Correlations between Retinal Arterial Morphometric Parameters and Neurodegeneration in Patients with Type 2 Diabetes Mellitus with No or Mild Diabetic Retinopathy

Background and Objectives: In patients with diabetes mellitus (DM), the neural retina is starting to degenerate before the development of vascular lesions. Our purpose was to investigate the correlation between the retinal arterial morphometric parameters and structural neurodegeneration in patients with type 2 DM with no or mild diabetic retinopathy (DR). Materials and Methods: This is a prospective study including 53 eyes of patients with type 2 DM and 32 eyes of healthy controls. Based on SD-OCT (spectral domain—optical coherence tomography) images, using a micro-densitometry method, we measured the outer and luminal diameter of retinal arteries and calculated the AWT (arterial wall thickness), WLR (wall-to-lumen ratio), and WCSA (wall cross-sectional area). GCL (ganglion cell layer) and RNFL (retinal nerve fiber layer) thickness were analyzed in correlation with the retinal arterial morphometric parameters mentioned above. Results: GCL was thinner in the inner quadrants in the NDR (no DR) group compared to controls (p <0.05). RAOD (retinal artery outer diameter), RALD (retinal artery lumen diameter), AWT, WLR, and WCSA were similar between groups. A regression model considering age, gender, duration of DM, and HbA1C was carried out. Central GCL thickness was correlated positively with RAOD (coefficient 0.360 per µm, p = 0.011), RALD (coefficient 0.283 per µm, p = 0.050), AWT (coefficient 0.304 per µm, p = 0.029), and WCSA (coefficient 3.90 per µm, p = 0.005). Duration of DM was positively correlated with WCSA (coefficient 0.311 per one year duration of diabetes, p = 0.043). Conclusions: Significant GCL thinning in the inner quadrants preceded the morphological retinal arterial morphometric changes, supporting the neurodegeneration as primary pathogenic mechanism in DR.

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Association of UCP1 and UCP2 variants with diabetic retinopathy susceptibility in type-2 diabetes mellitus patients: a meta-analysis

BMC Ophthalmology ◽

10.1186/s12886-021-01838-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xujia Liu ◽

Zehua Jiang ◽

Guihua Zhang ◽

Tsz Kin Ng ◽

Zhenggen Wu

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Fixed Effects ◽

Literature Search ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Fixed Effects Models ◽

Type 2 Dm ◽

Subgroup Analyses

Abstract Background Genetic association of uncoupling proteins (UCPs) variants with the susceptibility of diabetic retinopathy (DR) in diabetes mellitus (DM) patients has been reported but with controversy. Here we aimed to conduct a meta-analysis to confirm the association of different UCPs variants with DR. Methods Three databases (Medline Ovid, Embase Ovid and CENTRAL) were applied in the literature search. Five genetic models, including allelic, homozygous, heterozygous, dominant and recessive models, were evaluated. Odds ratios (OR) were estimated under the random or fixed-effects models. Subgroup analyses, publication bias and sensitivity analyses were also conducted. Results Eleven studies on 2 UCPs variants (UCP1 rs1800592 and UCP2 rs659366) were included. Our meta-analysis showed that UCP1 rs1800592 was not associated with DR in type-2 DM patients, and UCP2 rs659366 also showed no association with DR. In the subgroup analyses on the stage of DR, allele G of UCP1 rs1800592 significantly increased the susceptibility of proliferative diabetic retinopathy (PDR) in type-2 DM patients in the allelic (OR = 1.26, P = 0.03) and homozygous models (OR = 1.60, P = 0.04). Subgroup analysis on ethnicity did not found any significant association of rs1800592 and rs659366 with DR. Conclusion Our meta-analysis confirmed the association of UCP1 rs1800592 variant with PDR in patients with type-2 DM, suggesting its potential as a genetic marker for PDR prediction in population screening.

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Relationship of HbA1c to Diabetic Retinopathy in Type 2 DM Patients at Haji Adam Malik General Hospital 2017-2018

Sumatera Medical Journal ◽

10.32734/sumej.v3i3.3626 ◽

2021 ◽

Vol 3 (3) ◽

Author(s):

Yuni Silalahi ◽

Ricke Loesnihari

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

General Hospital ◽

Sampling Technique ◽

Simple Random Sampling ◽

Total Sample ◽

P Value ◽

Type 2 Dm ◽

Hba1c Levels

Diabetic retinopathy is a microvascular complication of diabetes mellitus. This complication can occur due to hyperglycemia that occurs in blood vessels for a long period of time. To determine whether there is a relationship between HbA1c levels on the incidence of diabetic retinopathy on pationts with type 2 diabetes mellitus in Haji Adam Malik General Hospital Medan period of 2017 until 2018. This research is an analitical study with retrospective method (case control) and conducted at the General Hospital of Haji Adam Malik Medan. Data collection was performed on medical records of diabetic retinopathy patients at Haji Adam Malik General Hospital Medan in the period January 2017 to December 2018. Data were collected by using medial records of patients with simple random sampling technique with a total sample is 46 samples, 23 samples of diabetic retinopathy, and 23 samples that were not diabetic retinopathy. The results of this study indicate that of 23 diabetic retinopathy samples, 2 of them had controlled HbA1c and the other 21 are not controlled. As well as of the 23 samples were not diabetic retinopathy, 5 of them had HbA1c controlled HbA1c and 18 were uncontrolled. The result of the analysis with chi square test showed no relationship between HbA1c levels to the incidemce of diabetic retinopathy in Type 2 DM patients with a p value of 0,06. From this study it was found that there was no relationship between HbA1c levels and the incidence of diabetic retinopathy for Haji Adam Malik General Hospital in the 2017-2018 period.

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Associations of serum uric acid level with diabetic retinopathy and albuminuria in patients with type 2 diabetes mellitus

Journal of International Medical Research ◽

10.1177/0300060520963980 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052096398

Author(s):

Lin Hou ◽

Yingzhou Shi ◽

Sichao Wang ◽

Qing Chen ◽

Qiu Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Uric Acid ◽

Serum Uric Acid ◽

Microvascular Complications ◽

Multivariate Logistic Regression Analysis ◽

Type 2 Dm

Objectives To analyze the associations of serum uric acid (SUA) level with diabetic microvascular complications, including diabetic retinopathy (DR) and diabetic nephropathy (DN), in patients with type 2 diabetes mellitus (DM). Methods Three hundred eighty-nine inpatients with type 2 DM were included in this retrospective analysis. Nonmydriatic fundus cameras were used to identify DR. Urinary albumin creatinine ratio was used to identify DN. Patients were divided into four groups according to SUA quartiles. Results The prevalences of DR and albuminuria increased with increasing SUA level. Multivariate logistic regression analysis showed that, following adjustment for other risk factors, higher levels of SUA (Q3 and Q4) were associated with greater risk for DR, compared with the lower level (Q1) (odds ratio [OR]: 3.056, 95% confidence interval [CI]: 1.506–6.198; OR: 3.417, 95% CI: 1.635–7.139, respectively). Moreover, higher levels of SUA (Q2, Q3, and Q4) were associated with greater risk for albuminuria (OR: 2.418, 95% CI: 1.059–5.522; OR: 7.233, 95% CI: 3.145–16.635; and OR: 8.911, 95% CI: 3.755–21.147, respectively). Conclusions SUA level was independently associated with DR and albuminuria in patients with type 2 DM. Elevated SUA level might be predictive for the occurrence of DR and DN.

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PREVALENCE OF DIABETIC RETINOPATHY IN TYPE 2 DIABETES MELLITUS: AN OBSERVATIONAL STUDY IN SOUTHERN INDIA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i8.19088 ◽

2017 ◽

Vol 10 (8) ◽

pp. 201

Author(s):

Satish Nayak ◽

Karthik Rao ◽

Navin Patil ◽

Jayaprakash B ◽

Amita Priya D ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Observational Study ◽

Proliferative Diabetic Retinopathy ◽

Prevalence Study ◽

Care Hospital ◽

Type 2 Dm

Objectives: In India, 69.1 million are diabetics as of 2015 compared to 18 million in 1995. Pan India prevalence study in diabetics carried out at 194 centers by All India Ophthalmological Society reported the prevalence of diabetic retinopathy (DR) among diabetics as 21.8%. DR is of two types, non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). The severity of NPDR depends on microaneurysms, hemorrhages, cotton wool spots, and beading of veins and can progress to PDR. Inherit characteristic of PDR is neovascularization. The aim of this observational prevalence study is to study the prevalence of diabetic retinopathy in Type 2 diabetic patients attending diabetic clinic and to study the distribution of diabetic retinopathy with respect to age, sex, and duration of disease in a tertiary care hospital in southern India.Methods: This is a retrospective observational study. Age above 20 years and patients diagnosed with Type 2 diabetes mellitus (DM) and examined by the ophthalmologist were included and others excluded. Data documented were analyzed using statistical software SPSS version 16.Results: About 52.07% of patients with Type 2 DM for more than 10 years had diabetic retinopathy and 13.07 % of patients with Type 2 DM for more than 5 years have diabetic retinopathy.Conclusion: India being the diabetic capital of the world and DR being the most common cause for visual impairment and blindness and it becomes empirical to assess the factors for its rising prevalence, which will significantly contribute in reducing the progression of DR.

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Neurodegeneration in Patients with Type 2 Diabetes Mellitus without Diabetic Retinopathy

Journal of Ophthalmology ◽

10.1155/2019/1825819 ◽

2019 ◽

Vol 2019 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Elena Garcia-Martin ◽

Marta Cipres ◽

Isabel Melchor ◽

Laura Gil-Arribas ◽

Elisa Vilades ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Disease Duration ◽

Vascular Complications ◽

Rnfl Thickness ◽

Type 2 Dm

Purpose. To evaluate neurodegeneration in patients with type 2 diabetes mellitus (DM2) without diabetic retinopathy and to assess the possible role of systemic vascular complications in retinal changes. Methods. Sixty eyes of 60 patients with DM2 and without any signs of diabetic retinopathy and 60 eyes of 60 healthy controls underwent retinal evaluation using Spectralis optical coherence tomography. Macular ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) were evaluated. Peripapillary RNFL thickness was assessed using Glaucoma and Axonal Analytics applications. Comparison between patients with the presence/absence of systemic vascular complications and different disease duration was made. Results. Macular GCL was reduced in patients compared to controls (p<0.001). Differences in the macular RNFL thickness were only observed in the outer inferior sector (p=0.033). A reduction in the peripapillary RNFL (average, inferior, and inferotemporal thickness, p<0.05 for all three) was observed in patients using both applications. Patients with chronic systemic vascular complications presented a reduction in the temporal RNFL (p=0.019) compared to patients without complications. The superotemporal RNFL thickness was thinner in patients with longer disease duration. Conclusions. Patients with type 2 DM without diabetic retinopathy and good metabolic control present neurodegeneration affecting neurons in the macular area and axons in different sectors of the optic disc. Systemic vascular complications contributed to further axonal damage in these patients, suggesting a possible role of subclinical ischaemia to retinal neurodegeneration in type 2 DM.

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Discordance in Retinal and Choroidal Vascular Densities in Patients with Type 2 Diabetes Mellitus on Optical Coherence Tomography Angiography

Journal of Ophthalmology ◽

10.1155/2021/8871602 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Ho Ra ◽

Nam Yeo Kang ◽

Jiyun Song ◽

Junhyuck Lee ◽

Inkee Kim ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Optical Coherence Tomography ◽

Type 2 Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Negative Correlation ◽

Optical Coherence Tomography Angiography ◽

Retinal Vessels ◽

Type 2 Dm

Purpose. In the present study, the retinal and choroidal vascular densities (VDs) in type 2 diabetes mellitus (DM) patients were analyzed using optical coherence tomography angiography (OCTA). Methods. The study included 282 eyes of 152 patients with type 2 DM (114 without retinopathy, 79 nonproliferative diabetic retinopathy (NPDR), 48 severe NPDR, and 41 proliferative diabetic retinopathy (PDR) eyes). The superficial and deep retinal vessel, choriocapillaris, and choroidal VDs were measured using a binarization method on OCTA images. VDs were compared based on retinopathy severity. Correlations among densities were analyzed. Results. Retinal and choriocapillaris VDs were lower in PDR than in NPDR (all P < 0.05 ). Correlation analysis showed significant positive correlations among densities of superficial and deep retinal vessels and choriocapillaris (all P < 0.001 ). Choroidal VD showed a negative correlation with superficial and deep retinal vessels and choriocapillaris (all P < 0.001 ). Retinal and choriocapillaris VDs showed a negative correlation with diabetic retinopathy (DR) grade (all P < 0.001 ); however, the choroidal VD showed a weak positive correlation ( P = 0.030 ). Conclusion. Choroidal VD increased as retinal and choriocapillaris VDs decreased, indicating that the outer layer of the choroid is less affected by DR severity and VD of larger choroidal vessels may even be increased as a compensatory mechanism for decreased retinal and choriocapillaris VDs in type 2 DM patients.

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THE SURGICAL TREATMENT OF DIABETIC MACULOTHE SURGICAL TREATMENT OF DIABETIC MACULOPATHY IN PATIENTS WITH DIABETES MELLITUS TYPE 2: EFFECTIVENESS, COMPLICATIONS, RELAPSEPATHY IN PATIENTS WITH DIABETES MELLITUS TYPE 2: EFFECTIVENESS, COMPLICATIONS, RELAPSES

Medical Science of Ukraine (MSU) ◽

10.32345/2664-4738.3-4.2019.05 ◽

2019 ◽

Vol 15 (3-4) ◽

pp. 32-38

Author(s):

Yu.O. Panchenko

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Surgical Treatment ◽

Proliferative Diabetic Retinopathy ◽

Diabetes Mellitus Type 2 ◽

Diabetic Maculopathy ◽

Ilm Peeling ◽

Type 2 Dm ◽

Patients With Diabetes

Relevance. It’s known a number of surgical treatment methods of diabetic maculopathy (DMP) in diabetes mellitus (DM) type 2: closed subtotal vitrectomy (CSV), which according to the testimony combined with peeling of the inner limiting membrane of the retina (ILM), panretinal laser coagulation of the retina (PRLC) and phacoemulsification of cataract (PEC). Objective. To study the effectiveness of different variants of vitreoretinal interventions, complications and frequency of DMP relapses in patients with type 2 diabetes. To study the effectiveness of different options for vitreoretinal interventions by the number of relapses of the DMP for patients with type 2 DM. Materials and methods. Observed 313 patients with type 2 DM (313 eyes) with DMP and primary (group 1; n=40), moderate or severe non-proliferative diabetic retinopathy (NPDR; group 2; n=92) and proliferative diabetic retinopathy (PDR; group 3; n=181). The severity of retinopathy and DMP was established under the International clinical scale of the American Academy of Ophthalmology (2002). 78 patients underwent CSV; 85 patients in addition to performing the vitrectomy was further held peeling of ILM in the macular region; 81 patient in addition to the CSV and peeling of the ILM was performed PRLC of the retina and in 69 patients additionally to all these interventions were made PEK. For statistical processing of obtained data was performed using the program Statistica 10 (StatSoft, Inc., USA). Results. The effectiveness of surgical treatment DMP was 70.3%; in 1st month follow-up, recurrence was observed in 23.0%; 3 months – 18.2%; 6 months – from 10.2% a year monitoring – 24.9% of patients. Efficiency of used methods was as follows: CSV – 67.9%; CSV + ILM peeling – 72.9%; CSV + ILM peeling + PRLC – 71.6%; CSV + ILM peeling + PLC + PEK – 68.1%. These differences had no statistical significance (p=0.87). Methods of treatment the recurrence rate at different periods of observation did not differ significantly; only after 1 month was more frequent relapses in patients who fulfilled the maximum number of types of operations (CSV, ILM peeling, PRLC and PEK) were 31.9% (p=0.025). When using only the CSV, and in complex use of all surgeries (CSV, ILM peeling, PRLC & FEK) all recurrences were early, of which the majority (77.3 and 80.0%, respectively) had persistent. In other types of surgery, most recurrences (91-96%) were in the early persistent and late. The effectiveness of DMP surgical treatment decreased with worsening of retinopathy and was 72.5% at the primary NPDR; 77.2% at moderate or severe NPDR and 66.3% in the DPR. DPR patients had a greater frequency (33.7%) and greater severity of relapses (the number of late relapses in patients of the 3rd group was higher than that in patients of the 1st and 2nd groups in 2.3 times; p=0.001). Conclusion. The study showed the high effectiveness of all techniques that increasingly depended on the severity of retinopathy was the worst with PDR.

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KNOWLEDGE OF DIABETIC RETINOPATHY AMONGST TYPE II DIABETES MELLITUS PATIENTS IN DR. WAHIDIN SUDIROHUSODO HOSPITAL

Nusantara Medical Science Journal ◽

10.20956/nmsj.v3i2.5777 ◽

2018 ◽

Vol 3 (2) ◽

pp. 23

Author(s):

Nursyamsi Nursyamsi ◽

Habibah Setyawati Muhiddin ◽

Gonardy Jennifer

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Type Ii Diabetes Mellitus ◽

University Hospital ◽

Delay In Diagnosis ◽

Descriptive Research ◽

Type 2 Dm ◽

Level Of Knowledge ◽

Internal Medicine Clinic

Introduction: Diabetic retinopathy (DR) is the leading cause of blindness that rises significantly each year along with the increasing diabetic population. It is estimated that 1 out of 3 people with diabetes will suffer from DR and 1 in 10 of them will be threatened with blindness. The main problem on DR management is the delay in diagnosis since most patients in the early stages do not experience visual impairment.Methods: Descriptive research was conducted over three months on 175 patients diagnosed with type 2 Diabetes Mellitus (DM) within the Internal Medicine Clinic at Hasanuddin University Hospital. Self-administered questionnaires were used to assess knowledge of DR amongst the diabetic patients.Results: The level of DR knowledge among type 2 DM was split into three categories. The level of knowledge on DM complication was within the good category for 109 patients (61.6%), whilst the level of knowledge on DR screening was within the the sufficient category for 150 patients (84.7%) and knowledge on DR management was within the good category for 98 patients (55.4%). Although the level of knowledge was categorized good for the majority of respondents, the remaining 45 (25.4%) respondents had never done DR screening, and most patients (57.1%) believed that DM patients tend not to screen due to the lack of knowledge about DR.Conclusion: In general, patients with type 2 DM have a good level of knowledge about diabetic retinopathy.

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Association of UCP1 and UCP2 Variants With Diabetic Retinopathy Susceptibility in Type-2 Diabetes Mellitus Patients: A Meta-analysis

10.21203/rs.3.rs-134894/v1 ◽

2020 ◽

Author(s):

Xujia Liu ◽

Zehua Jiang ◽

Guihua Zhang ◽

Tsz Kin Ng ◽

Zhenggen Wu

Keyword(s):

Diabetes Mellitus ◽

Diabetic Retinopathy ◽

Fixed Effects ◽

Literature Search ◽

Meta Analysis ◽

Sensitivity Analyses ◽

Fixed Effects Models ◽

Type 2 Dm ◽

Subgroup Analyses

Abstract Background: Genetic association of uncoupling proteins (UCPs) variants with the susceptibility of diabetic retinopathy (DR) in diabetes mellites (DM) patients has been reported but with controversy. Here we aimed to conduct a meta-analysis to confirm the association of different UCPs variants with DR.Methods: Three databases (Medline Ovid, Embase Ovid and CENTRAL) were applied in the literature search. Five genetic models, including allelic, homozygous, heterozygous, dominant and recessive models, were evaluated. Odds ratios (OR) were estimated under the random or fixed-effects models. Subgroup analyses, publication bias and sensitivity analyses were also conducted.Results: Eleven studies on 2 UCPs variants (UCP1 rs1800592 and UCP2 rs659366) were included. Our meta-analysis showed that UCP1 rs1800592 was not associated with DR in type-2 DM patients, and UCP2 rs659366 also showed no association with DR. In the subgroup analyses on the stage of DR, allele A of UCP1 rs1800592 significantly increased the susceptibility of proliferative diabetic retinopathy (PDR) in type-2 DM patients in the allelic (OR = 1.26, P = 0.03) and homozygous models (OR = 1.60, P = 0.04). Subgroup analysis on ethnicity did not found any significant association of rs1800592 and rs659366 with DR.Conclusion: Our meta-analysis confirmed the association of UCP1 rs1800592 variant with PDR in patients with type-2 DM, suggesting its potential as a genetic marker for PDR prediction in population screening.

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