scholarly journals PREVALENCE, PATHOGENESIS, CLASSIFICATION, IMAGING, SCREENING AND MANAGE-MENT OF DIABETIC RETINOPATHY- A CRITICAL REVIEW

2021 ◽  
Vol 9 (7) ◽  
pp. 1433-1442
Author(s):  
Narender Chanchal ◽  
Kushagra Goyal ◽  
Divya Vij ◽  
Rajesh Kumar Mishra
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Vision Loss ◽  
International Diabetes Federation ◽  
Pathological Process ◽  
Heterogeneous Cluster ◽  
Keywords Diabetic Retinopathy ◽  
Screening And Surveillance ◽  
Working Age ◽  
Microvascular Alterations

Diabetic retinopathy is that the leading reason for sightlessness among people between twenty-five and seventyfour years older within the industrialised world. Diabetes mellitus (DM) includes a heterogeneous cluster of disorders of carbohydrate, protein, and metastasis manifesting hyperglycemia. Diabetic retinopathy could be microangiopathy ensuing from the chronic effects of the disease, and shares similarities with the microvascular alterations that occur in different tissues at risk of DM equivalent to the kidneys and also the peripheral nerves. Diabetic retinopathy is assessed into nonproliferative and proliferative stages. Nonproliferative diabetic retinopathy (NPDR) involves progressive intraretinal microvascular alterations that may result in, and a lot of advanced proliferative stages outlined by extraretinal neovascularization. Imaging modalities in common clinical use for the management of NPDR and DME embrace structure photography, fluorescein angiography (FA), and optical coherence tomography (OCT). The suggested schedule for screening and surveillance for NPDR reflects data concerning the epidemiology and natural history of the disease. Diabetic retinopathy could be a leading explanationfor vision loss in working-age Americans and a major cause of sightlessness worldwide. The International Diabetes Federation estimates that as several as 592 million individuals worldwide can have DM in 2035, a rise from or so 387 million people calculable to possess the disease in 2014. Here, we tend to present a review of the presentunderstanding and new insights into biochemical mechanisms within the pathological process in DR, classification, furthermore as clinical treatments for DR patients. Keywords: Diabetic retinopathy, diabetes mellitus, retinal degeneration, fluoresces in angiography, optical coher- ence tomography, VEGF, focal/grid laser photocoagulation.

scholarly journals Macular oedema as manifestation of diabetic retinopathy

2017 ◽  
Vol 20 (4) ◽  
pp. 263-269 ◽  
Author(s):  
Mukharram M. Bikbov ◽  
Rinat R. Fayzrakhmanov ◽  
Rinat M. Zaynullin ◽  
Artur F. Zaynetdinov ◽  
Timur R. Gilmanshin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Macular Oedema ◽  
International Diabetes Federation ◽  
Pathological Process ◽  
Diagnostic Methods ◽  
Complex Nature ◽  
Diabetic Maculopathy ◽  
New Directions ◽  
Working Age

Diabetes mellitus is the third most dangerous disease of our time preceded by cardiovascular diseases and oncologic pathology. According to the International Diabetes Federation (January 1, 2016), worldwide approximately 415 million people aged 2079 years suffer from diabetes. The most significant manifestations of diabetes mellitus are lesions of the retina and blood vessels, which manifest as diabetic retinopathy and macular oedema, which lead to the inevitable loss of vision and disability in patients of working age. The existence of multile diagnostic methods and a broad classification provide an evidence of the complex nature of the pathological process of the macular zone in diabetes mellitus. However, to date, a single, generalised and accepted classification does not exist. Difficulties in the treatment of diabetic maculopathy are attributed to various forms of retinal lesions and ambiguities in the approach used to choose the disease management. It determines the importance of the development of diagnostic methods for the further correction of the standard treatment approach. New directions of surgical treatment allow relying on the best results of diabetic maculopathy treatment.

scholarly journals Diabetic Retinopathy: The Role of Mitochondria in the Neural Retina and Microvascular Disease

Antioxidants ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 905 ◽  
Author(s):  
David J. Miller ◽  
M. Ariel Cascio ◽  
Mariana G. Rosca
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Neurovascular Unit ◽  
Microvascular Disease ◽  
Retinal Disease ◽  
Neural Retina ◽  
Vascular Pathology ◽  
Future Research ◽  
Substrate Selection ◽  
Working Age

Diabetic retinopathy (DR), a common chronic complication of diabetes mellitus and the leading cause of vision loss in the working-age population, is clinically defined as a microvascular disease that involves damage of the retinal capillaries with secondary visual impairment. While its clinical diagnosis is based on vascular pathology, DR is associated with early abnormalities in the electroretinogram, indicating alterations of the neural retina and impaired visual signaling. The pathogenesis of DR is complex and likely involves the simultaneous dysregulation of multiple metabolic and signaling pathways through the retinal neurovascular unit. There is evidence that microvascular disease in DR is caused in part by altered energetic metabolism in the neural retina and specifically from signals originating in the photoreceptors. In this review, we discuss the main pathogenic mechanisms that link alterations in neural retina bioenergetics with vascular regression in DR. We focus specifically on the recent developments related to alterations in mitochondrial metabolism including energetic substrate selection, mitochondrial function, oxidation-reduction (redox) imbalance, and oxidative stress, and critically discuss the mechanisms of these changes and their consequences on retinal function. We also acknowledge implications for emerging therapeutic approaches and future research directions to find novel mitochondria-targeted therapeutic strategies to correct bioenergetics in diabetes. We conclude that retinal bioenergetics is affected in the early stages of diabetes with consequences beyond changes in ATP content, and that maintaining mitochondrial integrity may alleviate retinal disease.

Diabetic Retinopathy—Update on Prevention Techniques, Present Therapies, and New Leads

2014 ◽  
Vol 10 (01) ◽  
pp. 25
Author(s):  
Lauren M Marozas ◽  
Patrice E Fort ◽  
◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Developed Countries ◽  
Detection Methods ◽  
Retinal Microvasculature ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Combined Control ◽  
Working Age ◽  
Proactive Measures

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.

scholarly journals The Evolving Treatment Options for Diabetic Macular Edema

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Atul Jain ◽  
Neeta Varshney ◽  
Colin Smith
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Treatment Options ◽  
Previous Treatment ◽  
Common Cause ◽  
Working Age

Diabetic retinopathy (DR) is the leading cause of vision loss in working-age adults, and diabetic macular edema (DME) is the most common cause of visual impairment in individuals with DR. This review focuses on the pathophysiology, previous treatment paradigms, and emerging treatment options in the management of DME.

scholarly journals Diabetic retinopathy: treatment and prevention

2007 ◽  
Vol 4 (3_suppl) ◽  
pp. S9-S11 ◽  
Author(s):  
Paul M Dodson
Keyword(s):  
Diabetic Retinopathy ◽  
Standard Therapy ◽  
Vision Loss ◽  
Early Stage ◽  
Developed Countries ◽  
Relative Reduction ◽  
Treatment And Prevention ◽  
Working Age ◽  
Capillary Occlusion

Diabetic eye disease is the major cause of blindness and vision loss among working-age people in developed countries. Microangiopathy and capillary occlusion underlie the pathogenesis of disease. While laser treatment is regarded as the standard therapy, intensive medical management of glycaemia and hypertension is also a priority in order to reduce the risk of diabetic retinopathy. Recent data have prompted a re-evaluation of the role of lipid-modifying therapy in reducing diabetic retinopathy. The Fenofibrate Intervention for Event Lowering in Diabetes (FIELD) study demonstrated a significant 30% relative reduction in the need for first retinal laser therapy in patients with (predominantly early-stage) type 2 diabetes treated with fenofibrate 200 mg daily, from 5.2% with placebo to 3.6% with fenofibrate, p=0.0003. The benefit of fenofibrate was evident within the first year of treatment. These promising data justify further evaluation of the mechanism and role of fenofibrate, in addition to standard therapy, in the management of diabetic retinopathy.

scholarly journals tRNAleu A3243G Gene Mutation of Mitochondrial DNA as a Risk Factor for Diabetic Retinopathy in Type 2 Diabetes Mellitus in Bali

2022 ◽  
Vol 9 (1) ◽  
pp. 182-188
Author(s):  
Aprilla Berlianti ◽  
I Wayan Surudarma ◽  
Ida Ayu Dewi Wiryanthini
Keyword(s):  
Diabetes Mellitus ◽  
Mitochondrial Dna ◽  
Diabetic Retinopathy ◽  
Risk Factor ◽  
Gene Mutation ◽  
Keywords Diabetic Retinopathy ◽  
Relationship Analysis ◽  
Dna Mutations ◽  
Patients With Diabetes

Introduction: Diabetic retinopathy is one of the chronic complications in patients with diabetes mellitus caused by progressive microangiopathy. Various types of risk factors can affect the occurrence of diabetic retinopathy, one of which is mitochondrial DNA mutations in the tRNAleu A3243G gene that is common in T2DM. This study was conducted with the aim to identify whether the mutation of the tRNAleu A3243G gene acts as a risk factor for diabetic retinopathy in T2DM patients in Bali. Material and Methods: This study used a case control design with 35 T2DM patients with diabetic retinopathy and 35 T2DM patients without diabetic retinopathy. The techniques used to identify these mutations are PCR and DNA sequencing. Results: Based on the results obtained, no mutations were found in the tRNAleu A3243G gene in the entire sample. Therefore, the relationship analysis of the two variables cannot be identified. Conclusions: Mutations of the tRNAleu A3243G gene that were not successfully identified in this study can be concluded not play a role as a risk factor for diabetic retinopathy. Keywords: Diabetic Retinopathy, Diabetes Mellitus, tRNAleu Gene Mutation, Mitochondrial DNA.

scholarly journals Doença Ocular Diabética

2015 ◽  
Vol 28 (1) ◽  
pp. 107 ◽  
Author(s):  
José Henriques ◽  
Sara Vaz-Pereira ◽  
João Nascimento ◽  
Paulo Caldeira Rosa
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetes Complications ◽  
Microvascular Complications ◽  
Ischemic Optic Neuropathy ◽  
Corneal Erosion ◽  
Ocular Manifestations ◽  
Cranial Nerve Palsies ◽  
Working Age ◽  
Working Age Population

Diabetes mellitus is a chronic metabolic disease characterized by sustained hyperglycemia leading to macro and microvascular complications. The eye is one of the main organs affected by this disease, being diabetic retinopathy the most well-known microvascular complication and the leading cause of blindness in the working age population. However, diabetic ocular disease is not only characterized by diabetic retinopathy. Other important ocular manifestations of diabetes mellitus include cataract, glaucoma, ischemic optic neuropathy, cranial nerve palsies and recurrent corneal erosion syndrome. Here, we emphasize diabetic retinopathy as the most important and characteristic complication of diabetes mellitus, but also review less well-known complications with the aim to alert and sensitize non-ophthalmologist clinicians that treat diabetic individuals, in order to promote an early diagnosis and treatment of the sight-threatening complications of diabetes.<br /><strong>Keywords:</strong> Diabetes Complications; Diabetes Mellitus; Diabetic Retinopathy.

scholarly journals Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

2020 ◽  
Vol 17 (1) ◽  
pp. 310
Author(s):  
Abdah Khairiah Che Md Noor ◽  
Evelyn Li Min Tai ◽  
Yee Cheng Kueh ◽  
Ab Hamid Siti-Azrin ◽  
Zamri Noordin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Survival Time ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Ischemic Heart ◽  
Vitrectomy Surgery

Vitrectomy surgery in proliferative diabetic retinopathy improves the vision-related quality of life. However, there is lack of data on the duration of maintenance of visual gains post vitrectomy. This study thus aimed to determine the survival time of visual gains and the prognostic factors of vision loss after vitrectomy surgery for complications of proliferative diabetic retinopathy. A retrospective cohort study was conducted in an ophthalmology clinic in Malaysia. We included 134 patients with type 2 diabetes mellitus on follow-up after vitrectomy for proliferative diabetic retinopathy. Visual acuity was measured using the log of minimum angle of resolution (LogMar). A gain of ≥0.3 LogMar sustained on two subsequent visits was considered evidence of visual improvement post vitrectomy. Subjects were considered to have vision loss when their post-operative visual acuity subsequently dropped by ≥0.3 LogMar. Kaplan–Meier analysis was used to determine the survival time of visual gains. Cox Proportional Hazard regression was used to determine the prognostic factors of vision loss. The median age of patients was 56.00 years (IQR ± 10.00). The median duration of diabetes mellitus was 14.00 years (IQR ± 10.00). Approximately 50% of patients with initial improvement post vitrectomy subsequently experienced vision loss. The survival time, i.e., the median time from surgery until the number of patients with vision loss formed half of the original cohort, was 14.63 months (95% CI: 9.95, 19.32). Ischemic heart disease was a significant prognostic factor of vision loss. Patients with underlying ischemic heart disease (adjusted HR: 1.97, 95% CI: 1.18, 3.33) had a higher risk of vision loss post vitrectomy, after adjusting for other factors. Approximately half the patients with initial visual gains post vitrectomy maintained their vision for at least one year. Ischemic heart disease was a poor prognostic factor for preservation of visual gains post vitrectomy.

scholarly journals Diabetic Retinopathy, lncRNAs, and Inflammation: A Dynamic, Interconnected Network

2019 ◽  
Vol 8 (7) ◽  
pp. 1033 ◽  
Author(s):  
Saumik Biswas ◽  
Marie Sarabusky ◽  
Subrata Chakrabarti
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Interconnected Network ◽  
Working Age ◽  
Modulation Of Gene Expression ◽  
Non Coding Rnas ◽  
Working Age Population ◽  
Prevalence Of Diabetes Mellitus

Diabetic retinopathy (DR) is reaching epidemic levels globally due to the increase in prevalence of diabetes mellitus (DM). DR also has detrimental effects to quality of life, as it is the leading cause of blindness in the working-age population and the most common cause of vision loss in individuals with DM. Over several decades, many studies have recognized the role of inflammation in the development and progression of DR; however, in recent years, accumulating evidence has also suggested that non-coding RNAs, especially long non-coding (lncRNAs), are aberrantly expressed in diabetes and may play a putative role in the development and progression of DR through the modulation of gene expression at the transcriptional, post-transcriptional, or epigenetic level. In this review, we will first highlight some of the key inflammatory mediators and transcription factors involved in DR, and we will then introduce the critical roles of lncRNAs in DR and inflammation. Following this, we will discuss the implications of lncRNAs in other epigenetic mechanisms that may also contribute to the progression of inflammation in DR.

scholarly journals Diabetic Retinopathy. Morphofunctional State of the Retina in Pancreas Recipients

2021 ◽  
Vol 18 (3) ◽  
pp. 459-469
Author(s):  
I. V. Vorobyeva ◽  
L. K. Moshetova ◽  
A. V. Pinchuk ◽  
E. V. Bulava ◽  
K. E. Lazareva ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Pancreas Transplantation ◽  
Patient Management ◽  
Molecular Mechanisms ◽  
Vision Loss ◽  
Retinal Damage ◽  
Common Complication ◽  
Immunological Markers

Diabetes mellitus (DM) is one of the most common and rapidly progressing diseases worldwide. Diabetic retinopathy (DR) is a common complication of diabetes and the main cause of vision loss in middle-aged and elderly people. The development and progression of DR is closely related to the duration of diabetes, hyperglycemia, and arterial hypertension. There is growing evidence that inflammation is one of the key links in the pathogenesis of diabetic retinal damage, but the exact molecular mechanisms remain to be known. Pancreas transplantation (PT) is currently the only effective treatment for diabetes that restores normal physiological glucose metabolism. Due to the limited number of PT surgeries associated with the severity of intra- and postoperative complications and the acute issue of organ donation, studies on the assessment of DR after PT are few and contradictory. There is a need for further studies of the DR state after PT with the study of the influence of risk factors, determination of the level of immunological markers and the use of modern instrumental research methods to create effective patient management regimens in the postoperative period.

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