scholarly journals Commentary: Vitrectomy for proliferative diabetic retinopathy in patients with type 1 diabetes mellitus

2021 ◽  
Vol 69 (11) ◽  
pp. 3296
Author(s):  
Mohit Dogra ◽  
Uday Tekchandani
Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 36-42
Author(s):  
O.V. Kolenko ◽  
◽  
Y.B. Lebedev ◽  
A.Y. Khudyakov ◽  
E.L. Sorokin ◽  
...  

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.


Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1151
Author(s):  
Pedro Romero-Aroca ◽  
Raul Navarro-Gil ◽  
Albert Feliu ◽  
Aida Valls ◽  
Antonio Moreno ◽  
...  

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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