDR (4), with one eye developing both CSME and PDR. Phenotype A showed no association with development of vision-threatening complications. Seven eyes with phenotype B and three with phenotype C developed CIME. Phenotype C showed higher risk for CSME development, with 17.41 odds ratio (p = 0.010), compared with phenotypes A + B. All eyes that developed PDR were classified as phenotype C. Levels of HbA1c and triglycerides were increased in phenotype C (p < 0.001 and p = 0.018, respectively). In conclusion, phenotype C identifies eyes at higher risk for development of CSME and PDR, whereas phenotype A identifies eyes at very low risk for vision-threatening complications.

scholarly journals Clinically Significant Macular Edema and Survival in Type 1 and Type 2 Diabetes

2008 ◽  
Vol 145 (4) ◽  
pp. 700-706 ◽  
Author(s):  
Flavio E. Hirai ◽  
Michael D. Knudtson ◽  
Barbara E.K. Klein ◽  
Ronald Klein
Keyword(s):  
Type 2 Diabetes ◽  
Macular Edema ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Repeatability of Retinal Macular Thickness Measurements in Patients with Clinically Significant Macular Edema Using Two Different Scanning Protocols of Spectralis Optical Coherence Tomography

2015 ◽  
Vol 234 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Tito Fiore ◽  
Marco Lupidi ◽  
Sofia Androudi ◽  
Fabrizio Giansanti ◽  
Daniela Fruttini ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Retinal Thickness ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Significant Difference ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant ◽  
Thickness Measurements

Objective: To determine the repeatability of Spectralis optical coherence tomography (OCT) retinal thickness measurements in diabetic patients with clinically significant macular edema (CSME) using two different scanning protocols. Methods: Seventy-one eyes of 71 diabetic patients with CSME were included in the study. Coefficients of repeatability and intrasession variation coefficients were tested with 20 × 15 degree raster scans consisting of 19 or 37 high-resolution line scans (15 or 8 frames per scan, respectively) that were repeated 2 times by 1 experienced examiner. The first scan was set as the reference scan; the second scan was the follow-up scan and was performed with the use of the follow-up mode. Results: The mean and standard deviation for the central foveal subfield (CSF) using the first scanning method was 404 ± 88 μm, while it was 399 ± 86 μm using the second protocol, which was not statistically significantly different (p = 0.35, paired test). Particularly examining the CSF, the coefficient of repeatability was 1.48 (6.00 µm) and 1.49 (5.95 µm) for the 19- and the 37-B-scan acquisition, respectively, showing a nonstatistically significant difference (p < 0.001). Conclusions: Retinal thickness measurements in diabetic patients with CSME are repeatable using both scanning protocols (19 or 37 B-scans) with Spectralis OCT. The repeatability of the retinal thickness measurement does not improve by increasing the number of B-scans from 19 to 37.

scholarly journals EFFECT OF STATIN USE ON STATUS OF DIABETIC ETINOPATHY/ DIABETIC MACULAR EDEMA IN PATIENTS OF TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 48-51
Author(s):  
Lokesh Kumar Singh ◽  
Alka Gupta ◽  
Jigyasa Srivastava
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Ldl Cholesterol ◽  
Mean Value ◽  
Department Of Ophthalmology ◽  
A Prospective Study

AIM: Effect of statin use on status of diabetic retinopathy /diabetic macular edema in patients of type 2 diabetes mellitus Check the lipid profile and detail fundus examination of all patients included in study. Effect of lipid lowering agents (statin) on Diabetic retinopathy. Asses the changes in fundus of DME patients after giving statin. MATERIALS AND METHODS:- A prospective study was conducted in the OPD of upgraded department of ophthalmology at LLRM Medical College, Meerut over the duration of from July 2019 to June 2020. The proposed study was in association of status use and hyper triglyceridemia with diabetes macular edema in patients with type-2 diabetes and diabetic retinopathy. Clearance from institution ethics committee was obtained before the study was started. An informed consent was obtained from all the patients before including them in to the study. A total of 86 patients were divided in to two equal groups randomly RESULTS:- A prospective study was conducted in the OPD of upgraded department of ophthalmology at LLRM Medical College, Meerut over the duration of from July 2019 to June 2020 and sample size of patients taken was 86 About 70.9% of the patients in this study were males and 29.1% were females. About 26.7% of the study subjects in this study had diabetes mellitus since 16 – 20 years,25.6% since more than 20 years and 20.9% since 11 – 15 years. During the baseline the CSME in left eye was present in 24.4% of the cases and during follow up,the CSME was present in 10.5% of the cases . At the time of baseline,about 64% of the patients had no CSME in right eye and 36% had CSME.At the time of follow up 87.2% of the cases had no CSME and 12.8% had CSME. In mild NPDR during follow up,44.2% had mild NPDR,24.4% had moderate NPDR and 8.1% had severe NPDR at baseline. About17.4%ofthepatientswhohadmoderateNPDRatbaselinealsohadmoderateNPDRduringfollowupvisits inlefteye. Among all the patients with mild NPDR during follow up, 54.7% had mild NPDR, 22.1% had moderate NPDR and 10.5% had severe NPDR during baseline. About 12.8% who had moderate NPDR during baseline also had moderate NPDR during follow up in right eye Mean cholesterol level during baseline was 154.13 mg/dl and during follow up was 138.12 mg/dl which was statistically significant (p=0.000). The mean triglyceride level during the baseline was 178.37 mg/dl and during follow up was 156 mg/dl which was statistically significant between the two groups (p=0.000). Mean LDL cholesterol level during the baseline was 94.99 mg/dl and during follow up was 61.24 mg/dl which was statistically significant between baseline and follow up (p=0.000). This study had shown improvement of visual acuity,decrease in macular edema and progression of diabetic retinopathy. The study also revealed that ,the statins are effective in decreasing the total cholesterol, LDL cholesterol, and triglycerides. CONCLUSION:- This study had shown improvement of visual acuity,decrease in macular edema and progression of diabetic retinopathy in patients whom statins was given The study also revealed that,the statins are effective in decreasing the total cholesterol(mean value during baseline was 154.13 mg/dl which reduces to 138.12 mg/dl during follow up),LDL cholesterol (mean value reduces from 94.99 mg/dl during baseline to 61.24 mg/dl during follow up)and triglycerides (mean value during baseline 178.37 mg/dl to 156 mg/dl during follow up).as given.

scholarly journals Different retinopathy phenotypes in type 2 diabetes predict retinopathy progression

2020 ◽  
Author(s):  
Inês P. Marques ◽  
Maria H. Madeira ◽  
Ana L. Messias ◽  
António C.-V. Martinho ◽  
Torcato Santos ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Retinal Thickness ◽  
Formation Rate ◽  
Fundus Photography ◽  
Phenotype Classification ◽  
Design And Methods ◽  
Higher Sensitivity

Abstract Purpose To characterize the progression in retinopathy severity of different phenotypes of mild nonproliferative diabetic retinopathy (NPDR) in patients with type 2 diabetes. Design and methods Patients with type 2 diabetes and mild NPDR (ETDRS 20 or 35) were followed in a 5-year longitudinal study. Examinations, including color fundus photography (CFP) and optical coherence tomography (OCT and OCTA), were performed at baseline, 6 months and then annually. Phenotype classification was performed based on microaneurysm turnover (MAT, on CFP) and central retinal thickness (CRT, on OCT). Phenotype A is characterized by low MAT (< 6) and normal CRT; Phenotype B by low MAT (< 6) and increased CRT; and Phenotype C by higher MAT (≥ 6) with or without increased CRT. ETDRS grading of seven fields CFP was performed at the initial and last visits. Results Analysis of ETDRS grade step changes showed significant differences in diabetic retinopathy (DR) progression between the different phenotypes (p < 0.001). Of the 66 participants with phenotype A only 2 eyes (3%) presented 2-or-more-step worsening. None of the 50 participants characterized as phenotype B developed 2-step worsening, whereas 13 eyes (23.2%) characterized as phenotype C had 2-or-more-steps worsening. Phenotype C presents the higher risk for 2-or-more step worsening (OR: 15.94 95% CI: 3.45–73.71; p < 0.001) and higher sensitivity, correctly identifying 86.7% of cases at risk (AUC: 0.84 95% CI: 0.72–0.96; p < 0.001). Diabetic retinopathy severity progression was associated with HbA1c (p = 0.019), LDL levels (p = 0.043), and ocular factors as MAT (p = 0.010), MA formation rate (p = 0.014) and MA disappearance rate (p = 0.005). Capillary closure at 5-year follow-up, identified by lower vessel density (VD) on OCTA, was also associated with diabetic DR severity progression (p = 0.035). Conclusions Different DR phenotypes in type 2 diabetes show different risks of retinopathy progression. Phenotype C is associated with increased HbA1c values and presents a higher risk of a 2-or-more-step worsening of the ETDRS severity score.

Subclinical Macular Edema as a Predictor of Progression to Clinically Significant Macular Edema in Type 2 Diabetes

2013 ◽  
Vol 230 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Isabel Pires ◽  
Ana Rita Santos ◽  
Sandrina Nunes ◽  
Conceição Lobo ◽  
José Cunha-Vaz
Keyword(s):  
Type 2 Diabetes ◽  
Macular Edema ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant
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