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Sample records for early oxygen-induced retinopathy

  1. Gene expression microarray analysis of early oxygen-induced retinopathy in the rat.

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    Tea, Melinda; Fogarty, Rhys; Brereton, Helen M; Michael, Michael Z; Van der Hoek, Mark B; Tsykin, Anna; Coster, Douglas J; Williams, Keryn A

    2009-12-12

    Different inbred strains of rat differ in their susceptibility to oxygen-induced retinopathy (OIR), an animal model of human retinopathy of prematurity. We examined gene expression in Sprague-Dawley (susceptible) and Fischer 344 (resistant) neonatal rats after 3 days exposure to cyclic hyperoxia or room air, using Affymetrix rat Genearrays. False discovery rate analysis was used to identify differentially regulated genes. Such genes were then ranked by fold change and submitted to the online database, DAVID. The Sprague-Dawley list returned the term "response to hypoxia," absent from the Fischer 344 output. Manual analysis indicated that many genes known to be upregulated by hypoxia-inducible factor-1alpha were downregulated by cyclic hyperoxia. Quantitative real-time RT-PCR analysis of Egln3, Bnip3, Slc16a3, and Hk2 confirmed the microarray results. We conclude that combined methodologies are required for adequate dissection of the pathophysiology of strain susceptibility to OIR in the rat. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12177-009-9041-7) contains supplementary material, which is available to authorized users.

  2. Revisiting the mouse model of oxygen-induced retinopathy

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    Kim CB

    2016-05-01

    Full Text Available Clifford B Kim,1,2 Patricia A D’Amore,2–4 Kip M Connor1,2 1Angiogenesis Laboratory, Massachusetts Eye and Ear, 2Department of Ophthalmology, Harvard Medical School, 3Schepens Eye Research Institute, Massachusetts Eye and Ear, 4Department of Pathology, Harvard Medical School, Boston, MA, USA Abstract: Abnormal blood vessel growth in the retina is a hallmark of many retinal diseases, such as retinopathy of prematurity (ROP, proliferative diabetic retinopathy, and the wet form of age-related macular degeneration. In particular, ROP has been an important health concern for physicians since the advent of routine supplemental oxygen therapy for premature neonates more than 70 years ago. Since then, researchers have explored several animal models to better understand ROP and retinal vascular development. Of these models, the mouse model of oxygen-induced retinopathy (OIR has become the most widely used, and has played a pivotal role in our understanding of retinal angiogenesis and ocular immunology, as well as in the development of groundbreaking therapeutics such as anti-vascular endothelial growth factor injections for wet age-related macular degeneration. Numerous refinements to the model have been made since its inception in the 1950s, and technological advancements have expanded the use of the model across multiple scientific fields. In this review, we explore the historical developments that have led to the mouse OIR model utilized today, essential concepts of OIR, limitations of the model, and a representative selection of key findings from OIR, with particular emphasis on current research progress. Keywords: ROP, OIR, angiogenesis

  3. Targeting VEGF in canine oxygen-induced retinopathy - a model for human retinopathy of prematurity

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    McLeod DS

    2016-05-01

    Full Text Available D Scott McLeod, Gerard A Lutty Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Development of the dog superficial retinal vasculature is similar to the mechanism of human retinal vasculature development; they both develop by vasculogenesis, differentiation, and assembly of vascular precursors called angioblasts. Canine oxygen-induced retinopathy (OIR was first developed by Arnall Patz in an effort to experimentally determine the effects of hyperoxia on the development of the retinal vasculature. The canine OIR model has many characteristics in common with human retinopathy of prematurity. Exposure of 1-day-old dogs to hyperoxia for 4 days causes a vaso-obliteration throughout the retina. Vasoproliferation, after the animals have returned to room air, is robust. The initial small preretinal neovascular formations anastomose to form large preretinal membranes that eventually cause tractional retinal folds. The end-stage pathology of the canine model is similar to stage IV human retinopathy of prematurity. Therefore, canine OIR is an excellent forum to evaluate the response to drugs targeting VEGF and its receptors. Evaluation of an antibody to VEGF-R2 and the VEGF-Trap demonstrated that doses should be titered down so that preretinal neovascularization is inhibited but retinal revascularization is able to proceed, vascularizing peripheral retina and preventing it from being a source of VEGF. Keywords: angioblasts, blood vessels, endothelial cells, oxygen, retinopathy, retina, vascular endothelial cell growth factor

  4. Protective Role of Aldose Reductase Deletion in an Animal Model of Oxygen-Induced Retinopathy

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    Zhongjie Fu

    2011-05-01

    Full Text Available Retinopathy of prematurity (ROP is a common disease occurred in premature babies. Both vascular abnormality and neural dysfunction of the retina were reported, and oxidative stress was involved. Previously, it has been showed that deficiency of aldose reductase (AR, the rate-limiting enzyme in polyol pathway, lowered oxidative stress. Here, the effect of AR deletion on neonatal retinal injury was investigated by using a mouse model of ROP (oxygen-induced retinopathy, OIR. Seven-day-old pups were exposed to 75% oxygen for 5 days and then returned to room air. The vascular changes and neuronal/glial responses were examined and compared between wild-type and AR-deficient OIR mice. Significantly reduced vaso-obliterated area, blood vessel leakage, and early revascularization were observed in AR-deficient OIR mice. Moreover, reduced amacrine cells and less distorted strata were observed in AR-deficient OIR mice. Less astrocytic immunoreactivity and reduced Müller cell gliosis were also observed in AR-deficient mice. After OIR, nitrotyrosine immunoreactivity and poly (ADP-ribose (PAR translocation, which are two oxidative stress markers, were decreased in AR-deficient mice. Significant decrease in VEGF, pho-Erk1/2, pho-Akt, and pho-I?B expression was found in AR-deficient OIR retinae. Thus, these observations suggest that the deficiency of aldose reductase may protect the retina in the OIR model.

  5. 670nm photobiomodulation as a novel protection against retinopathy of prematurity: evidence from oxygen induced retinopathy models.

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    Riccardo Natoli

    Full Text Available INTRODUCTION: To investigate the validity of using 670nm red light as a preventative treatment for Retinopathy of Prematurity in two animal models of oxygen-induced retinopathy (OIR. MATERIALS AND METHODS: During and post exposure to hyperoxia, C57BL/6J mice or Sprague-Dawley rats were exposed to 670 nm light for 3 minutes a day (9J/cm². Whole mounted retinas were investigated for evidence of vascular abnormalities, while sections of neural retina were used to quantify levels of cell death using the TUNEL technique. Organs were removed, weighed and independent histopathology examination performed. RESULTS: 670 nm light reduced neovascularisation, vaso-obliteration and abnormal peripheral branching patterns of retinal vessels in OIR. The neural retina was also protected against OIR by 670 nm light exposure. OIR-exposed animals had severe lung pathology, including haemorrhage and oedema, that was significantly reduced in 670 nm+OIR light-exposed animals. There were no significance differences in the organ weights of animals in the 670 nm light-exposed animals, and no adverse effects of exposure to 670 nm light were detected. DISCUSSION: Low levels of exposure to 670 nm light protects against OIR and lung damage associated with exposure to high levels of oxygen, and may prove to be a non-invasive and inexpensive preventative treatment for ROP and chronic lung disease associated with prematurity.

  6. Honokiol inhibits pathological retinal neovascularization in oxygen-induced retinopathy mouse model

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    Vavilala, Divya Teja [Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO (United States); O’Bryhim, Bliss E. [Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS (United States); Ponnaluri, V.K. Chaithanya [Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO (United States); White, R. Sid; Radel, Jeff [Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS (United States); Symons, R.C. Andrew [Department of Ophthalmology, University of Kansas Medical Center, Kansas City, KS (United States); Ophthalmology Department, Royal Melbourne Hospital, University of Melbourne, Victoria (Australia); Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Victoria (Australia); Mukherji, Mridul, E-mail: mukherjim@umkc.edu [Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, MO (United States)

    2013-09-06

    Highlights: •Aberrant activation of HIF pathway is the underlying cause of ischemic neovascularization. •Honokiol has better therapeutic index as a HIF inhibitor than digoxin and doxorubicin. •Daily IP injection of honokiol in OIR mouse model reduced retinal neovascularization. •Honokiol also prevents vaso-obliteration, the characteristic feature of the OIR model. •Honokiol enhanced physiological revascularization of the retinal vascular plexuses. -- Abstract: Aberrant activation of the hypoxia inducible factor (HIF) pathway is the underlying cause of retinal neovascularization, one of the most common causes of blindness worldwide. The HIF pathway also plays critical roles during tumor angiogenesis and cancer stem cell transformation. We have recently shown that honokiol is a potent inhibitor of the HIF pathway in a number of cancer and retinal pigment epithelial cell lines. Here we evaluate the safety and efficacy of honokiol, digoxin, and doxorubicin, three recently identified HIF inhibitors from natural sources. Our studies show that honokiol has a better safety to efficacy profile as a HIF inhibitor than digoxin and doxorubicin. Further, we show for the first time that daily intraperitoneal injection of honokiol starting at postnatal day (P) 12 in an oxygen-induced retinopathy (OIR) mouse model significantly reduced retinal neovascularization at P17. Administration of honokiol also prevents the oxygen-induced central retinal vaso-obliteration, characteristic feature of the OIR model. Additionally, honokiol enhanced physiological revascularization of the retinal vascular plexuses. Since honokiol suppresses multiple pathways activated by HIF, in addition to the VEGF signaling, it may provide advantages over current treatments utilizing specific VEGF antagonists for ocular neovascular diseases and cancers.

  7. Expression and function of P16 in a rat model of oxygen-induced retinopathy

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    You Li

    2017-02-01

    Full Text Available AIM: To investigate the effect of p16 protein expression on the proliferation of retinal neovascularization in oxygen-induced retinopathy(OIR.METHODS: Totally 60 SD rats aged 7d were randomly divided into 4 groups: normal group, model group, intervention group and NS control group. Normal group was raised in a normal air feeding; model group at 75% high oxygen for 5d to establish the model of oxygen induced retinopathy; intervention group was given anti p16 methylation drug 5-aza-CdR(0.25 mg/kgintraperitoneal injection; NS control group was given the same volume NS intraperitoneal injection. The eyes were taken from each group and the left eyes were removed for observation of retinal neovascularization by HE staining, and immunohistochemistry and immunofluorescence were taken for observations of p16 protein expression. Right retina had been performed real time-PCR to analysis p16mRNA expression. RESULTS: The normal group were not found retinal neovascularization breaking through internal limiting mebrane. In model group and NS control group, the retinal tissue was obviously thickened, and a large number of new blood vessels were found. In the intervention group, a small amount of new blood vessels were found in the retina. The expression of p16 was low in the model group, the positive cell number was 19.52±2.67, and the number of the positive cells was 36.38±3.16 in the intervention group, the difference was statistically significant(P-△△ct=0.14±0.01, the expression of p16 mRNA in the intervention group rats retina was significantly higher than that of NS control group rat retina, there was significant difference between two groups(2-△△ct=0.68±0.08, PCONCLUSION: The abnormal expression of P16 may be closely related to the proliferation of retinal neovascularization. Inhibition of p16 methylation can decrease the proliferation of retinal neovascularization.

  8. Tenomodulin Inhibits Retinal Neovascularization in a Mouse Model of Oxygen-Induced Retinopathy

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    Tatsuhiko Sato

    2012-11-01

    Full Text Available We aimed to determine the anti-angiogenic effect of tenomodulin (TeM on retinal neovascularization in an oxygen-induced retinopathy (OIR mouse model. OIR was induced in C57BL/6 mice by exposing seven-day-old mice to 75% oxygen for five days followed by room air for five days. Control mice were exposed to room air from birth until postnatal day 17. Mice received intravitreal injections of 1 μg of TeM in one eye and PBS in the contralateral eye at P7 before being exposed to 75% oxygen. Eyes were collected at postnatal day 17. Retinal blood vessel patterns were visualized by fluorescein angiography. We quantified the number of neovascular nuclei that were present beyond the inner limiting membrane (ILM using histological methods with a masked approach. Furthermore, double immunohistochemical staining of TeM was performed on retinas to identify nuclei protruding into the vitreous cavity. Western blot was used to detect exogenous TeM protein. The central nonperfusion area (NPA, mm2 of TeM-injected eyes was significantly different from that of OIR and PBS-injected eyes, and the number of nuclei in new blood vessels breaking through the ILM in each retinal cross-section significantly differed from that of OIR eyes and PBS-injected control eyes. Cellular nuclei of new blood vessels protruding into the vitreous cavity were also observed in TeM-injected retinas by immunohistochemistry. Western blotting revealed a 16-kDa immunoreactive protein, indicating incorporation of an exogenous TeM fragment into the retina. Our data shows that TeM can effectively inhibit pathological angiogenesis in mouse eyes; indicating its potential role in prevention and treatment of ocular neovascularization.

  9. Activated complement classical pathway in a murine model of oxygen-induced retinopathy

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    Xue-Ying; Tao; Shi-Jie; Zheng; Bo; Lei

    2015-01-01

    AIM: To investigate whether the complement system is involved in a murine model of oxygen-induced retinopathy(OIR).METHODS: Forty C57BL/6J newborn mice were divided randomly into OIR group and control group. OIR was induced by exposing mice to 75% ±2% oxygen from postnatal 7d(P7) to P12 and then recovered in room air.For the control group, the litters were raised in room air.At the postnatal 17d(P17), gene expressions of the complement components of the classical pathway(CP),the mannose-binding lectin(MBL) pathway and the alternative pathway(AP) in the retina were determined by quantitative real-time polymerase chain reaction(RT-PCR). Retinal protein expressions of the key components in the CP were examined by Western blotting.· RESULTS: Whole mounted retina in the OIR mice showed area of central hypoperfusion in both superficial and deep layers and neovascular tufts in the periphery.The expressions of C1 qb and C4 b genes in the OIR retina were significantly higher than those of the controls. The expression of retinal complement factor B(CFB) gene in OIR mice was significantly lower than those of the controls. However, the expressions of C3 and complement factor H(CFH) genes were higher. The protein synthesis of the key components involved in the CP(C1q, C4 and C3) were also significantly higher in OIR mouse retina. Although MBL-associated serine protease 1(MASP1) and MASP2 were detected in both the OIR and the control groups, the expressions were weak and the difference between the two groups was not significant.CONCLUSION: Our data suggest that the complement system CP is activated during the pathogenesis of murine model of OIR.

  10. Anti-VEGF therapy in the management of retinopathy of prematurity: what we learn from representative animal models of oxygen-induced retinopathy

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    Wang H

    2016-05-01

    Full Text Available Haibo Wang Department of Ophthalmology, John A Moran Eye Center, The University of Utah, Salt Lake City, UT, USA Abstract: Retinopathy of prematurity (ROP remains a leading cause of childhood blindness, affecting infants born prematurely. ROP is characterized by the onset of delayed physiological retinal vascular development (PRVD and followed by pathologic neovascularization into the vitreous instead of the retina, called intravitreal neovascularization (IVNV. Therefore, the therapeutic strategy for treating ROP is to promote PRVD and inhibit or prevent IVNV. Vascular endothelial growth factor (VEGF plays an important role in the pathogenesis of ROP. There is a growing body of studies testing the use of anti-VEGF agents as a treatment for ROP. Intravitreal anti-VEGF treatment for ROP has potential advantages compared with laser photocoagulation, the gold standard for the treatment of severe ROP; however, intravitreal anti-VEGF treatment has been associated with reactivation of ROP and suppression of systemic VEGF that may affect body growth and organ development in preterm infants. Therefore, it is important to understand the role of VEGF in PRVD and IVNV. This review includes the current knowledge of anti-VEGF treatment for ROP from animal models of oxygen-induced retinopathy (OIR, highlighting the importance of VEGF inhibition by targeting retinal Müller cells, which inhibits IVNV and permits PRVD. The signaling events involved in mediating VEGF expression and promoting VEGF-mediated angiogenesis, including hypoxia-dependent signaling, erythropoietin/erythropoietin receptor-, oxidative stress-, beta-adrenergic receptor-, integrin-, Notch/Delta-like ligand 4- and exon guidance molecules-mediated signaling pathways, are also discussed. Keywords: vascular endothelial growth factor, retinopathy of prematurity, intravitreal neovascularization, oxygen-induced retinopathy model, physiological retinal vascular development

  11. Protective effect of maternal uteroplacental insufficiency on oxygen-induced retinopathy in offspring: removing bias of premature birth.

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    Becker, Silke; Wang, Haibo; Yu, Baifeng; Brown, Randy; Han, Xiaokun; Lane, Robert H; Hartnett, M Elizabeth

    2017-02-14

    To address the hypothesis that maternal uteroplacental insufficiency (UPI) increases severity of retinopathy of prematurity, we developed a composite rat model of UPI and oxygen-fluctuations and removed premature birth as a confounding factor. Timed-pregnant Sprague-Dawley dams underwent bilateral uterine artery ligation or anesthesia (control) at e19.5. Full-term pups developed in room air (RA) or an oxygen-induced retinopathy (OIR) model. Isolectin-stained retinal flat-mounts were analyzed for percent of areas of avascular/total retina (AVA) and of intravitreal neovascular/total retina (IVNV). Pup weights and serum and mRNA of liver and kidney VEGF, IGF-1, and erythropoietin (EPO) were determined. Multivariable mixed effects linear regressions and Pearson correlations were performed using STATA14. Postnatal growth restriction occurred in pups in UPI/RA, but not in UPI/OIR. Weight gain was similar between UPI/OIR and control/OIR pups. AVA was reduced and a trend toward reduced IVNV was seen in UPI/OIR compared to control/OIR. No difference in birth weights of UPI/OIR vs. control/OIR pups occurred. Serum and renal IGF-1 and EPO were significantly increased in UPI/OIR compared to control/OIR pups. In the absence of prematurity, UPI increased angiogenic factors in association with reduced OIR severity, suggesting that ischemia from UPI could yield protective angiogenic effects by offspring.

  12. Protective effect of maternal uteroplacental insufficiency on oxygen-induced retinopathy in offspring: removing bias of premature birth

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    Becker, Silke; Wang, Haibo; Yu, Baifeng; Brown, Randy; Han, Xiaokun; Lane, Robert H.; Hartnett, M. Elizabeth

    2017-01-01

    To address the hypothesis that maternal uteroplacental insufficiency (UPI) increases severity of retinopathy of prematurity, we developed a composite rat model of UPI and oxygen-fluctuations and removed premature birth as a confounding factor. Timed-pregnant Sprague-Dawley dams underwent bilateral uterine artery ligation or anesthesia (control) at e19.5. Full-term pups developed in room air (RA) or an oxygen-induced retinopathy (OIR) model. Isolectin-stained retinal flat-mounts were analyzed for percent of areas of avascular/total retina (AVA) and of intravitreal neovascular/total retina (IVNV). Pup weights and serum and mRNA of liver and kidney VEGF, IGF-1, and erythropoietin (EPO) were determined. Multivariable mixed effects linear regressions and Pearson correlations were performed using STATA14. Postnatal growth restriction occurred in pups in UPI/RA, but not in UPI/OIR. Weight gain was similar between UPI/OIR and control/OIR pups. AVA was reduced and a trend toward reduced IVNV was seen in UPI/OIR compared to control/OIR. No difference in birth weights of UPI/OIR vs. control/OIR pups occurred. Serum and renal IGF-1 and EPO were significantly increased in UPI/OIR compared to control/OIR pups. In the absence of prematurity, UPI increased angiogenic factors in association with reduced OIR severity, suggesting that ischemia from UPI could yield protective angiogenic effects by offspring. PMID:28195189

  13. CD34 Promotes Pathological Epi-Retinal Neovascularization in a Mouse Model of Oxygen-Induced Retinopathy.

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    Martin J Siemerink

    Full Text Available The sialomucins CD34 and podocalyxin (PODXL are anti-adhesive molecules expressed at the luminal membrane of endothelial cells of small blood vessels and facilitate vascular lumen formation in the developing mouse aorta. CD34 transcript and protein levels are increased during human angiogenesis, its expression is particularly enriched on endothelial tip cell filopodia and CD34 is a marker for tip cells in vitro. Here, we investigated whether CD34 merely marks endothelial tip cells or has a functional role in tip cells and angiogenesis. We assessed that silencing CD34 in human microvascular endothelial cells has little effect on endothelial cell migration or invasion, but has a significant effect on vascular-endothelial growth factor-induced angiogenic sprouting activity in vitro. In vivo, the absence of CD34 reduced the density of filopodia on retinal endothelial tip cells in neonatal mice, but did not influence the overall architecture of the retinal vascular network. In oxygen-induced retinopathy, Cd34-/- mice showed normal intra-retinal regenerative angiogenesis but the number of pathological epi-retinal neovascular tufts were reduced. We conclude that CD34 is not essential for developmental vascularization in the retina, but its expression promotes the formation of pathological, invasive vessels during neovascularization.

  14. CD34 Promotes Pathological Epi-Retinal Neovascularization in a Mouse Model of Oxygen-Induced Retinopathy

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    Siemerink, Martin J.; Dallinga, Marchien G.; Gora, Tomek; Cait, Jessica; Vogels, Ilse M. C.; Yetin-Arik, Bahar; Van Noorden, Cornelis J. F.; Klaassen, Ingeborg; McNagny, Kelly M.; Schlingemann, Reinier O.

    2016-01-01

    The sialomucins CD34 and podocalyxin (PODXL) are anti-adhesive molecules expressed at the luminal membrane of endothelial cells of small blood vessels and facilitate vascular lumen formation in the developing mouse aorta. CD34 transcript and protein levels are increased during human angiogenesis, its expression is particularly enriched on endothelial tip cell filopodia and CD34 is a marker for tip cells in vitro. Here, we investigated whether CD34 merely marks endothelial tip cells or has a functional role in tip cells and angiogenesis. We assessed that silencing CD34 in human microvascular endothelial cells has little effect on endothelial cell migration or invasion, but has a significant effect on vascular-endothelial growth factor-induced angiogenic sprouting activity in vitro. In vivo, the absence of CD34 reduced the density of filopodia on retinal endothelial tip cells in neonatal mice, but did not influence the overall architecture of the retinal vascular network. In oxygen-induced retinopathy, Cd34-/- mice showed normal intra-retinal regenerative angiogenesis but the number of pathological epi-retinal neovascular tufts were reduced. We conclude that CD34 is not essential for developmental vascularization in the retina, but its expression promotes the formation of pathological, invasive vessels during neovascularization. PMID:27352134

  15. PEDF mediates pathological neovascularization by regulating macrophage recruitment and polarization in the mouse model of oxygen-induced retinopathy

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    Gao, Sha; Li, Changwei; Zhu, Yanji; Wang, Yanuo; Sui, Ailing; Zhong, Yisheng; Xie, Bing; Shen, Xi

    2017-01-01

    Macrophages have been demonstrated to play a proangiogenic role in retinal pathological vascular growth. Pigment epithelium-derived factor (PEDF) works as a powerful endogenous angiogenesis inhibitor, but its role in macrophage recruitment and polarization is largely unknown. To explore the underlying mechanisms, we first evaluated macrophage polarization in the retinas of the oxygen-induced retinopathy (OIR) mouse model. Compared to that in normal controls, M1- and M2-like macrophages were all abundantly increased in the retinas of OIR mice. In addition, both M1 and M2 subtypes significantly promoted neovascularization in vitro and in vivo. In addition, we found that PEDF inhibited retinal neovascularization by dampening macrophage recruitment and polarization. Furthermore, PEDF inhibited macrophage polarization through adipose triglyceride lipase (ATGL) by regulating the activation of MAPKs and the Notch1 pathway, as we found that the phosphorylation of MAPKs, including p38MAPK, JNK and ERK, as well as the accumulation of Notch1 were essential for hypoxia-induced macrophage polarization, while PEDF significantly dampened M1 subtype-related iNOS and M2 subtype-related Arg-1 expression by inhibiting hypoxia-induced activation of Notch1 and MAPKs through ATGL. These findings reveal a protective role of PEDF against retinal neovascularization by regulating macrophage recruitment and polarization. PMID:28211523

  16. Structural neurodegeneration correlates with early diabetic retinopathy

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    Frydkjaer-Olsen, Ulrik; Hansen, Rasmus Søgaard; Peto, Tunde

    2017-01-01

    PURPOSE: To examine differences in structural and functional neurodegenerative measurements between patients with no and early diabetic retinopathy (DR). METHODS: In this cross-sectional study, we examined 103 patients with type 2 diabetes mellitus. In 7-field fundus photographs acquired with Top...

  17. A case of early-onset radiation retinopathy

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    Sato, Yoko; Den, Seika; Shimizu, Kazuhiro; Ikeda, Tsunehiko [Osaka Medical Coll., Takatsuki (Japan)

    2001-12-01

    We encountered a 27-year-old male early caused by radiation retinopathy five months after radiotherapy (51 Gy) for astrocytoma. The retinopathy was the proliferative retinopathy, with several dot and blot hemorrhages, hard and soft exudate, increased capillary permeability, macula edema and avasucular areas. So it was treated with panretial photocoagulation like diabetic retinopathy. Now hemorrhage, exudate, edema and avascular areas were improved. Photocoagulation treatment is effective to stop the progression of radiation retinopathy. Radiation retinopathy is sometimes early caused, therefore long-term follow up is recommended on starting radiotherapy. (author)

  18. Ocular Adverse Effects of Intravitreal Bevacizumab Are Potentiated by Intermittent Hypoxia in a Rat Model of Oxygen-Induced Retinopathy

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    Jeffrey J. Tan

    2017-01-01

    Full Text Available Intravitreal bevacizumab (Avastin use in preterm infants with retinopathy of prematurity is associated with severe neurological disabilities, suggesting vascular leakage. We examined the hypothesis that intermittent hypoxia (IH potentiates intravitreal Avastin leakage. Neonatal rats at birth were exposed to IH from birth (P0–P14. At P14, the time of eye opening in rats, a single dose of Avastin (0.125 mg was injected intravitreally into the left eye. Animals were placed in room air (RA until P23 or P45 for recovery (IHR. Hyperoxia-exposed and RA littermates served as oxygen controls, and equivalent volume saline served as the placebo controls. At P23 and P45 ocular angiogenesis, retinal pathology and ocular and systemic biomarkers of angiogenesis were examined. Retinal flatmounts showed poor peripheral vascularization in Avastin-treated and fellow eyes at P23, with numerous punctate hemorrhages and dilated, tortuous vessels with anastomoses at P45 in the rats exposed to IH. These adverse effects were associated with robust increases in systemic VEGF and in both treated and untreated fellow eyes. Histological analysis showed severe damage in the inner plexiform and inner nuclear layers. Exposure of IH/IHR-induced injured retinal microvasculature to anti-VEGF substances can result in vascular leakage and adverse effects in the developing neonate.

  19. Cost-effectiveness of early treatment for retinopathy of prematurity.

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    Kamholz, Karen L; Cole, Cynthia H; Gray, James E; Zupancic, John A F

    2009-01-01

    The Early Treatment for Retinopathy of Prematurity trial demonstrated that peripheral retinal ablation of eyes with high-risk prethreshold retinopathy of prematurity (early treatment) is associated with improved visual outcomes at 9 months' corrected gestational age compared with treatment at threshold disease (conventional management). However, early treatment increased the frequency of laser therapy, anesthesia with intubation, treatment-related systemic complications, and the need for repeat treatments. To determine the cost-effectiveness of an early treatment strategy for retinopathy of prematurity compared with conventional management. We developed a stochastic decision analytic model to assess the incremental cost of early treatment per eye with severe visual impairment prevented. We derived resource-use and efficacy estimates from the Early Treatment for Retinopathy of Prematurity trial's published outcome data. We used a third-party payer perspective. Our primary analysis focused on outcomes from birth through 9 months' corrected gestational age. A secondary analysis used a lifetime horizon. Parameter uncertainty was quantified by using probabilistic and deterministic sensitivity analyses. The incremental cost-effectiveness of early treatment was $14,200 per eye with severe visual impairment prevented. There was a 90% probability that the cost-effectiveness of early treatment would be less than $40,000 per eye with severe visual impairment prevented and a 0.5% probability that early treatment would be cost-saving (less costly and more effective). Limiting early treatment to more severely affected eyes (eyes with "type 1 retinopathy of prematurity" as defined by the Early Treatment for Retinopathy of Prematurity trial) had a cost-effectiveness of $6,200 per eye with severe visual impairment prevented. Analyses that considered long-term costs and outcomes found that early treatment was cost-saving. Early treatment of retinopathy of prematurity is both

  20. Early diagnosis of diabetic retinopathy in primary care

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    Jimenez-Baez, Maria Valeria; Barcenas-Contreras, Rodolfo; Morales Montoya, Carlos; Espinosa-Garcia, Laura Fatima

    2015-01-01

    Objective: To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2) in Quintana Roo, México. Methods: Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR) in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed. Results: In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women. Conclusions: The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases. PMID:26019380

  1. Early diagnosis of diabetic retinopathy in primary care

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    María Valeria Jiménez-Báez

    2015-03-01

    Full Text Available Objective:To evaluate the impact of a strategy for early detection of diabetic retinopathy in patients with type 2 diabetes mellitus (DMT2 in Quintana Roo, México.Methods:Study transversal, observational, prospective, analytical, eight primary care units from Mexican Social Security Institute in the northern delegation of the State of Quintana Roo, Mexico were included. A program for early detection of diabetic retinopathy (DR in adult 376,169 was designed. Were diagnosed 683 cases of type 2 diabetes, in 105 patients randomized was conducted to direct ophthalmoscopy were subjected to a secondary hospital were assigned. Will determine the degree of diabetic retinopathy and macular edema was performed.Results:In population were 55.2% female, mean age 48+11.1 years, 23.8 % had some degree of DR, 28.0% with mild non- proliferative diabetic retinopathy 48.0 % moderate 16.0% and severe and 8.0% showed proliferative diabetic retinopathy. Those over age 30 are 2.8 times more risk of developing DR, OR= 2.8; 95%CI: 0.42-18.0, and OR= 1.7; 95%CI: 1.02-2.95 women.Conclusions:The implementation of programs aimed at the early detection of debilitating conditions such as diabetic retinopathy health impact beneficiaries, effective links between primary care systems and provide second level positive health outcomes for patient diseases.

  2. Early Stage of Hypertensive Retinopathy; Is It Really Important?

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    Murat KARAMAN

    2014-09-01

    Full Text Available OBJECTIVE: To investigate the relationship between early stage hypertensive retinopathy (HTRP and endothelial dysfunction (ED in atherogenesis. MATERIAL and METHODS: A total of 99 subjects consisting of 73 patients diagnosed with Essential Hypertension (HT and 26 healthy subjects were included to the study. Flow mediated dilatation (FMD was performed to detect ED. Asymmetric dimethylarginine-ADMA was measured as a marker of ED and the hsCRP and sTWEAK levels were measured for microvascular inflammation. All patients were screened for retinopathy. RESULTS: The mean blood pressure of the hypertensive patients and the control subjects was 140.1±13.7/86.1±10.7 and 107.12±10.0/65.38±10.2 respectively. HTRP was positive in 60.3% (n=44 and negative in 39.7% (n=29 of the patients with hypertension. There was grade 1 retinopathy in 52.1% and grade 2 retinopathy in 8.2% of hypertensive patients. The hsCRP, sTWEAK and ADMA levels were significantly higher in hypertensive patients than in the control group (respectively, p=0,011, p=0,001, p=0,001. FMD levels were lower in the hypertensive group, as expected. FMD levels were lower in the retinopathy group when the hypertensive group with and without retinopathy and the control group compared. hsCRP, sTWEAK and ADMA levels were significantly higher in subjects with retinopathy. hsCRP, sTWEAK and ADMA levels were also significantly higher in subjects with retinopathy (p=0.039, p=0.001, p=0.001. CONCLUSION: ED is thought to play a role in HT etiology and is also important in the development of HT complications. It would be appropriate to evaluate hypertensive patients more carefully and perform the necessary laboratory tests to detect ED so that the proper treatment can be started (ACEI, exercise, lifestyle changes.

  3. Predictive algorithms for early detection of retinopathy of prematurity.

    Science.gov (United States)

    Piermarocchi, Stefano; Bini, Silvia; Martini, Ferdinando; Berton, Marianna; Lavini, Anna; Gusson, Elena; Marchini, Giorgio; Padovani, Ezio Maria; Macor, Sara; Pignatto, Silvia; Lanzetta, Paolo; Cattarossi, Luigi; Baraldi, Eugenio; Lago, Paola

    2017-03-01

    To evaluate sensitivity, specificity and the safest cut-offs of three predictive algorithms (WINROP, ROPScore and CHOP ROP) for retinopathy of prematurity (ROP). A retrospective study was conducted in three centres from 2012 to 2014; 445 preterms with gestational age (GA) ≤ 30 weeks and/or birthweight (BW) ≤ 1500 g, and additional unstable cases, were included. No-ROP, mild and type 1 ROP were categorized. The algorithms were analysed for infants with all parameters (GA, BW, weight gain, oxygen therapy, blood transfusion) needed for calculation (399 babies). Retinopathy of prematurity (ROP) was identified in both eyes in 116 patients (26.1%), and 44 (9.9%) had type 1 ROP. Gestational age and BW were significantly lower in ROP group compared with no-ROP subjects (GA: 26.7 ± 2.2 and 30.2 ± 1.9, respectively, p algorithms are a reliable tool for early identification of infants requiring referral to an ophthalmologist, for reorganizing resources and reducing stressful procedures to preterm babies. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  4. The alternative complement pathway aids in vascular regression during the early stages of a murine model of proliferative retinopathy.

    Science.gov (United States)

    Kim, Clifford; Smith, Kaylee E; Castillejos, Alexandra; Diaz-Aguilar, Daniel; Saint-Geniez, Magali; Connor, Kip M

    2016-03-01

    Proliferative retinopathic diseases often progress in 2 phases: initial regression of retinal vasculature (phase 1) followed by subsequent neovascularization (NV) (phase 2). The immune system has been shown to aid in vascular pruning in such retinopathies; however, little is known about the role of the alternative complement pathway in the initial vascular regression phase. Using a mouse model of oxygen-induced retinopathy (OIR), we observed that alternative complement pathway-deficient mice (Fb(-/-)) exhibited a mild decrease in vascular loss at postnatal day (P)8 compared with age- and strain-matched controls (P = 0.035). Laser capture microdissection was used to isolate the retinal blood vessels. Expression of the complement inhibitors Cd55 and Cd59 was significantly decreased in blood vessels isolated from hyperoxic retinas compared with those from normoxic control mice. Vegf expression was measured at P8 and found to be significantly lower in OIR mice than in normoxic control mice (P = 0.0048). Further examination of specific Vegf isoform expression revealed a significant decrease in Vegf120 (P = 0.00032) and Vegf188 (P = 0.0092). In conjunction with the major modulating effects of Vegf during early retinal vascular development, our data suggest a modest involvement of the alternative complement pathway in targeting vessels for regression in the initial vaso-obliteration stage of OIR. © The Author(s).

  5. 眼底荧光素血管造影在小鼠氧诱导视网膜病变中的应用评价%Evaluation of fundus fluorescein angiography in mice with oxygen -induced retinopathy

    Institute of Scientific and Technical Information of China (English)

    李蓉; 常远

    2016-01-01

    目的::在小鼠氧诱导视网膜病变模型( oxygen-induced retinopathy,OIR )中评价眼底荧光素血管造影( fundus fluorescein angiography,FFA)的应用价值。方法:将前期实验证实视网膜病变严重程度有明显差异的两组( B组>A组)各12只新生幼鼠于出生后第7 d置于75%浓度氧环境中,第12 d时返回正常空气环境中饲养。第17 d时将A组和B组的幼鼠均随机分配,分别进行FFA检查或高分子量FITC-Dextran灌注结合视网膜铺片检查,即每种检查方法纳入两组幼鼠各6只,利用图像分析软件对视网膜无灌注区进行定量分析和比较。结果:FFA结合图像分析软件能对视网膜无灌注区进行定量分析,与FITC-Dextran灌注结合视网膜铺片的测量结果有良好的可比性,两种方法得到的结果无统计学差异(P>0.05)。结论:FFA结合图像定量分析在小鼠OIR模型的血管病变评价中具有一定的实用价值。%AIM:To investigate avascuIopathy-evaIuating method using fundus fIuorescein angiography ( FFA) in mice with oxygen-induced retinopathy ( OIR) . METHODS:OIR modeI was induced by exposure of mice from groups A and B ( the retinopathy was known to be more severe in group B than that in group A by previous research) to high oxygen (75%) from postnataI day 7 (P7) to P12 (n=12 for each group) and returned to normaI environment at P12. On P17, the mice from both groups were randomIy assigned to accept FFA or high moIecuIar weight fIuorescein isothiocyanate dextran ( FITC - Dextran ) perfusion combined with stretched preparation of retina( each method invoIved 6 pups from each group ) . The retinaI non - perfused areas were quantified and compared by using image anaIysis software.RESULTS:FFA combined with image anaIysis software was abIe to quantify the retinaI non-perfused areas, which was comparabIe to the resuIts anaIyzed by FITC-Dextran perfusion combined with stretched preparation of retina. No statisticaI difference was

  6. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy

    DEFF Research Database (Denmark)

    Rasmussen, Malin Lundberg; Broe, Rebecca; Frydkjaer-Olsen, Ulrik;

    2015-01-01

    AIMS: To compare non-mydriatic, mydriatic and steered mydriatic widefield retinal images with mydriatic 7-field Early Treatment Diabetic Retinopathy Study (ETDRS)-standards in grading diabetic retinopathy (DR). METHODS: We examined 95 patients (190 eyes) with type 1 diabetes. A non-mydriatic, a m...

  7. 脂多糖诱导炎症对大鼠氧诱导视网膜病变的影响%Effects of LPS-induced inflammation on oxygen-induced retinopathy in rats

    Institute of Scientific and Technical Information of China (English)

    李晓琴; 张自峰; 王雨生; 高翔; 杨湘敏; 徐文芹

    2015-01-01

    目的 观察不同剂量脂多糖(lipopolysaccharide,LPS)诱导炎症对大鼠氧诱导视网膜病变(oxygen-induced retinopathy,OIR)的影响,以探讨炎症在早产儿视网膜病变(retinopathy of prematurity,ROP)中的作用.方法 将新生SD大鼠随机分组,实验组依据LPS注射剂量的不同分为LPS-50、LPS-100和LPS-500组,并分别设立正常对照组(N组)和氧诱导对照组(OIR组).N组幼鼠喂养于空气中,实验组和OIR组幼鼠饲养于氧气体积分数为80%/21%(24 h交替一次)的氧箱中至出生后14 d(P14),随后移至空气中继续饲养.实验组幼鼠行OIR处理过程中,于P7行LPS腹腔注射,LPS-50、LPS-100和LPS-500组注射剂量分别为50 μg·kg-1、100 μg·kg-1和500 μg·kg“.检测各组幼鼠在P7(注射前)、P8、P11和P14等不同时间点的体质量变化;并分别于P14和P18制作全视网膜铺片,通过GS-isolectin B4染色观察各组视网膜血管化及病理性新生血管情况.结果 在各检测时间点,各实验组和OIR组幼鼠的体质量均低于N组(P<0.05).P7时,各实验组和OIR组体质量无差别(P>0.05);至P8、P11和P14时,LPS-500组幼鼠体质量明显低于OIR组和其他实验组(P<0.05).P14时,N组幼鼠的浅层视网膜血管已覆盖整个视网膜;而OIR组和实验组幼鼠的视网膜均存在无血管区,且LPS-500组无血管区面积最大(27.32%±3.58%,P<0.01).P18时,N组视网膜血管网层次结构清晰;OIR组和实验组幼鼠的视网膜均出现病理性新生血管,且LPS-500组新生血管累及视网膜的范围最广(累及钟点数为6.83±1.72,P<0.01).结论 LPS诱导炎症可加重大鼠OIR,且在一定范围内呈剂量依赖性,提示炎症可能参与ROP病理过程.%Objective To investigate the role of inflammation in retinopathy of prematurity (ROP) by assessing the effects of different doses of lipopolysacchaxide (LPS) on oxygen-induced retinopathy (OIR) in rats.Methods Newborn Sprague Dawley rats were randomly divided into

  8. Role of early screening for diabetic retinopathy in patients with diabetes mellitus: An overview

    Directory of Open Access Journals (Sweden)

    Praveen Vashist

    2011-01-01

    Full Text Available Diabetes has emerged as a major public health problem in India. It is estimated that there were 40 million persons with diabetes in India in 2007 and this number is predicted to rise to almost 70 million by 2025. The impact of rapid urbanization, industrialization and lifestyle changes has led to an increasing trend in prevalence of diabetes and its associated complications such as neuropathy, nephropathy, vascular diseases (cardiac, cerebral and peripheral and retinopathy. Diabetic retinopathy is a important cause of avoidable blindness in India. Treatment interventions at early stages of diabetic retinopathy can reduce burden of blindness due to diabetic retinopathy. With the available cost-effective methods of early screening, appropriate strategies/models need to be developed. Such models need to have a well-developed mode for screening, diagnosis and referral at each hierarchal level beginning from primary health centers to specialized institutes for eye care. The National Program for Control of Blindness of India recommends opportunistic screening for identification of diabetic retinopathy. Every opportunity of contact with high-risk cases for diabetes and/or diabetic retinopathy should be utilized for screening, diagnosis and referral. All the stakeholders including the private sector will need to play a role. Along with this, awareness generation and behavior change amongst the diabetics and care support systems should also be part of the overall model. A major role can be played by community participation and improving the health seeking behavior among diabetics in order to reach a larger population and increasing the compliance for continued care.

  9. Vascular Changes and Neurodegeneration in the Early Stages of Diabetic Retinopathy

    DEFF Research Database (Denmark)

    Jonsson, Karoline Boegeberg; Frydkjaer-Olsen, Ulrik; Grauslund, Jakob

    2016-01-01

    INTRODUCTION: Neurodegeneration is an early component of diabetic retinopathy (DR). It is unclear whether neurodegeneration is an independent factor or a consequence of damaged retinal vasculature. The aims of this study were to review the literature concerning neurodegeneration in diabetic...... patients without or with early DR, and to examine whether neurodegeneration precedes visible vasculopathy in the pathogenesis of DR. METHODS: A systematic literature search was performed to identify studies which used optical coherence tomography (OCT) or multifocal electroretinography (mfERG) to detect...

  10. alpha-晶体蛋白在氧诱导小鼠视网膜病变中的表达%Expression of α-crystallin in oxygen induced retinopathy

    Institute of Scientific and Technical Information of China (English)

    石怡; 李筱荣; 汪建涛; 刘新玲

    2012-01-01

    目的:建立氧诱导视网膜病变小鼠动物模型,研究alphaA-和alphaB-晶体蛋白在其视网膜组织中的mRNA定量表达及定位分布特点.方法:选取34只C57/BL小鼠于出生后7 d(P7)置于(75±5)%高氧状态下饲养5d,后回到正常环境中;另选取34只同日龄幼鼠作为正常对照组.采用荧光素血管灌注及视网膜铺片法观察视网膜血管形态;并行Real time RT-PCR检测alphaA-和alphaB-晶体蛋白mRNA在氧诱导模型鼠和正常视网膜组织中表达水平,免疫荧光方法检测这两种晶体蛋白在视网膜组织中的定位分布情况.结果:实验组鼠的视网膜血管形态特征为相对低氧状态下5d后(P17)在其视网膜中周部有血管区和无血管区交界处大量新生血管形成,出现周边渗漏.实验组alphaA-晶体蛋白mRNA在视网膜组织中的表达为先降低后升高的趋势,差异具有统计学意义(F=220.378,P<0.01);实验组alphaB-晶体蛋白的表达呈现逐渐升高的趋势,但差异无统计学意义(F=0.895,P>0.05).两种alpha-晶体蛋白阳性细胞均表达在神经节细胞、内核及外核细胞层.结论:在氧诱导视网膜病变小鼠视网膜组织中,alphaA-和ahphaB-晶体蛋白在视网膜组织中表达具有时空依赖性.%Objective: To establish the mice model in oxygen induced retinopathy (OIR) and investigate the changes of alphaA- and al- phaB-crystallin protein mRNA expression and their location characteristics in retina. Methods: 34 seven days (P7) wild type C57BL/6J mice were chosen to put in a terrarium with oxygen density of (75 ±5)% ,breeded for five days and return to normal atmosphere and 34 mice were as control ones. The vascular perfusion of fluorescein and retinal stretched preparation were used to observe the morphologic changes of retinal vessels. Real time RT-PCR and FITC were used to observe expression of alphaA- and alphaB-crystallin protein,and the location of these proteins. Results: There was more neovascular

  11. Early retinopathy in the Bernese Mountain Dog in France: preliminary observations.

    Science.gov (United States)

    Chaudieu, G; Molon-Noblot, S

    2004-01-01

    The objective of the study was to describe a form of early retinopathy in the Bernese Mountain Dog in France. Sixty-two Bernese Mountain Dogs (38 males and 24 females), whose ages ranged from 2 months to 9 years, were examined over a period of 3 years. Visual behavior, pupillary light reflexes, menace responses and ocular fundi were evaluated in all animals. Electroretinography (ERG) was performed on six of the affected dogs after dark adaptation. Fluorescein angiography (FA) was performed on one affected dog. Whenever possible, the pedigrees of the affected dogs were evaluated. A histological examination of the retina was performed on one of the affected dogs. Eight dogs (seven males and one female) were diagnosed with retinopathy with an early onset of clinical signs. (Four dogs were aged between 3 months and 1 year, two dogs were aged 2 and 3.5 years, and one dog was 7 years old.) Night vision was impaired in most of the dogs. Retinopathy was characterized ophthalmoscopically by a bilateral, symmetrical horizontal zone of tapetal hyper-reflectivity adjacent to and above the optic disc, and sometimes by peri-papillary hyper-reflectivity. ERG changes included a reduction in b-wave amplitude varying from one case to another. Fluoroscein angiography demonstrated an ischemic-type alteration with epitheliopathy opposite the hyper-reflective zone. Pedigree examinations suggested a familial predisposition. The histological examination indicated photoreceptor degeneration that was more pronounced in the central tapetal zone. In France, retinopathy in the Bernese Mountain Dog involves an early retinal degeneration that produces specific manifestations of the ocular fundus, night visual impairment or blindness, and has familial transmission.

  12. 改良的氧诱导小鼠视网膜病变模型及其评价%Modification and evaluation of ameliorative oxygen-induced retinopathy mouse model

    Institute of Scientific and Technical Information of China (English)

    刘爱华; 孙靖; 张红

    2015-01-01

    Background Retinal neovascularization is associated with various disorders.Studying the pathogenesis of retinal neovascularization is of important significance.Oxygen-induced retinopathy(OIR) mouse model is a common animal model for the study of retinal neovascular diseases.However, conventional modeling methods usually cause high animal mortality and low rate of success.Objective This study aimed to establish a modified method of mouse OIR model.Methods Eighty 1-week-old SPF C57BL/6J mice were randomly divided into normal control group and OIR group with 40 mice for each.The newborn mice of the normal control group were kept in a normal air environment with their breast-feeding mothers, but the mice of postnatal 2 days (P2) in the OIR group were raised with two litters per cage until P7.The P7 mice exposed to oxygen tank containing 80% oxygen together with one or another mother mouse alternately daily for 5 days and then returned to the normal air environment.The success rate of modeling,mortality rate of maternal mice and survival rate of immature mice were evaluated.The mixed solution of fluorescein isothiocyanate (FITC) and PBS with 4% paraformaldehyde was infused into the hearts of P12, P14,P17 and P21 mice and the eyeballs were obtained after the mice were sacrificed for histopathological examination of retinas and preparation of retinal flatmounts.The number of vascular endothelial cells extending inner limiting membrane was counted and the distribution of retinal vessels was evaluated.The use and care of the animals complied with the Statement of ARVO.Results The survival rate of the neonatal mice was 100% both in the normal control group and the OIR group,and the survival rate of maternal mice was 85.7% in the OIR group.Retinal new vessels were found in the mice of the OIR group,with the success rate of modeling 100%.The retinal vessels distributed from optical disc toward periphery in P14 mice in the normal group.However,in the OIR group

  13. Delayed hyperoxic ventilation attenuates oxygen-induced free radical accumulation during early reperfusion after global brain ischemia.

    Science.gov (United States)

    Wang, Yan; Yuan, Li; Liu, Ping; Zhao, Min

    2015-02-11

    To compare the effect of immediate and delayed administration of oxygen on the accumulation of free radicals in ischemia-reperfusion animal models. Thirty-two adult male Mongolian gerbils with microdialysis probes implanted in the right hippocampal CA1 were divided randomly into four groups (eight each). One group was sham-operated (Sham group) whereas the other three groups were subjected to 10 min bilateral carotid artery occlusion (BCAO). BCAO-treated animals were then subjected to the following: (a) immediate 30% O2 (near normoxia, NO group), (b) immediate 100% O2 (hyperoxia, HO group), and (c) 30% O2 for 60 min, followed by 100% O2 for 60 min (delayed hyperoxia, DHO group). Hippocampal accumulation of hydroxyl radicals (•OH) during reperfusion was estimated by measuring 2,3-dihydroxybenzoic acid (DHBA) and 2,5-DHBA in microdialysis perfusate. Hippocampi were removed 2 h after perfusion to measure malondialdehyde, pyruvate dehydrogenase activity, indices of lipid peroxidation, and cellular respiration. At 24 h after BCAO, the histology of hippocampi was analyzed to rate the injury. Immediately after the onset of reperfusion, all groups showed markedly elevated DHBA, which returned to baseline over 1-2 h. Compared with the NO group, the HO group showed significantly higher peak DHBA and slower recovery. In contrast, the DHO group was not significantly different from the NO group in terms of the DHBA level. DHO animals also showed significantly lower hippocampal malondialdehyde accumulation and higher pyruvate dehydrogenase activity at 2 h after reperfusion versus the HO group. Histology analysis also showed animals in the DHO group with ameliorated injury compared with the HO group. Hydroxyl radical accumulation was more sensitive to O2 during early reperfusion. Delayed hyperoxia may re-establish oxidative metabolism while minimizing oxidative stress after CA.

  14. Role of Electrophysiology in the Early Diagnosis and Follow-Up of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Nicola Pescosolido

    2015-01-01

    Full Text Available Retinopathy is a severe and common complication of diabetes, representing a leading cause of blindness among working-age people in developed countries. It is estimated that the number of people with diabetic retinopathy (DR will increase from 126.6 million in 2011 to 191 million by 2030. The pathology seems to be characterized not only by the involvement of retinal microvessels but also by a real neuropathy of central nervous system, similar to what happens to the peripheral nerves, particularly affected by diabetes. The neurophysiological techniques help to assess retinal and nervous (optic tract function. Electroretinography (ERG and visual evoked potentials (VEP allow a more detailed study of the visual function and of the possible effects that diabetes can have on the visual function. These techniques have an important role both in the clinic and in research: the central nervous system, in fact, has received much less attention than the peripheral one in the study of the complications of diabetes. These techniques are safe, repeatable, quick, and objective. In addition, both the ERG (especially the oscillatory potentials and the flicker-ERG and VEP have proved to be successful tools for the early diagnosis of the disease and, potentially, for the ophthalmologic follow-up of diabetic patients.

  15. Development of Diagnostic Biomarkers for Detecting Diabetic Retinopathy at Early Stages Using Quantitative Proteomics

    Directory of Open Access Journals (Sweden)

    Jonghwa Jin

    2016-01-01

    Full Text Available Diabetic retinopathy (DR is a common microvascular complication caused by diabetes mellitus (DM and is a leading cause of vision impairment and loss among adults. Here, we performed a comprehensive proteomic analysis to discover biomarkers for DR. First, to identify biomarker candidates that are specifically expressed in human vitreous, we performed data-mining on both previously published DR-related studies and our experimental data; 96 proteins were then selected. To confirm and validate the selected biomarker candidates, candidates were selected, confirmed, and validated using plasma from diabetic patients without DR (No DR and diabetics with mild or moderate nonproliferative diabetic retinopathy (Mi or Mo NPDR using semiquantitative multiple reaction monitoring (SQ-MRM and stable-isotope dilution multiple reaction monitoring (SID-MRM. Additionally, we performed a multiplex assay using 15 biomarker candidates identified in the SID-MRM analysis, which resulted in merged AUC values of 0.99 (No DR versus Mo NPDR and 0.93 (No DR versus Mi and Mo NPDR. Although further validation with a larger sample size is needed, the 4-protein marker panel (APO4, C7, CLU, and ITIH2 could represent a useful multibiomarker model for detecting the early stages of DR.

  16. Early stimulation results in children with Retinopathy of Prematurity in Sancti Spíritus. 2007-2012.

    Directory of Open Access Journals (Sweden)

    Miriam Rodríguez Rodríguez

    2014-06-01

    Full Text Available A descriptive retrospective study with a longitudinal projection was made, since January 2007 until December 2010, in Retinopathy of prematurity and early stimulation consultations inside of Low vision´s department in Camilo Cienfuegos´ Hospital, with the objective to describe the result of laser treatment for retinopathy of prematurity, in order to avoid blindness in children who developed this illness. The data base used was the one of the provincial program of retinopathy. The population of the study was conformed by 36 children who developed retinopathy in the studied period, 11 children were taken as a sample, the one that received laser treatment because they have suffer stage III of the illness. Males prevailed, coming from five different municipalities of the province, must of them were rehabilitated with glasses for their residual ametropia after the treatment was employed. All of these made possible an adequate visual development and an economical saving of 58800 pesos for all the cases who didn´t develop a visual disability because of Retinopathy from the prematurity, and did not register in the Blind and low visual children´s School.

  17. Automated detection of dark and bright lesions in retinal images for early detection of diabetic retinopathy.

    Science.gov (United States)

    Akram, Usman M; Khan, Shoab A

    2012-10-01

    There is an ever-increasing interest in the development of automatic medical diagnosis systems due to the advancement in computing technology and also to improve the service by medical community. The knowledge about health and disease is required for reliable and accurate medical diagnosis. Diabetic Retinopathy (DR) is one of the most common causes of blindness and it can be prevented if detected and treated early. DR has different signs and the most distinctive are microaneurysm and haemorrhage which are dark lesions and hard exudates and cotton wool spots which are bright lesions. Location and structure of blood vessels and optic disk play important role in accurate detection and classification of dark and bright lesions for early detection of DR. In this article, we propose a computer aided system for the early detection of DR. The article presents algorithms for retinal image preprocessing, blood vessel enhancement and segmentation and optic disk localization and detection which eventually lead to detection of different DR lesions using proposed hybrid fuzzy classifier. The developed methods are tested on four different publicly available databases. The presented methods are compared with recently published methods and the results show that presented methods outperform all others.

  18. Fortified Extract of Red Berry, Ginkgo biloba, and White Willow Bark in Experimental Early Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Claudio Bucolo

    2013-01-01

    Full Text Available Diabetic retinopathy is a complex condition where inflammation and oxidative stress represent crucial pathways in the pathogenesis of the disease. Aim of the study was to investigate the effects of a fortified extract of red berries, Ginkgo biloba and white willow bark containing carnosine and α-lipoic acid in early retinal and plasma changes of streptozotocin-induced diabetic rats. Diabetes was induced by a single streptozotocin injection in Sprague Dawley rats. Diabetics and nondiabetic (control rats were treated daily with the fortified extract for the ten days. Retina samples were collected and analyzed for their TNF-α and VEGF content. Moreover, plasma oxidative stress was evaluated by thiobarbituric acid reacting substances (TBARS. Increased TNF-α and VEGF levels were observed in the retina of diabetic rats. Treatment with the fortified extract significantly lowered retinal cytokine levels and suppressed diabetes-related lipid peroxidation. These data demonstrate that the fortified extract attenuates the degree of retinal inflammation and plasma lipid peroxidation preserving the retina in early diabetic rats.

  19. Therapeutic effect of the compound Danshen dripping pill combined with laser acupoint irradiation on early diabetic retinopathy

    Science.gov (United States)

    Liu, Hui-Hui; Xiong, Guo-Xin; Zhang, Li-Ping

    2017-06-01

    To investigate the therapeutic effect of the compound Danshen dripping pill combined with laser acupoint irradiation on early diabetic retinopathy, 19 patients with early diabetic retinopathy were randomly divided into a treatment group and a control group. The TaiYang, YangBai, YuYao and ZanZhu acupoints of patients in the treatment group were irradiated with a semiconductor laser combined with the oral compound Danshen dropping pills, while those in the control group only used the oral compound Danshen dropping pills. The indicators of vision, mean defect of light sensitivity in the visual field, renal function and fasting blood glucose, were examined to evaluate the efficacy. After treatment, the above indicators of patients in the two groups were significantly improved and there was a significant difference between the two groups. This showed that the compound Danshen dripping pills combined with the laser acupoint irradiation can improve the ischemic and anoxic state of early diabetic retinopathy and improve the visual field.

  20. Fundus auto fluorescence and spectral domain ocular coherence tomography in the early detection of chloroquine retinopathy

    Directory of Open Access Journals (Sweden)

    Megan B. Goodman

    2015-03-01

    Full Text Available Purpose: To determine the sensitivity of spectral domain ocular coherence tomography (SD-OCT and fundus auto fluorescence (FAF images as a screening test to detect early changes in the retina prior to the onset of chloroquine retinopathy.Method: The study was conducted using patients taking chloroquine (CQ, referred by the Rheumatology Department to the Ophthalmology Department at Tygerberg Academic Hospital. Group A consisted of 59 patients on CQ for less than 5 years, and Group B consisted of 53 patients on CQ for more than 5 years. A 200 × 200 macula thickness map, 5-line raster SD-OCT on a Carl Zeiss Meditec Cirrus HD-OCT and FAF images on a Carl Zeiss Meditec Visucam 500 were recorded for 223 eyes. Images were reviewed independently, and then those of Groups A and B compared.Results: There were no statistically significant differences between Groups A and B. The criteria included the internal limiting membrane and the retinal pigment epithelium (ILM-RPE thickness, interdigitation zone integrity (p = 0.891, df = 1, χ² = 0.1876, ellipsoid zone integrity (p = 0.095, df = 2, χ² = 4.699 and FAF image irregularities (p = 0.479, df = 1, χ²= 4995978.Conclusion: The inclusion of SD-OCT and FAF as objective tests into the prescribed screening guidelines does not appear to simplify the detection of subclinical injury in patients on chloroquine treatment.

  1. Topographical distribution of retinal and optic disc neovascularization in early stages of proliferative diabetic retinopathy.

    Science.gov (United States)

    Jansson, Ragnhild W; Frøystein, Torbjørn; Krohn, Jørgen

    2012-12-17

    We analyzed the topography of proliferative diabetic retinopathy (PDR), and visualized the distribution of neovascularization of the optic disc (NVD) and elsewhere in the retina (NVE). The study included 174 eyes of 106 patients with early PDR. Data on the size and location of 391 NVE and 73 NVD were converted into a database of two-dimensional retinal and optic disc charts. The geometric centers of the neovascular lesions were plotted into corresponding areas of the charts, and the topographic distributions of the NVE and NVD were visualized by merging the charts and displaying the number of overlapping lesions on color-coded contour maps. A total of 141 (36%) NVE was located in the temporal and 250 (64%) in the nasal hemisphere (P distribution of the NVD in the temporal and nasal half of the optic disc was 46 (63%) and 27 (37%), respectively (P = 0.03). NVE in type 1 diabetes were located significantly farther from the fovea and optic disc, and were more numerous and larger than in type 2 diabetes. The number and diameter of the NVE were also significantly higher when the time from the last examination to the appearance of PDR exceeded 12 months. The majority of NVE lesions are located inferonasal to the optic disc and along the superior vascular arcades, while NVD have a predilection for the upper temporal disc rim. More extensive PDR is found in patients with type 1 diabetes and those with examination intervals longer than one year.

  2. Regenerative therapeutic potential of adipose stromal cells in early stage diabetic retinopathy.

    Directory of Open Access Journals (Sweden)

    Gangaraju Rajashekhar

    Full Text Available Diabetic retinopathy (DR is the leading cause of blindness in working-age adults. Early stage DR involves inflammation, vascular leakage, apoptosis of vascular cells and neurodegeneration. In this study, we hypothesized that cells derived from the stromal fraction of adipose tissue (ASC could therapeutically rescue early stage DR features. Streptozotocin (STZ induced diabetic athymic nude rats received single intravitreal injection of human ASC into one eye and saline into the other eye. Two months post onset of diabetes, administration of ASC significantly improved "b" wave amplitude (as measured by electroretinogram within 1-3 weeks of injection compared to saline treated diabetic eyes. Subsequently, retinal histopathological evaluation revealed a significant decrease in vascular leakage and apoptotic cells around the retinal vessels in the diabetic eyes that received ASC compared to the eyes that received saline injection. In addition, molecular analyses have shown down-regulation in inflammatory gene expression in diabetic retina that received ASC compared to eyes that received saline. Interestingly, ASC were found to be localized near retinal vessels at higher densities than seen in age matched non-diabetic retina that received ASC. In vitro, ASC displayed sustained proliferation and decreased apoptosis under hyperglycemic stress. In addition, ASC in co-culture with retinal endothelial cells enhance endothelial survival and collaborate to form vascular networks. Taken together, our findings suggest that ASC are able to rescue the neural retina from hyperglycemia-induced degeneration, resulting in importantly improved visual function. Our pre-clinical studies support the translational development of adipose stem cell-based therapy for DR to address both retinal capillary and neurodegeneration.

  3. Early Detection of Diabetic Retinopathy in Fluorescent Angiography Retinal Images Using Image Processing Methods

    Directory of Open Access Journals (Sweden)

    Meysam Tavakoli

    2010-12-01

    Full Text Available Introduction: Diabetic retinopathy (DR is the single largest cause of sight loss and blindness in the working age population of Western countries; it is the most common cause of blindness in adults between 20 and 60 years of age. Early diagnosis of DR is critical for preventing vision loss so early detection of microaneurysms (MAs as the first signs of DR is important. This paper addresses the automatic detection of MAs in fluorescein angiography fundus images, which plays a key role in computer assisted diagnosis of DR, a serious and frequent eye disease. Material and Methods: The algorithm can be divided into three main steps. The first step or pre-processing was for background normalization and contrast enhancement of the image. The second step aimed at detecting landmarks, i.e., all patterns possibly corresponding to vessels and the optic nerve head, which was achieved using a local radon transform. Then, MAs were extracted, which were used in the final step to automatically classify candidates into real MA and other objects. A database of 120 fluorescein angiography fundus images was used to train and test the algorithm. The algorithm was compared to manually obtained gradings of those images. Results: Sensitivity of diagnosis for DR was 94%, with specificity of 75%, and sensitivity of precise microaneurysm localization was 92%, at an average number of 8 false positives per image. Discussion and Conclusion: Sensitivity and specificity of this algorithm make it one of the best methods in this field. Using local radon transform in this algorithm eliminates the noise sensitivity for microaneurysm detection in retinal image analysis.

  4. Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation.

    Science.gov (United States)

    Shamir, Reuben R; Friedman, Yael; Joskowicz, Leo; Mimouni, Michael; Blumenthal, Eytan Z

    2016-01-01

    To compare accuracy, reproducibility and test duration for the Snellen and the Early Treatment Diabetic Retinopathy Study (ETDRS) charts, two main tools used to measure visual acuity (VA). A computer simulation was programmed to run multiple virtual patients, each with a unique set of assigned parameters, including VA, false-positive and false-negative error values. For each virtual patient, assigned VA was randomly chosen along a continuous scale spanning the range between 1.0 to 0.0 logMAR units (equivalent to 20/200 to 20/20). Each of 30 000 virtual patients were run ten times on each of the two VA charts. Average test duration (expressed as the total number of characters presented during the test ±SD) was 12.6±11.1 and 31.2±14.7 characters, for the Snellen and ETDRS, respectively. Accuracy, defined as the absolute difference (± SD) between the assigned VA and the measured VA, expressed in logMAR units, was superior in the ETDRS charts: 0.12±0.14 and 0.08±0.08, for the Snellen and ETDRS charts, respectively. Reproducibility, expressed as test-retest variability, was superior in the ETDRS charts: 0.23±0.17 and 0.11±0.09 logMAR units, for the Snellen and ETDRS charts, respectively. A comparison of true (assigned) VA to measured VA, demonstrated, on average, better accuracy and reproducibility of the ETDRS chart, but at the penalty of significantly longer test duration. These differences were most pronounced in the low VA range. The reproducibility using a simulation approach is in line with reproducibility values found in several clinical studies.

  5. Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation

    Directory of Open Access Journals (Sweden)

    Reuben R. Shamir

    2016-01-01

    Full Text Available AIM: To compare accuracy, reproducibility and test duration for the Snellen and the Early Treatment Diabetic Retinopathy Study (ETDRS charts, two main tools used to measure visual acuity (VA. METHODS: A computer simulation was programmed to run multiple virtual patients, each with a unique set of assigned parameters, including VA, false-positive and false-negative error values. For each virtual patient, assigned VA was randomly chosen along a continuous scale spanning the range between 1.0 to 0.0 logMAR units (equivalent to 20/200 to 20/20. Each of 30 000 virtual patients were run ten times on each of the two VA charts. RESULTS: Average test duration (expressed as the total number of characters presented during the test ±SD was 12.6±11.1 and 31.2±14.7 characters, for the Snellen and ETDRS, respectively. Accuracy, defined as the absolute difference (± SD between the assigned VA and the measured VA, expressed in logMAR units, was superior in the ETDRS charts: 0.12±0.14 and 0.08±0.08, for the Snellen and ETDRS charts, respectively. Reproducibility, expressed as test-retest variability, was superior in the ETDRS charts: 0.23±0.17 and 0.11±0.09 logMAR units, for the Snellen and ETDRS charts, respectively. CONCLUSION: A comparison of true (assigned VA to measured VA, demonstrated, on average, better accuracy and reproducibility of the ETDRS chart, but at the penalty of significantly longer test duration. These differences were most pronounced in the low VA range. The reproducibility using a simulation approach is in line with reproducibility values found in several clinical studies.

  6. Correlation between Retinal Vessel Calibre and Neurodegeneration in Patients with Type 2 Diabetes Mellitus in the European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR)

    DEFF Research Database (Denmark)

    Frydkjaer-Olsen, Ulrik; Soegaard Hansen, Rasmus; Simó, Rafael

    2016-01-01

    PURPOSE: To investigate the correlation between retinal vessel calibre and measurements of neurodegeneration in patients with type 2 diabetes (T2D) and no or early diabetic retinopathy (DR). METHODS: Baseline data on 440 patients with T2D from the EUROCONDOR clinical trial were used. DR was graded...... according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) scale, and patients with ETDRS levels 10-35 were included. Retinal vessel diameters were measured by semi-automatic software. Calibres were summarized into central retinal artery and vein equivalents (CRAE and CRVE). RESULTS: Median age...

  7. Diabetic Retinopathy Analysis

    Directory of Open Access Journals (Sweden)

    R. Sivakumar

    2005-01-01

    Full Text Available Diabetic retinopathy is one of the common complications of diabetes. Unfortunately, in many cases the patient is not aware of any symptoms until it is too late for effective treatment. Through analysis of evoked potential response of the retina, the optical nerve, and the optical brain center, a way will be paved for early diagnosis of diabetic retinopathy and prognosis during the treatment process. In this paper, we present an artificial-neural-network-based method to classify diabetic retinopathy subjects according to changes in visual evoked potential spectral components and an anatomically realistic computer model of the human eye under normal and retinopathy conditions in a virtual environment using 3D Max Studio and Windows Movie Maker.

  8. Segmentation of retinal blood vessels using artificial neural networks for early detection of diabetic retinopathy

    Science.gov (United States)

    Mann, Kulwinder S.; Kaur, Sukhpreet

    2017-06-01

    There are various eye diseases in the patients suffering from the diabetes which includes Diabetic Retinopathy, Glaucoma, Hypertension etc. These all are the most common sight threatening eye diseases due to the changes in the blood vessel structure. The proposed method using supervised methods concluded that the segmentation of the retinal blood vessels can be performed accurately using neural networks training. It uses features which include Gray level features; Moment Invariant based features, Gabor filtering, Intensity feature, Vesselness feature for feature vector computation. Then the feature vector is calculated using only the prominent features.

  9. [Eclipse retinopathy].

    Science.gov (United States)

    Johannessen, Simon; Høgsbro, Malou

    2014-11-10

    Eclipse retinopathy is a condition with macular damage resulting from viewing of a solar eclipse. This case report illustrates how eclipse retinopathy was diagnosed with a delay of more than 30 years. The report also summarises how solar eclipse can be observed without risk of retinal damage.

  10. Early postnatal hyperglycaemia is a risk factor for treatment-demanding retinopathy of prematurity

    DEFF Research Database (Denmark)

    Slidsborg, Carina; Jensen, Louise Bering; Rasmussen, Steen Christian

    2017-01-01

    BACKGROUND: To investigate whether neonatal hyperglycaemia in the first postnatal week is associated with treatment-demanding retinopathy of prematurity (ROP). METHODS: This is a Danish national, retrospective, case-control study of premature infants (birth period 2003-2006). Three national regis......: An independent association was found between the occurrence of hyperglycaemic events during the first postnatal week and later development of treatment-demanding ROP, when adjusted for known risk factors.......BACKGROUND: To investigate whether neonatal hyperglycaemia in the first postnatal week is associated with treatment-demanding retinopathy of prematurity (ROP). METHODS: This is a Danish national, retrospective, case-control study of premature infants (birth period 2003-2006). Three national...... was borderline significant (t-test; p=0.047). Hyperglycaemic events (indexed value) were statistically significantly different between the two study groups (Mann-Whitney U test; pindependent risk factor (OR: 1.022; 95% CI 1.002 to 1.042; p=0.031). CONCLUSION...

  11. Downregulation of serum IGF-1 for treatment of early worsening of diabetic retinopathy: a long-term follow-up of two cases.

    Science.gov (United States)

    Chantelau, Ernst; Meyer-Schwickerath, Rolf; Klabe, Karsten

    2010-01-01

    In 2003, we reported on 2 cases of nonproliferative and proliferative diabetic retinopathy, subsequent to HbA1c reduction by intensive insulin therapy (so-called early worsening of diabetic retinopathy). This acute condition could partly be reversed by discontinuation of intensive insulin therapy, whereby glycemia increased and serum IGF-1 concentration decreased [Ophthalmologica 2003;217:373-377]. On review 7 years later, both type-2 diabetic patients were on insulin therapy but had failed to achieve good glycemic control. One patient had mild background retinopathy on both eyes, with visual acuity of 1.0 and 0.7 after cataract extraction plus intravitreal triamcinolone injection. The 2nd patient was blind in one eye from secondary glaucoma due to vitrectomy and silicone oil filling; the fellow eye displayed residual retinal neovascularization with a hyaloid membrane and a visual acuity of 0.5. Hence, early worsening as opposed to late worsening of diabetic retinopathy seems to benefit from therapeutic suppression of growth factor action.

  12. [Diabetic retinopathy during pregnancy.

    DEFF Research Database (Denmark)

    Mathiesen, E.R.; Rasmussen, K.L.; Laugesen, C.S.

    2008-01-01

    (62%) women with type 1 and three (17%) with type 2 diabetes at the first examination. In 26 (34%) retinopathy progressed; four women developed proliferations, three macular oedema and three reduction of visual acuity >/=0.2 on Snellen's chart in at least one eye. HbA1c in early pregnancy was the only...

  13. Comparison of visual acuity in macular degeneration patients measured with snellen and early treatment diabetic retinopathy study charts.

    Science.gov (United States)

    Falkenstein, Iryna A; Cochran, Denine E; Azen, Stanley P; Dustin, Laurie; Tammewar, Ajay M; Kozak, Igor; Freeman, William R

    2008-02-01

    To compare the measurements of visual acuity (VA) results measured with Snellen and Early Treatment Diabetic Retinopathy Study (ETDRS) charts in eyes with and without age-related macular degeneration (AMD). Cross-sectional study. One hundred four participants (190 eyes) selected from a university retina practice; 80 participants (142 eyes) had some degree of AMD. Visual acuity was measured in each patient using standard procedure with both Snellen and ETDRS charts in random order. Statistical analysis of the results was performed. Difference in VA measured by both charts in logarithm of minimal angle of resolution (logMAR) notations. Overall, the mean Snellen VA was 0.78 logMAR (= 20/120), and the mean ETDRS VA in the same eye was 0.54 logMAR (= 20/70; P20/30). On average, 20/200 on Snellen was 20/95 on ETDRS (>3 lines difference), and 20/30 on Snellen was 20/25 on ETDRS (Snellen and ETDRS charts, and it was more pronounced in the group with poor vision. The ETDRS measurements yielded better VA, particularly in participants with vision Snellen charts) with outcomes from clinical trials (which typically measure VA using ETDRS charts).

  14. Diabetic retinopathy: A predictor of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Fawzia El Demerdash

    2012-06-01

    Conclusion: Diabetic retinopathy is a good predictor of coronary artery disease that exceeds the conventional risk factors. Diabetics with retinopathy would benefit from early coronary angiography and diabetic retinocoronary clinics are warranted.

  15. Diabetic retinopathy in acromegaly

    Directory of Open Access Journals (Sweden)

    Said Azzoug

    2014-01-01

    Full Text Available Introduction: Although growth hormone (GH has been implicated in the pathogenesis of diabetic retinopathy (DR, DR is deemed to be rare in patients with GH excess. Our aim was to study its prevalence in subjects with acromegaly suffering from diabetes mellitus (DM, to analyze its characteristics, and to look for predictive factors such as age at diagnosis, GH concentration and duration, DM duration, DM control, and family background. Materials and Methods: Forty patients with acromegaly and DM (21 males, 19 females, median age = 50 years, underwent a systematic ophthalmological examination with dilated funduscopy to seek diabetic retinopathy. Results: Among this population, 05 (12.5% had DR. It was at an early stage or background retinopathy in 3 cases and at a more advanced stage or proliferative retinopathy in 2 cases. We did not find any correlation with age at diagnosis, GH levels and duration, DM duration and family history of DM, but poor glycemic control seems to play a role although statistical analysis showed borderline significance. Conclusion: From this study, we conclude that prevalence of DR in patients with acromegaly is 12.5%, and it is slight or moderate. Among studied factors, only poor glycemic control seems to be implicated in its development.

  16. Op-power in diabetic retinopathy

    NARCIS (Netherlands)

    K. van der Torren (Kors)

    1990-01-01

    textabstractThe present study is mainly concerned with the role of the OPs in diagnosing early diabetic retinopathy. In 1966 Simonsen had already found a clear relation between background diabetic retinopathy and the disappearance of OPs at the ascending limb of the b-wave of the ERG. Many investiga

  17. Association of macular pigment optical density with early stage of non-proliferative diabetic retinopathy in Chinese patients with type 2 diabetes mellitus

    Science.gov (United States)

    She, Chong-Yang; Gu, Hong; Xu, Jun; Yang, Xiu-Fen; Ren, Xue-Tao; Liu, Ning-Pu

    2016-01-01

    AIM To detect the association between macular pigment optical density (MPOD), which reflects the antioxidant ability of retina, and diabetic retinopathy (DR) and to investigate the correlated factors of MPOD. METHODS Totally 435 subjects of urban Chinese were recruited to the study and divided into 3 groups: non-diabetes mellitus controls (NDM), diabetic patients without retinopathy (DWR), and patients with early stage of non-proliferative diabetic retinopathy (DR). Demographic and lifestyle characteristics were ascertained by questionnaire. A food-frequency questionnaire, general physical and ophthalmic examinations were completed for all participants. MPOD was measured by heterochromatic flicker photometry. Foveal thickness was measured by optical coherence tomography. The difference of MPOD among 3 groups was analyzed by analysis of covariance. The correlation analyses of MPOD with the candidate influence factors were assessed using the generalized estimating equations (GEE) model. RESULTS Of the 435 participants, 34 could not perform the MPOD measurements. Final analysis included 401 subjects, including 48 were in DR group, 134 in DWR group, and 219 in NDM group. MPOD was not significantly different among DR (0.49±0.21), DWR (0.45±0.21), and NDM (0.49±0.17) groups (P=0.24) after adjustment for fasting plasma glycemia, central foveal thickness, green vegetables, Chinese wolfberry, carotene and vitamin E. For all the 401 participants included, MPOD was positively associated with central foveal thickness (E=0.0007, P=0.001), Chinese wolfberry (E=0.0345, P=0.01), and green vegetables (E=0.0596, Pdiabetes or early stage of DR in the studied population. MPOD level is positively associated with thicker central foveal thickness and higher intake of foods containing carotenoids. PMID:27803860

  18. [Diabetic retinopathy during pregnancy.

    DEFF Research Database (Denmark)

    Mathiesen, E.R.; Rasmussen, K.L.; Laugesen, C.S.

    2008-01-01

    (62%) women with type 1 and three (17%) with type 2 diabetes at the first examination. In 26 (34%) retinopathy progressed; four women developed proliferations, three macular oedema and three reduction of visual acuity >/=0.2 on Snellen's chart in at least one eye. HbA1c in early pregnancy was the only...... among women with high HbA1c values in early pregnancy. A few women developed proliferations, macular oedema and reduction of visual acuity. Development of sight-threatening alterations during pregnancy remains a clinical problem Udgivelsesdato: 2008/12/8...

  19. Paraneoplastic retinopathies

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    Marko Hawlina

    2005-10-01

    Full Text Available Background: Two types of retinopathy are known to be associated with patients with malignancies: cancer associated retinopathy-CAR and cutaneus melanoma associated retinopathy-MAR. Autoantibodies against recoverin or against α -enolase have been described in CAR, and autoatibodies against ON-bipolar cells are formed in MAR. An outline of the pathogenetic mechanisms and an example of each cases disorder are presented.Case reports: In both patients, the following were performed: complete clinical examination, visual acuity, visual fields, fluorescein angiography and electroretinography. The first patient was a 78 year-old man with epidermoid carcinoma of the the lung and metastases of liver and kidney suffered rapidly progressive bilateral visual loss. He suffered complete loss of vision (amaurosis with Anton’s syndrome. Retinal examination showed severe arterial narrowing with lipid plaques and age-related pigmentary changes. The ERG was nondetectable, and the diagnosis was CAR. The second patient was a 62 years old man who presented with acute onset of bilateral night blindness, photopsia and shimmering four years after excision of a cutaneus malignant melanoma. Visual acuity was 0.5 in the right eye and 0.8 in the left eye. The visual fields showed constriction to 15° in both eyes on Goldmann perimetry. The retinal examination was normal. ERG maximal response was electronegative, with normal a-wave amplitude and reduced b-wave. ON-OFF ERG showed loss of ON-response b-wave and normal OFF-response d-wave, typical for MAR.Conclusions: CAR and MAR are rare paraneoplastic sindromes, that are characterised by rapid onset of acquired bilateral visual loss and night blindness. There are usually shimmering photopsias in MAR and fundus examination is normal. The fundus is initially normal in CAR, but becomes abnormal as the disorder progresses. Typical changes in ERG may precede the presentation of malignancy and therefore awareness of this

  20. Correlation between Retinal Vessel Calibre and Neurodegeneration in Patients with Type 2 Diabetes Mellitus in the European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR)

    DEFF Research Database (Denmark)

    Frydkjaer-Olsen, Ulrik; Soegaard Hansen, Rasmus; Simó, Rafael;

    2016-01-01

    PURPOSE: To investigate the correlation between retinal vessel calibre and measurements of neurodegeneration in patients with type 2 diabetes (T2D) and no or early diabetic retinopathy (DR). METHODS: Baseline data on 440 patients with T2D from the EUROCONDOR clinical trial were used. DR was graded...... according to the Early Treatment of Diabetic Retinopathy Study (ETDRS) scale, and patients with ETDRS levels 10-35 were included. Retinal vessel diameters were measured by semi-automatic software. Calibres were summarized into central retinal artery and vein equivalents (CRAE and CRVE). RESULTS: Median age...... and diabetes duration were 64.0 and 10.3 years, respectively. ETDRS levels were 10 (42.3%), 20 (27.5%) and 35 (30.2%). The median CRAE and CRVE were 146.7 and 215.3 µm, respectively. CRAE did not differ according to ETRDS level (p = 0.12), but wider CRVE were found in patients with higher ETDRS levels (p = 0...

  1. Diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    A. Moreno

    Full Text Available This paper describes the importance of diabetic retinopathy in the loss of visual function. We exposed the most important risk factors, such as diabetes duration, poor metabolic control, pregnancy, puberty, hypertension, poor control of blood lipids, renal disease, and sleep apnea syndrome. We describe the pathogenesis of the disease, small retinal vessel microangiopathies which produce extravasation, edema and ischemia phenomena. We put special emphasis on the vascular endothelial growth factor (VEGF and its pathogenic importance. They are also described the main clinical symptoms as microaneurysms, intraretinal hemorrhages, hard and soft exudates, intraretinal microvascular abnormalities (IRMA, venous disorders, formation of new vessels and diabetic macular edema (the latter being the most common cause of vision loss. Finally we describe the latest diagnostic techniques and eye treatment, with special emphasis on obesity surgery importance as more important preventive factor to eliminate the predisposing and precipitating disease symptoms.

  2. 尿微量白蛋白对早期糖尿病视网膜病变的临床意义%Diagnostic significance of urine microalbumin test for early diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    乔宇; 王平

    2016-01-01

    ? Diabetic retinopathy is one of those significant complications of diabetes.With the increasing number of diabetic patients, blind caused by diabetic retinopathy is a serious threat to human health which cannot be neglected, but there is no highly effective treatment for it. Consequently, early detection and preventive treatment for it are important.Currently, studies have found that urine microalbumin had a close relation with diabetic retinopathy and that urine microalbumin might play an important role in early predicting of diabetic retinopathy. The review is about the diagnostic significance of urine microalbumin test for early diabetic retinopathy.%糖尿病视网膜病变是糖尿病非常重要的并发症之一。目前对于糖尿病视网膜病变的治疗并没有非常有效的治疗手段,所以在糖尿病视网膜病变的前期,早期发现与预防治疗显得格外的重要,近年研究发现尿微量蛋白与糖尿病视网膜病变密切相关,对于早期防治糖尿病视网膜病变具有重要意义,本文就尿微量白蛋白在早期的糖尿病视网膜病变中的临床意义作一综述。

  3. 糖尿病视网膜病变的早期防治%Emphasizing the early prevention and treatment for diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    许迅

    2008-01-01

    Diabetic retinopathy is a complication of diabetes which is difficult to reverse and can result in blindness.Ophthalmologists in China are facing quite a challenge according to the weak prevention and treatment system of DR.At present,the emphasis should be placed on the early prevention and treatment,but the appropriate guidelines founded on evidence-based medicine still have been absent.Currently,we should deeply realize the problems existing in early prevention and treatment of DR in China,fully recognize the necessity and importance of it,actively spread the new international classification,adopt the ways of public health,start by primary health care and fully cooperate with different fields of the society to strengthen the practice and research work on the early prevention and treatment of DR.%糖尿病视网膜病变(diabetic retinopathy,DR)是一种难于逆转的致盲性眼病.鉴于目前我国治疗严重、复杂DR的医疗资源非常有限,因此,有必要将防盲工作的重点转移到DR的早期防治方面.但由于我国DR防治体系相对薄弱,尚缺乏根据循证医学原则所制定的恰当的防治指南,故广泛开展DR的早期防治工作尚面临较多困难.为此,充分认识DR早期防治的必要性和重要性,积极推广DR国际分型标准,采用公共卫生的途径,从初级卫生保健抓起,多方通力协作,加强其早期防治的实践和研究工作,将成为各级政府和DR防治工作者所面临的一项重要任务.

  4. Diagnosis of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Anupriyaa Mukherjee

    2015-02-01

    Full Text Available Diabetic retinopathy is a disease, caused by alternation in the retinal blood vessels. It is a strong sign of early blindness and if it is not treated may tend to complete blindness and the vision lost once cannot be restored once again. In this paper different image processing techniques are used to differentiate between the normal and the diseased image. The attempt is made to see where the problem actually lies so that proper diagnosis of patient can be done. Pre processing of an image, optic disk detection, Blood vessels extraction, Exudates detection are some of the methods that are applied here. Other algorithms are designed to obtain the desired result. A large number of populations are affected by this disease around the world.

  5. Fenofibrate and Diabetic Retinopathy.

    Science.gov (United States)

    Knickelbein, Jared E; Abbott, Akshar B; Chew, Emily Y

    2016-10-01

    Diabetic retinopathy, a common and sight-threatening microvascular complication of diabetes mellitus, is a leading cause of blindness among working-aged adults. Medical therapies including intensive control of hyperglycemia and hypertension have been shown to reduce the incidence and progression of diabetic retinopathy. The association of dyslipidemia and treatment with statins with diabetic retinopathy is inconsistent in epidemiologic studies. However, two recent randomized clinical trials have demonstrated beneficial effects of systemic fenofibrate therapy in reducing the progression of diabetic retinopathy independently of serum lipid levels. These findings suggest that fenofibrate may be an effective strategy for reducing the progression of diabetic retinopathy, thus reducing the large and growing public health burden of treating the sight-threatening complications of diabetic retinopathy.

  6. Diabetic Retinopathy: Nature and Extent.

    Science.gov (United States)

    Coughlin, W. Ronald; Patz, Arnall

    1978-01-01

    The authors discuss the incidence and prevalence of diabetic retinopathy in juvenile and maturity onset diabetics, background and proliferative retinopathy, and current modalities of treatment. (Author)

  7. Endoplasmic reticulum stress and diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Toshiyuki Oshitari

    2008-02-01

    Full Text Available Toshiyuki Oshitari1,2, Natsuyo Hata1, Shuichi Yamamoto11Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan; 2Department of Ophthalmology, Kimitsu Central Hospital, Kisarazu City, Chiba, JapanAbstract: Endoplasmic reticulum (ER stress is involved in the pathogenesis of several diseases including Alzheimer disease and Parkinson disease. Many recent studies have shown that ER stress is related to the pathogenesis of diabetes mellitus, and with the death of pancreatic β-cells, insulin resistance, and the death of the vascular cells in the retina. Diabetic retinopathy is a major complication of diabetes and results in death of both neural and vascular cells. Because the death of the neurons directly affects visual function, the precise mechanism causing the death of neurons in early diabetic retinopathy must be determined. The ideal therapy for preventing the onset and the progression of diabetic retinopathy would be to treat the factors involved with both the vascular and neuronal abnormalities in diabetic retinopathy. In this review, we present evidence that ER stress is involved in the death of both retinal neurons and vascular cells in diabetic eyes, and thus reducing or blocking ER stress may be a potential therapy for preventing the onset and the progression of diabetic retinopathy.Keywords: endoplasmic reticulum stress, diabetic retinopathy, vascular cell death, neuronal cell death

  8. Factors Contributing to Discrepancy Between Visual Acuity Fractions Derived From a Snellen Chart and Letter Scores on the Early Treatment Diabetic Retinopathy Study Chart.

    Science.gov (United States)

    Chen, Fred K; Agelis, Lillian Evangelia; Peh, Khaik K; Teong, Joanne; Wong, Evan Norman Xi Ming

    2014-01-01

    To report factors influencing the relationship between visual acuity (VA) fractions measured on Snellen chart and letter scores on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. This was a retrospective review from a single ophthalmology outpatient clinic. All patients had routine consecutive VA testing in the right eye using a Snellen chart (1-6 m) and the ETDRS chart (4 m and/or 1 m), by the same optometrist, using a standardized testing protocol for each chart. Both acuity fractions and letter scores were converted to their equivalent logarithm of minimum angle of resolution (logMAR) for comparison. Multiple regression analysis was performed. A total of 237 patients with a wide range of ocular disease and VAs were enrolled. Mean age was 63 years (range, 18-95 years). Recorded VA (logMAR) was better on Snellen chart by a mean (95% limits of agreement) of -0.07 (-0.33 to +0.18, P Snellen and ETDRS charts was nonuniform across VA range. This has implications on interpretation of published studies converting Snellen fractions to logMAR for analysis and reporting of VA outcomes.

  9. Multicenter clinical trial of early treatment of retinopathy of prematurity%早期治疗早产儿视网膜病变的多中心临床试验

    Institute of Scientific and Technical Information of China (English)

    李蓉; 王雨生

    2012-01-01

    Retinal ablation has yet been shown to be effective in preventing blindness from retinopathy of prematurity (ROP), but the optimal treatment timing may be more important. The Early Treatment for Retinopathy of Prematurity Study ( ET-ROP) sponsored by National Eye Institute (NEI) is the largest and most influential clinical trial to test whether early treatment in carefully selected cases will result in an overall better visual outcome than treatment at the conventional threshold point in the disease. Most objective and detailed results obtained form this trial has become significant evidences for our ROP clinical work.%视网膜消融是公认的治疗早产儿视网膜病变(retinopathy of prematurity,ROP)的有效方法,寻求最佳的治疗时机意义重大.在评估早期治疗的优越性和安全性的临床研究中,以美国国立眼科研究所发起的早期治疗ROP研究临床试验的规模最大,影响最深.该试验得出的客观和翔实的结果,已成为目前ROP临床工作重要的循证医学证据.

  10. Radiation retinopathy; Les retinopathies radio-induites

    Energy Technology Data Exchange (ETDEWEB)

    Lumbroso, L.; Desjardins, L. [Institut Curie, Serv. d' Ophtalmologie, 75 - Paris (France); Dendale, R.; Fourquet, A. [Institut Curie, Serv. de Radiotherapie, 75 - Paris (France)

    2002-09-01

    Radiation retinopathy is a retinal micro-angiopathy, observed after irradiation of the eye. It can rarely lead to neo-vascular glaucoma and enucleation due to pain. It is due to a progressive retinal capillary then vascular occlusion. Total irradiation dose, dose fraction, and surface of the irradiated retina seem to be strong predictive factors for radiation retinopathy. Patients who underwent an irradiation near the eye (skull base tumors, nasal and paranasal tumors, or brain tumors) should be followed by periodic ophthalmologic examination to detect and treat when necessary the non perfusion areas. (authors)

  11. The Adenosinergic System in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    J. Vindeirinho

    2016-01-01

    Full Text Available The neurodegenerative and inflammatory environment that is prevalent in the diabetic eye is a key player in the development and progression of diabetic retinopathy. The adenosinergic system is widely regarded as a significant modulator of neurotransmission and the inflammatory response, through the actions of the four types of adenosine receptors (A1R, A2AR, A2BR, and A3R, and thus could be revealed as a potential player in the events unfolding in the early stages of diabetic retinopathy. Herein, we review the studies that explore the impact of diabetic conditions on the retinal adenosinergic system, as well as the role of the said system in ameliorating or exacerbating those conditions. The experimental results described suggest that this system is heavily affected by diabetic conditions and that the modulation of its components could reveal potential therapeutic targets for the treatment of diabetic retinopathy, particularly in the early stages of the disease.

  12. Early nursing intervention of retinopathy of premature children%早产儿视网膜病变的早期护理

    Institute of Scientific and Technical Information of China (English)

    宋霞梅; 钟春霞; 韦素松

    2012-01-01

    Objective To investigate the early screening; treatment and care methods of the retinopathy (ROP) of preterm children. Methods 210 premature children born in our hospital were selected to conduct eye screening,treatment and care from January to December 2009.The nursing key points were summarized. Results Among 210 preterm children,15 cases occurred ROP,the rate was 7.1%.Lesions appeared to be the threshold for laser treatment in 8 patients (16 eyes),accounting for 3.8%.The ROP morbidity rate was higher in birth weight ≤ 1000 g group than that in birth weight > 1000 g group,higher in gestational age ≤32-week group than that in gestational age> 32 weeks,higher in the inhalation oxygen concentration ≤ 96% group than in inhalation oxygen concentration > 96% group.Significant difference existed in ROP and non-ROP preterm children. Conclusions The incidence of retinopathy of premature children was closely related with low gestational age,low birth weight and prolonged and high-concentration oxygen inhalation,timely screening and early intervention care should be given to them.%目的 探讨早产儿视网膜病变(ROP)的早期筛查、治疗及护理方法.方法 选择2009年1~12月在我院出生的210例早产儿,进行眼部筛查、治疗及护理,将护理要点进行总结.结果 210例早产儿中,有15例发生ROP,发生率为7.1%.出现阈值病变需进行激光治疗者8例(16只眼)占3.8%.出生体质量≤1000 g组的ROP患病率显著高于出生体质量>1000 g组,孕周≤32周组的ROP患病率显著高于孕周>32周组,吸氧浓度≤96%组的ROP患病率低于吸氧浓度>96%组.无ROP与有ROP的早产儿吸氧时间相比差异显著.结论 早产儿视网膜病变的发生与低胎龄、低出生体质量和高浓度、长时间吸氧关系密切,应及时筛查,早期进行护理干预.

  13. GEMCITABINE-INDUCED RETINOPATHY.

    Science.gov (United States)

    Kovach, Jaclyn L

    2016-10-31

    To report a case of Purtscher-like retinopathy associated with gemcitabine. The author reports a 68-year-old woman who presented with a 4-month history of bilateral vision loss. She had a history of diabetes, hypertension, and leiomyosarcoma, diagnosed 5 months before presentation and had completed 5 cycles of combination treatment with gemcitabine and docetaxel. Clinical examination revealed a Purtscher-like retinopathy that improved after gemcitabine cessation without the development of cystoid macular edema or retinal neovascularization. This case highlights the importance of recognizing gemcitabine-induced ischemic retinopathy that can be associated with life-threatening myocardial or renal ischemia.

  14. Retinopathy of Prematurity (ROP)

    Science.gov (United States)

    ... of Prematurity (ROP) Facts About Retinopathy of Prematurity (ROP) This information was developed by the National Eye ... blind from ROP. Are there different stages of ROP? Yes. ROP is classified in five stages, ranging ...

  15. Proliferative retinopathy predicts nephropathy

    DEFF Research Database (Denmark)

    Karlberg, Charlotte; Falk, Christine; Green, Anders;

    2012-01-01

    We wanted to examine proliferative retinopathy as a marker of incident nephropathy in a 25-year follow-up study of a population-based cohort of Danish type 1 diabetic patients and to examine cross-sectional associations between nephropathy and retinopathy in long-term surviving patients of the same...... photographs at follow-up. Single spot urine was used to evaluate nephropathy at both examinations. Proliferative retinopathy was present in 29 patients (15.8%) at baseline. At follow-up, these patients were more likely to macroalbuminuria (20.7% vs. 6.5%) than patients without proliferative retinopathy...... at baseline. In a multivariate logistic regression adjusted for baseline age, sex, duration of diabetes, smoking, HbA(1,) systolic and diastolic blood pressure, odds ratio of nephropathy (micro- and macroalbuminuria combined) was 2.98 (95% confidence interval 1.18-7.51, p = 0.02) for patients...

  16. Pharmacotherapies for Diabetic Retinopathy: Present and Future

    Directory of Open Access Journals (Sweden)

    Stephen G. Schwartz

    2007-01-01

    Full Text Available Diabetic retinopathy remains a major cause of worldwide preventable blindness. Measures to avoid blindness include medical management (control of blood sugar, blood pressure, and serum lipids and ocular management (laser photocoagulation and pars plana vitrectomy. Adjunctive pharmacologic therapies (intravitreal triamcinolone acetonide and anti-vascular endothelial growth factor agents have shown early promise in the treatment of both diabetic macular edema and proliferative diabetic retinopathy. Other medications under investigation include the fluocinolone acetonide implantable device, extended-release dexamethasone implant, oral ruboxistaurin, and intravitreal hyaluronidase.

  17. Evaluation the index of ophthalmic arteries in diabetic patients with retinopathy compared to diabetic patients without retinopathy using color Doppler ultrasound

    Directory of Open Access Journals (Sweden)

    Mohammad Ghasem Hanafi

    2016-12-01

    Full Text Available Diabetic retinopathy is the most common eye complication in diabetic patients that early detection of this complication is essential. The aim of this study was to evaluate ophthalmic artery index in diabetic retinopathy by Doppler ultrasound. . In this cross-sectional study, 64 patients were studied in 4 groups (healthy, diabetic without retinopathy, background retinopathy and proliferative retinopathy. Resistance index (RI and Pulsatile Index (PI were assessed by color Doppler ultrasound. The obtained data were analyzed by ANOVA and chi-square test and ROC curve. RI in diabetic patients with proliferative retinopathy has the highest mean (0.83 and the lowest mean was observed in healthy subjects (0.54 (P <0.001 as well as in PI, the highest rate was in diabetic patients with proliferative retinopathy (1.41 and the lowest was in healthy subjects (0.92 (P <0.001. The results of our study showed that the sensitivity, specificity, positive and negative predictive values and overall accuracy of RI and PI in diabetic patients with proliferative retinopathy in the best cut-off points (0.645 and 1.0175 respectively were 100%.Ophthalmic artery index RI and PI was significantly increased in patients with diabetic retinopathy and the sensitivity and specificity for detection retinopathy was 100%. Color Doppler ultrasound method is more efficient for screening diabetic patients with retinopathy.

  18. Plasma prostaglandin and diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Maurya OPS

    1987-01-01

    Full Text Available Estimation of prostaglandin El (PGE levels by bioassay technique (Ritcher Crossland was carried out in 15 normal persons, 15 diabetic patients without Retinopathy, and 30 diabetic patients with Retinopathy. Plasma PGE 1 values were higher in diabetic patients with or without retinopathy than in normal subjects Plasma PGE 1 levels were significantly higher in diabetic with retinopathy than in the control group (p < 0.001, whereas in diabetics without retinopathy the PGE levels did not show a statistically significant difference from controls In diabetic patients with retinopathy, the mean value of PGE 1 was higher in proliferative retinopathy than in background retinopathy, but on statistical analysis, it was not of much significane (P> 0.8.

  19. Failure to initiate early insulin therapy - A risk factor for diabetic retinopathy in insulin users with Type 2 diabetes mellitus: Sankara Nethralaya-Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS, Report number 35

    Directory of Open Access Journals (Sweden)

    Aditi Gupta

    2016-01-01

    Full Text Available Context: Insulin users have been reported to have a higher incidence of diabetic retinopathy (DR. Aim: The aim was to elucidate the factors associated with DR among insulin users, especially association between duration, prior to initiating insulin for Type 2 diabetes mellitus (DM and developing DR. Materials and Methods: Retrospective cross-sectional observational study included 1414 subjects having Type 2 DM. Insulin users were defined as subjects using insulin for glycemic control, and insulin nonusers as those either not using any antidiabetic treatment or using diet control or oral medications. The duration before initiating insulin after diagnosis was calculated by subtracting the duration of insulin usage from the duration of DM. DR was clinically graded using Klein′s classification. SPSS (version 9.0 was used for statistical analysis. Results: Insulin users had more incidence of DR (52.9% vs. 16.3%, P 5 years and sub-optimal glycemic control (glycosylated hemoglobin <7.0%. Among insulin users, abdominal obesity was found to be a significant predictor of DR; DR is associated with longer duration prior to initiating insulin therapy in Type 2 DM subjects with suboptimal glycemic control.

  20. ROCK as a Therapeutic Target of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Ryoichi Arita

    2010-01-01

    Full Text Available The increasing global prevalence of diabetes is a critical problem for public health. In particular, diabetic retinopathy, a prevalent ocular complication of diabetes mellitus, causes severe vision loss in working population. A better understanding of the pathogenesis and the development of new pharmacologic treatments are needed. This paper describes the relevance between Rho/ROCK pathway and the pathogenesis of diabetic retinopathy from its early to late stages. Moreover, the therapeutic potential of ROCK inhibitor in the total management of diabetic retinopathy is discussed.

  1. Dopamine and myopia in retinopathy of prematurity%早产儿视网膜病变患者的近视与多巴胺

    Institute of Scientific and Technical Information of China (English)

    谢黎; 王平

    2016-01-01

    早产儿视网膜病变(retinopathy of prematurity,ROP)是早产儿及低体重儿发生的一种异常新生血管形成和纤维组织增生性视网膜病变,被视为引起儿童视觉受损的重要疾病之一,严重病例可导致视力永久丧失.国内外大量研究发现ROP影响视网膜的发育及功能,主要影响感光细胞,且临床研究发现这种视网膜功能障碍既使早期得到控制,后续仍易发生屈光不正,尤其是近视.最新研究发现氧诱导小鼠视网膜病变(oxygeninduced induced retinopathy,OIR)的神经视网膜功能障碍可能与OIR诱导多巴胺(dopamine,DA)释放和活性的变化有关.ROP患儿早期出现近视及近视发生率高与ROP影响视网膜多巴胺的分泌及释放密切相关,深入探讨DA在ROP近视中的作用将为临床ROP患儿中近视防治提供新的思路.%Retinopathy of prematurity (ROP) is a kind of abnormal neovascularization and fibrous tissue proliferation retinopathy in premature and low birth weight infants.It is regarded as one of the important diseases causing visual impairment in children,which can lead to permanent visual loss.A large number of domestic and foreign study found that ROP affected retinal development and function,mainly affected the tight-sensitive cells,and clinical study found that the retinal dysfunction even early controlled,usually following the ametropia,especially myopia.Recent studies have found that oxygen induced retinopathy (OIR) retinal dysfunction may be related to the release of dopamine (DA) and the changes in the activity of DA.Studies found that ROP early myopia and the high incidence of myopia in children with ROP were close ly related to the effect of ROP on the secretion and release of dopamine in the retina.Therefore,discussing the role of DA in ROP myopia will provide a new way of thinking for the prevention and treatment of myopia in children with ROP.

  2. Detection of Hypertension Retinopathy Using Deep Learning and Boltzmann Machines

    Science.gov (United States)

    Triwijoyo, B. K.; Pradipto, Y. D.

    2017-01-01

    hypertensive retinopathy (HR) in the retina of the eye is disturbance caused by high blood pressure disease, where there is a systemic change of arterial in the blood vessels of the retina. Most heart attacks occur in patients caused by high blood pressure symptoms of undiagnosed. Hypertensive retinopathy Symptoms such as arteriolar narrowing, retinal haemorrhage and cotton wool spots. Based on this reasons, the early diagnosis of the symptoms of hypertensive retinopathy is very urgent to aim the prevention and treatment more accurate. This research aims to develop a system for early detection of hypertension retinopathy stage. The proposed method is to determine the combined features artery and vein diameter ratio (AVR) as well as changes position with Optic Disk (OD) in retinal images to review the classification of hypertensive retinopathy using Deep Neural Networks (DNN) and Boltzmann Machines approach. We choose this approach of because based on previous research DNN models were more accurate in the image pattern recognition, whereas Boltzmann machines selected because It requires speedy iteration in the process of learning neural network. The expected results from this research are designed a prototype system early detection of hypertensive retinopathy stage and analysed the effectiveness and accuracy of the proposed methods.

  3. PRESUMED CHOLOROQUINE RETINOPATHY

    African Journals Online (AJOL)

    quine retinopathy were reviewed: 5 women and 14. (73.7%) men. The age ... ranged from six months to ten years, with a mean of 4.1 years. ... muscles with high doses. ... men and 5 (26.3%) women. ... The higher the dose, the worse the visual.

  4. New Diagnostic and Therapeutic Approaches for Preventing the Progression of Diabetic Retinopathy

    OpenAIRE

    2016-01-01

    Diabetic retinopathy (DR) is a severe sight-threatening complication of diabetes mellitus. Retinal laser photocoagulation, antivascular endothelial growth factors, steroid therapy, and pars plana vitrectomy are now used extensively to treat advanced stages of diabetic retinopathy. Currently, diagnostic devices like ultrawide field fundus fluorescein angiography and the improvement of optical coherence tomography have provided quicker and more precise diagnosis of early diabetic retinopathy. T...

  5. 早产儿视网膜病的早期诊断及防治措施%Early diagnosis,prevention and treatment of retinopathy of prematurity

    Institute of Scientific and Technical Information of China (English)

    陈超; 石文静

    2004-01-01

    近年早产儿视网膜病(retinopathy of prematurity,ROP)发病率明显增高,ROP已成为儿童致盲的重要原因,约占儿童致盲原因的6%~18%。目前,世界上已公认ROP的发病率可作为衡量新生儿重症监护病房(NICU)质量的标准之一。因此,应尽快健全和完善ROP的早期诊断及防治措施。

  6. Bloom syndrome: multiple retinopathies in a chromosome breakage disorder.

    Science.gov (United States)

    Bhisitkul, R B; Rizen, M

    2004-03-01

    To describe multiple retinal abnormalities in a patient with Bloom syndrome, including early macular drusen, diabetic retinopathy, and the onset of leukaemic retinopathy. Clinical data were collected over 1 year of follow up, and ocular abnormalities in Bloom syndrome were reviewed from the literature. A 39 year old man with a rare autosomal recessive "chromosome breakage" syndrome was followed. A variety of ocular findings have been reported in Bloom syndrome; this patient had hard drusen in both maculae, non-proliferative diabetic retinopathy, and haemorrhagic retinopathy as a herald of acute lymphocytic leukaemia. Bloom syndrome is a rare disorder of genomic instability, in which a variety of ocular abnormalities have been found. Described here are multiple retinal manifestations arising from characteristic systemic associations of diabetes mellitus and leukaemia, as well as macular hard drusen.

  7. Radiation Retinopathy: Case report and review

    Directory of Open Access Journals (Sweden)

    Young Lorna

    2007-04-01

    Full Text Available Abstract Background Ocular damage from radiation treatment is a well established phenomenon. Many factors are now known to influence the incidence of radiation retinopathy, including total dosage and daily fraction size. Patients who are diabetic, hypertensive or received previous chemotherapy are more susceptible to radiation retinopathy. Case Presentation A 55 year old male was referred from the oncology department with epiphora. His medical history included Type 2 Insulin treated Diabetes Mellitus and hypertension. One year prior to presentation he had undergone a total rhinectomy with a 4 week course of post-operative radiotherapy for an aggressive sqaumous cell carcinoma of the nose. On examination the visual acuity was noted to be 6/36 left eye and 6/9 right eye. Posterior segment examination revealed marked retinal ischaemia present in the posterior pole and macular region of both eyes. The appearance was not thought to be typical of diabetic changes, radiation retinopathy being the more likely diagnosis especially in view of his history. Over the next four months the vision in both eyes rapidly deteriorated to 3/60 left eye and 1/60 right eye. Bilateral pan retinal photocoagulation was thought to be appropriate treatment at this point. Conclusion This case highlights the importance for ophthalmologists and oncologists to be aware of the close relationship between diabetes and radiation treatment and the profound rapid impact this combination of factors may have on visual function. Radiation is being used with increasing frequency for ocular and orbital disease, because of this more cases of radiation retinopathy may become prevalent. Factors which may potentiate radiation retinopathy should be well known including, increased radiation dosage, increased fraction size, concomitant systemic vascular disease and use of chemotherapy. Counselling should be offered in all cases at risk of visual loss. As no effective treatment currently exists

  8. Automated Detection and Differentiation of Drusen, Exudates, and Cotton-wool Spots in Digital Color Fundus Photographs for Early Diagnosis of Diabetic Retinopathy IOVS-06-0996 accepted version

    Science.gov (United States)

    Niemeijer, Meindert; van Ginneken, Bram; Russell, Stephen R.; Suttorp-Schulten, Maria S.A.

    2008-01-01

    Purpose To describe and evaluate a machine learning based, automated system to detect exudates and cotton-wool spots in digital color fundus photographs, and differentiate them from drusen, for early diagnosis of diabetic retinopathy. Methods Three hundred retinal images from one eye of three hundred patients with diabetes were selected from a diabetic retinopathy telediagnosis database (non-mydriatic camera two field photography); 100 with previously diagnosed ‘bright’ lesions, and 200 without. A machine learning computer program was developed that can identify and differentiate among drusen, (hard) exudates, and cotton-wool spots. A human expert standard for the 300 images was obtained by consensus annotation by two retinal specialists. Sensitivities and specificities of the annotations on the 300 images by the automated system and a third retinal specialist were determined. Results The system achieved an area under the ROC curve of 0.95 and sensitivity/specificity pairs of 0.95/0.88 for the detection of ‘bright’ lesions of any type, and 0.95/0.86, 0.70/0.93 and 0.77/0.88 for the detection of exudates, cotton-wool spots and drusen, respectively. The third retinal specialist achieved pairs of 0.95/0.74 for ‘bright’ lesions, and 0.90/0.98, 0.87/0.98 and 0.92/0.79 per lesion type. Conclusions An machine learning based, automated system capable of detecting exudates and cotton-wool spots and differentiating them from drusen in color images obtained in community based diabetic patients has been developed and approaches the performance level of that of retinal experts. If the machine learning can be improved with additional training datasets, it may be useful to detect clinically important ‘bright’ lesions, enhance early diagnosis and reduce suffering from visual loss in patients with diabetes. PMID:17460289

  9. Diabetic retinopathy in acromegaly

    OpenAIRE

    Said Azzoug; Farida Chentli

    2014-01-01

    Introduction: Although growth hormone (GH) has been implicated in the pathogenesis of diabetic retinopathy (DR), DR is deemed to be rare in patients with GH excess. Our aim was to study its prevalence in subjects with acromegaly suffering from diabetes mellitus (DM), to analyze its characteristics, and to look for predictive factors such as age at diagnosis, GH concentration and duration, DM duration, DM control, and family background. Materials and Methods: Forty patients with acromegaly and...

  10. Purtscher-Like Retinopathy

    Directory of Open Access Journals (Sweden)

    Rita Massa

    2015-01-01

    Full Text Available Purtscher-like retinopathy is associated with retinal hemorrhages and ischaemia probably due to the complement-mediated leukoembolization. It is a rare and severe angiopathy found in conditions such as acute pancreatitis. Case. We present a case of a 53-year-old man who presented with a Purtscher-like retinopathy associated with the development of acute pancreatitis in the context of a Klatskin tumour (a hilar cholangiocarcinoma. The ophthalmologic evaluation revealed the best corrected visual acuity (BCVA of 20/32 in the right eye (RE and of 20/40 in the left eye (LE; biomicroscopy of anterior segment showed scleral icterus and fundoscopy revealed peripapillary cotton-wool spots, optic disc edema, and RPE hypo- and hyperpigmentation in the middle peripheral retina in both eyes with an intraretinal hemorrhage in the LE. 15 months after the initial presentation, without ophthalmological treatment, there was an improvement of BCVA to 20/20 in both eyes and optical coherence tomography (OCT revealed areas of reduction of retinal nerve fiber layer thickness corresponding to the previous cotton-wool spots. Conclusion. Purtscher-like retinopathy should not be neglected in complex clinical contexts. Its unclear pathophysiology determines an uncertain treatment strategy, but a meticulous follow-up is compulsory in order to avoid its severe complications.

  11. Cancer-associated retinopathy: an autoimmune retinopathy

    Directory of Open Access Journals (Sweden)

    Nurbuanto Tradjutrisno

    2016-02-01

    Full Text Available Cancer-associated retinopathy (CAR is a paraneoplastic syndrome most commonly associated with small-cell carcinoma of the lung, but also less frequently reported in patients with breast, endometrial, and other cancers. A paraneoplastic syndrome (PNS is a secondary organ dysfunction occurring in a cancer patient at a site that is anatomically remote from the tumor. PNS is not due to a direct effect of the tumor itself or its metastases but caused by other mechanisms, commonly autoimmune mechanisms develop when malignant tumors express proteins, paraneoplastic antigens (PNA, which are normally present only in neurons. One retinal antigen implicated in the autoimmune mechanism of CAR is recoverin, a 23 kDa photoreceptor-specific calcium-binding protein modulating the activity of photoreceptor guanylyl cyclase. The anti-recoverin antibodies induced by the primary tumor may on contact with intraretinal recoverin initiate a photoreceptor degeneration and trigger photoreceptor death by apoptosis, thus causing blindness. Other circulating antibodies directed against a 46 kDa protein identified as retinol enolase and a 60 kDa retinal protein have been demonstrated in patients with clinically diagnosed CAR syndrome. In certain patients no specific antibody has been identified. This suggests that the CAR syndrome includes an heterogenous group of autoimmune conditions directed against various retinal proteins.

  12. Automated microaneurysm detection algorithms applied to diabetic retinopathy retinal images

    Directory of Open Access Journals (Sweden)

    Akara Sopharak

    2013-07-01

    Full Text Available Diabetic retinopathy is the commonest cause of blindness in working age people. It is characterised and graded by the development of retinal microaneurysms, haemorrhages and exudates. The damage caused by diabetic retinopathy can be prevented if it is treated in its early stages. Therefore, automated early detection can limit the severity of the disease, improve the follow-up management of diabetic patients and assist ophthalmologists in investigating and treating the disease more efficiently. This review focuses on microaneurysm detection as the earliest clinically localised characteristic of diabetic retinopathy, a frequently observed complication in both Type 1 and Type 2 diabetes. Algorithms used for microaneurysm detection from retinal images are reviewed. A number of features used to extract microaneurysm are summarised. Furthermore, a comparative analysis of reported methods used to automatically detect microaneurysms is presented and discussed. The performance of methods and their complexity are also discussed.

  13. The role of CTGF in diabetic retinopathy.

    Science.gov (United States)

    Klaassen, Ingeborg; van Geest, Rob J; Kuiper, Esther J; van Noorden, Cornelis J F; Schlingemann, Reinier O

    2015-04-01

    Connective tissue growth factor (CTGF, CCN2) contributes to fibrotic responses in diabetic retinopathy, both before clinical manifestations occur in the pre-clinical stage of diabetic retinopathy (PCDR) and in proliferative diabetic retinopathy (PDR), the late clinical stage of the disease. CTGF is a secreted protein that modulates the actions of many growth factors and extracellular matrix (ECM) proteins, leading to tissue reorganization, such as ECM formation and remodeling, basal lamina (BL) thickening, pericyte apoptosis, angiogenesis, wound healing and fibrosis. In PCDR, CTGF contributes to thickening of the retinal capillary BL and is involved in loss of pericytes. In this stage, CTGF expression is induced by advanced glycation end products, and by growth factors such as vascular endothelial growth factor (VEGF) and transforming growth factor (TGF)-β. In PDR, the switch from neovascularization to a fibrotic phase - the angio-fibrotic switch - in PDR is driven by CTGF, in a critical balance with vascular endothelial growth factor (VEGF). We discuss here the roles of CTGF in the pathogenesis of DR in relation to ECM remodeling and wound healing mechanisms, and explore whether CTGF may be a potential novel therapeutic target in the clinical management of early as well as late stages of DR.

  14. microRNA-218 Inhibits Oxygen-induced Retinal Neovascularization via Reducing the Expression of Roundabout 1

    Institute of Scientific and Technical Information of China (English)

    Shuang Han; Yi-Chun Kong; Bei Sun; Quan-Hong Han; Ying Chen; Yu-Chuan Wang

    2016-01-01

    Background:The mechanisms of pathological retinal neovascularization (RNV) remain unknown.Several microRNAs were reported to be involved in the process of RNV.Oxygen-induced retinopathy (OIR) is a useful model to investigate RNV.Our present work explored the expression and the role of microRNA-128 (miR-218) in oxygen-induced RNV.Methods:OIR was used to establish RNV model.The expression level ofmiR-218 in the retina from OIR mice was assessed by quantitative real-time reverse transcfiptase polymerase chain reaction.Fluorescein angiography was performed in retinae of OIR mice,and RNV was quantified by hematoxylin and eosin staining to evaluate the effect of pCDH-CMV-miR-218 intravitreal injection on RNV in OIR mice.Roundabout 1 (Robo 1) expression was detected by Western blotting in mouse retinal vascular endothelial cells expressing a high or low level ofmiR-218 and retinal tissues from OIR mice.Cell migration was evaluated by scratch wound assay.Results:In OIR mice,the expression level of miR-218 was significantly down-regulated (P =0.006).Retinal Robo1 expression was significantly increased at both mRNA and protein levels (P =0.001,0.008;respectively),miR-218 intravitreal injection inhibited retinal angiogenesis in OIR mice,and the restoration of miR-218 in retina led to down-regulation of Robo 1.Conclusions:Our experiments showed that restoration of miR-218 inhibited retinal angiogenesis via targeting Robo 1.MiR-218 contributed to the inhibition of retinal angiogenesis and miR-218 might be a new therapeutic target for preventing RNV.

  15. Diabetic retinopathy - ocular complications of diabetesmellitus

    Institute of Scientific and Technical Information of China (English)

    Martin M Nentwich; Michael W Ulbig

    2015-01-01

    In industrialized nations diabetic retinopathy is the mostfrequent microvascular complication of diabetes mellitusand the most common cause of blindness in the workingagepopulation. In the next 15 years, the number ofpatients suffering from diabetes mellitus is expected toincrease significantly. By the year 2030, about 440 millionpeople in the age-group 20-79 years are estimated to besuffering from diabetes mellitus worldwide (prevalence7.7%), while in 2010 there were 285 million people withdiabetes mellitus (prevalence 6.4%). This accounts foran increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e. , exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.

  16. Current report from Russian Diabetic Retinopathy Register

    Directory of Open Access Journals (Sweden)

    Dmitriy Valentinovich Lipatov

    2014-03-01

    Full Text Available A pandemic expansion of diabetes mellitus (DM observed nowadays across the globe is increasingly acknowledged as a disaster by all peoples of the world. Statistical analysis indicates an annual increase in prevalence of DM in Russian Federation that had reached 3 779 423 registered patients by 01.01.2013. Besides the humanitarian aspects, DM poses severe economic challenges for this country – challenges that stem both from high mortality and growing disability rate due to limb loss, decrease in visual acuity and need for hemodialysis, plaguing many DM patients.Aim. To produce an epidemiological evaluation based on the dynamics of prevalence of diabetic retinopathy in the Russian Federation – nationwide and in individual regions – across the last 13 years.Materials and Methods. Current survey included patients from various regions of the Russian Federation that were examined during epidemiological missions conducted by the federal Endocrinology Research Centre (2000–2009, as well as National Programmes «Health» (2007 and «Diabetes – Learn In Advance» (2012–2013.Results. In the Russian Federation registered more than 630,000 patients with different stages of diabetic retinopathy. The prevalence of diabetic retinopathy among adults (18 years and older with type 1 diabetes is 35.25%, while in type 2 diabetes - 16.67%. On average, this means that almost one in five patients (17.63% with diabetes have certain eye problems.Conclusion. In summary, our data indicate a dramatic growth in the rate of diabetic ocular complications, with a particular increase in proliferative diabetic retinopathy, complicated cataract and neovascular glaucoma. These findings call for an even closer attention to early diagnostics, adequate management and, above everything else, timely prevention of ocular pathologies in patients with DM.

  17. Diabetic Retinopathy Screening and Monitoring of Early Stage Disease in Australian General Practice: Tackling Preventable Blindness within a Chronic Care Model

    Directory of Open Access Journals (Sweden)

    Lisa Crossland

    2016-01-01

    Full Text Available Introduction. Diabetic retinopathy (DR is the leading cause of preventable blindness in Australia. Up to 50% of people with proliferative DR who do not receive timely treatment will become legally blind within five years. Innovative and accessible screening, involving a variety of primary care providers, will become increasingly important if patients with diabetes are to receive optimal eye care. Method. An open controlled trial design was used. Five intervention practices in urban, regional, and rural Australia partnered with ophthalmologists via telehealth undertook DR screening and monitoring of type 2 diabetes patients and were compared with control practices undertaking usual care 2011–2014. Results. Recorded screening rates were 100% across intervention practices, compared with 22–53% in control practices. 31/577 (5% of patients in the control practices were diagnosed with mild-moderate DR, of whom 9 (29% had appropriate follow-up recorded. This was compared with 39/447 (9% of patients in the intervention group, of whom 37 (95% had appropriate follow-up recorded. Discussion and Conclusion. General practice-based DR screening via Annual Cycle of Care arrangements is effective across differing practice locations. It offers improved recording of screening outcomes for Australians with type 2 diabetes and better follow-up of those with screen abnormalities.

  18. Awareness of diabetic retinopathy amongst diabetic patients at the murtala mohammed hospital, Kano, Nigeria

    Directory of Open Access Journals (Sweden)

    I Mohammed

    2009-01-01

    Full Text Available Background:Blindness from diabetic retinopathy is a preventable complication of diabetes if the retinopathy is detected early. Among other approaches, strong awareness of retinopathy by diabetic patients could help in the early detection, management and prevention of this complication. This study sets out to determine the general awareness of diabetic retinopathy amongst diabetic patients attending the outpatient diabetes clinic of the Murtala Muhammad hospital, Kano. This is the central reference general hospital within the ancient and historic walls of the traditional city of Kano. The hospital has an eye unit but with a paucity of manpower and equipment. Most diabetic patients often on self-referral usually present to the eye clinic only when they experience a marked reduction in vision. In the case of diabetic retinopathy, this is unfortunately late for any meaningful intervention. Although primary diabetic caregivers are usually aware of the possibility of eye complications from diabetes, they tend to wait until patients make visual complaints before screening them or inviting eye care personnel to join in the management. Diabetic retinopathy screening protocols are in most cases either not available, or not strictly followed. Patient awareness of diabetic retinopathy and its associated risk factors should aid compliance with risk control measures, and help drive patient demand for retinopathy screening. Method:This is a cross sectional study conducted using an interviewer-administered questionnaire. All consenting adult patients seen at the diabetes clinic over a one-month period were recruited for the study. Results:A total of 185 patients were involved with a mean age of 55.4 years. The majority of the patients (78.4% had no formal western education and were mainly traders, farmers or housewives. 84.3% of the patients were generally aware of diabetic retinopathy with their main source of information being hospital staff and fellow

  19. Retinopathy in a diabetic population

    National Research Council Canada - National Science Library

    Shrestha, S; Malla, O K; Karki, D B; Byanju, R N

    2007-01-01

    The study was conducted with the aim to find out the prevalence of diabetic retinopathy among diabetics on treatment, to find out the presence of associated risk factors and to determine the knowledge...

  20. DIAGNOSIS OF DIABETIC RETINOPATHY USING MACHINE LEARNING TECHNIQUES

    Directory of Open Access Journals (Sweden)

    R. Priya

    2013-07-01

    Full Text Available Diabetic retinopathy (DR is an eye disease caused by the complication of diabetes and we should detect it early for effective treatment. As diabetes progresses, the vision of a patient may start to deteriorate and lead to diabetic retinopathy. As a result, two groups were identified, namely non-proliferative diabetic retinopathy (NPDR and proliferative diabetic retinopathy (PDR. In this paper, to diagnose diabetic retinopathy, three models like Probabilistic Neural network (PNN, Bayesian Classification and Support vector machine (SVM are described and their performances are compared. The amount of the disease spread in the retina can be identified by extracting the features of the retina. The features like blood vessels, haemmoraghes of NPDR image and exudates of PDR image are extracted from the raw images using the image processing techniques and fed to the classifier for classification. A total of 350 fundus images were used, out of which 100 were used for training and 250 images were used for testing. Experimental results show that PNN has an accuracy of 89.6 % Bayes Classifier has an accuracy of 94.4% and SVM has an accuracy of 97.6%. This infers that the SVM model outperforms all other models. Also our system is also run on 130 images available from “DIARETDB0: Evaluation Database and Methodology for Diabetic Retinopathy” and the results show that PNN has an accuracy of 87.69% Bayes Classifier has an accuracy of 90.76% and SVM has an accuracy of 95.38%.

  1. Regression of retinopathy by squalamine in a mouse model.

    Science.gov (United States)

    Higgins, Rosemary D; Yan, Yun; Geng, Yixun; Zasloff, Michael; Williams, Jon I

    2004-07-01

    The goal of this study was to determine whether an antiangiogenic agent, squalamine, given late during the evolution of oxygen-induced retinopathy (OIR) in the mouse, could improve retinal neovascularization. OIR was induced in neonatal C57BL6 mice and the neonates were treated s.c. with squalamine doses begun at various times after OIR induction. A system of retinal whole mounts and assessment of neovascular nuclei extending beyond the inner limiting membrane from animals reared under room air or OIR conditions and killed periodically from d 12 to 21 were used to assess retinopathy in squalamine-treated and untreated animals. OIR evolved after 75% oxygen exposure in neonatal mice with florid retinal neovascularization developing by d 14. Squalamine (single dose, 25 mg/kg s.c.) given on d 15 or 16, but not d 17, substantially improved retinal neovascularization in the mouse model of OIR. There was improvement seen in the degree of blood vessel tuft formation, blood vessel tortuosity, and central vasoconstriction with squalamine treatment at d 15 or 16. Single-dose squalamine at d 12 was effective at reducing subsequent development of retinal neovascularization at doses as low as 1 mg/kg. Squalamine is a very active inhibitor of OIR in mouse neonates at doses as low as 1 mg/kg given once. Further, squalamine given late in the course of OIR improves retinopathy by inducing regression of retinal neovessels and abrogating invasion of new vessels beyond the inner-limiting membrane of the retina.

  2. Correlation between Cystatin C and retinopathy of type-two diabetes mellitus patients.

    Science.gov (United States)

    Qian, C; Wan, G M; Yan, P S; Wang, W Z; Liang, S Z; Dong, Y

    2017-01-01

    Diabetic retinopathy is one of most common diabetic microvascular complications. In recent years the incidence of the disease has increased, hence early diagnosis and treatment are of great importance. In order to find reliable biological indexes to diagnose and treat type-two diabetes mellitus promptly, this study focused on the correlation between Cystatin C (Cys C) and retinopathy of type-two diabetes mellitus patients. One hundred and eighty type-two diabetes mellitus patients and one hundred healthy controls (the control group) were chosen in this study. Of the patients ninety-eight patients had typetwo diabetes mellitus without retinopathy (non-diabetic retinopathy group) and eighty-two had typetwo diabetes mellitus with retinopathy (diabetic retinopathy group). Correlation of Cys C and typetwo diabetic retinopathy was analyzed by examining the waist-hip ratio, fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c), and Cys C of both groups. The results showed that FBG, TC, TG, LDL-C, HbA1c, Cys C in the type-two diabetes mellitus patients group were higher than those of the control group (P less than 0.05). Age, course of diabetes, FBG, HbA1c, and Cys C levels were statistically significant in both the DR group and NDR group (P less than 0.05). The result of logistic regression analysis indicates that there was a positive correlation between type-two diabetic retinopathy development and age, course of diabetes, and Cys C level (P less than 0.05). Thus, it can be seen that changes of Cys C levels can assist early diagnosis and treatment of diabetic retinopathy to some extent. The patients with high Cys C level, long course of diabetes, and old age are more likely to have diabetic retinopathy.

  3. Micronutrients and Diabetic Retinopathy A Systematic Review

    NARCIS (Netherlands)

    Lee, Chee-Tin Christine; Gayton, Emma L.; Beulens, Joline W. J.; Flanagan, Declan W.; Adler, Amanda I.

    Background: We have evaluated the evidence for the association between intake and blood levels of micronutrients and diabetic retinopathy. Treatment for diabetic retinopathy requires significant clinical input and specialist ophthalmologic care. Micronutrients, including vitamin C, vitamin E, and

  4. Micronutrients and Diabetic Retinopathy A Systematic Review

    NARCIS (Netherlands)

    Lee, Chee-Tin Christine; Gayton, Emma L.; Beulens, Joline W. J.; Flanagan, Declan W.; Adler, Amanda I.

    2010-01-01

    Background: We have evaluated the evidence for the association between intake and blood levels of micronutrients and diabetic retinopathy. Treatment for diabetic retinopathy requires significant clinical input and specialist ophthalmologic care. Micronutrients, including vitamin C, vitamin E, and ma

  5. [Patophysiology of diabetic retinopathy].

    Science.gov (United States)

    Kolár, P

    2013-03-01

    Diabetic retinopathy (DR) is the affection of the retina in patients with diabetes mellitus (DM). The basic causative factor is prolonged hyperglycaemia. DR is microangiopathy, ie impairment of retinal capillaries. Pathophysiology of DR is very complex and there are involved in many factors. The first and most fundamental factor is the failure blood-retinal barrier (BRB). The major mechanism causing malfunction of BRB are advanced glycation end-products (AGE). In the failure of the inner BRB are involved losses of endothelial cells in capillaries, together with the losses of pericytes. A very important role in the failure of BRB plays too increased adhesivity of leukocytes. Further important role play also AGE and their receptor RAGE. They stimulate cascade of pathological processes damaging BRB. The second important factors in the pathophysiology of DR are vasoactive factors. The most important is vascular endothelial growth factor (VEGF), further than protein kinase C (PKC), histamine, angiotensin II, matrix metaloproteinases. The third important factor in the pathophysiology of DR is the vitreoretinal interface. There plays important role detachment of posterior vitreous, cortical vitreous, internal limiting membrane.

  6. Local retinal sensitivity in relation to specific retinopathy lesions in diabetic macular oedema

    DEFF Research Database (Denmark)

    Soliman, Wael; Hasler, Pascal; Sander, Birgit;

    2012-01-01

    with nonproliferative diabetic retinopathy and recently diagnosed untreated DMO. Investigations included microperimetry, fluorescein angiography, colour fundus photography, and OCT. All measures and gradings were made for each of the nine fields of an early treatment diabetic retinopathy study macula template......Purpose: To study microperimetric macular sensitivity in diabetic macular oedema (DMO) in relation to lesion characteristics obtained by optical coherence tomography (OCT), colour fundus photography, and fluorescein angiography (FA). Methods: The study comprised 20 eyes in 15 patients...

  7. Diabetic Retinopathy in Nnewi, Nigeria.

    African Journals Online (AJOL)

    Diabetics should be educated on the ocular complications of the disease. Since laser and ... Blindness was defined as visual acuity less than 3/60 while acuity greater .... retinopathy will run its full natural history as seen in the present study:.

  8. Relationship between retinopathy and cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Colakoglu Onder; Taskiran Bengur; Dayi Selcuk; Sozmen Bulent; Unsal Belkis; Maden Ahmet; Pasa Eser; Aslan S. Leyla

    2005-01-01

    AIM: To evaluate ophthalmic disorders with special attention to retinopathy in cirrhotic patients. Vitamin A deficiency-related ophthalmopathy, xerophthalmia, and color blindness may be documented in cirrhosis due to various etiologies. Retinopathy is an obscure feature of cirrhosis. METHODS: Thirty-two cirrhotic patients, who were followed up by Clinics of Gastroenterology, Izmir Ataturk Teaching and Research Hospital, were enrolled to the study. Associated systemic diseases such as diabetes mellitus and hypertension were excluded. Thirty-two healthy volunteers took part as the control subjects. All participants had ophthalmologic examination in the same hospital. RESULTS: Five (15.6%) of the cirrhotic subjects had soft exudate in the retina. None of the control subjects had retinopathy (P<0.05). Intraocular pressure (IOP) measured for both eyes were also significantly lower in the cirrhotics (P<0.05 vs P = 0.01). There were no statistically significant differences between the two groups in terms of other ophthalmic pathologies. The ophthalmic findings did not show up any differences according to the etiology of cirrhosis. CONCLUSION: Soft exudates may develop in cirrhotic patients probably due to loss of synthetic function of liver and hemodynamic effects of portal hypertension. Retinopathy must be sought in cirrhosis because of its severe morbidity.

  9. DISCOVERING ABNORMAL PATCHES AND TRANSFORMATIONS OF DIABETICS RETINOPATHY IN BIG FUNDUS COLLECTIONS

    Directory of Open Access Journals (Sweden)

    Yuqian ZHOU

    2017-01-01

    Full Text Available Diabetic retinopathy (DR is one of the retinal diseases due to long-term effect of diabetes. Early detection for diabetic retinopathy is crucial since timely treatment can prevent progressive loss of vision. The most common diagnosis technique of diabetic retinopathy is to screen abnormalities through retinal fundus images by clinicians. However, limited number of well-trained clinicians increase the possibilities of misdiagnosing. In this work, we propose a big-data-driven automatic computer-aided diagnosing (CAD system for diabetic retinopathy severity regression based on transfer learning, which starts from a deep convolutional neural network pre-trained on generic images, and adapts it to large-scale DR datasets. From images in the training set, we also automatically segment the abnormal patches with an occlusion test, and model the transformations and deterioration process of DR. Our results can be widely used for fast diagnosis of DR, medical education and public-level healthcare propagation.

  10. Acute eclipse retinopathy: a small case series.

    Science.gov (United States)

    Khatib, Nur; Knyazer, Boris; Lifshitz, Tova; Levy, Jaime

    2014-01-01

    We present four young patients with acute severe solar retinopathy after observation of the total eclipse on January 4, 2011 without appropriate eye protection. Funduscopic findings were accompanied by optical coherence tomography (OCT) investigation of the macula. All our patients were young (range 14-29 years). In three of the four patients we have been able to repeat OCT evaluation revealing that the retinal changes were reversible, but delineating mild pathology in the retinal pigment epithelium and photoreceptors. Best-corrected visual acuity in the fourth case was 6/24. In addition, macular edema, which has been previously described in literature, could not be demonstrated by OCT. In the two cases we performed an early fluorescein angiogram, no pathology was seen.

  11. Effect of doxycycline vs placebo on retinal function and diabetic retinopathy progression in patients with severe nonproliferative or non-high-risk proliferative diabetic retinopathy

    DEFF Research Database (Denmark)

    Scott, Ingrid U; Jackson, Gregory R; Quillen, David A

    2014-01-01

    : We conducted a randomized, double-masked, 24-month proof-of-concept clinical trial. Thirty patients (from hospital-based retina practices) with 1 or more eyes with severe NPDR or PDR less than Early Treatment Diabetic Retinopathy Study-defined high-risk PDR. INTERVENTIONS: Patients were randomized......IMPORTANCE: Inflammation may contribute to the pathogenesis of diabetic retinopathy (DR). OBJECTIVES: To investigate, in a proof-of-concept clinical trial, whether low-dose oral doxycycline monohydrate can (1) slow the deterioration of, or improve, retinal function or (2) induce regression or slow...... adaptation, visual acuity, and quality of life) and anatomic factors (Early Treatment Diabetic Retinopathy Study DR severity level, area of retinal thickening, central macular thickness, macular volume, and retinal vessel diameters). RESULTS: From baseline to month 24, mean FDP foveal sensitivity decreased...

  12. Nanotechnology and Nanotoxicology in Retinopathy

    Directory of Open Access Journals (Sweden)

    Tae Geol Lee

    2011-11-01

    Full Text Available Nanoparticles are nanometer-scaled particles, and can be utilized in the form of nanocapsules, nanoconjugates, or nanoparticles themselves for the treatment of retinopathy, including angiogensis-related blindness, retinal degeneration, and uveitis. They are thought to improve the bioavailability in the retina and the permeability of therapeutic molecules across the barriers of the eye, such as the cornea, conjunctiva, and especially, blood-retinal barriers (BRBs. However, consisting of multiple neuronal cells, the retina can be the target of neuronal toxicity of nanoparticles, in common with the central and peripheral nervous system. Furthermore, the ability of nanoparticles to pass through the BRBs might increase the possibility of toxicity, simultaneously promoting distribution in the retinal layers. In this regard, we discussed nanotechnology and nanotoxicology in the treatment of retinopathy.

  13. Solar Retinopathy: A Multimodal Analysis

    Directory of Open Access Journals (Sweden)

    Claudia Bruè

    2013-01-01

    Full Text Available Purpose. Solar retinopathy is a rare clinical disturbance, for which spectral-domain optical coherence tomography (SD-OCT findings are not always consistent. We report on two cases of solar retinopathy and discuss its differential diagnosis. Methods. This is an observational case study. Results. A 12-year-old female was referred to ophthalmology for bilateral scotoma. Visual acuity was 20/50 in both eyes. Fundus examination was unremarkable, except for slight yellowish material in the central macula, bilaterally. SD-OCT revealed juxtafoveal microcystic cavities in the outer retina, interruption of the external limiting membrane and the inner and outer segment junctions, with disorganized material in the vitelliform space. Fundus autofluorescence showed hypoautofluorescence surrounded by a relatively hyperautofluorescent ring, bilaterally. Similar clinical and morphological findings were detected in a 27-year-old male. Conclusions. Solar retinopathy has a subtle presentation and patients often deny sun-gazing. SD-OCT and fundus autofluorescence are noninvasive and useful tools for its diagnosis.

  14. Using a patient image archive to diagnose retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Tobin Jr, Kenneth William [ORNL; Abramoff, M.D. [University of Iowa; Chaum, Edward [University of Tennessee, Knoxville (UTK); Giancardo, Luca [ORNL; Govindaswamy, Priya [Oak Ridge National Laboratory (ORNL); Karnowski, Thomas Paul [ORNL; Tennant, M [University of Alberta; Swainson, Stephen [University of Alberta

    2008-01-01

    Diabetes has become an epidemic that is expected to impact 365 million people worldwide by 2025. Consequently, diabetic retinopathy is the leading cause of blindness in the industrialized world today. If detected early, treatments can preserve vision and significantly reduce debilitating blindness. Through this research we are developing and testing a method for automating the diagnosis of retinopathy in a screening environment using a patient archive and digital fundus imagery. We present an overview of our content-based image retrieval (CBIR) approach and provide performance results for a dataset of 98 images from a study in Canada when compared to an archive of 1,355 patients from a study in the Netherlands. An aggregate performance of 89% correct diagnosis is achieved, demonstrating the potential of automated, web-based diagnosis for a broad range of imagery collected under different conditions and with different cameras.

  15. Frequency and Clinical Characteristics of Hydroxychloroquine Retinopathy in Korean Patients with Rheumatologic Diseases

    Science.gov (United States)

    2017-01-01

    This study aimed to evaluate the frequency and clinical characteristics of hydroxychloroquine (HCQ) retinopathy in Korean patients with rheumatologic diseases. We retrospectively reviewed medical records of 310 patients taking HCQ. Ophthalmic examinations included spectral-domain optical coherence tomography (SD-OCT), automated visual field test, and fundus autofluorescence. The severity of retinopathy was categorized as early, moderate, or severe, and the location was categorized as parafoveal, pericentral, or mixed pattern. Among 310 patients, 9 patients (2.9%) were diagnosed as HCQ retinopathy. Among the patients with HCQ use ≥ 5 years (n = 174), the frequency was 5.2%. Only 1 (11.1%) of the 9 patients was symptomatic. The mean daily dose per kilogram of real body weight of the 9 patients was 5.6 mg, and only 3 had used 6.5 mg or more. Four of the 9 patients had severe HCQ retinopathy. Six of the 9 patients showed pericentral or mixed pattern of retinal damage. Consequently, the frequency of HCQ retinopathy in Korean patients was not low, especially when administered at a high cumulative dose and for a long duration. Screening of HCQ retinopathy by the recommended guidelines that include SD-OCT seems useful and should be done to detect retinal damage earlier in patients with chronic exposure to HCQ. PMID:28145658

  16. Corneal confocal microscopy detects neuropathy in patients with type 1 diabetes without retinopathy or microalbuminuria.

    Directory of Open Access Journals (Sweden)

    Ioannis N Petropoulos

    Full Text Available Corneal innervation is increasingly used as a surrogate marker of human diabetic peripheral neuropathy (DPN however its temporal relationship with the other microvascular complications of diabetes is not fully established. In this cross-sectional, observational study we aimed to assess whether neuropathy occurred in patients with type 1 diabetes, without retinopathy or microalbuminuria.All participants underwent detailed assessment of peripheral neuropathy [neuropathy disability score (NDS, vibration perception threshold (VPT, peroneal motor nerve conduction velocity (PMNCV, sural sensory nerve conduction velocity (SSNCV and in vivo corneal confocal microscopy (IVCCM], retinopathy (digital fundus photography and albuminuria status [albumin: creatinine ratio (ACR].53 patients with Type 1 diabetes with (n=37 and without retinopathy (n=16 were compared to control subjects (n=27. SSNCV, corneal nerve fibre (CNFD and branch (CNBD density and length (CNFL were reduced significantly (p<0.001 in diabetic patients without retinopathy compared to control subjects. Furthermore, CNFD, CNBD and CNFL were also significantly (p<0.001 reduced in diabetic patients without microalbuminuria (n=39, compared to control subjects. Greater neuropathic severity was associated with established retinopathy and microalbuminuria.IVCCM detects early small fibre damage in the absence of retinopathy or microalbuminuria in patients with Type 1 diabetes.

  17. 维生素E联合三七治疗早期糖尿病视网膜病变的临床观察%Clinical Observation on Vitamin E Capsule and SanQi in Treating Early Diabetic Retinopathy

    Institute of Scientific and Technical Information of China (English)

    邓洪; 谢青; 郑云燕; 王庆开

    2014-01-01

    Objective:To observe clinical effects of Vitamin E capsule and SanQi (Panax pseudo-ginseng) powder in treating early diabetic retinopathy (DR). Methods:Ninety patients (including 179 eyes) were randomized into three groups. 30 cases of the treatment group (60 eyes), who took Vitamin E capsule and SanQi powder;30 cas-es of the control group (60 eyes), who were administered with calcium dobesilate dispersible tablets;and 30 cases of routine treatment group (59 eyes). All the patients were treated for 120 days. Fundus examination, fluorescence fun-dus angiography, the examinations of sight and visual field of the patients were preformed before and after treating;at the same time, the functions of liver and kidney, blood rheology and others were detected. Results:Microvascular disease of the fundus and blood viscosity in both groups were improved, fundus edema and microaneurysm were re-lieved, the difference was significant when the treatment group was compared with the control group (P<0.05). Conclusion:Vitamin E capsule and SanQi powder could improve the state of ischemia and hypoxia in the patients with early DR, promote the absorption of retinal edema and microaneurysm and delay the loss of vision.%目的:观察维生素E胶囊联合三七粉治疗早期糖尿病视网膜病变的临床疗效。方法:将90例(179只眼)早期糖尿病视网膜病变患者随机分为3组。治疗组30例(60只眼),口服维生素E胶丸加三七粉;对照组30例(60只眼),口服羟苯磺酸钙分散片;常规治疗组30例(59只眼),仅对基础疾病进行治疗。用药时间120天。治疗前后对所有患者进行眼底检查及荧光素眼底血管造影、视力、视野检查,同时检测肝肾功能、血液流变学等指标。结果:治疗组和对照组的眼底微血管病变和血液黏度均得到一定程度的改善,眼底水肿减退,微血管瘤减少,与常规治疗组比较差异显著(P<0.05)。结论:维生素E加三

  18. Micronutrients and diabetic retinopathy a systematic review.

    Science.gov (United States)

    Lee, Chee-Tin Christine; Gayton, Emma L; Beulens, Joline W J; Flanagan, Declan W; Adler, Amanda I

    2010-01-01

    We have evaluated the evidence for the association between intake and blood levels of micronutrients and diabetic retinopathy. Treatment for diabetic retinopathy requires significant clinical input and specialist ophthalmologic care. Micronutrients, including vitamin C, vitamin E, and magnesium, may interfere with pathologic mechanisms of diabetic retinopathy and potentially alter its risk. We conducted a search of epidemiologic literature in PubMed and Embase from 1988 to May 2008, using keywords for exposures, including magnesium, ascorbic acid, alpha-tocopherol and antioxidants, and outcomes, including diabetic retinopathy. Two authors independently extracted data and assessed the quality of the studies using the Newcastle-Ottawa Scale. The overall quality of evidence was graded as I (highest), II, or III (lowest). Of the 766 studies identified, we reviewed 15 studies, comprising 4094 individuals. For vitamin C, hospital-based studies reported an inverse association between plasma levels with retinopathy, whereas population-based studies showed no association between dietary intake and retinopathy. For vitamin E, there was no association with dietary intake or plasma levels and retinopathy. For magnesium, a single prospective analysis showed an association between low levels in plasma and progression of retinopathy, but cross-sectional studies reported inconsistent results. In the assessment of quality, population-based studies had higher ratings than hospital-based studies. The evidence suggests that dietary intake or plasma levels of vitamins C and E and magnesium do not seem to be associated with diabetic retinopathy. Because of differences in study designs and measurement of micronutrients, incomplete ascertainment of retinopathy, and residual confounding, these findings require confirmation. The authors have no proprietary or commercial interest in any of the materials discussed in this article. Copyright 2010 American Academy of Ophthalmology. Published by

  19. Global prevalence and major risk factors of diabetic retinopathy

    DEFF Research Database (Denmark)

    Yau, Joanne W Y; Rogers, Sophie L; Kawasaki, Ryo;

    2012-01-01

    To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes.......To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes....

  20. Pharmacologic therapies for diabetic retinopathy and diabetic macular edema.

    Science.gov (United States)

    Rechtman, Ehud; Harris, Alon; Garzozi, Hanna J; Ciulla, Thomas A

    2007-12-01

    Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of blindness in the working-aged population of most developed countries. The increasing number of persons with diabetes worldwide suggests that DR/DME will continue to be major contributors to vision loss and associated functional impairment for years to come. Early detection of retinopathy in persons with diabetes is critical in preventing visual loss, but current methods of screening fail to identify a sizable number of high-risk patients. The control of diabetes-associated metabolic abnormalities (ie, hyperglycemia, hyperlipidemia, and hypertension) is also important in preserving visual function, as these conditions have been identified as risk factors for both the development and progression of DR/DME. The non-pharmacologic interventions for DR/DME, laser photocoagulation and vitrectomy, only target advanced stages of disease. Several biochemical mechanisms, including increased vascular endothelial growth factor production, protein kinase C beta activation, oxidative stress, and accumulation of intracellular sorbitol and advanced glycosylation end products, may contribute to the vascular disruptions that characterize DR/DME. The inhibition of these pathways holds the promise of the intervention for diabetic retinopathy with higher success rate and also at earlier, non-sight-threatening stages.

  1. Automatic Exudate Detection from Non-dilated Diabetic Retinopathy Retinal Images Using Fuzzy C-means Clustering

    OpenAIRE

    Akara Sopharak; Sarah Barman; Bunyarit Uyyanonvara

    2009-01-01

    Exudates are the primary sign of Diabetic Retinopathy. Early detection can potentially reduce the risk of blindness. An automatic method to detect exudates from low-contrast digital images of retinopathy patients with non-dilated pupils using a Fuzzy C-Means (FCM) clustering is proposed. Contrast enhancement preprocessing is applied before four features, namely intensity, standard deviation on intensity, hue and a number of edge pixels, are extracted to supply as input parameters to coarse se...

  2. Prevalence of and risk factors for diabetic retinopathy among the patients with diabetes mellitus in Dharan municipality, Nepal

    Directory of Open Access Journals (Sweden)

    Shailesh Mani Pokharel

    2015-09-01

    Full Text Available Background & Objectives: The individuals with diabetes have 29 times higher chance of becoming blind due to diabetic retinopathy than non-diabetic of similar age and gender. The knowledge on the factors for it can help detect the disease in its early course. The study was conducted with objectives to study the prevalence of diabetic retinopathy and its risk factors in a diabetic population.Materials and Methods: A community based cross-sectional study that involved 418 subjects with type 2 diabetes, living in the Dharan municipality of Nepal was carried out using convenient sampling method.Results: The prevalence of diabetic retinopathy was 38.8%. Prevalence of mild, moderate, severe and very severe non-proliferative diabetic retinopathy was 9.1%, 16.3%, 6.2% and 17.2% respectively. Prevalence of proliferative diabetic retinopathy and clinically significant macular edema was 3.8% and 1.9% respectively. Among the risk factors studied age, hypoglycemic drug intake, family history and duration of diabetes mellitus had a significant association with the occurrence of diabetic retinopathy (p<0.05.Conclusions: The prevalence of diabetic retinopathy in patients with diabetes mellitus was 38.8% and increase risk factors for it are age, hypoglycemic drug intake, family history of diabetes, duration of diabetes.JCMS Nepal. 2015;11(1: 17-21

  3. Visual impairment and blindness in type 2 diabetics: Ife-Ijesa diabetic retinopathy study.

    Science.gov (United States)

    Onakpoya, O H; Kolawole, B A; Adeoye, A O; Adegbehingbe, B O; Laoye, O

    2016-08-01

    Diabetes and blindness are important health issues globally; we determined the prevalence of blindness, diabetic retinopathy, and other eye diseases in Nigerian-type 2 diabetics. A prospective, cross-sectional study was conducted on consenting type 2 diabetic patients who had scheduled comprehensive eye examination including dilated funduscopy with +78DS. Visual status was graded using the WHO criteria. Approval from Institutional Ethics Committee was obtained. Primary outcome measures were the prevalence and causes of blindness as well as prevalence of diabetic retinopathy. Secondary outcome measures were the presence of other eye diseases. Data were analyzed using SPSS version 13. Two hundred and sixty-six eyes of 133 type 2 diabetic patients aged 22-89 years were studied; 69 (51.9 %) were males while 64 (48.1 %) were females. Five (3.8 %) patients were blind while 27 (20.3 %) were visually impaired. Cataract was the leading cause of blindness (60 %) and visual impairment was found in 59.3 %. Diabetic retinopathy was present in 37 (27.8 %) diabetic patients of which 5 (3.8 %) were proliferative. Diabetic macular edema was present in 31 (23.3 %) patients. Severe visual impairment and blindness were commoner in those with diabetic retinopathy. Refractive error 67 (25.2 %), cataract 63 (23.7 %), and chronic glaucoma 44 (16.5 %) were the most prevalent non-diabetic retinopathy eye diseases. High prevalence of blindness, diabetic retinopathy, and other diseases are seen in type 2 diabetics. Health education, early diagnosis as well as treatment of diabetic retinopathy and other diseases will largely alleviate these ocular morbidities.

  4. Prevention effects of 17β-estradiol on retinopathy of prematurity in animal models

    Directory of Open Access Journals (Sweden)

    Hai-Yan Fan

    2014-05-01

    Full Text Available AIM:To explore the effects and mechanisms of 17β-estradiol on retinopathy of prematurity in rats. METHODS: Eighty 7-day-old SD rats were randomly divided into normol group, high oxygen group, 17β-estradiol treatment group and vegetable oil treatment group. Rats of the high oxygen group were put into the environment exposed to 75% oxygen for 5d and backed to room air for another 5d to establish the oxygen-induced retinopathy model. The treatment group was given 17β-estradiol by injection with the dose of 0.5uL/rat/d(2μg/μLbefore exposed to 75% oxygen. The vegetable oil treatment group is similar to 17β-estradiol treatment group but the medicine changed to vegetable oil. Counting the endotheliocyte nuclei of new vessels which extended from retina to vitreous body in the tissue-slice of HE staining, and investigate the change of retinal blood vessels by using methods of retina flat-mount. The expression of VEGF in retina by immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCRanalysis. RESULTS: Rats treated with E2 showed less neovascularization than high oxygen group and oxygen-exposed rats treated with vegetable oil(PCONCLUSION:17β-estradiol has prevention effects in retinal neovascularization and the mechanism may involve in its interaction with VEGF.

  5. Oxidative stress in diabetic patients with retinopathy

    African Journals Online (AJOL)

    blood sugar (FBS) in diabetic patients with and without retinopathy. Materials and Methods: The .... to DNA may induce cell death or mutation that could give rise, several ..... from the peroxidative damage of the membrane lipids. Jennings et al.

  6. [Proliferative diabetic retinopathy -- therapeutic approach (clinical case)].

    Science.gov (United States)

    Burcea, M; Muşat, Ovidiu; Mahdi, Labib; Gheorghe, Andreea; Spulbar, F; Gobej, I

    2014-01-01

    We present the case of a 54 year old pacient diagnosed with neglected insulin dependent diabetes and proliferative diabetic retinopathy. Surgery was recommended and we practiced posterior vitrectomy, endolaser and heavy silicone oil endotamponade. Post-operative evolution was favorable.

  7. Paraneoplastic retinopathy associated with retroperitoneal liposarcoma

    Directory of Open Access Journals (Sweden)

    Mineo Kondo

    2010-03-01

    Full Text Available Mineo Kondo1, Kumiko Mokuno2, Ai Uemura1, Shu Kachi1, Makoto Nakamura1, Atsuya Kondo3, Hiroko Terasaki11Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan; 2Department of Ophthalmology, 3Department of Urology, Kariya Toyota General Hospital Kariya, JapanAbstract: We report a case of paraneoplastic retinopathy associated with a retroperitoneal liposarcoma. A 42-year-old man was referred to our hospital with complaints of night blindness and blurred vision in the peripheral field. Electroretinograms showed a progressive amplitude reduction in his both eyes. Abdominal magnetic resonance imaging showed a large retroperitoneal mass, and pathologic examination revealed a dedifferentiated liposarcoma. Western blot analysis showed an antiretinal antibody in the serum of our patient, and his serum reacted with the photoreceptors of a bovine retina. To the best of our knowledge, this is the first case of paraneoplastic retinopathy associated with a liposarcoma.Keywords: paraneoplastic retinopathy, retroperitneal liposarcoma, electroretinogram, cancerassociated retinopathy

  8. Differential TGF-beta Signaling in Retinal Vascular Cells: A Role in Diabetic Retinopathy?

    NARCIS (Netherlands)

    R.J. van der Geest; I. Klaassen; I.M.C. Vogels; C.J.F. van Noorden; R.O. Schlingemann

    2010-01-01

    PURPOSE. An early hallmark of preclinical diabetic retinopathy is thickening of the capillary basal lamina (BL). TGF-beta, a multipotent cytokine acting through its receptors ALK5 and -1, has been postulated to be involved in this phenomenon. In light of this possible role, TGF-beta signaling and it

  9. Radiation retinopathy secondary to treatment of maxillary sinus carcinoma: a dramatic case.

    Science.gov (United States)

    Galindo-Bocero, J; Macías-Franco, S; Sánchez-García, S; Fonollá-Gil, M; García-Alonso, A

    2017-10-01

    A 53-year old male presented with visual impairment in right eye after irradiation of right maxillary sinus carcinoma. Funduscopy shows radiation retinopathy: haemorrhages, exudates, macular oedema, and peripheral retinal ischaemia. A poor outcome was achieved despite laser treatment and intravitreal injections of bevacizumab, resulting in evisceration of the affected eye. Radiation retinopathy must be considered in any loss of vision after head and neck irradiation. Ophthalmological long-term follow-up of these patients is essential for an early diagnosis. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Diabetic retinopathy (DR: everybody's business

    Directory of Open Access Journals (Sweden)

    David Yorston

    2011-09-01

    Full Text Available Diabetes is on the increase worldwide, due mainly to the rise in the number of people with type 2 diabetes. Type 2 diabetes is becoming more common because:* People are living longer, and diabetes is more prevalent in older people.* As people increasingly migrate to urban areas, exercise less, eat more, and eat less healthy food, more people are becoming obese – a primary cause of type 2 diabetes.Diabetes increases the risk of a range of eye diseases, including cataract, but the main cause of blindness associated with diabetes is diabetic retinopathy (DR. DR usually develops between ten and twenty years after the onset of diabetes, and develops faster when diabetes is undiagnosed and untreated.People with DR whose sight is at risk can be treated, most commonly with laser, to prevent visual impairment and blindness. Sadly, there is no treatment that can restore vision that has already been lost.

  11. PACAP Is Protective in a Rat Model of Retinopathy of Prematurity.

    Science.gov (United States)

    Kvarik, Timea; Mammel, Barbara; Reglodi, Dora; Kovacs, Krisztina; Werling, Dora; Bede, Brigitta; Vaczy, Alexandra; Fabian, Eszter; Toth, Gabor; Kiss, Peter; Tamas, Andrea; Ertl, Tibor; Gyarmati, Judit; Atlasz, Tamas

    2016-10-01

    The oxygen-induced retinopathy (OIR) is a well-established rodent model of retinopathy of prematurity (ROP), which is one of the most common causes of childhood visual impairment affecting preterm babies. Pituitary adenylate cyclase-activating polypeptide (PACAP) is known to have neuroprotective effects. Several studies have revealed the presence of PACAP and its receptors in the retina and reported its protective effects in ischemic and diabetic retinopathy. In this study, we investigated whether PACAP administration can influence the vascular changes in the rat OIR model. OIR was generated by placing the animals in daily alternating 10/50 oxygen concentrations from postnatal day (PD) 0 to PD14 then returned them to room air. Meanwhile, animals received PACAP or saline intraperitoneally or intravitreally from PD1 to PD8 or on PD11, PD14, and PD17, respectively. On PD19 ± 1, the retinas were isolated and the vessels were visualized by isolectin staining. The percentage of avascular to whole retinal areas and the number of branching points were measured. Change in cytokine expression was also determined. Intravitreal treatment with PACAP remarkably reduced the extent of avascular area compared to the non- and saline-treated OIR groups. Intraperitoneal PACAP injection did not influence the vascular extent. Retinal images of room-air controls did not show vascular alterations. No changes in the number of vessel branching were observed after treatments. Alterations in cytokine profile after local PACAP injection further supported the protective role of the peptide. This is the first study to examine the effects of PACAP in ROP. Although the exact mechanism is still not revealed, the present results show that PACAP treatment can ameliorate the vascular changes in the animal model of ROP.

  12. Role of endoplasmic reticulum stress in the loss of retinal ganglion cells in diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Liping Yang; Lemeng Wu; Dongmei Wang; Ying Li; Hongliang Dou; Mark OMTso; Zhizhong Ma

    2013-01-01

    Endoplasmic reticulum stress is closely involved in the early stage of diabetic retinopathy. In the present study, a streptozotocin-induced diabetic animal model was given an intraperitoneal injection of tauroursodeoxycholic acid. Results from immunofluorescent co-localization experiments showed that both caspase-12 protein and c-Jun N-terminal kinase 1 phosphorylation levels significantly in-creased, which was associated with retinal ganglion celldeath in diabetic retinas. The C/ERB ho-mologous protein pathway directly contributed to glial reactivity, and was subsequently responsible for neuronal loss and vascular abnormalities in diabetic retinopathy. Our experimental findings in-dicate that endoplasmic reticulum stress plays an important role in diabetes-induced retinal neu-ronal loss and vascular abnormalities, and that inhibiting the activation of the endoplasmic reticulum stress pathway provides effective protection against diabetic retinopathy.

  13. Antisense Oligonucleotide Therapy in Diabetic Retinopathy

    Science.gov (United States)

    Hnik, Peter; Boyer, David S.; Grillone, Lisa R.; Clement, John G.; Henry, Scott P.; Green, Ellen A.

    2009-01-01

    Diabetic retinopathy is one of the leading causes of blindness in the United States and other parts of the world. Historically, laser photocoagulation and vitrectomy surgery have been used for the treatment of diabetic retinopathy, including diabetic macular edema. Both procedures have proven to be useful under certain conditions but have their limitations. New pathways and processes that promote diabetic retinopathy have been identified, and several new therapeutic approaches are under investigation. These new therapies may be beneficial in the treatment of diabetic retinopathy and include antivascular endothelial growth factor agents, corticosteroids, and therapies that may potentially target a number of additional diabetic retinopathy-related factors and processes, including antisense oligonucleotides. Second-generation antisense oligonucleotides, such as iCo-007, may offer a significant advantage in the treatment of diabetic retinopathy by downregulating the signal pathways of multiple growth factors that seem to play a critical role in the process of ocular angiogenesis and vascular leakage. Benefits of such molecules are expected to include the specificity of the kinase target and an extended half-life, resulting in less frequent intravitreal drug administration, resistance to molecule degradation, and a good safety profile. PMID:20144342

  14. Diabetic retinopathy screening using deep neural network.

    Science.gov (United States)

    Ramachandran, Nishanthan; Chiong, Hong Sheng; Sime, Mary Jane; Wilson, Graham A

    2017-09-07

    Importance There is a burgeoning interest in the use of deep neural network in diabetic retinal screening. To determine whether a deep neural network could satisfactorily detect diabetic retinopathy that requires referral to an ophthalmologist from a local diabetic retinal screening programme and an international database. Design Retrospective audit Samples Diabetic retinal photos from Otago database photographed during October 2016 (485 photos); and 1200 photos from Messidor international database. Receiver operating characteristic curve to illustrate the ability of a deep neural network to identify referable diabetic retinopathy (moderate or worse diabetic retinopathy or exudates within one disc diameter of the fovea). Main Outcome Measures Area under the receiver operating characteristic curve, sensitivity and specificity RESULTS: For detecting referable diabetic retinopathy, the deep neural network had an area under receiver operating characteristic curve of 0.901 (95% CI, 0.807-0.995) with 84.6% sensitivity and 79.7% specificity for Otago and 0.980 (95% CI, 0.973-0.986) with 96.0% sensitivity and 90.0% specificity for Messidor. Conclusions and Relevance This study has shown that a deep neural network can detect referable diabetic retinopathy with sensitivities and specificities close to or better than 80% from both an international and a domestic (New Zealand) database. We believe that deep neural networks can be integrated into community screening once they can successfully detect both diabetic retinopathy and diabetic macular oedema. This article is protected by copyright. All rights reserved.

  15. Bevacizumab treatment reduces retinal neovascularization in a mouse model of retinopathy of prematurity

    Institute of Scientific and Technical Information of China (English)

    Fei; Feng; Yan; Cheng; Qing-Huai; Liu

    2014-01-01

    ·AIM: To evaluate the effect of different bevacizumab concentrations on retinal neovascularization in a retinopathy of prematurity(ROP) mouse model.·METHODS: A total of 60 of C57BL/6 J mice were exposed to 75% ±2% oxygen from postnatal d7 to postnatal d12. Fifteen nonexposed mice served as negative controls(group A). On d12, 30 mice(group C)were injected with 2.5 μg intravitreal bevacizumab(IVB),30 mice(group D) were injected with 1.25 μg IVB in one eye. The contralateral eyes were injected with balanced salt solution(BSS)(control group =group B). The adenosine diphosphatase(ADPase) histochemical technique was used for retinal flat mount to assess the oxygen-induced changes of retinal vessels.Neovascularization was quantified by counting the endothelial cell proliferation on the vitreal side of the inner limiting membrane of the retina. Histological changes were examined by light microscopy. The mRNA levels of vascular endothelial growth factor(VEGF) were quantified by Real-time PCR. Western-blotting analysis was performed to examine the expression of P-VEGFR.· RESULTS: Comparing with the control group B,regular distributions and reduced tortuosity of vessels were observed in our retinal flat mounts in groups C and D. The endothelial cell count per histological section was lower in groups C(P <0.0001) and D(P <0.0001) compared with the control group B. Histological evaluation showed no retinal toxicity in any group. In all oxygen treated groups VEGF mRNA expression was significantly increased as compared to age-matched controls. No significant change in VEGF mRNA expression could be achieved in either of the treatments or the oxygen controls. The results of the Western blot were consistent with that of the Real-time PCR analysis.·CONCLUSION: An intravitreal injection of bevacizumab is able to reduce angioproliferative retinopathy in a mouse model for oxygen-induced retinopathy.

  16. Theory of the oxygen-induced restructuring of Cu(110) and Cu(100) surfaces

    DEFF Research Database (Denmark)

    Jacobsen, Karsten Wedel; Nørskov, Jens Kehlet

    1990-01-01

    A model calculation based on the effective-medium theory of the oxygen-induced reconstruction of the (110) and (100) surfaces of Cu is presented. Equilibrium structures are calculated from a minimization of the total energy of the system. Missing-row-type reconstructions are found to be most stab...... in both cases, and an analysis is presented, showing what the driving force is behind these reconstructions....

  17. Evaluation of VEGF gene polymorphisms and proliferative diabetic retinopathy in Mexican population

    Science.gov (United States)

    Gonzalez-Salinas, Roberto; Garcia-Gutierrez, Maria C; Garcia-Aguirre, Gerardo; Morales-Canton, Virgilio; Velez-Montoya, Raul; Soberon-Ventura, Vidal R; Gonzalez, Victoria; Lechuga, Rodrigo; Garcia-Solis, Pablo; Garcia-Gutierrez, David G; Garcia-Solis, Marco Vinicio; Saenz de Viteri, Manuel; Solis-S, Juan C

    2017-01-01

    AIM To assess if the included vascular endothelial growth factor (VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mellitus (T2DM). METHODS A case-control study was conducted in adult individuals with T2DM associated to proliferative retinopathy or non-proliferative retinopathy from Oct. 2014 to Jun. 2015 from the Retina Department of the Asociation to Prevent Blindness in Mexico. The selected patients were adults with a diagnosis of T2DM ≥5y. All subjects had a comprehensive ocular examination and the classification of the retinopathy severity was made considering the Early Treatment Diabetic Retinopathy Study (ETDRS) standardization protocols. Genomic DNA was extracted from whole fresh blood. All samples were genotyped by qPCR for selected VEGF polymorphisms. Hardy-Weinberg equilibrium was calculated by comparing Chi-square values between the expected and the observed values for genotype counts. RESULTS In total 142 individuals were enrolled, 71 individuals with T2DM and associated proliferative retinopathy and 71 individuals with non-proliferative retinopathy. One-sided Fisher's exact test was performed for rs3025021 [OR (95% CI)=0.44(0.08-2.2); P=0.25] and rs2010963 [OR (95% CI)=0.63(0.25-1.6); P=0.23]. The minor allelic frequencies obtained were 26% for rs3025021, 10% for rs3025035 and 61% for rs2010963. The pairwise linkage disequilibrium between the three SNP was assessed, and was as follows: rs3025021 vs rs3025035: D'=1.0, r2=0.1043, P≤0.0001; rs3025021 vs rs2010963: D'=0.442, r2=0.0446, P=0.149; rs3025035 vs rs2010963: D'=0.505, r2=0.0214, P=0.142. CONCLUSION This is the first analysis involving VEGF polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that

  18. Automated microaneurysm detection in diabetic retinopathy using curvelet transform

    Science.gov (United States)

    Ali Shah, Syed Ayaz; Laude, Augustinus; Faye, Ibrahima; Tang, Tong Boon

    2016-10-01

    Microaneurysms (MAs) are known to be the early signs of diabetic retinopathy (DR). An automated MA detection system based on curvelet transform is proposed for color fundus image analysis. Candidates of MA were extracted in two parallel steps. In step one, blood vessels were removed from preprocessed green band image and preliminary MA candidates were selected by local thresholding technique. In step two, based on statistical features, the image background was estimated. The results from the two steps allowed us to identify preliminary MA candidates which were also present in the image foreground. A collection set of features was fed to a rule-based classifier to divide the candidates into MAs and non-MAs. The proposed system was tested with Retinopathy Online Challenge database. The automated system detected 162 MAs out of 336, thus achieved a sensitivity of 48.21% with 65 false positives per image. Counting MA is a means to measure the progression of DR. Hence, the proposed system may be deployed to monitor the progression of DR at early stage in population studies.

  19. Vitrectomy for proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Chao Peng

    2013-10-01

    Full Text Available AIM:To observe the clinical effect of vitrectomy for proliferative diabetic retinopathy(PDR.METHODS: The clinical data of 55 cases(65 eyes, underwent vitrectomy, membrane peeling, endolaser photocoagulation and silicone oil or C3F8 injection, were retrospectively studied. During 6 months to 1 year follow-up period, visual acuity, intraocular pressure, retinal conditions and complications were observed.RESULTS: All 65 eyes received vitrectomy, of which silicone oil was tamponaded in 32 eyes, C3F8 was injected in 8 eyes, BBS was filled in 25 eyes. Visual improvement achieved in 42 eyes. Two eyes were manually vision, form count fingers to 0.05 in 18 eyes, >0.05-0.1 in 28 eyes, >0.1-0.3 in 12 eyes and >0.3 in 5 eyes. Retinal hole was occurred in 7 eyes, limitations fibrosis membrane remained in 8 eyes, retinal detachment appeared in 5 eyes, IOP increased in 18 eyes, vitreous hemorrhage relapsed in 12 eyes, 36 eyes received supplemental photocoagulation treatment 1-3 times after operation.CONCLUSION:Vitrectomy combined endophotocoagulation is an effective treatment for PDR. Silicone oil tamponade can limit the hemorrhage.

  20. Study on the correlation of serum lipid metabolism and central retinal artery hemodynamics with diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Ran-Yang Guo

    2016-01-01

    Objective:To explore the correlation of serum lipid metabolism and central retinal artery (CRA) hemodynamics with diabetic retinopathy (DR).Methods:A total of 120 patients with type 2 diabetes who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and divided into NDR group (non-diabetic retinopathy), NPR group (non-proliferative retinopathy), and PR group (proliferative retinopathy) with 40 cases in each group according to DR clinical staging. Moreover, 50 healthy individuals who came for physical examinations were served as the control group. The full automatic biochemical analyzer was used to detect the levels of TG, TC, LDL-C, and HDL-C. The color Doppler flow imaging (CDFI) was used to detect EDV, PSV, RI, and PI of CRA and OA.Results:The levels of TG, TC, and LDL-C in NDG, NPR, and PR groups were gradually increased with the aggravation of retinopathy, HDL-C was reduced, the comparison among the three groups was statistically significant, and the comparison with the control group was statistically significant. EDV, PSV, and PI of CRA and OA in NDG, NPR, and PR groups were gradually increased with the aggravation of retinopathy, RI was reduced, the comparison among the three groups was statistically significant, and the comparison with the control group was statistically significant. Conclusions: The lipid metabolism disorder can promote the occurrence and development of DR. The change of CRA and OA hemodynamics is an important pathological basis for developing DR. Clinical detection of serum lipid level and monitoring of the changes of fundus artery hemocynamic parameters are of great significance in early detecting DR.

  1. Retinopathies in premature infants, incidence, risk factors, prevention and treatment

    Directory of Open Access Journals (Sweden)

    Chernenkov Yu.V.

    2014-12-01

    Full Text Available Research Objective: Analysis of incidence and accompanying states, detection of risk factors of retinopathies in premature infants (RN, dynamic monitoring and improvement of medical actions. Material and Methods: 134 children have been surveyed in the group of risk on development of RN for the last 2 years. Results: From 134 surveyed infants with gestation from 22 to 37 weeks and body weight at birth from 750 to 2500 kg. At 56 children (41,8% the retinopathy of various degree of expressiveness has been revealed. 38 children with RN of 1-2 stages (67,8% from which at 22 (39,3% —the disease ended with the induced regress after a course of «retinalamin», at 16 (28,6% of RN — spontaneous regress. 4 children (7,1% had RN 2-3 of the Art., 3-4 Art. at 12 (21,4%, and 5 Art. a cicatricial phase with retinal detachment — 2 (3,5%. In 12 cases the laser photocoagulation in the eye centers is carried out. Conclusion: The revealed relationship of cause and effect of risk factors of formation of RN with features of a current ofthe neonatal period at patients with RN, promoted development of the system of monitoring, implementation of the program of treatment and rehabilitation of prematurely born children suffering RN. Ophthalmologic screening of premature infants with the use of the ophthalmologic digital pediatric camera "Ret Cam 3" allows to diagnose a retinopathy at early stages, in due time to hold preventive an3 medical measures that allows to lower the invalidization of this group of children.

  2. Serum TNF-Alpha Level Predicts Nonproliferative Diabetic Retinopathy in Children

    Directory of Open Access Journals (Sweden)

    Katarzyna Zorena

    2007-01-01

    Full Text Available The aim of this study was identification of the immunologic markers of the damage to the eye apparatus at early stages of diabetes mellitus (DM type 1 children. One hundred and eleven children with DM type 1 were divided into two groups: those with nonproliferative diabetic retinopathy (NPDR and without retinopathy. All the children had their daily urine albumin excretion, HbA1c, C-peptide measured, 24-hour blood pressure monitoring, and ophthalmologic examination. Levels of TNF-α, IL-6, and IL-12 in serum were measured by ELISA tests (Quantikine High Sensitivity Human by R&D Systems, Minneapolis, Minn, USA. The NPDR children demonstrated a significantly longer duration of the disease in addition to higher HbA1c, albumin excretion rate, C-reactive protein, systolic blood pressure, as well as TNF-α and IL-6 levels than those without retinopathy. The logistic regression revealed that the risk of NPDR was strongly dependent on TNF-α [(OR 4.01; 95%CI 2.01–7.96]. TNF-α appears to be the most significant predictor among the analyzed parameters of damage to the eye apparatus. The early introduction of the TNF-α antagonists to the treatment of young patients with DM type 1 who show high serum activity of the TNF-α may prevent them from development of diabetic retinopathy.

  3. 早产儿氧疗与视网膜病的早期诊断和防治%Oxygen therepy for premature infants and early treatment and prevention of retinopathy of prematurity

    Institute of Scientific and Technical Information of China (English)

    陈超

    2005-01-01

    近年,极低出生体重(VLBW)甚至超低出生体重(ELBW)的早产儿较前增多。这些早产儿机体发育未成熟,生存能力极差,发生许多严重合并症,为抢救其生命,大多必须采用不同方式的氧疗,否则,会发生脑缺氧,导致脑瘫、智力障碍等后遗症。但早产儿氧疗与早产儿视网膜病(retinopathy of prematurity,ROP)的发生有密切关系,目前ROP已成为世界范围内儿童致盲的重要原因,约占儿童致盲原因的6%~18%。因此,早产儿氧疗与ROP防治是新生儿领域面临的一个重要临床问题。本文主要讨论ROP发生的高危因素、早产儿氧疗与ROP的关系及ROP的防治。

  4. Microvascular retinopathy in subjects without diabetes

    DEFF Research Database (Denmark)

    Munch, Inger Christine; Kessel, Line; Borch-Johnsen, Knut

    2012-01-01

    tolerance testing, clinical and laboratory examinations, non-invasive ocular lens fluorometry and seven-field fundus photography. Results: Retinopathy was present in 8.3% (CI(95) 6.3-10.3%) of subjects. Higher systolic blood pressure (SBP) (p = 0.032), increasing body mass index (BMI) (p = 0.014) and wider......Purpose: Retinal vascular lesions such as microaneurysms and haemorrhages, while typical of diabetic retinopathy, are also seen in subjects without diabetes where they are associated with elevated cardiovascular mortality. In theory, these lesions could be a consequence of past hyperglycaemia. We...... examined the prevalence and risk factors for retinopathy, including lens fluorescence, a biomarker of cumulative life-time glycaemia in adults without diabetes. Methods: Cross-sectional population-based study of 711 subjects without diabetes (WHO 1999 criteria) aged 30-60 years, including oral glucose...

  5. Targeting Neovascularization in Ischemic Retinopathy: Recent Advances

    Science.gov (United States)

    Al-Shabrawey, Mohamed; Elsherbiny, Mohamed; Nussbaum, Julian; Othman, Amira; Megyerdi, Sylvia; Tawfik, Amany

    2014-01-01

    Pathological retinal neovascularization (RNV) is a common micro-vascular complication in several retinal diseases including retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration and central vein occlusion. The current therapeutic modalities of RNV are invasive and although they may slow or halt the progression of the disease they are unlikely to restore normal acuity. Therefore, there is an urgent need to develop treatment modalities, which are less invasive and therefore associated with fewer procedural complications and systemic side effects. This review article summarizes our understanding of the pathophysiology and current treatment of RNV in ischemic retinopathies; lists potential therapeutic targets; and provides a framework for the development of future treatment modalities. PMID:25598837

  6. Prevalence of systemic co-morbidities in patients with various grades of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Pradeep Venkatesh

    2014-01-01

    Full Text Available Background & objectives : Though diabetes affects multiple organs, most studies highlight the occurence of only one complication in isolation. We conducted a hospital-based study to estimate the co-existence of significant systemic co-morbid conditions in patients with varying grades of diabetic retinopathy. Methods : A total of 170 consecutive patients with diabetic retinopathy were prospectively recruited for the study between June 2009 to June 2010 at a tertiary care eye centre in north India. Retinopathy was graded by fundus biomicroscopy and fundus photography and classified into three categories (mild-moderate nonproliferative retinopathy, proliferative retinopathy requiring only laser and proliferative retinopathy requiring surgery. Nephropathy was classified by calculating the six variable estimated glomerular filtration rate (eGFR for all patients. Nerve conduction studies and clinical assessment were used to determine presence of neuropathy. Co-existence of macrovascular disease and peripheral vascular disease was also ascertained. Results : The percentages of patients with overt nephropathy in the three groups were 19.2, 38.0 and 41.2, respectively. Significant linear trends were observed for serum creatinine (P=0.004, albumin (P=0.017 and eGFR (P=0.030. A higher per cent had abnormal nerve conduction on electrophysiology than that diagnosed clinically (65.4 vs. 44.2, 76.0 vs. 40.0 and 64.8 vs. 48.6, respectively. The odds ratio (95% CI for co-existence of nephropathy, neuropathy, CVA (cerebrovascular accidents and PVD (peripheral vascular disease was 2.9, 0.9, 4.8 and 3.5, respectively. Independent of retinopathy severity, patients with clinically significant macular oedema (CSME had a higher percentage of nephropathy ( p0 < 0.005. Interpretation & conclusions : The co-existence of overt nephropathy, nerve conduction based neuropathy and macrovascular co-morbidity in patients with early grades of diabetic retinopathy was significant

  7. Reversible retinopathy associated with oral deferasirox therapy.

    Science.gov (United States)

    Walia, Harpreet S; Yan, Jiong

    2013-07-17

    A 17-year-old girl with a history of sickle cell anaemia undergoing chronic blood transfusions and iron-chelation therapy presented for multiple ophthalmic examinations. During treatment with deferoxamine, her examination remained stable but 2 years after changing to deferasirox she presented with decreased visual acuity and only mild funduscopic changes. Marked electrophysiological abnormalities were also evident. After cessation of deferasirox, her visual acuity improved and electrophysiological responses improved. No prior reports of deferasirox-related retinopathy are available. We suggest that oral deferasirox caused a reversible retinopathy in our patient and clinicians be aware of this entity.

  8. Reversible retinopathy associated with oral deferasirox therapy

    Science.gov (United States)

    Walia, Harpreet S; Yan, Jiong

    2013-01-01

    A 17-year-old girl with a history of sickle cell anaemia undergoing chronic blood transfusions and iron-chelation therapy presented for multiple ophthalmic examinations. During treatment with deferoxamine, her examination remained stable but 2 years after changing to deferasirox she presented with decreased visual acuity and only mild funduscopic changes. Marked electrophysiological abnormalities were also evident. After cessation of deferasirox, her visual acuity improved and electrophysiological responses improved. No prior reports of deferasirox-related retinopathy are available. We suggest that oral deferasirox caused a reversible retinopathy in our patient and clinicians be aware of this entity. PMID:23867877

  9. [Diabetic retinopathy complications--12-year retrospective study].

    Science.gov (United States)

    Ignat, Florica; Davidescu, Livia

    2002-01-01

    It is analyzed, on a retrospective study on 12 years, the incidence of diabetus melitus cases, hospitalized in the Ophthalmologic Clinic from Craiova with special mention to the frequency of the diabetic retinopathy, of it's complications and in an accordance to other general diseases, especially cardiovascular's, which contributes to the aggravation of the diabetic ocular in juries evolution. The study underlines the high incidence of the new founded cases with diabetus melitus in complicated diabetes retinopathy stage; the high frequency of ocular complications is explained, according to our statistic facts and through an insufficient treatment, sometimes incorrect and many other cases total neglected by the patients.

  10. Current treatments for radiation retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Giuliari, Gian Paolo; Simpson, E. Rand (Princess Margaret Hospital, Univ. of Toronto, Dept. of Ophthalmology and Vision Sciences, Toronto (Canada)), e-mail: gpgiuliari@gmail.com; Sadaka, Ama (Schepens Eye Research Inst., Boston, MA (United States)); Hinkle, David M. (Massachusetts Eye Research and Surgery Institution, Cambridge, MA (United States))

    2011-01-15

    Background. To review the currently available therapeutic modalities for radiation retinopathy (RR), including newer investigational interventions directed towards specific aspects of the pathophysiology of this refractory complication. Methods. A review of the literature encompassing the pathogenesis of RR and the current therapeutic modalities available was performed. Results. RR is a chronic and progressive condition that results from exposure to any source of radiation. It might be secondary to radiation treatment of intraocular tumors such as choroidal melanomas, retinoblastomas, and choroidal metastasis, or from unavoidable exposure to excessive radiation from the treatment of extraocular tumors like cephalic, nasopharyngeal, orbital, and paranasal malignancies. After the results of the Collaborative Ocular Melanoma Study, most of the choroidal melanomas are being treated with plaque brachytherapy increasing by that the incidence of this radiation complication. RR has been reported to occur in as many as 60% of eyes treated with plaque radiation, with higher rates associated with larger tumors. Initially, the condition manifests as a radiation vasculopathy clinically seen as microaneurysms and telangiectasis, with posterior development of retinal hard exudates and hemorrhages, macular edema, neovascularization and tractional retinal detachment. Regrettably, the management of these eyes remains limited. Photodynamic therapy, laser photocoagulation, oral pentoxyphylline and hyperbaric oxygen have been attempted as treatment modalities with inconclusive results. Intravitreal injections of anti-vascular endothelial growth factor such as bevacizumab, ranibizumab and pegaptanib sodium have been recently used, also with variable results. Discussion. RR is a common vision threatening complication following radiation therapy. The available therapeutic options are limited and show unsatisfactory results. Further large investigative studies are required for developing

  11. Water and oxygen induced degradation of small molecule organic solar cells

    DEFF Research Database (Denmark)

    Hermenau, Martin; Riede, Moritz; Leo, Karl

    2011-01-01

    Small molecule organic solar cells were studied with respect to water and oxygen induced degradation by mapping the spatial distribution of reaction products in order to elucidate the degradation patterns and failure mechanisms. The active layers consist of a 30 nm bulk heterojunction formed...... with isotopic labeling using H218O and 18O2 provided information on where and to what extent the atmosphere had reacted with the device. A comparison was made between the use of a humid (oxygen free) atmosphere, a dry oxygen atmosphere, and a dry (oxygen free) nitrogen atmosphere during testing of devices...

  12. Raman spectroscopy of human vitreous collagen in diabetic retinopathy

    Science.gov (United States)

    Sebag, Jerry; Nie, Shuming; Reiser, Karen M.; Yu, Nai-Teng

    1992-08-01

    In diabetes nonenzymatic glycation alters collagen throughout the body resulting in the histopathology that underlies diabetic disease in several organs. In the eye such changes in vitreous collagen could contribute to vitreous degeneration and the progression of proliferative diabetic retinopathy. Previous studies have demonstrated early glycation and advanced endproducts in the vitreous of humans with proliferative diabetic retinopathy. Near-infrared Fourier-transform Raman spectroscopy was performed on vitreous obtained at surgery from diabetic patients and from non-diabetic control subjects. The findings were compared to measurements obtained in untreated and glycated (in vitro) rat-tail tendon collagen. The results demonstrated substantial changes in diabetic vitreous collagen resulting from glycation, most likely advanced glycation endproducts. This approach appears to be useful as a means of characterizing the molecular changes induced by diabetes. Furthermore, this technique could be developed as a way of quantifying these changes in vivo in several tissues, so as to gauge the severity of non-enzymatic glycation and monitor the response to therapy.

  13. Pharmacological Approach for Treatment of Retinopathy of Prematurity

    Directory of Open Access Journals (Sweden)

    İmren Akkoyun

    2012-12-01

    Full Text Available Current standard of screening examination for retinopathy of prematurity (ROP is determined in international guidelines. The criteria for classification and therapy are also determined in international guidelines, and currently, retinal laser fotocoagulation of peripheral avascular retinal area is gold standard (ETROP, Early Treatment for Retinopathy of Prematurity Cooperative Group for proliferative ROP. Vitreoretinal surgery will be used in cases with retinal detachment. In case series after off-label injection of anti-VEGF (vascular endothelial growth factor agent bevacizumab and in the first report of BEAT-ROP study in proliferative ROP the results are promising. Furthermore, beside the intravitreal anti-VEGF therapy, systemic therapy with mediators like IGF-1 (insulin-like growth factor and/or ω3-fatty acids outlines pharmacological approach to treatment of ROP. The results of well-designed clinical trials of intravitreal anti-VEGF therapy and pharmacological systemic therapy with the above-mentioned mediators for ROP are needed in order to provide information as to the balance of risk versus benefit, as well as practical guidance regarding optimal treatment parameters and follow-up.(Turk J Ophthalmol 2012; 42: 466-73

  14. Prospects for angiotensin receptor blockers in diabetic retinopathy

    DEFF Research Database (Denmark)

    Sjølie, Anne Katrin

    2007-01-01

    Retinopathy is the most common microvascular complication of diabetes mellitus, and is an important cause of blindness worldwide. Clinical trials have demonstrated that tight metabolic control inhibits the progression of retinopathy. Good blood pressure control has been shown to be protective...... in type 2 diabetes, and it may also reduce proliferative retinopathy in type 1 diabetes. However, such control is often difficult to achieve in clinical practice, and may be associated with problems such as hypoglycaemia. New therapies are therefore needed to reduce the risk of retinopathy....... There is growing evidence that the renin-angiotensin system (RAS) plays an important role in the pathogenesis of diabetic retinopathy, and this has led to interest in RAS inhibitors as agents to prevent retinopathy. Several trials have suggested that ACE inhibitor therapy can inhibit progression of retinopathy...

  15. Classification of Non-Proliferative Diabetic Retinopathy Based on Segmented Exudates using K-Means Clustering

    Directory of Open Access Journals (Sweden)

    Handayani Tjandrasa

    2014-12-01

    Full Text Available Diabetic retinopathy is a severe complication retinal disease caused by advanced diabetes mellitus. Long suffering of this disease without threatment may cause blindness. Therefore, early detection of diabetic retinopathy is very important to prevent to become proliferative. One indication that a patient has diabetic retinopathy is the existence of hard exudates besides other indications such as microaneurysms and hemorrhages. In this study, the existence of hard exudates is applied to classify the moderate and severe grading of non-proliferative diabetic retinopathy in retinal fundus images. The hard exudates are segmented using K-means clustering. The segmented regions are extracted to obtain a feature vector which consists of the areas, the perimeters, the number of centroids and its standard deviation. Using three different classifiers, i.e. soft margin Support Vector Machine, Multilayer Perceptron, and Radial Basis Function Network, we achieve the accuracy of 89.29%, 91.07%, and 85.71% respectively, for 56 training data and 56 testing data of retinal images.

  16. DIABETIC RETINOPATHY: HOW AWARE ARE THE PHYSICIANS?

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    Narendra P

    2014-05-01

    Full Text Available PURPOSE: The purpose of the study was to assess the awareness of physicians in rural Kolar district towards diabetes and diabetic retinopathy. MATERIALS AND METHODS: A cross sectional survey was conducted in rural Kolar district during May 2013. The study participants were 38 physicians and 2 general practitioners who had special training in diabetes. The data were collected by means of filling up of pre-tested specially designed questionnaires focused on awareness towards Diabetes Mellitus and Diabetic retinopathy. The assessment was done by total score as satisfactory (Diabetic retinopathy awareness index >12, moderately satisfactory (DRAI 9-11 or unsatisfactory if index 12 was attained by only 55% (22/40 practitioners. Nearly 62.5% of physicians refer the diabetics to ophthalmologists only when they develop significant vision problems. CONCLUSION: This survey highlighted some of the lacunae in the knowledge about referral system of the general physicians and identified the need for improvement in awareness regarding the management of the patients with diabetes and diabetic retinopathy. To improve patient compliance, physician needs to educate their diabetic patients about the importance of setting an annual eye examination routinely before the development of vision loss.

  17. Noninvasive Retinal Markers in Diabetic Retinopathy

    DEFF Research Database (Denmark)

    Blindbæk, Søren Leer; Torp, Thomas Lee; Lundberg, Kristian

    2017-01-01

    The retinal vascular system is the only part of the human body available for direct, in vivo inspection. Noninvasive retinal markers are important to identity patients in risk of sight-threatening diabetic retinopathy. Studies have correlated structural features like retinal vascular caliber and ...

  18. Duplex Color Doppler Evaluation of Retinal Arterial Blood Flow in Type 2 Diabetic Subjects without Retinopathy

    Directory of Open Access Journals (Sweden)

    Mashah Binte Amin

    2014-09-01

    Full Text Available Background: Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness which is usually preventable if retinopathy is diagnosed early and treated promptly. In ophthalmology, color Doppler imaging is a new method that enables us to assess the orbital vasculature. It allows for simultaneous two dimensional anatomical and Doppler evaluations of hemodynamic characteristics of retinal artery. Objective: To observe the difference between Doppler flow velocity indices (peak systolic velocity, end diastolic velocity and resistive index of retinal artery in type 2 diabetic subjects without retinopathy and those of normal controls. Materials and Methods: This case-control study was carried out in the department of Radiology and Imaging, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM in collaboration with Ophthalmology Outpatient Department, BIRDEM, Dhaka from July 2011 to June 2013. Eighty diabetic patients without retinopathy aged 27–68 years were enrolled as cases and age and sex matched 80 healthy subjects were selected as controls. Type 1 diabetic patients, type 2 diabetics with retinopathy, hypertensive and dyslipidemic subjects were excluded from the study. All the selected subjects underwent duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHZ linear phase transducer. Duplex color Doppler findings including spectral analysis (PSV, EDV and RI were recorded. Unpaired t test was done to compare blood flow velocity indices of retinal artery in type 2 diabetic patients without retinopathy and that of healthy control subjects. p value <0.05 was considered as significant. Results: Majority (42.5% and 47.5% of subjects were in 4th decade of life in both groups with predominance of males. The mean duration of diabetes was 4.56 ± 2.1 years. Mean peak systolic

  19. Serum fructosamine and retinopathy of prematurity.

    Science.gov (United States)

    Bozdag, Senol; Oguz, Serife Suna; Gokmen, Tulin; Tunay, Zuhal; Tok, Levent; Uras, Nurdan; Erdeve, Omer; Dilmen, Ugur

    2011-12-01

    To determine whether serum fructosamine which is a good marker for detecting hyperglycemia during the previous 2 to 3 wk in infants could predict the development of retinopathy of prematurity in very low birth weight infants. One hundred sixty seven premature infants who had a birth weight of < 1500 g and a gestational age of less than 32 wk were investigated in the present study. Blood glucose was measured at the bedside and infants were recorded as hyperglycemic if their mean blood glucose levels were higher than 150 mg/dL. Serum corrected fructosamine level was obtained from the cord blood at birth and after the first month of life. The infants' eyes were examined by ophthalmologists to detect retinopathy of prematurity at the gestational age of 32 wk or at four wk after birth, whichever came first. Corrected fructosamine was 319.6 ± 59.6 and 272.8 ± 50.6 mmol/l for group 1 on 1(st) and 30(th) day respectively; 320 ± 61.7 and 268.2 ± 47.3 mmol/l for groups 2 + 3 on 1(st) and 30(th) day respectively which did not differ between groups (p = 0.766 and p = 0.665), whereas duration of hyperglycemia was 1.69 ± 1.1 day in group 1 compared with 3.05 ± 2.4 day in groups 2 + 3 which was significantly different (p = 0.019). The multivariate regression analysis indicated that the duration of hyperglycemia in days was significantly correlated with the development of retinopathy of prematurity (OR 3.26; 95% CI 1.09-9.80; p = 0.035). Although the duration of hyperglycemia may contribute to the development of retinopathy of prematurity, serum corrected fructosamine does not have a good predictive value in developing retinopathy of prematurity in very-low-birth-weight (VLBW) infants.

  20. [Interdisciplinary interaction in vascular diseases of the eye, diabetes and diabetic retinopathy].

    Science.gov (United States)

    Kleophas, W; Dellanna, F

    2014-01-01

    The incidence of diabetes mellitus type 2 is greatly increasing worldwide. An early therapy with intensified control of diabetes and blood pressure is especially important to avoid delayed complications. In addition to diabetic foot syndrome, diabetic retinopathy and diabetic nephropathy still represent commonly occurring problems. Despite improvements in the quality of care, the targets of the St. Vincent Declaration have still not yet been achieved. Diabetic retinopathy and diabetic nephropathy show parallels in the course of the disease and in the pathological anatomical alterations which have led to the inauguration of a diabetic renal-retinal syndrome. The ophthalmological assessment of the retina was previously considered to be a diagnostic aid for assessment of diabetic nephropathy; however, nowadays a simple estimation of the glomerular filtration rate using the modification of diet in renal disease (MDRD) formula and determination of microalbuminuria can in contrast give ophthalmologists an early indication of the possible presence of microangiopathic alterations.

  1. Correlational Study of Diabetic Retinopathy and Hearing Loss.

    Science.gov (United States)

    Ooley, Caroline; Jun, Weon; Le, Kim; Kim, Allen; Rock, Nathan; Cardenal, Molly; Kline, Rebecca; Aldrich, Drew; Hayes, John

    2017-03-01

    Our research goal was to complete a retrospective chart review to determine if there is a correlation between the level of diabetic retinopathy and diabetic neurosensory hearing loss. A retrospective analysis of 175 Department of Veterans Affairs Computerized Patient Record System charts was completed at the VA Portland Health Care System. Subjects were classified by degree of diabetic retinopathy as follows: no diabetic retinopathy (n = 80), mild nonproliferative diabetic retinopathy (n = 51), moderate nonproliferative diabetic retinopathy (n = 25), and combined severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy (PDR) (n = 17). Degree of sensorineural hearing was collected for each ear. Additionally, measures of diabetic control, including hemoglobin A1C, and creatinine, were recorded. After controlling for diabetic control, as measured by HbA1C and creatinine, level of diabetic retinopathy was significantly associated with hearing loss severity in both ears (right ear, P = .018 and left ear, P = .007). When adjusted to include diabetes control, the severity of diabetic retinopathy showed a correlation with degree of hearing loss at most levels. Because of this association, recommendation for hearing evaluations may be considered for those with mild, moderate, or severe nonproliferative or proliferative diabetic retinopathy.

  2. The 16-year incidence, progression and regression of diabetic retinopathy in a young population-based Danish cohort with type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Broe, Rebecca; Rasmussen, Malin Lundberg; Frydkjaer-Olsen, Ulrik;

    2014-01-01

    The aim was to investigate the long-term incidence of proliferative diabetic retinopathy (PDR), and progression and regression of diabetic retinopathy (DR) and associated risk factors in young Danish patients with Type 1 diabetes mellitus. In 1987-89, a pediatric cohort involving approximately 75...... % of all children with Type 1 diabetes in Denmark retinopathy graded and all relevant diabetic parameters assessed. Of those, 185 (54.6 %) were evaluated again in 2011 for the same clinical parameters. All retinal images...... were graded using modified early treatment of DR study for 1995 and 2011. In 1995, mean age was 21.0 years and mean diabetes duration 13.5 years. The 16-year incidence of proliferative retinopathy, 2-step progression and 2-step regression of DR was 31.0, 64.4 and 0.0 %, respectively, while...

  3. Microaneurysm count as a predictor of long-term progression in diabetic retinopathy in young patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Rasmussen, M L; Broe, R; Frydkjaer-Olsen, U

    2015-01-01

    of diabetes were 20.6 and 12.9 years, respectively. Two-field (1995) and seven-field (2011) fundus photographs were taken in accordance with the European Diabetes Study Group (EURODIAB) and the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol, respectively. DR was graded in accordance to the ETDRS...

  4. The Danish Registry of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Andersen N

    2016-10-01

    Full Text Available Nis Andersen,1,2 Jesper Østergaard Hjortdal,1,3 Katja Christina Schielke,4 Toke Bek,3 Jakob Grauslund,5 Caroline Schmidt Laugesen,6 Henrik Lund-Andersen,7 Charlotte Cerqueira,8 Jens Andresen2 1Danish Ophthalmological Society, Copenhagen, 2Organization of Danish Ophthalmologists in Private Practice, Copenhagen, 3Department of Ophthalmology, Aarhus University Hospital, Aarhus, 4Department of Ophthalmology, Aalborg University Hospital, Aalborg, 5Department of Ophthalmology, Odense University Hospital, Odense, 6Department of Ophthalmology, Copenhagen University Hospital Roskilde, Roskilde, 7Department of Ophthalmology, Glostrup Hospital, 8Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, Rigshospitalet – Glostrup, University of Copenhagen, Copenhagen, Denmark Aim of database: To monitor the development of diabetic eye disease in Denmark and to evaluate the accessibility and effectiveness of diabetic eye screening programs with focus on interregional variations.Target population: The target population includes all patients diagnosed with diabetes. Denmark (5.5 million inhabitants has ~320,000 diabetes patients with an annual increase of 27,000 newly diagnosed patients. The Danish Registry of Diabetic Retinopathy (DiaBase ­collects data on all diabetes patients aged ≥18 years who attend screening for diabetic eye disease in hospital eye departments and in private ophthalmological practice. In 2014–2015, DiaBase included data collected from 77,968 diabetes patients.Main variables: The main variables provide data for calculation of performance indicators to monitor the quality of diabetic eye screening and development of diabetic retinopathy. Data with respect to age, sex, best corrected visual acuity, screening frequency, grading of diabetic retinopathy and maculopathy at each visit, progression/regression of diabetic eye disease, and prevalence of blindness were obtained. Data

  5. Blood pressure control for diabetic retinopathy.

    Science.gov (United States)

    Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

    2015-01-31

    Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial characteristics, incidence and progression of retinopathy, visual acuity, quality of life

  6. STUDY OF THE PREVALENCE OF MICROALBUMINURIA AND RETINOPATHY IN PREDIABETES IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Purushottam Rao

    2015-02-01

    complications is needed for prevention of overt diabetes, diabetic retinopathy and nephropathy by early intervention

  7. SERUM FIBRINOGEN LEVELS AND ITS RELATION TO DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Adil Majeed

    2015-11-01

    Full Text Available BACKGROUND Elevation of plasma fibrinogen is thought to be one of the major risk factors associated with increase in blood viscosity in patients with diabetic retinopathy. Diabetic retinopathy being a microangiopathy, the study was done with the aim to assess the relationship between serum fibrinogen levels in patients with and without diabetic retinopathy. MATERIALS AND METHODS This study was conducted at Government Medical College, Srinagar, in which 101 diabetic patients with and without retinopathy were evaluated. These patients were classified into two groups: 1 Patients with diabetic retinopathy, which included 50 patients. 2 Patients without diabetic retinopathy, which included 51 patients. Each patient was subjected to a comprehensive ocular examination and the results were recorded and analyzed in detail. RESULTS Our study which was prospective, non-randomized hospital based study was undertaken for the period of 18 months to see the association between fibrinogen levels in the blood and the development of diabetic retinopathy. Our study included 101 patients with type-2 diabetes. Among this Group-1 included 50 patients with diabetic retinopathy and Group-2 included 51 patients without diabetic retinopathy. In our study, total number of female patients were 65 (64.35% and males were 36 (35.64%. The mean age for males and females was 57.5 and 54.6 years respectively. Mean duration of diabetes in patients with retinopathy and without retinopathy was 10.9 and 5.7 years respectively. It was observed in our study that most of the patients with diabetic retinopathy had compromised visual acuity in one or both eyes, i.e., Vn>6/60. We found that out of 50 patients with diabetic retinopathy, 36 (72% patients were having raised serum fibrinogen levels, while as out of 51 patients without diabetic retinopathy 17 (33.33% patients were having raised serum fibrinogen levels, and mean serum fibrinogen levels in patients with and without retinopathy

  8. To report a case of unilateral proliferative retinopathy following noncerebral malaria with Plasmodium falciparum in Southern India

    Directory of Open Access Journals (Sweden)

    Aditya Verma

    2015-01-01

    Full Text Available The retinopathy in association with malaria fever described so far includes retinal hemorrhages, vessel changes, retinal discoloration/whitening and papilledema. Malaria retinopathy has been mostly described in severe cases, associated with Plasmodium falciparum, correlating the patho-physiology of retinal and cerebral manifestations. We report an unusual case of proliferative retinopathy as a manifestation of malaria fever, caused by P. falciparum with no cerebral involvement. The patient had features of unilateral retinal vascular occlusion with proliferative changes and vitreous hemorrhage. To the best of our knowledge, such a case has never been reported so far in the literature. This report highlights the possible occurrence of severe proliferative changes associated with malaria fever, which if diagnosed early can prevent possible blindness.

  9. Choroidal thickness in patients with diabetic retinopathy

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    Ünsal E

    2014-03-01

    Full Text Available Erkan Ünsal, Kadir Eltutar, Sibel Zirtiloğlu, Nurhan Dinçer, Sezin Özdoğan Erkul, Hülya GüngelDepartment of Ophthalmology, Istanbul Education and Research Hospital, Istanbul, TurkeyPurpose: The aim of the study reported here was to assess choroidal thickness (CT and central macular thickness (CMT in patients with diabetic retinopathy.Materials and methods: A total of 151 eyes from 80 patients from the retina department of Istanbul Training and Research Hospital who had type 2 diabetes mellitus with diabetic retinopathy were studied retrospectively in this cross-sectional research. Patients were divided into three groups: mild–moderate nonproliferative diabetic retinopathy without macular edema (NPDR, mild–moderate nonproliferative diabetic retinopathy with macular edema (DME, and proliferative diabetic retinopathy (PDR. In addition, 40 eyes of 20 healthy individuals comprised a control group. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-µm intervals up to 1,500 µm temporal and nasal to the fovea. The CMT measurement was obtained for each eye. Serum hemoglobin A1c (HbA1c levels were measured.Results: The study included 191 eyes, comprising 151 eyes of 80 patients and 40 eyes of 20 healthy individuals. Of the 151 patient eyes, 61 had NPDR, 62 had PDR, and 28 eyes had DME. There was no statistically significant difference in age between the groups (P>0.05. In both the PDR and DME groups, the CT was statistically significantly decreased compared with the control group (P<0.001, P<0.001 for the PDR and DME groups, respectively. The mean CMT in the DME group was increased significantly compared with both the NPDR and PDR groups (P<0.001, P<0.001, respectively. In all three groups, serum HbA1c levels were found to be increased significantly compared with the control group (P=0.000. We found a statistically weak–moderate negative correlation between

  10. Oxygen-induced shape changes of Pt nanoparticles on MgO(100)

    Energy Technology Data Exchange (ETDEWEB)

    Hejral, Uta; Stierle, Andreas; Vlad, Alina; Delheusy, Melissa; Dosch, Helmut [Max-Planck-Institut fuer Metallforschung, Heisenbergstr. 3, 70569 Stuttgart (Germany)

    2010-07-01

    Platinum nanoparticles on oxide carrier materials are used in heterogenous catalysis and are applied successfully in reactions like the oxidation of hydrocarbons or carbon monoxide. In order to achieve better catalyst efficiency, lifetime and selectivity it is important to comprehend catalytic processes on an atomic basis. Thus, the interplay between particle shape, adsorbed oxygen, bulk oxides and catalytic activity needs to be understood. Therefore Pt nanoparticles have been grown epitaxially on MgO(100) substrates under controlled conditions. It has previously been reported that Rh nanoparticles undergo reversible shape changes induced by surface oxides. We have studied oxygen-induced shape changes of Pt nanoparticles on MgO(100) by means of in situ X-ray diffraction. The experiment was performed at 300 C and oxygen pressures ranging from UHV to 500 mbar. The experimental results are compared to theoretically predicted ones.

  11. Retinopathy of prematurity outcome in infants with Prethreshold Retinopathy of Prematurity and oxygen saturation > 94% in room air : The High Oxygen Percentage in Retinopathy of Prematurity study

    NARCIS (Netherlands)

    McGregor, ML; Bremer, DL; Cole, C; McClead, RE; Phelps, DL; Fellows, RR; Oden, N

    2002-01-01

    Objectives. To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (Spo(2))

  12. Novel Pharmacologic Approaches for the Management of Diabetic Retinopathy

    Science.gov (United States)

    Kovach, Jaclyn L.; Schwartz, Stephen G.

    2010-01-01

    Diabetic retinopathy is the leading cause of vision loss among working-age people in the United States. The hallmark of diabetic retinopathy is vascular compromise. Increased vascular permeability leads to the development of diabetic macular edema, which is the major cause of vision loss in patients with diabetic retinopathy. Vascular occlusion causes retinal ischemia and subsequent angiogenesis (proliferative diabetic retinopathy), which increases the risk for vitreous hemorrhage and retinal detachment. Over the past 30 years our understanding of the pathophysiology of diabetic retinopathy has evolved greatly and has fostered the development of many novel treatments for this condition. This article will review promising new local and systemic pharmacologic treatments for diabetic macular edema and proliferative diabetic retinopathy. PMID:20352067

  13. Study of refractive development state and clinic affective factors in premature infants without retinopathy during their early life%早产儿生后第一年屈光发育及其影响因素的研究

    Institute of Scientific and Technical Information of China (English)

    童梅玲; 王淼; 魏宁; 吴广强; 张桂英; 薛子颖

    2011-01-01

    [Objective] To explore the development of the refractive status and clinical risk factors in premature infants without retinopathy during their first year after birth. [Methods] 94 medical health premature infants at 6 months of corrected age during January 2008 to March 2010 were selected, and their refractive development to 12 months were tracked up. Refraction was determined at 6 months, 9 months and 12 months old by Suresight Welch. The impact of gestational age and birth weight on refractive status of premature infants were analyzed. [Results] High incidence of astigmatism was found on preterm infants, and it declined with the age increasing. At 9 and 12 months old of corrected age, birth weight was an influencing factor of refractive error in premature infants. At 12 months old of corrected age, gestational age was another important influencing factor of refractive error in premature infants. [Conclusions] During the first year after birth, refraction of premature infants is changeable. The incidence of ametropia, especially the degree of astigmatism, is decreased with age increasing. Birth weight and gestational age both are important factors which can influence refraction of premature infants.%[目的]探讨无视网膜病变早产儿在出生后第一年屈光发育特征和影响其发育的临床因素,了解早产儿的早期视觉发育.[方法]选取2008年12月-2010年3月在本院随访的早产儿94人,从校正月龄6月龄起跟踪随访至12月龄的屈光发育.分别检测6月龄、9月龄、12月龄时屈光状态,分析不同出生体重、胎龄对眼屈光状态发育的影响.[结果]早产儿远视和近视的发生率在不同月龄组间差异无统计学意义,而散光的发生率及程度均较高,分别为6月龄(55%),9月龄(22%),12月龄(10%),差异具有统计学意义,随年龄增长散光呈下降趋势.早产儿校正9月龄和12月龄组显示出生体重影响着屈光不正发生率,在12月龄时显示胎龄越小屈光

  14. The Danish Registry of Diabetic Retinopathy

    DEFF Research Database (Denmark)

    Andersen, Nis; Hjortdal, Jesper Østergaard; Schielke, Katja Christina;

    2016-01-01

    AIM OF DATABASE: To monitor the development of diabetic eye disease in Denmark and to evaluate the accessibility and effectiveness of diabetic eye screening programs with focus on interregional variations. TARGET POPULATION: The target population includes all patients diagnosed with diabetes....... Denmark (5.5 million inhabitants) has ~320,000 diabetes patients with an annual increase of 27,000 newly diagnosed patients. The Danish Registry of Diabetic Retinopathy (DiaBase) collects data on all diabetes patients aged ≥18 years who attend screening for diabetic eye disease in hospital eye departments...... and in private ophthalmological practice. In 2014-2015, DiaBase included data collected from 77,968 diabetes patients. MAIN VARIABLES: The main variables provide data for calculation of performance indicators to monitor the quality of diabetic eye screening and development of diabetic retinopathy. Data...

  15. Radiation Retinopathy Associated with Central Retinal Vein Occlusion

    Institute of Scientific and Technical Information of China (English)

    Yan; Liu; FengWen

    2007-01-01

    Purpose: To report a case of radiation retinopathy associated with central retinal vein occlusion.Methods: The clinical features and fundus fluorescein angiography of this case were analyzed.Results: The patient had been treated with radiotherapy for her nasopharyngeal carcinoma, and presented with sudden visual loss in the left eye. The funduscopic examination and fluorescein angiography showed the features of radiation retinopathy in both eyes, and central retinal vein occlusion in the left eye.Conclusions: Radiation retinopathy can be associated with central retinal vein occlusion in the same eye, and it seems that the endothelial cell loss caused by radiation retinopathy may lead to retinal vein occlusion.

  16. Digital Imaging and Screening for Diabetic Retinopathy

    OpenAIRE

    Hull, C.

    2008-01-01

    The National Screening Committee has stated that “All people with diabetes aged 12 years and older should be offered screening for sight-threatening diabetic retinopathy using digital photography.”1 Digital imaging offers several advantages such as archiving, ease of viewing evidence of progression, quality assurance, patient education and immediate indication of ungradable images. Knowledge of key aspects of digital imaging technology and performance therefore underpin screening for diabetic...

  17. [Optical coherence tomography in solar eclipse retinopathy].

    Science.gov (United States)

    Calvo-González, C; Reche-Frutos, J; Santos-Bueso, E; Díaz-Valle, D; Benítez-del-Castillo, J M; García-Sánchez, J

    2006-05-01

    We describe the case of a patient suffering from acute visual loss soon after watching a solar eclipse. Optical coherence tomography was the main diagnostic tool used. Solar retinopathy is now an unusual cause of visual loss, although there are still some cases diagnosed, especially after viewing solar eclipses. Optical coherence tomography is suitable for detecting permanent retinal injuries related to solar exposure, with the outer retinal layers being typically affected.

  18. Paraneoplastic retinopathy associated with occult bladder cancer

    DEFF Research Database (Denmark)

    Nivean, M; Muttuvelu, Danson V; Afzelius, Pia Maria Tullia

    2016-01-01

    The aim was to report the first case of cancer-associated retinopathy (CAR) presenting before bladder cancer diagnosis. A 71-year-old woman with a history of bilateral vision loss underwent subsequent complete ophthalmic examination include a fluorescein angiography, full-field electroretinogram ...... photoreceptor dysfunction, confirmed by ERG, should alert to a possible remote effect of known or occult malignancy. In the latter, PET-CT may be exploited as a powerful diagnostic tool....

  19. Insulin, insulin analogues and diabetic retinopathy.

    Science.gov (United States)

    Chantelau, Ernst; Kimmerle, Renate; Meyer-Schwickerath, Rolf

    2008-02-01

    Insulin is absolutely vital for living beings. It is not only involved in metabolism, but also in the regulation of growth factors, e.g. IGF-1. In this review we address the role insulin has in the natural evolution of diabetic retinopathy. On the one hand, chronic deficiency of insulin and IGF-1 at the retina is thought to cause capillary degeneration, with subsequent ischaemia. On the other hand, acute abundance of (exogenously administered) insulin and IGF-1 enhances ischaemia-induced VEGF expression. A critical ratio of tissue VEGF-susceptibility: VEGF-availability triggers vascular proliferation (i.e. of micro-aneurysms and/or abnormal vessels). The patent-protected insulin analogues Lispro, Glulisine, Aspart, Glargine and Detemir are artificial insulin derivatives with altered biological responses compared to natural insulin (e.g. divergent insulin and /or IGF-1 receptor-binding characteristics, signalling patterns, and mitogenicity). Their safety profiles concerning diabetic retinopathy remain to be established by randomised controlled trials. Anecdotal reports and circumstantial evidence suggest that Lispro and Glargine might worsen diabetic retinopathy.

  20. Treatment effects of captopril on non-proliferative diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    WANG Ning; ZHENG Zhi; JIN Hui-yi; XU Xun

    2012-01-01

    Background Diabetic retinopathy (DR) is one of the most common complications of diabetes.Angiotensin-converting enzyme inhibitor is thought to play an important role in preventing and treating retinal diseases in animal models of DR.The aim of the present study was to investigate the role of angiotensin-converting enzyme inhibitor (ACEI,captopril) in the treatment of patients with non-proliferative DR.Methods Three hundred and seventeen type 2 diabetic patients (88.05% of participants) without or with mild to moderate non-proliferative retinopathy were randomly divided into captopril group (n=202) and placebo group (n=115).All subjects received 24-month follow-up.General clinical examinations,including blood pressure and glycated hemoglobin,as well as comprehensive standardized ophthalmic examinations were performed.Color fundus photography and optical coherence tomography (OCT) were used to grade diabetic retinopathy and detect macular edema respectively.Results The levels of blood pressure and glycated hemoglobin in the two groups of patients remained within the normal range during the entire follow-up and no significant difference was found between the initial and last visits,suggesting that ACEI drugs play a protective role on the DR patients independent of its anti-blood pressure role.DR classification showed that 169 eyes (83.66%) remained unchanged and the DR grade of 33 eyes (16.34%) increased in captopril group,while 84 eyes (73.04%) remained unchanged and the grade of 31 eyes (26.96%) increased in placebo group (P=0.024).Captopril treatment improved macular edema in 55.45% eyes,which was significantly higher than the 37.39% improvement in placebo group (P=0.002).No significant difference was found in the visual acuity between the two groups (P=0.271).Conclusion Captopril can improve or delay the development of DR and macular edema,which can be used in the early treatment of DR patients with type 2 diabetic mellitus.

  1. The potential role of IGF-I receptor mRNA in rats with diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    匡洪宇; 邹伟; 刘丹; 史榕荇; 程丽华; 殷慧清; 刘晓民

    2003-01-01

    Objective To evaluate the potential role of insulin-like growth factor-1 receptor mRNA(IGF-IR mRNA) in the onset and development of retinopathy in diabetic rats.Methods A diabetic model was duplicated in Wistar rats. The early changes in the retina were examined using light and transmission electron microscopy. Expression of IGF-IR mRNA was analyzed using in situ hybridization.Results Weak expression of IGF-IR mRNA(5%) was found in retinas of normal rats, but was significantly increased (15% and 18%) in the retinas of diabetic rats after 3 and 6 months of diabetes (P<0.01). In situ hybridization and morphological study demonstrated that there was a positive correlation between IGF-IR mRNA expression and retinal changes at various stages.Conclusion Increased IGF-IR mRNA might play an important role in the onset and development of diabetic retinopathy.

  2. DETECTION OF BLOOD VESSELS AND MEASUREMENT OF VESSEL WIDTH FOR DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    S.Sukanya

    2014-09-01

    Full Text Available The proposed method measures the retinal blood vessel diameter to identify arteriolar narrowing, arteriovenous (AV nicking, branching coefficients to detect early diabetic retinopathy. It utilizes the vessel centerline and edge information to measure the width for a vessel segment. From the input retinal image, the vascular network is extracted using the local entropy thresholding method. The vessel boundaries are extracted using sobel edge detection method. The skeletonization operation is applied to the vascular network and mapping the vessel boundaries and the skeleton image. The branching point detection method is then performed to localize all crossing locations. A rotational invariant mask to search the pixel pairs from the edge image, and calculate the shortest distance pair which provides the vessel width (or diameter for that cross-section. Variation in the width measurement identifies the diabetic retinopathy.

  3. [The origin of papillary neovascularization in patients with proliferative diabetic retinopathy].

    Science.gov (United States)

    Sdobnikova, S V; Mazurina, N K

    2004-01-01

    The case study covers examinations of 63 patients with diabetes mellitus (DM), type 1, and with proliferative diabetic retinopathy (PDR). According to the results of fluorescence angiography, the patients were shared between 3 groups: Group 1--early contrasting of papillary vascular neoplasms; Group 2--late contrasting; and Group 3--mixed contrasting. We explained the available differences by that the vascular neoplasms of the optic nerve disk (OND) originate from 2 main blood supply basins, i.e. choroidal and retinal ones. They reflect, with respect to the above stated, the hemodynamic properties of the choroidal mycocirculation, which is characterized by a higher hemodynamic load and a higher intravascular pressure, or the retinal hemomicrocirculation. The pathological signs of diabetic retinopathy in the choroidal system may fail to correlate with changes in the retinal vascular system itself. Therefore, the findings of fluorescence angiography do not always represent the genuine scope of pathological manifestations occurring in the hemomicrocirculation system in case of PDR.

  4. Improvement of the classification accuracy in discriminating diabetic retinopathy by multifocal electroretinogram analysis

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The multifocal electroretinogram (mfERG) is a newly developed electrophysiological technique. In this paper, a classification method is proposed for early diagnosis of the diabetic retinopathy using mfERG data. MfERG records were obtained from eyes of healthy individuals and patients with diabetes at different stages. For each mfERG record, 103 local responses were extracted. Amplitude value of each point on all the mfERG local responses was looked as one potential feature to classify the experimental subjects. Feature subsets were selected from the feature space by comparing the inter-intra distance. Based on the selected feature subset, Fisher's linear classifiers were trained. And the final classification decision of the record was made by voting all the classifiers' outputs. Applying the method to classify all experimental subjects, very low error rates were achieved. Some crucial properties of the diabetic retinopathy classification method are also discussed.

  5. One-year progression of diabetic subclinical macular edema in eyes with mild nonproliferative diabetic retinopathy

    DEFF Research Database (Denmark)

    Tejerina, Amparo Navea; Vujosevic, Stela; Varano, Monica

    2015-01-01

    PURPOSE: To characterize the 1-year progression of retinal thickness (RT) increase occurring in eyes with subclinical macular edema in type 2 diabetes. METHODS: Forty-eight type 2 diabetic eyes/patients with mild nonproliferative diabetic retinopathy (NPDR; levels 20 and 35 in the Early Treatment...... Diabetic Retinopathy Study) classified as presenting subclinical macular edema at baseline completed the 1-year follow-up period, from a sample of 194 followed in a 12-month observational and prospective study (ClinicalTrials.gov identifier: NCT01145599). Automated segmentation of the retinal layers...... in these eyes was performed, followed by verification and correction by a human grader. RESULTS: The highest increase in RT over the 1-year follow-up period for the 48 eyes/patients with subclinical macular edema was found in the inner nuclear layer (INL). Progression to clinical macular edema was also...

  6. Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening.

    Directory of Open Access Journals (Sweden)

    Ramachandran Rajalakshmi

    Full Text Available To evaluate the sensitivity and specificity of "fundus on phone' (FOP camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR detection and DR severity in comparison with 7-standard field digital retinal photography.Single-site, prospective, comparative, instrument validation study.301 patients (602 eyes with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR was defined by the presence of proliferative DR(PDR or diabetic macular edema. The sensitivity, specificity and image quality were assessed.The mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1 and 98.4% (95%CI 94.3-99.8 respectively and the kappa (ĸ agreement was 0.90 (95%CI-0.85-0.95 p<0.001 while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9, specificity 94.9% (95%CI 89.7-98.2 and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001, compared to conventional photography.Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

  7. Validation of Smartphone Based Retinal Photography for Diabetic Retinopathy Screening.

    Science.gov (United States)

    Rajalakshmi, Ramachandran; Arulmalar, Subramanian; Usha, Manoharan; Prathiba, Vijayaraghavan; Kareemuddin, Khaji Syed; Anjana, Ranjit Mohan; Mohan, Viswanathan

    2015-01-01

    To evaluate the sensitivity and specificity of "fundus on phone' (FOP) camera, a smartphone based retinal imaging system, as a screening tool for diabetic retinopathy (DR) detection and DR severity in comparison with 7-standard field digital retinal photography. Single-site, prospective, comparative, instrument validation study. 301 patients (602 eyes) with type 2 diabetes underwent standard seven-field digital fundus photography with both Carl Zeiss fundus camera and indigenous FOP at a tertiary care diabetes centre in South India. Grading of DR was performed by two independent retina specialists using modified Early Treatment of Diabetic Retinopathy Study grading system. Sight threatening DR (STDR) was defined by the presence of proliferative DR(PDR) or diabetic macular edema. The sensitivity, specificity and image quality were assessed. The mean age of the participants was 53.5 ±9.6 years and mean duration of diabetes 12.5±7.3 years. The Zeiss camera showed that 43.9% had non-proliferative DR(NPDR) and 15.3% had PDR while the FOP camera showed that 40.2% had NPDR and 15.3% had PDR. The sensitivity and specificity for detecting any DR by FOP was 92.7% (95%CI 87.8-96.1) and 98.4% (95%CI 94.3-99.8) respectively and the kappa (ĸ) agreement was 0.90 (95%CI-0.85-0.95 p<0.001) while for STDR, the sensitivity was 87.9% (95%CI 83.2-92.9), specificity 94.9% (95%CI 89.7-98.2) and ĸ agreement was 0.80 (95%CI 0.71-0.89 p<0.001), compared to conventional photography. Retinal photography using FOP camera is effective for screening and diagnosis of DR and STDR with high sensitivity and specificity and has substantial agreement with conventional retinal photography.

  8. A slowly progressive retinopathy in the Shetland Sheepdog.

    Science.gov (United States)

    Karlstam, Lena; Hertil, Eva; Zeiss, Caroline; Ropstad, Ernst Otto; Bjerkås, Ellen; Dubielzig, Richard R; Ekesten, Björn

    2011-07-01

    To describe a slowly progressive retinopathy (SPR) in Shetland Sheepdogs. Animals  Forty adult Shetlands Sheepdogs with ophthalmoscopic signs of SPR and six normal Shetland Sheepdogs were included in the study. Ophthalmic examination including slit-lamp biomicroscopy and ophthalmoscopy was performed in all dogs. Electroretinograms and obstacle course-test were performed in 13 affected and 6 normal dogs. The SPR dogs were subdivided into two groups according to their dark-adapted b-wave amplitudes. SPR1-dogs had ophthalmoscopic signs of SPR, but normal dark-adapted b-wave amplitudes. Dogs with both ophthalmoscopic signs and subnormal, dark-adapted b-wave amplitudes were assigned to group SPR2. Eyes from two SPR2 dogs were obtained for microscopic examination. The ophthalmoscopic changes included bilateral, symmetrical, greyish discoloration in the peripheral tapetal fundus with normal or marginally attenuated vessels. Repeated examination showed that the ophthalmoscopic changes slowly spread across the central parts of the tapetal fundus, but did not progress to obvious neuroretinal thinning presenting as tapetal hyper-reflectivity. The dogs did not appear seriously visually impaired. SPR2 showed significantly reduced b-wave amplitudes throughout dark-adaptation. Microscopy showed thinning of the outer nuclear layer and abnormal appearance of rod and cone outer segments. Testing for the progressive rod-cone degeneration ( prcd )-mutation in three dogs with SPR was negative. Slowly progressive retinopathy is a generalized rod-cone degeneration that on ophthalmoscopy looks similar to early stages of progressive retinal atrophy. The ophthalmoscopic findings are slowly progressive without tapetal hyper-reflectivity. Visual impairment is not obvious and the electroretinogram is more subtly altered than in progressive retinal atrophy. The etiology remains unclear. SPR is not caused by the prcd-mutation. © 2011 American College of Veterinary Ophthalmologists.

  9. Clinical analysis of laser photocoagulation for diabetic retinopathy%糖尿病视网膜病变激光光凝治疗疗效分析

    Institute of Scientific and Technical Information of China (English)

    张志红; 王媛媛; 曹江欣

    2013-01-01

    目的探讨激光光凝治疗糖尿病视网膜病变(DR)的疗效。方法 以DR患者54例108眼为研究对象,对增殖期(PDR)96眼行标准全视网膜光凝,非增殖期(NPDR)22眼行弥漫视网膜光凝。结果 视力提高或不变90眼,有效率83.3%。FFA检查示有效率86.1%。结论 激光光凝术是治疗DR 的一个有效方法,要把握光凝时机,争取早期发现并及时治疗DR,提高激光光凝的疗效。%Objective :To evaluate the efficacy of laser coagulation for diabetic retinopathy. Method :Total 54 patients (108 eyes) of diabetic retinopathy were as the object of this study. 96 eyes with proliferative diabetic retinopathy (PDR) were given panretinal photocoagulation. 22 eyes with non-proliferative diabetic retinopathy(NPDR)were given scatter photocoagulation.Results : the eyes of vision improve or no change are 90,totle effective rate is 83.3. totle effective rate of FFA examination is 86.1%. Conclusion: Laser photocoagulation is an effective method for diabetic retinopathy. It has different efficacy for the different stages of diabetic retinopathy. It can improve the efficacy of laser photocoagulation that we seize the opportunity of laser photocoagulation for diabetic retinopathy,early detecting and timely treating diabetic retinopathy.

  10. Blood pressure control for diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Diana V. Do

    Full Text Available BACKGROUND: Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure.OBJECTIVES: The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes.METHODS:Search methods: We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria: We included in this review randomized controlled trials (RCTs in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis: Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We

  11. Blood pressure control for diabetic retinopathy

    Science.gov (United States)

    Do, Diana V; Wang, Xue; Vedula, Satyanarayana S; Marrone, Michael; Sleilati, Gina; Hawkins, Barbara S; Frank, Robert N

    2015-01-01

    Background Diabetic retinopathy is a common complication of diabetes and a leading cause of visual impairment and blindness. Research has established the importance of blood glucose control to prevent development and progression of the ocular complications of diabetes. Simultaneous blood pressure control has been advocated for the same purpose, but findings reported from individual studies have supported varying conclusions regarding the ocular benefit of interventions on blood pressure. Objectives The primary aim of this review was to summarize the existing evidence regarding the effect of interventions to control or reduce blood pressure levels among diabetics on incidence and progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs. A secondary aim was to compare classes of anti-hypertensive medications with respect to the same outcomes. Search methods We searched a number of electronic databases including CENTRAL as well as ongoing trial registries. We last searched the electronic databases on 25 April 2014. We also reviewed reference lists of review articles and trial reports selected for inclusion. In addition, we contacted investigators of trials with potentially pertinent data. Selection criteria We included in this review randomized controlled trials (RCTs) in which either type 1 or type 2 diabetic participants, with or without hypertension, were assigned randomly to intense versus less intense blood pressure control, to blood pressure control versus usual care or no intervention on blood pressure, or to different classes of anti-hypertensive agents versus placebo. Data collection and analysis Pairs of review authors independently reviewed titles and abstracts from electronic and manual searches and the full text of any document that appeared to be relevant. We assessed included trials independently for risk of bias with respect to outcomes reported in this review. We extracted data regarding trial

  12. Molecular Markers of Diabetic Retinopathy: Potential Screening Tool of the Future?

    Science.gov (United States)

    Pusparajah, Priyia; Lee, Learn-Han; Abdul Kadir, Khalid

    2016-01-01

    Diabetic retinopathy (DR) is among the leading causes of new onset blindness in adults. Effective treatment may delay the onset and progression of this disease provided it is diagnosed early. At present retinopathy can only be diagnosed via formal examination of the eye by a trained specialist, which limits the population that can be effectively screened. An easily accessible, reliable screening biomarker of diabetic retinopathy would be of tremendous benefit in detecting the population in need of further assessment and treatment. This review highlights specific biomarkers that show promise as screening markers to detect early diabetic retinopathy or even to detect patients at increased risk of DR at the time of diagnosis of diabetes. The pathobiology of DR is complex and multifactorial giving rise to a wide array of potential biomarkers. This review provides an overview of these pathways and looks at older markers such as advanced glycation end products (AGEs), inflammatory markers, vascular endothelial growth factor (VEGF) as well as other newer proteins with a role in the pathogenesis of DR including neuroprotective factors such as brain derived neurotrophic factor (BDNF) and Pigment Epithelium Derived Factor (PEDF); SA100A12, pentraxin 3, brain natriuretic peptide, apelin 3, and chemerin as well as various metabolites such as lipoprotein A, folate, and homocysteine. We also consider the possible role of proteins identified through proteomics work whose levels are altered in the sera of patients with DR as screening markers though their role in pathophysiology remains to be characterized. The role of microRNA as a promising new screening marker is also discussed. PMID:27313539

  13. Molecular Markers of Diabetic Retinopathy: Potential Screening Tool of the Future?

    Directory of Open Access Journals (Sweden)

    Priyia ePusparajah

    2016-06-01

    Full Text Available Diabetic retinopathy (DR is among the leading causes of new onset blindness in adults. Effective treatment may delay the onset and progression of this disease provided it is diagnosed early. At present retinopathy can only be diagnosed via formal examination of the eye by a trained specialist, which limits the population that can be effectively screened. An easily accessible, reliable screening biomarker of diabetic retinopathy would be of tremendous benefit in detecting the population in need of further assessment and treatment. This review highlights specific biomarkers that show promise as screening markers to detect early diabetic retinopathy or even to detect patients at increased risk of DR at the time of diagnosis of diabetes. The pathobiology of DR is complex and multifactorial giving rise to a wide array of potential biomarkers. This review provides an overview of these pathways and looks at older markers such as advanced glycation end products(AGEs, inflammatory markers, vascular endothelial growth factor (VEGF as well as other newer proteins with a role in the pathogenesis of DR including neuroprotective factors such as brain derived neurotrophic factor (BDNF and Pigment Epithelium Derived Factor (PEDF; SA100A12, pentraxin 3, brain natriuretic peptide, apelin 3 and chemerin as well as various metabolites such as lipoprotein A, folate and homocysteine. We also consider the possible role of proteins identified through proteomics work whose levels are altered in the sera of patients with DR as screening markers though their role in pathophysiology remains to be characterized. The role of microRNA as a promising new screening marker is also discussed.

  14. SERUM MAGNESIUM, LIPID PROFILE AND GLYCATED HAEMOGLOBIN IN DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Sunanda Vusikala

    2016-07-01

    Full Text Available BACKGROUND Diabetic retinopathy is one of the important microvascular complications of diabetes mellitus of long duration. Alterations in trace metals like magnesium and lipid profile was observed in diabetic retinopathy with hyperglycaemic status. AIM The study was taken up to assess the role of magnesium, lipid profile and glycated haemoglobin in diabetic retinopathy. MATERIALS AND METHODS A total of 80 subjects between 40-65 years were included in the study. Group 1 includes 20 age and sex matched healthy controls. Group 2 includes 30 cases of Diabetes mellitus without retinopathy. Group 3 includes 30 cases of Diabetes mellitus with retinopathy. RESULTS Magnesium was found to be significantly low in the diabetic group with retinopathy. Serum cholesterol and triglycerides were significantly elevated in the diabetic group with retinopathy. Fasting and Postprandial plasma glucose and glycated haemoglobin (HbA1c levels confirmed the glycaemic status of each of the groups. CONCLUSIONS Hypomagnesemia, hypercholesterolaemia, hypertriglyceridemia was observed in diabetic retinopathy along with increased levels of glycated haemoglobin in our study.

  15. Fast oxygen diffusion and iodide defects mediate oxygen-induced degradation of perovskite solar cells

    Science.gov (United States)

    Aristidou, Nicholas; Eames, Christopher; Sanchez-Molina, Irene; Bu, Xiangnan; Kosco, Jan; Islam, M. Saiful; Haque, Saif A.

    2017-05-01

    Methylammonium lead halide perovskites are attracting intense interest as promising materials for next-generation solar cells, but serious issues related to long-term stability need to be addressed. Perovskite films based on CH3NH3PbI3 undergo rapid degradation when exposed to oxygen and light. Here, we report mechanistic insights into this oxygen-induced photodegradation from a range of experimental and computational techniques. We find fast oxygen diffusion into CH3NH3PbI3 films is accompanied by photo-induced formation of highly reactive superoxide species. Perovskite films composed of small crystallites show higher yields of superoxide and lower stability. Ab initio simulations indicate that iodide vacancies are the preferred sites in mediating the photo-induced formation of superoxide species from oxygen. Thin-film passivation with iodide salts is shown to enhance film and device stability. The understanding of degradation phenomena gained from this study is important for the future design and optimization of stable perovskite solar cells.

  16. A Review on Recent Developments for Detection of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Javeria Amin

    2016-01-01

    Full Text Available Diabetic retinopathy is caused by the retinal micro vasculature which may be formed as a result of diabetes mellitus. Blindness may appear as a result of unchecked and severe cases of diabetic retinopathy. Manual inspection of fundus images to check morphological changes in microaneurysms, exudates, blood vessels, hemorrhages, and macula is a very time-consuming and tedious work. It can be made easily with the help of computer-aided system and intervariability for the observer. In this paper, several techniques for detecting microaneurysms, hemorrhages, and exudates are discussed for ultimate detection of nonproliferative diabetic retinopathy. Blood vessels detection techniques are also discussed for the diagnosis of proliferative diabetic retinopathy. Furthermore, the paper elaborates a discussion on the experiments accessed by authors for the detection of diabetic retinopathy. This work will be helpful for the researchers and technical persons who want to utilize the ongoing research in this area.

  17. A Review on Recent Developments for Detection of Diabetic Retinopathy

    Science.gov (United States)

    2016-01-01

    Diabetic retinopathy is caused by the retinal micro vasculature which may be formed as a result of diabetes mellitus. Blindness may appear as a result of unchecked and severe cases of diabetic retinopathy. Manual inspection of fundus images to check morphological changes in microaneurysms, exudates, blood vessels, hemorrhages, and macula is a very time-consuming and tedious work. It can be made easily with the help of computer-aided system and intervariability for the observer. In this paper, several techniques for detecting microaneurysms, hemorrhages, and exudates are discussed for ultimate detection of nonproliferative diabetic retinopathy. Blood vessels detection techniques are also discussed for the diagnosis of proliferative diabetic retinopathy. Furthermore, the paper elaborates a discussion on the experiments accessed by authors for the detection of diabetic retinopathy. This work will be helpful for the researchers and technical persons who want to utilize the ongoing research in this area. PMID:27777811

  18. Euglycemic progression: worsening of diabetic retinopathy in poorly controlled type 2 diabetes in minorities.

    Science.gov (United States)

    Shurter, A; Genter, P; Ouyang, D; Ipp, E

    2013-06-01

    In type 2 diabetes, early effects of strict near-normalization of glucose control on macrovascular and microvascular disease are still uncertain. We evaluated the effects of early dramatic improvement in glycemia on retinal disease in poorly controlled diabetes. A retrospective, case-control study in public hospital patients with type 2 diabetes, who had annual retinal imaging as part of a case management program or standard diabetes care. Patients included had ≥2 two retinal images ≥1 one year apart, and at least 3 HbA1C measurements. Retinal images were graded using a modified Scottish Diabetic Retinopathy grading scheme. An 'intensive' group (n=34) with HbA1C decrease >1.5% was compared with randomly chosen patients (n=34) with minimal HbA1C changes. Mean HbA1C (±SEM) over two years was similar in intensive (8.5 ± 0.21%) and control groups (8.1 ± 0.28%, p=NS). However, the intensive group had higher baseline HbA1C and a mean maximal decrease of 4.0 ± 0.41% in contrast to the control group (0.2 ± 0.11%). Retinopathy grade progressed +0.7 ± 0.25 units from baseline in the intensive group (p=0.015), a 22.6% worsening. The control group changed minimally from baseline (0.03 ± 0.14 units, p=NS). Change in retinopathy grade was significantly different between groups (p=0.02). More eyes worsened by ≥ 1 retinal grade (p=0.0025) and developed sight-threatening retinopathy (p=0.003) in the intensive group. Visual acuity was unchanged. Diabetic retinopathy significantly worsened in poorly controlled type 2 diabetes after early intensification of glycemic control and dramatic HbA1C change. Retinal status should be part of risk-factor evaluation in patients likely to experience marked reductions in HbA1C in poorly controlled diabetes. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. Optical coherence tomography in late solar retinopathy

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    Janković Aleksandar

    2011-01-01

    Full Text Available Introduction. Solar retinopathy refers to retinal injury induced by direct or indirect solar viewing. Case report. We presented a patient who had observed partial solar eclipse 51 year before. He had bilaterally decreased vision and scar of the macular region at the time of presentation. The basic diagnostic tool applied in the presented patient, optical coherence tomography, showed hyporeflexivity of the outer retina in the segment of retinal pigment epithelialphotoreceptors complex with atrophy and thinning of the foveolar region. Conclusion. Optical coherence tomography is a powerful, non-invasive diagnostic tool which can ease the diagnosis and estimate the level and nature of the macular region damage.

  20. Automatic detection Non-proliferative Diabetic Retinopathy using image processing techniques

    Directory of Open Access Journals (Sweden)

    RajuS. Maher

    2016-01-01

    Full Text Available Diabetes is a chronic disease that is reaching epidemic proportions worldwide. There are currently more than 190 million people with diabetes worldwide. The World Health Organization (WHO estimates that this will rise to 221 million by the year 2010, largely due to population growth, ageing, urbanization and a sedentary lifestyle. Diabetes is currently the fourth main cause of death in most developed countries. In Singapore, the prevalence of diabetes in our population is 8.2% according to the 2004 National Health Survey. This is expected to grow as our population age. Diabetic Retinopathy, if not well managed and controlled, can progress steadily to devastating complications like blindness. At present, various analyses on complicated interaction between hereditary and environmental factors are being undertaken regarding the onset of diabetes. The development of diabetic complication has become a major concern regarding the prognosis of diabetic patients. Diabetes Retinopathy is one of the most common diseases that people get affected by over the years. By doing this paper, we hope to detect the stages of Diabetic Retinopathy as early as possible so as to prevent and cure more Singaporeans from falling prey to this disease.

  1. Disturbance of Inorganic Phosphate Metabolism in Diabetes Mellitus: Its Relevance to the Pathogenesis of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    H. Vorum

    2014-01-01

    Full Text Available Early in the progression of diabetes, a paradoxical metabolic imbalance in inorganic phosphate (Pi occurs that may lead to reduced high energy phosphate and tissue hypoxia. These changes take place in the cells and tissues in which the entry of glucose is not controlled by insulin, particularly in poorly regulated diabetes patients in whom long-term vascular complications are more likely. Various conditions are involved in this disturbance in Pi. First, the homeostatic function of the kidneys is suboptimal in diabetes, because elevated blood glucose concentrations depolarize the brush border membrane for Pi reabsorption and lead to lack of intracellular phosphate and hyperphosphaturia. Second, during hyperglycemic-hyperinsulinemic intervals, high amounts of glucose enter muscle and fat tissues, which are insulin sensitive. Intracellular glucose is metabolized by phosphorylation, which leads to a reduction in plasma Pi, and subsequent deleterious effects on glucose metabolism in insulin insensitive tissues. Hypophosphatemia is closely related to a decrease in adenosine triphosphate (ATP in the aging process and in uremia. Any interruption of optimal ATP production might lead to cell injury and possible cell death, and evidence will be provided herein that such cell death does occur in diabetic retinopathy. Based on this information, the mechanism of capillary microaneurysms formation in diabetic retinopathy and the pathogenesis of diabetic retinopathy must be reevaluated.

  2. Cell Therapy Applications for Retinal Vascular Diseases: Diabetic Retinopathy and Retinal Vein Occlusion.

    Science.gov (United States)

    Park, Susanna S

    2016-04-01

    Retinal vascular conditions, such as diabetic retinopathy and retinal vein occlusion, remain leading causes of vision loss. No therapy exists to restore vision loss resulting from retinal ischemia and associated retinal degeneration. Tissue regeneration is possible with cell therapy. The goal would be to restore or replace the damaged retinal vasculature and the retinal neurons that are damaged and/or degenerating from the hypoxic insult. Currently, various adult cell therapies have been explored as potential treatment. They include mesenchymal stem cells, vascular precursor cells (i.e., CD34+ cells, hematopoietic cells or endothelial progenitor cells), and adipose stromal cells. Preclinical studies show that all these cells have a paracrine trophic effect on damaged ischemic tissue, leading to tissue preservation. Endothelial progenitor cells and adipose stromal cells integrate into the damaged retinal vascular wall in preclinical models of diabetic retinopathy and ischemia-reperfusion injury. Mesenchymal stem cells do not integrate as readily but appear to have a primary paracrine trophic effect. Early phase clinical trials have been initiated and ongoing using mesenchymal stem cells or autologous bone marrow CD34+ cells injected intravitreally as potential therapy for diabetic retinopathy or retinal vein occlusion. Adipose stromal cells or pluripotent stem cells differentiated into endothelial colony-forming cells have been explored in preclinical studies and show promise as possible therapies for retinal vascular disorders. The relative safety or efficacy of these various cell therapies for treating retinal vascular disorders have yet to be determined.

  3. DESIGN AND DEVELOP A COMPUTER AIDED DESIGN FOR AUTOMATIC EXUDATES DETECTION FOR DIABETIC RETINOPATHY SCREENING

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    C. A. SATHIYAMOORTHY

    2016-04-01

    Full Text Available Diabetic Retinopathy is a severe and widely spread eye disease which can lead to blindness. One of the main symptoms for vision loss is Exudates and it could be prevented by applying an early screening process. In the Existing systems, a Fuzzy C-Means Clustering technique is used for detecting the exudates for analyzation. The main objective of this paper is, to improve the efficiency of the Exudates detection in diabetic retinopathy images. To do this, a three Stage – [TS] approach is introduced for detecting and extracting the exudates automatically from the retinal images for screening the Diabetic retinopathy. TS functions on the image in three levels such as Pre-processing the image, enhancing the image and detecting the Exudates accurately. After successful detection, the detected exudates are classified using GLCM method for finding the accuracy. The TS approach is experimented using MATLAB software and the performance evaluation can be proved by comparing the results with the existing approach’s result and with the hand-drawn ground truths images from the expert ophthalmologist.

  4. Insulin Pump Therapy Is Associated with Lower Rates of Retinopathy and Peripheral Nerve Abnormality

    Science.gov (United States)

    Zabeen, Bedowra; Craig, Maria E.; Virk, Sohaib A.; Pryke, Alison; Chan, Albert K. F.; Cho, Yoon Hi; Benitez-Aguirre, Paul Z.; Hing, Stephen; Donaghue, Kim C.

    2016-01-01

    Objective To compare rates of microvascular complications in adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI). Research Design and Methods Prospective cohort of 989 patients (aged 12–20 years; diabetes duration >5 years) treated with CSII or MDI for >12 months. Microvascular complications were assessed from 2000–14: early retinopathy (seven-field fundal photography), peripheral nerve function (thermal and vibration threshold testing), autonomic nerve abnormality (heart rate variability analysis of electrocardiogram recordings) and albuminuria (albumin creatinine ratio/timed overnight albumin excretion). Generalized estimating equations (GEE) were used to examine the relationship between treatment and complications rates, adjusting for socio-economic status (SES) and known risk factors including HbA1c and diabetes duration. Results Comparing CSII with MDI: HbA1C was 8.6% [70mmol/mol] vs. 8.7% [72 mmol/mol]) (p = 0.7), retinopathy 17% vs. 22% (p = 0.06); microalbuminuria 1% vs. 4% (p = 0.07), peripheral nerve abnormality 27% vs. 33% (p = 0.108) and autonomic nerve abnormality 24% vs. 28% (p = 0.401). In multivariable GEE, CSII use was associated with lower rates of retinopathy (OR 0.66, 95% CI 0.45–0.95, p = 0.029) and peripheral nerve abnormality (OR 0.63, 95% CI 0.42–0.95, p = 0.026), but not albuminuria (OR 0.46, 95% CI 0.10–2.17, p = 0.33). SES was not associated with any of the complication outcomes. Conclusions In adolescents, CSII use is associated with lower rates of retinopathy and peripheral nerve abnormality, suggesting an apparent benefit of CSII over MDI independent of glycemic control or SES. PMID:27050468

  5. MRI biomarkers for evaluation of treatment efficacy in preclinical diabetic retinopathy.

    Science.gov (United States)

    Berkowitz, Bruce A; Bissig, David; Dutczak, Oliver; Corbett, Shannon; North, Rob; Roberts, Robin

    2013-07-01

    One sober consequence of the current epidemic of diabetes mellitus is that an increasing number of people world-wide will partially or completely lose their sight to diabetic retinopathy. Clinically, the sight-threatening complications of diabetes are diagnosed and treated based on visible retinal lesions (e.g., dot-blot hemorrhages or retinal neovascularization). However, such anatomical microvascular lesions are slow to respond with treatment. Thus, there remains an urgent need for imaging biomarkers that are abnormal before retinal lesions are visibly apparent and are responsive to treatment. Here, the development of new MRI methods, such as manganese-enhanced MRI, for evaluating early diabetes-evoked retinal pathophysiology, and its usefulness in guiding new treatments for diabetic retinopathy are reviewed. In diabetic retinopathy, not all important diagnostic and prognostic needs are well served by optical methods. In the absence of gross anatomy changes, critical times when drug intervention is most likely to be successful at reducing vision loss are missed by most light-based methods and thus provide little help in guiding diagnosis and treatment. For example, before clinical symptoms, is there an optimal time to intervene with drug therapy? Is a drug reaching its target? How does one assess optimal drug dose, schedule, and routes? How well do current experimental models mimic the clinical condition? As discussed herein, MRI is as an analytical tool for addressing these unmet needs. Future clinical applications of MRI can be envisioned such as in clinical trials to assess drug treatment efficacy, or as an adjunct approach to refine or clarify a difficult clinical case. New MRI-generated hypotheses about the pathogenesis of diabetic retinopathy and its treatment are discussed. In the coming years, a substantial growth in the development and application of MRI is expected to address relevant question in both the basic sciences and in the clinic.

  6. Insulin Pump Therapy Is Associated with Lower Rates of Retinopathy and Peripheral Nerve Abnormality.

    Directory of Open Access Journals (Sweden)

    Bedowra Zabeen

    Full Text Available To compare rates of microvascular complications in adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion (CSII versus multiple daily injections (MDI.Prospective cohort of 989 patients (aged 12-20 years; diabetes duration >5 years treated with CSII or MDI for >12 months. Microvascular complications were assessed from 2000-14: early retinopathy (seven-field fundal photography, peripheral nerve function (thermal and vibration threshold testing, autonomic nerve abnormality (heart rate variability analysis of electrocardiogram recordings and albuminuria (albumin creatinine ratio/timed overnight albumin excretion. Generalized estimating equations (GEE were used to examine the relationship between treatment and complications rates, adjusting for socio-economic status (SES and known risk factors including HbA1c and diabetes duration.Comparing CSII with MDI: HbA1C was 8.6% [70mmol/mol] vs. 8.7% [72 mmol/mol] (p = 0.7, retinopathy 17% vs. 22% (p = 0.06; microalbuminuria 1% vs. 4% (p = 0.07, peripheral nerve abnormality 27% vs. 33% (p = 0.108 and autonomic nerve abnormality 24% vs. 28% (p = 0.401. In multivariable GEE, CSII use was associated with lower rates of retinopathy (OR 0.66, 95% CI 0.45-0.95, p = 0.029 and peripheral nerve abnormality (OR 0.63, 95% CI 0.42-0.95, p = 0.026, but not albuminuria (OR 0.46, 95% CI 0.10-2.17, p = 0.33. SES was not associated with any of the complication outcomes.In adolescents, CSII use is associated with lower rates of retinopathy and peripheral nerve abnormality, suggesting an apparent benefit of CSII over MDI independent of glycemic control or SES.

  7. Photocoagulation as treatment of diabetic retinopathy

    Science.gov (United States)

    Sanchez, J.; Fernandez, L.; de Pedraza, Maria L.; Gamella, C.; Santervas, R.

    1992-03-01

    Diabetes Mellitus is a chronic disease that is revealed with a lot of alterations due to factors such as an absolute or relative reduction of the insulin. It is usually accompanied by generalized arteriosclerosis and prepares for certain microvasculares pathologies such as retinopathy, nefropathy, and neuropathy. The first effects of diabetes in the retina seem to act on the capillaries. The functional modifications of the retinal circulation appear before the structural ones. These consist of the blood flux damage and the obligation of the hematorretinal barrier with extravasacy as can be proved in the fluorophotometry of the vitreous humor. Nowadays, medical treatments are more effective and only vitrectomy and photocoagulation are used in diabetic retinopathy. For that, the argon laser and the xenon arch are used. The treatment is usually spread panretine, with coagulation in a grid pattern around the eye, avoiding the macula and other vital structures, and treating the neoformed blood vessels. The rate of grave visual loss in the studies carried out with there techniques was 12 in relation to 28 in the non-treated cases. The most important factors of risk found, were the discal neoformed blood vessels and the hemorrhage of the vitreous humor. Adverse effects were found such as the reduction of visual sharpness and the contrition of the visual field, these are greater in patients treated with the xenon arch than in those treated with the argon laser.

  8. Inflammation and Pharmacological Treatment in Diabetic Retinopathy

    Science.gov (United States)

    Kaštelan, Snježana; Tomić, Martina; Gverović Antunica, Antonela; Salopek Rabatić, Jasminka; Ljubić, Spomenka

    2013-01-01

    Diabetic retinopathy (DR), the most common microvascular complication of diabetes mellitus, is estimated to be the leading cause of new blindness in the working population of developed countries. Primary interventions such as intensive glycemic control, strict blood pressure regulation, and lipid-modifying therapy as well as local ocular treatment (laser photocoagulation and pars plana vitrectomy) can significantly reduce the risk of retinopathy occurrence and progression. Considering the limitations of current DR treatments development of new therapeutic strategies, it becomes necessary to focus on pharmacological treatment. Currently, there is increasing evidence that inflammatory processes have a considerable role in the pathogenesis of DR with multiple studies showing an association of various systemic as well as local (vitreous and aqueous fluid) inflammatory factors and the progression of DR. Since inflammation is identified as a relevant mechanism, significant effort has been directed to the development of new concepts for the prevention and treatment of DR acting on the inflammatory processes and the use of pharmacological agents with anti-inflammatory effect. Inhibiting the inflammatory pathway could be an appealing treatment option for DR in future practices, and as further prospective randomized clinical trials accumulate data, the role and guidelines of anti-inflammatory pharmacologic treatments will become clearer. PMID:24288441

  9. Inflammation and Pharmacological Treatment in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Snježana Kaštelan

    2013-01-01

    Full Text Available Diabetic retinopathy (DR, the most common microvascular complication of diabetes mellitus, is estimated to be the leading cause of new blindness in the working population of developed countries. Primary interventions such as intensive glycemic control, strict blood pressure regulation, and lipid-modifying therapy as well as local ocular treatment (laser photocoagulation and pars plana vitrectomy can significantly reduce the risk of retinopathy occurrence and progression. Considering the limitations of current DR treatments development of new therapeutic strategies, it becomes necessary to focus on pharmacological treatment. Currently, there is increasing evidence that inflammatory processes have a considerable role in the pathogenesis of DR with multiple studies showing an association of various systemic as well as local (vitreous and aqueous fluid inflammatory factors and the progression of DR. Since inflammation is identified as a relevant mechanism, significant effort has been directed to the development of new concepts for the prevention and treatment of DR acting on the inflammatory processes and the use of pharmacological agents with anti-inflammatory effect. Inhibiting the inflammatory pathway could be an appealing treatment option for DR in future practices, and as further prospective randomized clinical trials accumulate data, the role and guidelines of anti-inflammatory pharmacologic treatments will become clearer.

  10. Purtscher's retinopathy followed by neovascular glaucoma

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    Kuroda M

    2013-11-01

    Full Text Available Masasko Kuroda,1 Akihiro Nishida,1 Masashi Kikuchi,2 Yasuo Kurimoto11Department of Ophthalmology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan; 2Kikuchi Eye Clinic, Kobe, Hyogo, JapanAbstract: We report the case of a 66-year-old Japanese man who developed neovascular glaucoma secondary to Purtscher's retinopathy following a head injury. The patient presented at our hospital with blurred vision and a visual field abnormality in his left eye 1 month after suffering from a head injury. Upon initial presentation, his best-corrected visual acuity on a decimal chart was 1.5 oculus dexter and 0.6 oculus sinister. The intraocular pressure (IOP was 12 mmHg in both eyes. Fundus examination of the left eye revealed multiple white lesions in the posterior pole. Optical coherence tomography demonstrated retinal edema, particularly in the inner retina. On the basis of these findings, a diagnosis of Purtscher's retinopathy was made. One month after the initial examination, the visual acuity in the left eye deteriorated to 0.01 in decimal chart, and the IOP increased to 37 mmHg. Gonioscopy showed angle neovascularization. The patient received an intravitreal bevacizumab injection and panretinal photocoagulation. Subsequently, the IOP normalized and the angle neovascularization regressed.Keywords: blurred vision, visual field, retinal edema, head injury, head trauma

  11. Erythrocyte phospholipid and polyunsaturated fatty acid composition in diabetic retinopathy.

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    Philippe Koehrer

    Full Text Available Long chain polyunsaturated fatty acids (LCPUFAs including docosahexaenoic acid and arachidonic acid are suspected to play a key role in the pathogenesis of diabetes. LCPUFAs are known to be preferentially concentrated in specific phospholipids termed as plasmalogens. This study was aimed to highlight potential changes in the metabolism of phospholipids, and particularly plasmalogens, and LCPUFAs at various stages of diabetic retinopathy in humans.We performed lipidomic analyses on red blood cell membranes from controls and mainly type 2 diabetes mellitus patients with or without retinopathy. The fatty acid composition of erythrocytes was determined by gas chromatography and the phospholipid structure was determined by liquid chromatography equipped with an electrospray ionisation source and coupled with a tandem mass spectrometer (LC-ESI-MS/MS. A significant decrease in levels of docosahexaenoic acid and arachidonic acid in erythrocytes of diabetic patients with or without retinopathy was observed. The origin of this decrease was a loss of phosphatidyl-ethanolamine phospholipids esterified with these LCPUFAs. In diabetic patients without retinopathy, this change was balanced by an increase in the levels of several phosphatidyl-choline species. No influence of diabetes nor of diabetic retinopathy was observed on the concentrations of plasmalogen-type phospholipids.Diabetes and diabetic retinopathy were associated with a reduction of erythrocyte LCPUFAs in phosphatidyl-ethanolamines. The increase of the amounts of phosphatidyl-choline species in erythrocytes of diabetic patients without diabetic retinopathy might be a compensatory mechanism for the loss of LC-PUFA-rich phosphatidyl-ethanolamines.

  12. Preclinical screening for retinopathy of prematurity risk using IGF1 levels at 3 weeks post-partum.

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    Alejandro Pérez-Muñuzuri

    Full Text Available Following current recommendations for preventing retinopathy of prematurity (ROP involves screening a large number of patients. We performed a prospective study to establish a useful screening system for ROP prediction and we have determined that measuring serum levels of IGF1 at week three and the presence of sepsis have a high predictive value for the subsequent development of ROP. A total of 145 premature newborn, with birthweight <1500 g and/or <32 weeks gestational age, were enrolled. 26.9% of them showed some form of retinopathy. A significant association was found between the development of retinopathy and each of the following variables: early gestational age, low birthweight, requiring mechanical ventilation, oxygen treatment, intracranial haemorrhage, sepsis during the first three weeks, bronchopulmonary dysplasia, the need for erythrocyte transfusion, erythropoietin treatment, and low levels of serum IGF1 in the third week. A multiple logistic regression analysis was used to obtain curves for the probability of developing ROP, based on the main factors linked with ROP, namely serum levels of IGF1 and presence of sepsis. Such preclinical screening has the ability to identify patients with high-risk of developing retinopathy and should lead to better prediction for ROP, while at the same time optimising the use of clinical resources, both human and material.

  13. Algorithms for digital image processing in diabetic retinopathy.

    Science.gov (United States)

    Winder, R J; Morrow, P J; McRitchie, I N; Bailie, J R; Hart, P M

    2009-12-01

    This work examined recent literature on digital image processing in the field of diabetic retinopathy. Algorithms were categorized into 5 steps (preprocessing; localization and segmentation of the optic disk; segmentation of the retinal vasculature; localization of the macula and fovea; localization and segmentation of retinopathy). The variety of outcome measures, use of a gold standard or ground truth, data sample sizes and the use of image databases is discussed. It is intended that our classification of algorithms into a small number of categories, definition of terms and discussion of evolving techniques will provide guidance to algorithm designers for diabetic retinopathy.

  14. Influence of nitric oxide synthase inhibitor on gerbil behavior after hyperbaric oxygen-induced convulsion

    Institute of Scientific and Technical Information of China (English)

    Jianguang Zhou; Changyun Liu; Yiqun Fang; Yingqi Zhou; Erli Xu; Jingchang Liu

    2008-01-01

    BACKGROUND: Studies have reported that nitric oxide synthase (NOS) inhibitor can prolong the latency of hyperbaric oxygen-induced convulsion (HBOC). However, there are very few reports addressing the influence of NOS inhibitor on mental behavior.OBJECTIVE: To investigate behavioral changes after HBOC in gerbils, as well as the influence of NOS inhibitor.DESIGN, TIME AND SETTING: Randomized experiments were performed in the Laboratory of Hyperbaric Pressure and Diving Physiology, Naval Medical Research Institute of Chinese PLA (Shanghai,China) from March 2005 to June 2007.MATERIALS: Forty male gerbils were randomly divided into five groups: HBOC, saline control, NOS inhibitor, pressure control, and normal control. Each group contained eight animals.METHODS: In the HBOC group, once depression induction ended, animals were removed from the chamber five minutes after the first appearance of generalized convulsion induced by 0.5 MPa hyperbaric oxygen. Ten minutes before entering the chamber, saline control and NOS inhibitor animals were intraperitoneally injected with 1 mL saline and 20 mg/kg NG-nitro-L-arginine, respectively. The pressure control group was only exposed to 0.5 MPa. The remaining procedures in these three groups were identical to the HBOC group. The normal control group received no intervention.MAIN OUTCOME MEASURES: Open field test scores in gerbils prior to HBOC, as well as immediately,24 hours, and 72 hours after decompression ended.RESULTS: HBOC was not detected in either the normal control or the pressure control group, and there were no significant differences in opcn field test scores prior to and after HBOC (P > 0.05). HBOC occurred in the HBOC, saline control, and NOS inhibitor groups, with significant differences in open field test scores after decompression ended compared to normal control and pressure control groups (P < 0.05-0.01).Compared to the HBOC and saline control groups, the NOS inhibitor group exhibited a significantly lower score in

  15. Monitoring of Diabetic Retinopathy in relation to Bariatric Surgery

    DEFF Research Database (Denmark)

    Brynskov, Troels; Laugesen, Caroline Schmidt; Svenningsen, Annette Lykke

    2016-01-01

    BACKGROUND: To investigate the need for closer perioperative monitoring of diabetic retinopathy in patients with type 2 diabetes undergoing bariatric surgery. METHODS: Prospective observational clinical study of 56 patients with type 2 diabetes undergoing bariatric surgery. The patients were...... examined with 7-field fundus images and optical coherence tomography scans 2 weeks before and 1, 3, 6 and 12 months after bariatric surgery. Worsening was defined as a two-step change in the Wisconsin Epidemiologic Study of Diabetic Retinopathy scale or appearance or worsening of macular edema...... preoperatively where HbA1c was 6.4 ± 1.9 %. CONCLUSIONS: Diabetic retinopathy was clinically stable after bariatric surgery, and none of the observed changes would have resulted in a changed screening interval at our center. This supports adherence to regular diabetic retinopathy screening guidelines following...

  16. The North Jutland County Diabetic Retinopathy Study (NCDRS). Population characteristics

    DEFF Research Database (Denmark)

    Knudsen, L.L.; Lervang, H.H.; Lundbye-Christensen, Søren;

    Abstract Purpose: Several population based studies have reported blood glucose levels and blood pressure to be risk factors for the development of proliferativ retinopathy and diabetic maculopathy. Despite their importance, these studies were initiated more than two decades ago and may therefore...... reflect the treatment and population composition of a previous era. Studies of the present diabetic population are therefore in demand. Methods: The present cross–section study included 656 type 1 and 328 type 2 diabetic subjects undergoing diabetic retinopathy screening. Crude prevalence rates...... for proliferative diabetic retinopathy, maculopathy, several specific lesions and non–ophthalmic findings were assessed together with their association to a simplified and internationally approved retinal grading. Results: The crude prevalence of proliferative retinopathy was found to be 5.6 % and 0.9 % for type 1...

  17. Evaluation of the Treatment of Diabetic Retinopathy A Research Project

    Science.gov (United States)

    Kupfer, Carl

    1973-01-01

    Evaluated is the treatment of diabetic retinopathy (blindness due to ruptured vessels of the retina as a side effect of diabetes), and described is a research project comparing two types of photocoagulation treatment. (DB)

  18. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.

    2008-01-01

    PURPOSE: To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR) without ophthalmoscopically visible fundus changes. METHODS: Retrospective case series. Two consecutive patients with bilateral AZOOR with photopsia corresponding to areas of visual field loss and a normal fundus...

  19. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.

    2008-01-01

    To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR) without ophthalmoscopically visible fundus changes. Retrospective case series. Two consecutive patients with bilateral AZOOR with photopsia corresponding to areas of visual field loss and a normal fundus appearance were...

  20. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

    Zibrandtsen, N.; Munch, I.C.; Klemp, K.

    2006-01-01

    Purpose: To assess retinal morphology in acute zonal occult outer retinopathy (AZOOR). Methods: Three patients with a normal ophthalmoscopic fundus appearance, a history of photopsia, and visual field loss compatible with AZOOR were examined using optical coherence tomography, automated perimetry...

  1. Automated Detection and Differentiation of Drusen, Exudates, and Cotton-Wool Spots in Digital Color Fundus Photographs for Diabetic Retinopathy Diagnosis

    NARCIS (Netherlands)

    Niemeijer, M.; van Ginneken, B.; Russel, S.R.; Suttorp-Schulten, M.S.A.; Abràmoff, M.D.

    2007-01-01

    purpose. To describe and evaluate a machine learning-based, automated system to detect exudates and cotton-wool spots in digital color fundus photographs and differentiate them from drusen, for early diagnosis of diabetic retinopathy. methods. Three hundred retinal images from one eye of 300

  2. Characterization of Retinal Disease Progression in a 1-Year Longitudinal Study of Eyes With Mild Nonproliferative Retinopathy in Diabetes Type 2

    DEFF Research Database (Denmark)

    Ribeiro, Luisa; Bandello, Francesco; Tejerina, Amparo Navea

    2015-01-01

    PURPOSE: To identify eyes of patients with diabetes type 2 that show progression of retinal disease within a 1-year period using noninvasive techniques. METHODS: Three hundred seventy-four type 2 diabetic patients with mild nonproliferative diabetic retinopathy (Early Treatment Diabetic Retinopathy...... clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Progression of retinal thickening was registered in eyes that had either subclinical or clinical macular edema at baseline. CONCLUSIONS: Changes in MA activity measured with Retmarker...

  3. Visual evoked potential changes in patients with diabetes mellitus without retinopathy

    Directory of Open Access Journals (Sweden)

    Sangeeta Gupta

    2015-12-01

    Results: The study has demonstrated significant prolongation of mean P100 latency, reduction in N75-P100 amplitudes and increased interocular latency difference in the diabetics as compared to the control group. The duration of the illness was found to alter the mean P100 latency while the glycaemic status of the diabetics was not found to be correlated with the PRVEP abnormalities. Conclusions: VEP responses are deranged in diabetic patients before the development of retinopathy. VEP measurements can be used for the early diagnosis of visual dysfunctions in the diabetes for a better prognosis of the condition. [Int J Res Med Sci 2015; 3(12.000: 3591-3598

  4. Human Genetics of Diabetic Retinopathy: Current Perspectives

    Directory of Open Access Journals (Sweden)

    Daniel P. K. Ng

    2010-01-01

    Full Text Available Diabetic retinopathy (DR is a most severe microvascular complication which, if left unchecked, can be sight-threatening. With the global prevalence of diabetes being relentlessly projected to rise to 438 million subjects by 2030, DR will undoubtedly pose a major public health concern. Efforts to unravel the human genetics of DR have been undertaken using the candidate gene and linkage approaches, while GWAS efforts are still lacking. Aside from evidence for a few genes including aldose reductase and vascular endothelial growth factor, the genetics of DR remain poorly elucidated. Nevertheless, the promise of impactful scientific discoveries may be realized if concerted and collaborative efforts are mounted to identify the genes for DR. Harnessing new genetic technologies and resources such as the upcoming 1000 Genomes Project will help advance this field of research, and potentially lead to a rich harvest of insights into the biological mechanisms underlying this debilitating complication.

  5. Steroid-induced central serous retinopathy

    Directory of Open Access Journals (Sweden)

    Samidh P Shah

    2011-01-01

    Full Text Available A-24 year-old male was prescribed prednisolone (60 mg/day for left sided facial palsy. After three days of therapy, the patient complained of black spots in his vision in right eye. Fluorescein angiography of right eye showed evidence of central serous retinopathy (CSR. Prednisolone dose was withdrawn gradually and the patient improved within a week. There were no other systemic or ophthalmic diseases reported by the patient, which could have caused this condition. An improvement after dechallenge confirmed steroid-induced CSR. Recurrent CSR is known to cause permanent loss of vision. Hence, awareness regarding this adverse drug reaction (ADR with steroids and its reporting can minimize this complication and help in better patient management.

  6. Automated detection of diabetic retinopathy in retinal images

    Directory of Open Access Journals (Sweden)

    Carmen Valverde

    2016-01-01

    Full Text Available Diabetic retinopathy (DR is a disease with an increasing prevalence and the main cause of blindness among working-age population. The risk of severe vision loss can be significantly reduced by timely diagnosis and treatment. Systematic screening for DR has been identified as a cost-effective way to save health services resources. Automatic retinal image analysis is emerging as an important screening tool for early DR detection, which can reduce the workload associated to manual grading as well as save diagnosis costs and time. Many research efforts in the last years have been devoted to developing automatic tools to help in the detection and evaluation of DR lesions. However, there is a large variability in the databases and evaluation criteria used in the literature, which hampers a direct comparison of the different studies. This work is aimed at summarizing the results of the available algorithms for the detection and classification of DR pathology. A detailed literature search was conducted using PubMed. Selected relevant studies in the last 10 years were scrutinized and included in the review. Furthermore, we will try to give an overview of the available commercial software for automatic retinal image analysis.

  7. Neuroprotection as a Therapeutic Target for Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Cristina Hernández

    2016-01-01

    Full Text Available Diabetic retinopathy (DR is a multifactorial progressive disease of the retina and a leading cause of vision loss. DR has long been regarded as a vascular disorder, although neuronal death and visual impairment appear before vascular lesions, suggesting an important role played by neurodegeneration in DR and the appropriateness of neuroprotective strategies. Upregulation of vascular endothelial growth factor (VEGF, the main target of current therapies, is likely to be one of the first responses to retinal hyperglycemic stress and VEGF may represent an important survival factor in early phases of DR. Of central importance for clinical trials is the detection of retinal neurodegeneration in the clinical setting, and spectral domain optical coherence tomography seems the most indicated technique. Many substances have been tested in animal studies for their neuroprotective properties and for possible use in humans. Perhaps, the most intriguing perspective is the use of endogenous neuroprotective substances or nutraceuticals. Together, the data point to the central role of neurodegeneration in the pathogenesis of DR and indicate neuroprotection as an effective strategy for treating this disease. However, clinical trials to determine not only the effectiveness and safety but also the compliance of a noninvasive route of drug administration are needed.

  8. The Clinical Importance of Changes in Diabetic Retinopathy Severity Score.

    Science.gov (United States)

    Ip, Michael S; Zhang, Jiameng; Ehrlich, Jason S

    2017-05-01

    To investigate the clinical importance of changes in diabetic retinopathy severity score (DRSS) in patients with diabetic macular edema (DME) treated with intravitreal ranibizumab. Post hoc analysis of the phase III RIDE and RISE studies of ranibizumab for treatment of DME. Four hundred sixty-eight eyes treated with ranibizumab from randomization with gradable DRSS on baseline fundus photographs. Visual and anatomic outcomes were examined in eyes grouped according to DRSS change from baseline to month 24. Mean best-corrected visual acuity (BCVA) letter score change, proportion of patients with 15 or more Early Treatment Diabetic Retinopathy Study (ETDRS) letter score change, mean contrast sensitivity change, proportion of patients with resolved macular edema, and leakage on fluorescein angiography. Most (56.8%) patients treated with ranibizumab experienced 1-step or more improvement in DRSS from baseline to month 24; 40.0% had no change, and 3.2% experienced DRSS worsening. Patients with DRSS stability or improvement had greater mean BCVA letter score changes (+15.1, +14.2, +11.3, and +11.2 letters for ≥3-step improvement, ≥2-step improvement, 1-step improvement, and no DRSS change, respectively) compared with +5.0 letters in patients who had any DRSS worsening. Best-corrected visual acuity letter score gain of 15 letters or more was more common in patients with 2-step or 3-step or more DRSS improvement (51.9% and 44.6%, respectively) compared with those with a 1-step DRSS improvement, no change, or worsening (37.9%, 39.6%, and 26.7%, respectively). A loss of 15 letters or more in BCVA was more common in patients with any DRSS worsening (13.3%) compared with patients who had stable or improved DRSS (0%-2.8%). Resolution of macular edema was more common in patients with DRSS improvement: 84.2%, 87.7%, and 92.3% of patients with 1-step, 2-step or more, and 3-step or more improvement in DRSS achieved central foveal thickness of 250 μm or less, compared with

  9. Retinopatía diabética Diabetic retinopathy

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    D. Aliseda

    2008-01-01

    Full Text Available La diabetes mellitus es una patología metabólica que en su evolución afecta a diferentes órganos, entre ellos los ojos. La microangiopatía diabética afecta de manera precoz y específica a la retina. La aparición de la retinopatía está directamente relacionada con el tiempo de evolución de la enfermedad y del control metabólico. La microangiopatía diabética en la retina muestra alteraciones específicas como son los microaneurismas, los exudados duros o blandos, las microhemorragias intrarretinianas, dilataciones venosas arrosariadas y anomalías microvasculares intrarretinianas. Estas alteraciones en la microcirculación retiniana causan dos fenómenos fisiopatológicos: cierre capilar con la consiguiente isquemia o extravasación del contenido intravascular al estroma provocando edema. En este capítulo se exponen la clasificación y tratamientos de la retinopatía diabética, excluyendo el edema macular, según los diferentes estudios multicéntricos presentes en la bibliografía actual.Diabetes mellitus is a metabolic pathology whose evolution affects different organs, amongst them the eye. Diabetic microangiopathy affects the retina in an early and specific way. The appearance of retinopathy is directly related to the time of evolution of the disease and metabolic control. Diabetic microangiopathy in the retina shows specific alterations such as micro-aneurysms, soft or hard exudates, intra-retinal micro-haemorrhages, beaded veins and intraretinal microvascular anomalies. These alterations in the retinal microcirculation cause two physiopathological phenomena: capillary closure with the resulting ischaemia or extravasation of intravascular content to the stroma causing edema. In this chapter we set out the classification and treatments of diabetic retinopathy, excluding macular edema, according to the different multicentric studies present in the current bibliography.

  10. Reversal of the Caspase-Dependent Apoptotic Cytotoxicity Pathway by Taurine from Lycium barbarum (Goji Berry in Human Retinal Pigment Epithelial Cells: Potential Benefit in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    M. K. Song

    2012-01-01

    Full Text Available Diabetic retinopathy is a preventable microvascular diabetic complication and a leading cause of vision loss. Retinal pigment epithelial cell apoptosis is an early event in diabetic retinopathy. Taurine is reportedly beneficial for diabetic retinopathy and is abundant in the fruit of Lycium barbarum (LB. We have investigated the effect of pure taurine and an extract of LB rich in taurine on a model of diabetic retinopathy, the retinal ARPE-19 cell line exposed to high glucose. We demonstrate for the first time that LB extract and the active ligand, taurine, dose dependently enhance cell viability following high glucose treatment in the ARPE-19 retinal epithelial cell line. This cytoprotective effect was associated with the attenuation of high glucose-induced apoptosis, which was shown by characteristic morphological staining and the dose-dependent decrease in the number of apoptotic cells, determined by flow cytometry. Moreover, we have shown that LB extract and taurine dose dependently downregulate caspase-3 protein expression and the enzymatic activity of caspase-3. We conclude that taurine, a major component of LB, and the LB extract, have a cytoprotective effect against glucose exposure in a human retinal epithelial cell line and may provide useful approaches to delaying diabetic retinopathy progression.

  11. Analysis of diabetic retinopathy biomarker VEGF gene by computational approaches

    OpenAIRE

    Jayashree Sadasivam; Ramesh, N.; K. Vijayalakshmi; Vinni Viridi; Shiva prasad

    2012-01-01

    Diabetic retinopathy, the most common diabetic eye disease, is caused by changes in the blood vessels of the retina which remains the major cause. It is characterized by vascular permeability and increased tissue ischemia and angiogenesis. One of the biomarker for Diabetic retinopathy has been identified as Vascular Endothelial Growth Factor ( VEGF )gene by computational analysis. VEGF is a sub-family of growth factors, the platelet-derived growth factor family of cystine-knot growth factors...

  12. Long-term effects of therapy with ranibizumab on diabetic retinopathy severity and baseline risk factors for worsening retinopathy.

    Science.gov (United States)

    Ip, Michael S; Domalpally, Amitha; Sun, Jennifer K; Ehrlich, Jason S

    2015-02-01

    To assess the effects of intravitreal ranibizumab on diabetic retinopathy (DR) severity when administered for up to 3 years, evaluate the effect of delayed initiation of ranibizumab therapy on DR severity, and identify baseline patient characteristics associated with the development of proliferative DR (PDR). Exploratory analyses of phase III, randomized, double-masked, sham-controlled multicenter clinical trials. Adults with diabetic macular edema (DME) (N = 759), baseline best-corrected visual acuity 20/40 to 20/320 Snellen equivalent, and central foveal thickness ≥275 μm. Patients were randomized to monthly 0.3 or 0.5 mg ranibizumab or sham injections. Sham participants could switch to 0.5 mg ranibizumab during the third year (sham/0.5 mg crossover). Baseline risk factors were evaluated to explore potential associations with development of PDR. Time to first development of PDR was analyzed by Kaplan-Meier methods to calculate cumulative probabilities by group. Study eye change on the Early Treatment Diabetic Retinopathy Study severity scale and a composite clinical outcome evaluating progression to PDR based on photographic changes plus clinically important events defining PDR. At month 36, a greater proportion of ranibizumab-treated eyes had ≥2- or ≥3-step DR improvement compared with sham/0.5 mg crossover. A ≥3-step improvement was achieved at 36 months by 3.3%, 15.0%, and 13.2% of sham/0.5 mg, 0.3 mg, and 0.5 mg ranibizumab-treated eyes, respectively (P eyes in the sham/0.5 mg group developed PDR, as measured by composite outcome, compared with 18.3% and 17.1% of eyes treated with 0.3 or 0.5 mg ranibizumab, respectively. The presence of macular capillary nonperfusion at baseline seems to be associated with progression to PDR in ranibizumab-treated eyes but did not meaningfully influence visual acuity improvement in eyes with DME after ranibizumab therapy. Ranibizumab, as administered to patients with DME for 12 to 36 months in these studies, can

  13. Role of FEN1 S187 phosphorylation in counteracting oxygen-induced stress and regulating postnatal heart development.

    Science.gov (United States)

    Zhou, Lina; Dai, Huifang; Wu, Jian; Zhou, Mian; Yuan, Hua; Du, Juan; Yang, Lu; Wu, Xiwei; Xu, Hong; Hua, Yuejin; Xu, Jian; Zheng, Li; Shen, Binghui

    2017-01-01

    Flap endonuclease 1 (FEN1) phosphorylation is proposed to regulate the action of FEN1 in DNA repair as well as Okazaki fragment maturation. However, the biologic significance of FEN1 phosphorylation in response to DNA damage remains unknown. Here, we report an in vivo role for FEN1 phosphorylation, using a mouse line carrying S187A FEN1, which abolishes FEN1 phosphorylation. Although S187A mouse embryonic fibroblast cells showed normal proliferation under low oxygen levels (2%), the mutant cells accumulated oxidative DNA damage, activated DNA damage checkpoints, and showed G1-phase arrest at atmospheric oxygen levels (21%). This suggests an essential role for FEN1 phosphorylation in repairing oxygen-induced DNA damage and maintaining proper cell cycle progression. Consistently, the mutant cardiomyocytes showed G1-phase arrest due to activation of the p53-mediated DNA damage response at the neonatal stage, which reduces the proliferation potential of the cardiomyocytes and impairs heart development. Nearly 50% of newborns with the S187A mutant died in the first week due to failure to undergo the peroxisome proliferator-activated receptor signaling-dependent switch from glycolysis to fatty acid oxidation. The adult mutant mice developed dilated hearts and showed significantly shorter life spans. Altogether, our results reveal an important role of FEN1 phosphorylation to counteract oxygen-induced stress in the heart during the fetal-to-neonatal transition.-Zhou, L., Dai, H., Wu, J., Zhou, M., Yuan, H., Du, J., Yang, L., Wu, X., Xu, H., Hua, Y., Xu, J., Zheng, L., Shen, B. Role of FEN1 S187 phosphorylation in counteracting oxygen-induced stress and regulating postnatal heart development. © FASEB.

  14. Early

    Directory of Open Access Journals (Sweden)

    Kamel Abd Elaziz Mohamed

    2014-04-01

    Conclusion: Early PDT is recommended for patients who require prolonged tracheal intubation in the ICU as outcomes like the duration of mechanical ventilation length of ICU stay and hospital stay were significantly shorter in early tracheostomy.

  15. Progression of diabetic retinopathy during pregnancy in women with type 2 diabetes

    DEFF Research Database (Denmark)

    Rasmussen, K.L.; Laugesen, C.S.; Nielsen, Lene Ringholm;

    2010-01-01

    We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes.......We studied the progression of diabetic retinopathy during pregnancy in women with type 2 diabetes....

  16. PLVAP in diabetic retinopathy: A gatekeeper of angiogenesis and vascular permeability

    NARCIS (Netherlands)

    Wiśniewska-Kruk, J.

    2014-01-01

    Nowadays, approximately 4 million people worldwide experience blindness or severe vision loss caused by diabetic retinopathy. Diabetic retinopathy is a multifactorial disease that can progress from minor changes in vascular permeability, into a proliferative retinal disorder. The increasing incidenc

  17. Metabolic factors in the development of retinopathy of juvenile-onset type I diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Khosla P

    1994-01-01

    Full Text Available Thirty-five patients of insulin-dependent diabetes mellitus (IDDM were investigated for the effect of various metabolic factors on retinopathy. The severity of retinopathy increased with duration and age of onset of IDDM. Degree of glycaemia (fasting blood sugar, FBS was similar in patients with or without retinopathy. All IDDM patients as a group showed severe carbohydrate intolerance with lower basal and post glucose serum immunoreactive insulin (IRI levels and serum C-peptide radioimmunoreactivity (CPR as compared to controls. The insulin secretory response was similar in no retinopathy, mild retinopathy and severe retinopathy groups. Patients with retinopathy had higher incidence of hyperlipidemia but mean serum levels of cholesterol and triglyceride were similar. This study does not suggest a direct relationship between the various metabolic factors studied and retinopathy due to IDDM

  18. Pregnancy-induced sight-threatening diabetic retinopathy in women with Type 1 diabetes

    DEFF Research Database (Denmark)

    Vestgaard, Marianne; Nielsen, Lene Ringholm; Laugesen, C.S.

    2010-01-01

    To determine the progression of diabetic retinopathy in pregnant women with diabetes offered tight glycaemic and blood pressure control.......To determine the progression of diabetic retinopathy in pregnant women with diabetes offered tight glycaemic and blood pressure control....

  19. Pregnancy-induced sight-threatening diabetic retinopathy in women with Type 1 diabetes

    DEFF Research Database (Denmark)

    Vestgaard, Marianne; Nielsen, Lene Ringholm; Laugesen, C.S.

    2010-01-01

    To determine the progression of diabetic retinopathy in pregnant women with diabetes offered tight glycaemic and blood pressure control.......To determine the progression of diabetic retinopathy in pregnant women with diabetes offered tight glycaemic and blood pressure control....

  20. Automatic Exudate Detection from Non-dilated Diabetic Retinopathy Retinal Images Using Fuzzy C-means Clustering.

    Science.gov (United States)

    Sopharak, Akara; Uyyanonvara, Bunyarit; Barman, Sarah

    2009-01-01

    Exudates are the primary sign of Diabetic Retinopathy. Early detection can potentially reduce the risk of blindness. An automatic method to detect exudates from low-contrast digital images of retinopathy patients with non-dilated pupils using a Fuzzy C-Means (FCM) clustering is proposed. Contrast enhancement preprocessing is applied before four features, namely intensity, standard deviation on intensity, hue and a number of edge pixels, are extracted to supply as input parameters to coarse segmentation using FCM clustering method. The first result is then fine-tuned with morphological techniques. The detection results are validated by comparing with expert ophthalmologists' hand-drawn ground-truths. Sensitivity, specificity, positive predictive value (PPV), positive likelihood ratio (PLR) and accuracy are used to evaluate overall performance. It is found that the proposed method detects exudates successfully with sensitivity, specificity, PPV, PLR and accuracy of 87.28%, 99.24%, 42.77%, 224.26 and 99.11%, respectively.

  1. 糖尿病视网膜病变的诊治%Diagnosis and treatment of diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    宋静; 孙莉

    2013-01-01

    糖尿病视网膜病变(diabetic retinopathy, DR)是目前国内外主要的致盲性眼病,同时导致重大的社会经济负担。多种危险因素参与其发生和进展,早期诊断并积极治疗可以防止或延缓其进展。%Diabetic retinopathy is the main blinding eye disease at home and abroad now, which causes serious social and economic burden. Multiple risk factors involve in its development and progression. Early diagnosis and aggressive treatment can prevent or delay its progress.

  2. Programs for Detecting and Treating Retinopathy of Prematurity: Role of the Neonatal Team.

    Science.gov (United States)

    Grover, Sudhanshu; Katoch, Deeksha; Dogra, Mangat R; Kumar, Praveen

    2016-11-07

    High quality perinatal-neonatal care can prevent severe Retinopathy of Prematurity (ROP) in most cases. Preterm infants who do develop retinopathy can also have good visual outcomes if screening and treatment are done timely. National Neonatology Forum published clinical practice guidelines for timely screening and treatment of ROP in neonatal care units in the country in 2010. It is also listed as one of the condition under Rashtriya Bal Swasthya Karyakram for early identification and early intervention, and is currently a focus area under the National Program for Control of Blindness. Technical and operational guidelines for screening and treatment have been released. Programs like home-based neonatal care can be utilized for ensuring timely screening and follow-up of high-risk infants. Prevention, timely diagnosis and treatment requires well-coordinated teamwork between neonatologists, ophthalmologists, nurses and obstetricians. The neonatal care team should have an evidence-based screening policy, must coordinate and facilitate screening by ophthalmologist, and provide pre and post-operative support, if treatment is required. The neonatologist also has an important responsibility of educating the healthcare workers and the families. A team approach and inter-sectoral coordination are the keys to success of a national drive to decrease the burden of preventable blindness due to ROP.

  3. Proliferative Diabetic Retinopathy Surgery against the Background of Prior Retinal Laser Coagulation

    Directory of Open Access Journals (Sweden)

    Fazilat Bakhritdinova, PhD, ScD¹

    2013-03-01

    Full Text Available The study has been performed to compare the immediate and long-term outcomes of Vitreoretinal Surgery (VS on patients with Proliferative Diabetic Retinopathy (PDR in relation to Prior Retinal Laser Coagulation (PLC. The study included 56 patients (71 eyes with diabetes mellitus (type 2 - 52/93%, men – 39/75% complicated with proliferative diabetic retinopathy (PDR, requiring VS. Of these, 33 eyes (no PLC underwent primary vitrectomy, while the remaining 38 eyes (PLC had undergone panretinal laser coagulation over the past five years. In our study, PLC significantly contributed to the preservation of improved functional retinal status, despite the development of complications, which is an indication for VS. The PLC patients exhibited early recovery and a higher visual acuity throughout the observation period. Thus, the study revealed that in the case of prior VS, laser photocoagulation of the retina helps preserve the visual acuity, both at the time of and during the first year after surgery, reduces surgery duration and decreases the need to tamponade the vitreous cavity with silicone oil. Besides, PLC of the retina is accompanied by a significantly lower incidence of intra- and post-operational hemorrhage and reduces the need for repeated vitreoretinal procedures. The present study presents further arguments in favor of early retinal laser photocoagulation on patients with diabetes mellitus complicated by PDR.

  4. Analysis of the Anxiety and Depression for Patients with Type 2 Diabetic Retinopathy in Different Period%不同时期2型糖尿病视网膜病变患者焦虑抑郁分析

    Institute of Scientific and Technical Information of China (English)

    刘奎香; 贺庆娟; 李廷

    2014-01-01

    Objective To study the anxiety and depression status of patients with type 2 diabetic retinopathy in different period. Methods Experimental group (patients with proliferative diabetic retinopathy)and control group (patients with non-proliferative diabetic retinopathy ) were all patients to our hospital,each group had 50 people. Cross-sectional survey about Hamilton rating scalefor anxiety (HAMA) and depression self-rating scale (HAMD)were carried out,then do statistical analysis. Results Patients with proliferative diabetic retinopathy got higher scores higher in anxiety depression test than that who with non-proliferative diabetic retinopathy. And the dif erence has statistical significance.Conclusion Higher at ention should be paid to psychological treatment for patients with proliferative diabetic retinopathy,and early intervention treatment of diabetic retinopathy for patients with non-proliferative diabetic retinopathy.%目的探讨非增殖期与增殖期糖尿病病变患者的焦虑抑郁心理状态。方法试验组及对照组均取于我院就诊的患有增殖期及非增殖期糖尿病视网膜病变的患者,各50例,对其进行焦虑及抑郁自评量表调查并对结果进行统计分析。结果增殖期糖尿病视网膜病变患者焦虑抑郁得分较非增殖期患者明显增高,差异有统计学意义。结论应重视对增殖期糖尿病视网膜病变患者的心理治疗及非增殖期糖尿病视网膜病变患者的早期干预治疗。

  5. Vitamin Status as a Determinant of Serum Homocysteine Concentration in Type 2 Diabetic Retinopathy

    OpenAIRE

    Pandelis Fotiou; Athanasios Raptis; George Apergis; George Dimitriadis; Ioannis Vergados; Panagiotis Theodossiadis

    2014-01-01

    We investigated the association of serum homocysteine levels and vitamin status with type 2 diabetic retinopathy. This study included 65 patients with and 75 patients without diabetic retinopathy. Patients with diabetic retinopathy had significantly higher serum homocysteine levels (P < 0.001), higher prevalence of hyperhomocysteinemia (P < 0.001), lower serum folic acid (P < 0.001), and vitamin B12 (P = 0.014) levels than those without diabetic retinopathy. Regression analysis revealed that ...

  6. Evaluating choroidal thickness in diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Chan CY

    2014-06-01

    Full Text Available Chee Yee Chan,1 Thanos D Papakostas,2 Demetrios Vavvas2 1Department of Ophthalmology, 2Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USAWe read with interest the article by Unsal et al1 and congratulate them on their work assessing choroidal thickness in patients with diabetic retinopathy. We will like to highlight some factors of relevance.Unsal et al state that their measurement of the choroid was from the outer part of the retinal pigment epithelial layer to the choroidal scleral junction.1 However, their Figure 2 seems to draw the upper border of the choroid at various locations (external limiting membrane, inner/outer segment junction, top of the retinal pigment epithelium.1 An illustrative diagram (Figure 1 for measuring choroidal thickness can be seen in the study reported by Copete et al.2 Recent studies of the thickness of the retinal pigment epithelium–Bruch’s membrane complex in normal individuals ranged from 17.5 μm to 28.2 μm.3 Hence, measurement of choroidal thickness has to be drawn correctly and consistently at the same location (outer part of the retinal pigment epithelium to minimize potential inaccuracies. View original paper by Unsal and colleagues.

  7. Effect ofSalvia miltiorrhiza on retinopathy

    Institute of Scientific and Technical Information of China (English)

    Li Zhang; Shu-Zhen Dai; Xiao-Dong Nie; Lei Zhu; Feng Xing; Li-Ya Wang

    2013-01-01

    Objective:To explore the effect of Salvia miltiorrhiza on diabetic retinopathy(DR).Methods:Diabetic mice of natural incidence type with monogenic inheritance were selected.Alloxan was injected into the caudal vein of mice once to induceDR.The structural changes of retina tissue in normal mice,DR mice and mice with high, medium and low dose ofSalvia miltiorrhiza injection were observed under microscope.Then the blood glucose concentration and malonaldehyde(MDA) content were detected.Results:There were some microaneurysms in retina ofDR group, number of gangliocyte was decreased significantly, and cells were sparse and in disorder.After modeling, the blood glucose level of high-dose Salvia miltiorrhiza group(SMⅢ group) was significantly different fromDR group(P<0.01).Till the tenth week, the blood glucose level of allSM groups was decreased significantly compared withDR group(P<0.01).The effective rates of threeSM groups were93.8%,76.4% and50.3%, respectively.After ten weeks,MDA content ofDR group was significantly higher than those of the normal control group andSM group(P<0.01), and medium and low doseSM groups had significantly higherMDA than that of normal control group(P<0.01). Conclusions:Salvia miltiorrhiza had certain protective effect onDRmice through the blood-ocular barrier.

  8. Treatment of threshold retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Deshpande Dhanashree

    1998-01-01

    Full Text Available This report deals with our experience in the management of threshold retinopathy of prematurity (ROP. A total of 45 eyes of 23 infants were subjected to treatment of threshold ROP. 26.1% of these infants had a birth weight of >l,500 gm. The preferred modality of treatment was laser indirect photocoagulation, which was facilitated by scleral depression. Cryopexy was done in cases with nondilating pupils or medial haze and was always under general anaesthesia. Retreatment with either modality was needed in 42.2% eyes; in this the skip areas were covered. Total regression of diseases was achieved in 91.1% eyes with no sequelae. All the 4 eyes that progressed to stage 5 despite treatment had zone 1 disease. Major treatment-induced complications did not occur in this series. This study underscores the importance of routine screening of infants upto 2,000 gm birth weight for ROP and the excellent response that is achieved with laser photocoagulation in inducing regression of threshold ROP. Laser is the preferred method of treatment in view of the absence of treatment-related morbidity to the premature infants.

  9. Prolactin and vasoinhibins: Endogenous players in diabetic retinopathy.

    Science.gov (United States)

    Triebel, Jakob; Macotela, Yazmín; de la Escalera, Gonzalo Martínez; Clapp, Carmen

    2011-10-01

    Diabetic retinopathy is a disease of the retinal microvasculature that develops as a complication of diabetes mellitus and constitutes a major cause of blindness in adults of all ages. Diabetic retinopathy is characterized by the loss of capillary cells leading to increased vasopermeability, ischemia, and hypoxia that trigger the excessive formation of new blood vessels in the retina. The influence of the pituitary gland in the pathophysiology of diabetic retinopathy was recognized nearly six decades ago, but the contribution of pituitary hormones to this disease remains unclear. Recent studies have shown that the pituitary hormone prolactin is proteolytically cleaved to vasoinhibins, a family of peptides with potent antivasopermeability, vasoconstrictive, and antiangiogenic actions that can protect the eye against the deleterious effects of the diabetic state. In this review, we summarize what is known about the changes in the circulating levels of prolactin and vasoinhibins during diabetes and diabetic retinopathy as well as the implications of these changes for the development and progression of the disease with particular attention to hyperprolactinemia in pregnancy and postpartum. We discuss the effects of prolactin and vasoinhibins that may impact diabetic retinopathy and suggest these hormones as important targets for therapeutic interventions. Copyright © 2011 Wiley Periodicals, Inc.

  10. CORELATION OF DRY EYE STATUS WITH SEVERITY OF DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Tanushree

    2014-11-01

    Full Text Available AIM: To study the correlation of dry eye status with severity of diabetic retinopathy. MATERIALS AND METHODS: SETTINGS AND DESIGN: Prospective study. One hundred patients with diabetes mellitus attending the outpatient and in-patient department, Department of Ophthalmology, K. R. Hospital, Mysore, were included under the study, between the periods from January 2014 to July 2014 (6 months. Informed and written consent was taken from all the patients. After detailed history, all necessary ocular and systemic examination was done. All diabetes mellitus patients were analyzed for dry eye status and presence of diabetic retinopathy changes. Dry eye status was evaluated with Schirmer’s test, Tear film break up time and conjunctival impression cytology. Retinal status evaluation was done by direct ophthalmoscopy, indirect ophthalmoscopy and Slit lamp Biomicroscopy using 78D lens after pupillary dilation. Diabetic retinopathy was graded accordingly to ETDRS classification. STATISTICAL ANALYSIS: All data were analyzed using descriptive statistics and Chi square test and contingency coefficient analysis was applied. RESULTS: A total of 100 diabetes mellitus patients were analyzed. 56 (56% patients had Diabetic retinopathy and 44(44% had normal fundus picture. Out of the 100 diabetes mellitus patients, 36 (36% patients had dry eye. Significant association (P – 0.001 between dry eye and diabetes mellitus was seen. CONCLUSION: Dry eye and diabetes mellitus have a common association. Dry eye is more frequent in diabetes mellitus patients with longer duration and in patients with Diabetic retinopathy.

  11. RETINOPATHY, GLUCOSE, AND INSULIN IN AN ELDERLY POPULATION - THE ROTTERDAM STUDY

    NARCIS (Netherlands)

    STOLK, RP; VINGERLING, [No Value; DEJONG, PTVM; DIELEMANS, Hubertus J.A.; HOFMAN, A; LAMBERTS, SWJ; POLS, HAP; GROBBEE, DE

    1995-01-01

    We studied the association between retinopathy and glucose metabolism in a population-based study of elderly men and women, Glucose metabolism was assessed by serum fructosamine and a nonfasting oral glucose tolerance test, and retinopathy was evaluated by fundus photography, Retinopathy was present

  12. PREVALENCE OF DIABETIC RETINOPATHY IN RIMS SRIKAKULAM, INDIA: A HOSPITAL BASED STUDY

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    Surya Chandra

    2015-05-01

    Full Text Available OBJECTIVE: assessment of the prevalence of diabetic retinopathy among people staying in Srikakulam MATERIAL AND METHOD S : A cross - sectional hospital based study was done for 500 patients with established diabetes who came to eye OPD at Rajiv Gandhi Institute of medical Sciences, Srikakulam. T hey were evaluated for the presence or absence of retinopathy caused by the underlyin g Diabetes. Necessary clinical examination was done and the findings were noted separately. No follow - up was done in this study. Indirect Ophthalmoscope, Direct Ophthalmoscope 90D Lens, slit lamp bio - microscope and Fundus Photography were used for examinat ion. Statistical package for Social Sciences (SPSS was taken for statistical analysis. p60 yrs of age and 49 patients (32.03% wer e between 40 - 60 yrs of age. 51 (33.33% were males and 102 (66.67% were females. Mild DR was present in 154 (15.4% eyes, moderate to severe DR in 94 (9.4% eyes, proliferative DR in 17(1.7% eyes and diabetic maculopathy in 41(4.1% eyes. 38 patients (2 4.8% with diabetes of = 15 yr. Patients who were on irregular or inadequate treatment with OHA, insulin or both and with improper adher ence to medication had more prevalence of DR. CONCLUSION: The study concluded that Diabetic Retinopathy is highly prevalent in Srikakulam district Andhra P radesh and necessary steps should be taken for early detection of the disease and appropriate treatment to prevent blindness which can be caused by this disease .

  13. Clinical Analysis of Retinopathy of Prematurity%早产儿视网膜病变的临床分析

    Institute of Scientific and Technical Information of China (English)

    邓燕; 于春红; 廖瑜俊; 杨洋; 彭小维; 殷小龙

    2009-01-01

    case of 5 lesions and a case of 4 lesions had poor prognosis.1 case whose lesion developed from 2 to 3 had effective treatment of retinal laser.The other cases's retina was fully vascularized.ConclusionThe incidence of retinopathy is negatively correlated with birth weight,and is positively correlated with the length of oxygen uptake and its levels.Early inspection,early detection and early treatment are of importance in preventing blinding caused by retinopathy in premature infants.

  14. Automated detection of exudates for diabetic retinopathy screening

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, Alan D [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom); Philip, Sam [Diabetes Retinal Screening Service, David Anderson Building, Foresterhill Road, Aberdeen, AB25 2ZP (United Kingdom); Goatman, Keith A [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom); Williams, Graeme J [Diabetes Retinal Screening Service, David Anderson Building, Foresterhill Road, Aberdeen, AB25 2ZP (United Kingdom); Olson, John A [Diabetes Retinal Screening Service, David Anderson Building, Foresterhill Road, Aberdeen, AB25 2ZP (United Kingdom); Sharp, Peter F [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom)

    2007-12-21

    Automated image analysis is being widely sought to reduce the workload required for grading images resulting from diabetic retinopathy screening programmes. The recognition of exudates in retinal images is an important goal for automated analysis since these are one of the indicators that the disease has progressed to a stage requiring referral to an ophthalmologist. Candidate exudates were detected using a multi-scale morphological process. Based on local properties, the likelihoods of a candidate being a member of classes exudate, drusen or background were determined. This leads to a likelihood of the image containing exudates which can be thresholded to create a binary decision. Compared to a clinical reference standard, images containing exudates were detected with sensitivity 95.0% and specificity 84.6% in a test set of 13 219 images of which 300 contained exudates. Depending on requirements, this method could form part of an automated system to detect images showing either any diabetic retinopathy or referable diabetic retinopathy.

  15. ANAEMIC RETINOPATHY WITH THROMBOCYTOPENIA: AN INTERESTING CASE REPORT

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    Parul

    2014-07-01

    Full Text Available Anemia is a group of disorders characterized by decrease in number of circulating red blood cells, decrease in amount of hemoglobin in each cell or both. We report an interesting case of young female who presented to us with clinical presentation of anemic retinopathy with thrombocytopenia. History of bleeding gums with menorrhagia was present. She had short history of diminish vision in both eyes. Fundus changes were very typical of anemic retinopathy with presence of Roth spots as characteristic finding. Disc pallor and venous tortousity was also present in both eyes. Fundus picture showed marked improvement with blood transfusion. Our case confirms the association of anemic retinopathy in patients suffering with severe anemia with coexisting thrombocytopenia

  16. Plasma prekallikrein as a risk factor for diabetic retinopathy.

    Science.gov (United States)

    Kedzierska, Karolina; Ciechanowski, Kazimierz; Gołembiewska, Edyta; Safranow, Krzysztof; Ciechanowicz, Andrzej; Domański, Leszek; Myślak, Marek; Róźański, Jacek

    2005-01-01

    The aim of the study was to verify the hypothesis that in diabetes there is an increased activation of coagulation system leading in consequence to diabetic retinopathy. Thirty three healthy subjects (controls, 16 males and 17 females) and 35 patients with diabetes type 1 (15 males and 20 females) were examined. We monitored plasma prekallikrein (PPK), glycemia, fructosamine, glycosylated hemoglobin, activated partial thromboplastin time (PTT), INR, fibrinolysis in euglobulins time (FET), level of antithrombin III (AT III), fibrinogen (Fb) and fibrinogen degradation products (FDP). In diabetic patients without retinopathy, PKK concentration was 16% higher (p PKK concentration was 50% higher (p <0.001) than in controls. In the subgroup of patients with proliferative retinopathy PTT was significantly shorter (p <0.001), and FET was significantly longer (p <0.001) than in control. In patients with diabetes higher FDP concentrations were found than in controls (p <0.05). Significant correlations were found between PPK and fructosamine levels in all diabetic patients (R(S)=+0.57 p <0.001), in diabetic patients without retinopathy (R(S)=+0.61, p <0.05), and in diabetic patients with retinopathy (R(S)=+0.62, p <0.005). We found negative correlation between PPK concentration and PTT (R(S)=-0.43, p <0.001) and positive correlation between PPK concentration and FET (R(S)=+0.59, p <0.00001) in the entire study group. The occurrence of diabetic retinopathy is connected with higher levels of plasma prekallikrein.

  17. Rates of progression in diabetic retinopathy during different time periods: a systematic review and meta-analysis

    DEFF Research Database (Denmark)

    Wong, Tien Y; Mwamburi, Mkaya; Klein, Ronald

    2009-01-01

    This meta-analysis reviews rates of progression of diabetic retinopathy to proliferative diabetic retinopathy (PDR) and/or severe visual loss (SVL) and temporal trends.......This meta-analysis reviews rates of progression of diabetic retinopathy to proliferative diabetic retinopathy (PDR) and/or severe visual loss (SVL) and temporal trends....

  18. Plantar Fascia Thickness is Longitudinally Associated with Retinopathy and Renal Dysfunction: A Prospective Study from Adolescence to Adulthood

    Science.gov (United States)

    Benitez-Aguirre, Paul Z.; Craig, Maria E.; Jenkins, Alicia J.; Gallego, Patricia H.; Cusumano, Janine; Duffin, Anthony C.; Hing, Stephen; Donaghue, Kim C.

    2012-01-01

    Aim The aim was to study the longitudinal relationship between plantar fascia thickness (PFT) as a measure of tissue glycation and microvascular (MV) complications in young persons with type 1 diabetes (T1DM). Methods We conducted a prospective longitudinal cohort study of 152 (69 male) adolescents with T1DM who underwent repeated MV complications assessments and ultrasound measurements of PFT from baseline (1997–2002) until 2008. Retinopathy was assessed by 7-field stereoscopic fundal photography and nephropathy by albumin excretion rate (AER) from three timed overnight urine specimens. Longitudinal analysis was performed using generalized estimating equations (GEE). Results Median (interquartile range) age at baseline was 15.1 (13.4–16.8) years, and median follow-up was 8.3 (7.0–9.5) years, with 4 (3–6) visits per patient. Glycemic control improved from baseline to final visit [glycated hemoglobin (HbA1c) 8.5% to 8.0%, respectively; p = .004]. Prevalence of retinopathy increased from 20% to 51% (p 7.5 µg/min) increased from 26% to 29% (p = .2). A greater increase in PFT (mm/year) was associated with retinopathy at the final assessment (ΔPFT 1st vs. 2nd–4th quartiles, χ2 = 9.87, p = .02). In multivariate GEE, greater PFT was longitudinally associated with retinopathy [odds ratio (OR) 4.6, 95% confidence interval (CI) 2.0–10.3] and early renal dysfunction (OR 3.2, CI 1.3–8.0) after adjusting for gender, blood pressure standard deviation scores, HbA1c, and total cholesterol. Conclusions In young people with T1DM, PFT was longitudinally associated with retinopathy and early renal dysfunction, highlighting the importance of early glycemic control and supporting the role of metabolic memory in MV complications. Measurement of PFT by ultrasound offers a noninvasive estimate of glycemic burden and tissue glycation. PMID:22538146

  19. Acute Zonal Occult Outer Retinopathy: Vision Loss in an Active Duty Soldier

    Directory of Open Access Journals (Sweden)

    Courtney M. Crawford

    2013-01-01

    Full Text Available Objective. To describe a case of acute zonal occult outer retinopathy (AZOOR in an active duty patient. Methods. In this paper we studied fundus photographs, optical coherence tomograph, Humphrey visual field 30-2, fundus autofluorescence images, fluorescein angiograms, and electroretinography. Results. Exam findings on presentation: a 34-year-old American Indian female presented with bilateral photopsias, early RPE irregularity, and an early temporal visual field defect. Progression RPE damage and visual field defect along with ERG findings support final diagnosis of AZOOR. Conclusion. AZOOR may initially be identified as a broader category of disease called the “AZOOR complex of disorders”. Specific visual field defects, ERG results, and clinical exam findings will help distinguish AZOOR from other similar disorders.

  20. DETECTION OF HARD EXUDATES IN DIABETIC RETINOPATHY RETINAL IMAGES BY UTILIZING VISUAL DICTIONARY AND CLASSIFIER APPROACHES

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    Kemal Akyol

    2016-06-01

    Full Text Available Diabetic retinopathy is a disease that causes blindness resulting from damages that emerge in the retina depending on the diabetes mellitus. There are two stages of the disease including the non-proliferative and proliferative. Eyesight loss is blocked by means of early detection and diagnosis of non-proliferative DR findings. In this study, we designed a decision support system for automatic detection of hard exudates which are early stage DR lesions. This system consists of region-of-interest, feature extraction, visual dictionary and classifying stages. We tested the performance of the system, which we carried out based on system learning and analysis of new retinal images, on the public DIARETDB1 retinal image dataset. Experimental results showed us that machine learning technique suggested by us is successful.

  1. Dengue Fever Presenting as Purtscher-like Retinopathy.

    Science.gov (United States)

    Lima, Luiz H; Vianello, Silvana; Pimentel, Sérgio; Costa de Andrade, Gabriel; Zett, Claudio; Muller, Léo; Farah, Michel E; Belfort, Rubens

    2017-03-21

    To report the fundus manifestations and spectral-domain optical coherence tomographic (SD-OCT) features of dengue fever presenting as Purtscher-like retinopathy. Retrospective review of two cases of dengue fever. Color fundus photograph revealed the presence of cotton-wool spots in a Purtscher-like configuration in the posterior pole of all study eyes. SD-OCT demonstrated increased reflectivity signal in the inner retinal layers, and after a variable follow-up period, there was complete disappearance of cotton-wool spots and persistence of the hyperreflectivity signal. We report two unique cases of dengue fever associated with retinal lesions in a configuration of Purtscher-like retinopathy.

  2. Retinopathy of prematurity and risk factors: a prospective cohort study

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    Angell Linda

    2005-06-01

    Full Text Available Abstract Background Increased survival of extremely low birth infants due to advances in antenatal and neonatal care has resulted in a population of infants at high risk of developing retinopathy of prematurity (ROP. Therapeutic interventions include the use of antenatal and postnatal steroids however, their effects on the severity of ROP is in dispute. In addition, it has not been investigated whether severe ROP is due to therapeutic interventions or due to the severity of illness. The aim of the present study was to assess the association between the incidence of severe retinopathy of prematurity (greater than stage 2 – International classification of ROP and mechanical ventilation, oxygen therapy, gestational age, antenatal and postnatal steroids in extremely low birth weight infants. Methods Neonates admitted to the neonatal intensive care unit in Lansing, Michigan, during 1993–2000 were followed to determine factors influencing the development of severe retinopathy of prematurity. Ophthalmologic examinations were started at 6 weeks and followed until resolution. We used logistic regression to estimate the relative risk (odds ratio associated with risk factors of ROP. Results Of the neonates with ≤ 1500 g birth weight, admitted to the neonatal intensive care unit, 85% (616/725 survived. Severe retinopathy of prematurity was detected in 7.8% of 576 neonates who had eye examinations. Neonates of lower gestational age (≤ 25 weeks and 26–28 weeks had an increased odds ratio of 8.49 and 3.19 for the development of severe retinopathy of prematurity, respectively, compared to those 29 weeks and older. Late postnatal steroid treatment starting after 3 weeks of life showed 2.9-fold increased odds ratio, in particular administration for two weeks and more (OR: 4.09, 95% CI: 1.52–11.03. With increasing antenatal steroids courses the risk of severe retinopathy of prematurity decreased, however, it was not significant. Lower gestational age

  3. Transthyretin represses neovascularization in diabetic retinopathy

    Science.gov (United States)

    Shao, Jun

    2016-01-01

    Purpose The apoptosis of human umbilical vein endothelial cells has been reportedly induced by the protein transthyretin (TTR). In human ocular tissue, TTR is generally considered to be secreted mainly by retinal pigment epithelial cells (hRPECs); however, whether TTR affects the development of neovascularization in diabetic retinopathy (DR) remains unclear. Methods Natural and simulated DR media were used to culture human retinal microvascular endothelial cells (hRECs). Hyperglycemia was simulated by increasing the glucose concentration from 5.5 mM up to 25 mM, while hypoxia was induced with 200 µM CoCl2. To understand the effects of TTR on hRECs, cell proliferation was investigated under natural and DR conditions. Overexpression of TTR, an in vitro wound-healing assay, and a tube formation assay were employed to study the repression of TTR on hRECs. Real-time fluorescence quantitative PCR (qRT-PCR) was used to study the mRNA levels of DR-related genes, such as Tie2, VEGFR1, VEGFR2, Angpt1, and Angpt2. Results The proliferation of hRECs was significantly decreased in the simulated hyperglycemic and hypoxic DR environments. The cells were further repressed by added exogenous or endogenous TTR only under hyperglycemic conditions. The in vitro migration and tube formation processes of the hRECs were inhibited with TTR; furthermore, in the hyperglycemia and hyperglycemia/hypoxia environments, the levels of Tie2 and Angpt1 mRNA were enhanced with exogenous TTR, while those of VEGFR1, VEGFR2, and Angpt1 were repressed. Conclusions In hyperglycemia, the proliferation, migration, and neovascularization of hRECs were significantly inhibited by TTR. The key genes for DR neovascularization, including Tie2, VEGFR1, VEGFR2, Angpt1, and Angpt2, were regulated by TTR. Under DR conditions, TTR significantly represses neovascularization by inhibiting the proliferation, migration and tube formation of hRECs. PMID:27746673

  4. Vessel discoloration detection in malarial retinopathy

    Science.gov (United States)

    Agurto, C.; Nemeth, S.; Barriga, S.; Soliz, P.; MacCormick, I.; Taylor, T.; Harding, S.; Lewallen, S.; Joshi, V.

    2016-03-01

    Cerebral malaria (CM) is a life-threatening clinical syndrome associated with malarial infection. It affects approximately 200 million people, mostly sub-Saharan African children under five years of age. Malarial retinopathy (MR) is a condition in which lesions such as whitening and vessel discoloration that are highly specific to CM appear in the retina. Other unrelated diseases can present with symptoms similar to CM, therefore the exact nature of the clinical symptoms must be ascertained in order to avoid misdiagnosis, which can lead to inappropriate treatment and, potentially, death. In this paper we outline the first system to detect the presence of discolored vessels associated with MR as a means to improve the CM diagnosis. We modified and improved our previous vessel segmentation algorithm by incorporating the `a' channel of the CIELab color space and noise reduction. We then divided the segmented vasculature into vessel segments and extracted features at the wall and in the centerline of the segment. Finally, we used a regression classifier to sort the segments into discolored and not-discolored vessel classes. By counting the abnormal vessel segments in each image, we were able to divide the analyzed images into two groups: normal and presence of vessel discoloration due to MR. We achieved an accuracy of 85% with sensitivity of 94% and specificity of 67%. In clinical practice, this algorithm would be combined with other MR retinal pathology detection algorithms. Therefore, a high specificity can be achieved. By choosing a different operating point in the ROC curve, our system achieved sensitivity of 67% with specificity of 100%.

  5. Diabetic retinopathy and diabetic macular edema: pathophysiology, screening, and novel therapies.

    Science.gov (United States)

    Ciulla, Thomas A; Amador, Armando G; Zinman, Bernard

    2003-09-01

    Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of blindness in the working-age population of most developed countries. The increasing number of individuals with diabetes worldwide suggests that DR and DME will continue to be major contributors to vision loss and associated functional impairment for years to come. Early detection of retinopathy in individuals with diabetes is critical in preventing visual loss, but current methods of screening fail to identify a sizable number of high-risk patients. The control of diabetes-associated metabolic abnormalities (i.e., hyperglycemia, hyperlipidemia, and hypertension) is also important in preserving visual function because these conditions have been identified as risk factors for both the development and progression of DR/DME. The currently available interventions for DR/DME, laser photocoagulation and vitrectomy, only target advanced stages of disease. Several biochemical mechanisms, including protein kinase C-beta activation, increased vascular endothelial growth factor production, oxidative stress, and accumulation of intracellular sorbitol and advanced glycosylation end products, may contribute to the vascular disruptions that characterize DR/DME. The inhibition of these pathways holds the promise of intervention for DR at earlier non-sight-threatening stages. To implement new therapies effectively, more individuals will need to be screened for DR/DME at earlier stages-a process requiring both improved technology and interdisciplinary cooperation among physicians caring for patients with diabetes.

  6. Diabetic retinopathy: loss of neuroretinal adaptation to the diabetic metabolic environment

    Science.gov (United States)

    Abcouwer, Steven F.; Gardner, Thomas W.

    2014-01-01

    Diabetic retinopathy (DR) impairs vision of patients with type 1 and type 2 diabetes, associated with vascular dysfunction and occlusion, retinal edema, hemorrhage, and inappropriate growth of new blood vessels. The recent success of biologic treatments targeting vascular endothelial growth factor (VEGF) demonstrates that treating the vascular aspects in the later stages of the disease can preserve vision in many patients. It would also be highly desirable to prevent the onset of the disease or arrest its progression at a stage preceding the appearance of overt microvascular pathologies. The progression of DR is not necessarily linear but may follow a series of steps that evolve over the course of multiple years. Abundant data suggest that diabetes affects the entire neurovascular unit of the retina, with an early loss of neurovascular coupling, gradual neurodegeneration, gliosis, and neuroinflammation before observable vascular pathologies. In this article, we consider the pathology of diabetic retinopathy from the point of view that diabetes causes measurable dysfunctions in the complex integral network of cell types that produce and maintain human vision. PMID:24673341

  7. Simple hybrid method for fine microaneurysm detection from non-dilated diabetic retinopathy retinal images.

    Science.gov (United States)

    Sopharak, Akara; Uyyanonvara, Bunyarit; Barman, Sarah

    2013-01-01

    Microaneurysms detection is an important task in computer aided diagnosis of diabetic retinopathy. Microaneurysms are the first clinical sign of diabetic retinopathy, a major cause of vision loss in diabetic patients. Early microaneurysm detection can help reduce the incidence of blindness. Automatic detection of microaneurysms is still an open problem due to their tiny sizes, low contrast and also similarity with blood vessels. It is particularly very difficult to detect fine microaneurysms, especially from non-dilated pupils and that is the goal of this paper. Simple yet effective methods are used. They are coarse segmentation using mathematic morphology and fine segmentation using naive Bayes classifier. A total of 18 microaneurysms features are proposed in this paper and they are extracted for naive Bayes classifier. The detected microaneurysms are validated by comparing at pixel level with ophthalmologists' hand-drawn ground-truth. The sensitivity, specificity, precision and accuracy are 85.68, 99.99, 83.34 and 99.99%, respectively.

  8. Study of 27 aqueous humor cytokines in patients with type 2 diabetes with or without retinopathy

    Science.gov (United States)

    Dong, Ning; Xu, Bing; Wang, Bingsong

    2013-01-01

    Purpose To compare the changes in the levels of 27 aqueous humor cytokines between nondiabetic controls and patients with type 2 diabetes and to ascertain the association of these cytokines with diabetic retinopathy (DR). Methods Undiluted aqueous humor samples were obtained from 102 nondiabetic patients (102 eyes) and 136 consecutive diabetic patients (136 eyes) who were divided into nine groups according to the Early Treatment of Diabetic Retinopathy Study severity scale. The concentrations of 27 cytokines in the aqueous humor samples were measured using a multiplex bead immunoassay. Results Compared with the nondiabetic controls, the diabetic patients had significantly higher concentrations of interleukin-1β (IL-1β; phumor. However, the IL-10 (p=0.002) and IL-12 (p=0.013) concentrations were significantly lower for the diabetic patients. There were no significant differences in the concentrations of other cytokines between the diabetic patients and the controls. The IL-1β, IL-6, IL-8, monocyte chemoattractant protein-1, and interferon gamma-induced protein-10 levels in the aqueous humor increased as the severity of DR increased. The correlation was significant. However, the vascular endothelial growth factor concentration was not correlated with the severity of DR. In addition, the IL-10 and IL-12 levels in the aqueous humor decreased as the severity of DR increased, and this negative correlation was significant. Conclusions Various cytokines associated with inflammation and angiogenesis may contribute to the pathogenesis of DR, and chemokines may be more closely related to the development of this disease. PMID:23922491

  9. Sickle cell disease retinopathy: characterization among pediatric and teenage patients from northeastern Brazil

    Science.gov (United States)

    de Almeida Oliveira, Dayse Cury; Carvalho, Magda O.S.; do Nascimento, Valma Maria Lopes; Villas-Bôas, Flávia Silva; Galvão-Castro, Bernardo; Goncalves, Marilda Souza

    2014-01-01

    Objective The aim of the present study was to characterize sickle cell disease retinopathy in children and teenagers from Bahia, the state in northeastern Brazil with the highest incidence and prevalence of sickle cell disease. Methods A group of 51 sickle cell disease patients (36 hemoglobin SS and 15 hemoglobin SC) with ages ranging from 4 to 18 years was studied. Ophthalmological examinations were performed in all patients. Moreover, a fluorescein angiography was also performed in over 10-year-old patients. Results The most common ocular lesions were vascular tortuosity, which was found in nine (25%) hemoglobin SS patients, and black sunburst, in three (20%) hemoglobin SC patients. Peripheral arterial closure was observed in five (13.9%) hemoglobin SS patients and in three (13.3%) hemoglobin SC patients. Arteriovenous anastomoses were present in six (16.5%) hemoglobin SS patients and six (37.5%) hemoglobin SC patients. Neovascularization was not identified in any of the patients. Conclusions This study supports the use of early ophthalmological examinations in young sickle cell disease patients to prevent the progression of retinopathy to severe disease and further blindness. PMID:25305166

  10. Expression and significance of HIF-1α and VEGF in rats with diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Hong-Tao Yan; Guan-Fang Su

    2014-01-01

    Objective:To investigate the expression of hypoxia inducible factor-1α(HIF-1α) and vascular endothelial growth factor(VEGF) in diabetic retinopathy(DR) rats and its effect on theDR occurrence and development.Methods:A total of120SD rats were randomly divided into trial group and control group with60 in each.STZi.p. was used in the trial group to establish theDM model, citrate buffer salt of same amount was usedi.p. to the control group.1,3 and6 months after injection, respective20 rats were sacrificed in each group to observe expression ofHIF-1α andVEGF in the rat retina tissue at different time points.Results:Expression ofHIF-1α andVEGF were negative in the control group; expression ofHIF-1α andVEGF protein in retinal tissue were weak after1 month ofDR mold formation.It showed progressive enhancement along with the progression in different organizations, differences between groups were significant (P<0.05).Conclusions:Expressions ofHIF-1α andVEGF were correlated with disease progression in early diabetic retinopathy.Retinal oxygen can induce over-expression ofHIF-1α andVEGF.It shows thatHIF-1α andVEGF play an important role in the pathogenesis ofDR.

  11. Auto-mobilized adult hematopoietic stem cells advance neovasculature in diabetic retinopathy of mice

    Institute of Scientific and Technical Information of China (English)

    TIAN Bei; LI Xiao-xin; SHEN Li; ZHAO Min; YU Wen-zhen

    2010-01-01

    Background Hematopoietic stem cells (HSCs) can be used to deliver functionally active angiostatic molecules to the retinal vasculature by targeting active astrocytes and may be useful in targeting pre-angiogenic retinal lesions. We sought to determine whether HSC mobilization can ameliorate early diabetic retinopathy in mice.Methods Mice were devided into four groups: normal mice control group, normal mice HSC-mobilized group, diabetic mice control group and diabetic mice HSC mobilized group. Murine stem cell growth factor (murine SCF) and recombined human granulocyte colony stimulating factor (rhG-csf) were administered to the mice with diabetes and without diabetes for continuous 5 days to induce autologous HSCs mobilization, and subcutaneous injection of physiological saline was used as control. Immunohistochemical double staining was conducted with anti-mouse rat CD31 monoclonal antibody and anti-BrdU rat antibody.Results Marked HSCs clearly increased after SCF plus G-csf-mobilization. Non-mobilized diabetic mice showed more HSCs than normal mice (P=0.032), and peripheral blood significantly increased in both diabetic and normal mice (P=0.000).Diabetic mice showed more CD31 positive capillary vessels (P=0.000) and accelerated endothelial cell regeneration. Only diabetic HSC-mobilized mice expressed both BrdU and CD31 antigens in the endothelial cells of new capillaries.Conclusion Auto-mobilized adult hematopoietic stem cells advance neovasculature in diabetic retinopathy of mice.

  12. Current Trends in the Monitoring and Treatment of Diabetic Retinopathy in Young Adults

    Directory of Open Access Journals (Sweden)

    Dorota Raczyńska

    2014-01-01

    Full Text Available The diagnosis and treatment of diabetic retinopathy (DR in young adults have significantly improved in recent years. Research methods have widened significantly, for example, by introducing spectral optical tomography of the eye. Invasive diagnostics, for example, fluorescein angiography, are done less frequently. The early introduction of an insulin pump to improve the administration of insulin is likely to delay the development of diabetic retinopathy, which is particularly important for young patients with type 1 diabetes mellitus (T1DM. The first years of diabetes occurring during childhood and youth are the most appropriate to introduce proper therapeutic intervention before any irreversible changes in the eyes appear. The treatment of DR includes increased metabolic control, laserotherapy, pharmacological treatment (antiangiogenic and anti-inflammatory treatment, enzymatic vitreolysis, and intravitreal injections, and surgery. This paper summarizes the up-to-date developments in the diagnostics and treatment of DR. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual ophthalmology journals, books, and leading pharmaceutical company websites.

  13. Proliferative retinopathy and proteinuria predict mortality rate in type 1 diabetic patients from Fyn County, Denmark

    DEFF Research Database (Denmark)

    Grauslund, J; Green, A; Sjølie, A K

    2008-01-01

    .01 (95% CI 0.72-1.42) and 2.04 (1.43-2.91) for patients with non-proliferative and proliferative retinopathy respectively at baseline compared with patients with no retinopathy. After adjusting for proteinuria, HR among patients with proliferative retinopathy lost statistical significance, but still...... remained 1.48 (95% CI 0.98-2.23). The 10 year survival rate of patients who had proliferative retinopathy as well as proteinuria at baseline was 22.2% and significantly lower (pproteinuria only (70.3%), proliferative retinopathy only (79.0%) or neither (86.6%). CONCLUSIONS....../INTERPRETATION: Proliferative retinopathy and proteinuria predict mortality rate in a population-based cohort of type 1 diabetic patients. In combination they act even more strongly. Non-proliferative diabetic retinopathy did not affect survival rate....

  14. Photography or Ophthalmoscopy for Detection of Diabetic Retinopathy?

    NARCIS (Netherlands)

    Leiden, Hendrik A. van; Moll, Annette C.; Dekker, Jacqueline M.; Abramoff, M.D.; Polak, Bettine C.P.

    2003-01-01

    The U.K. National Screening Committee recommended digital fundus photography as the screening method of choice for diabetic retinopathy (DR). However, concerns have been expressed about replacing ophthalmoscopy with slit-lamp biomicroscopy by digital photography. These concerns included the possibil

  15. Can screening for retinopathy of prematurity be reduced?

    NARCIS (Netherlands)

    Termote, JUM; Donders, ART; Schalij-Delfos, NE; Lenselink, CH; van Angeren, CSD; Lissone, SCJL; Cats, BP

    2005-01-01

    Background. As screening,for retinopathy of prematurity (ROP) is costly, time-consuming for the ophthalmologist and discomforting for the neonate, the minimum number of infants should be screened for ROP, without missing infants with severe ROP, at risk for threshold ROP. Objectives: To develop a di

  16. Hypoxia-induced retinopathy model in adult zebrafish

    DEFF Research Database (Denmark)

    Cao, Ziquan; Jensen, Lasse D.; Rouhi, Pegah;

    2010-01-01

    . In this article, we describe protocols that create hypoxia-induced retinopathy in adult zebrafish. Adult fli1: EGFP zebrafish are placed in hypoxic water for 3-10 d and retinal neovascularization is analyzed using confocal microscopy. It usually takes 11 d to obtain conclusive results using the hypoxia...

  17. Body Mass Index and Retinopathy in Type 1 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Snježana Kaštelan

    2014-01-01

    Full Text Available Aim. To investigate whether body mass index (BMI independently or in correlation with other risk factors is associated with diabetic retinopathy (DR progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n=86, group 2 (mild/moderate nonproliferative DR; n=33, and group 3 (severe/very severe NPDR or proliferative DR; n=57. Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03 ± 3.52, gr. 2: 25.36 ± 3.44, gr. 3: 26.93 ± 3.24; P<0.01. A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy.

  18. Body Mass Index and Retinopathy in Type 1 Diabetic Patients

    Science.gov (United States)

    Kaštelan, Snježana; Salopek Rabatić, Jasminka; Tomić, Martina; Gverović Antunica, Antonela; Ljubić, Spomenka; Kaštelan, Helena; Orešković, Darko

    2014-01-01

    Aim. To investigate whether body mass index (BMI) independently or in correlation with other risk factors is associated with diabetic retinopathy (DR) progression. Methods. The study included 176 patients with type 1 diabetes divided into three groups according to DR status: group 1 (no retinopathy; n = 86), group 2 (mild/moderate nonproliferative DR; n = 33), and group 3 (severe/very severe NPDR or proliferative DR; n = 57). Results. A significant deterioration of HbA1c, an increase in total cholesterol, systolic, diastolic blood pressure, and diabetic nephropathy with the progression of retinopathy were found. DR progression was correlated with diabetes duration, HbA1c, hypertension, total cholesterol, and the presence of nephropathy. In patients without nephropathy, statistical analyses showed that progression of retinopathy increased significantly with higher BMI (gr. 1: 24.03 ± 3.52, gr. 2: 25.36 ± 3.44, gr. 3: 26.93 ± 3.24; P < 0.01). A positive correlation between BMI and a significant deterioration of HbA1c, an increase in cholesterol, triglycerides, and hypertension was observed. Conclusion. BMI in correlation with HbA1c, cholesterol, and hypertension appears to be associated with the progression of DR in type 1 diabetic patients without nephropathy. However, additional studies are required to investigate the pathogenic role of obesity and weight loss in retinal diabetic complications particularly relating to nephropathy. PMID:24696683

  19. Screening Diabetic Retinopathy in Developing Countries using Retinal Images

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    D. SIVA SUNDHARA RAJA

    2015-03-01

    Full Text Available In developing countries, diabetic retinopathy (DR is the leading cause of blindness in diabetic patients due to intraocular hypertension or high glucose level. Its detection in an earlier stage is essential to prevent vision loss in type 2 diabetic patients. In this paper, the computer aided automatic screening system for diabetic retinopathy is proposed. DR can be diagnosed by detecting the abnormal lesions such as hemorrhages in retinal images and analyzing its relationship with the fovea region. The proposed method consists of the following stages, namely: retinal image enhancement and classification, hemorrhages detection and segmentation, fovea localization and Diabetic Retinopathy classification. The multi directional local histogram equalization is used to enhance the retinal image for better classification rate. The Gabor transform and Support vector machine (SVM classifier is used for retinal image classifications. The proposed method is tested on publicly available HRFand DIARETDB1datasets. The sensitivity and specificity of hemorrhages detection are 94.76% and 99.85%, respectively. Thus, the severity of Diabetic Retinopathy in Type 2 diabetic patients can be easily identified by detecting fovea region and hemorrhage lesions and analyzing the relation between them to prevent vision loss in diabetic patients.

  20. The North Jutland County Diabetic Retinopathy Study (NCDRS): population characteristics

    DEFF Research Database (Denmark)

    Knudsen, Lars Loumann; Lervang, Hans-Henrik; Lundbye-Christensen, Søren

    2006-01-01

    Background: Several population-based studies have reported blood glucose levels and blood pressure to be risk factors for the development of diabetic retinopathy. These studies were initiated more than two decades ago and may therefore reflect the treatment and population composition of a previous...... for clinically significant macular oedema. These data suggest different risk factors for these clinical entities....

  1. Improving patient compliance with diabetic retinopathy screening and treatment

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    Karinya Lewis

    2015-06-01

    Full Text Available Diabetic retinopathy is one of the many complications of diabetes. Because there are no symptoms initially, patients will not realise that they have the condition until it is at a proliferative stage or they develop macular oedema, when their vision becomes affected. Unfortunately, vision that has been lost may never be regained.

  2. Serum MiRNA Biomarkers serve as a Fingerprint for Proliferative Diabetic Retinopathy

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    Shao Qing

    2014-11-01

    Full Text Available Background: Diabetic retinopathy (DR is a retinopathy resulting from diabetes mellitus (DM which was classified into non-proliferative DR (NPDR and proliferative DR (PDR. Without an early screening and effective diagnosis, patients with PDR will develop serious complications. Therefore, we sought to identify special serum microRNAs (miRNAs that can serve as a novel non-invasive screening signature of PDR and test its specificity and sensitivity in the early diagnosis of PDR. Methods: In total, we obtained serum samples from 90 PDR cases, 90 matched NPDR patients and 20 controls. An initial screening of miRNA expression was performed through TaqMan Low Density Array (TLDA. The candidate miRNAs were validated by individual reverse transcription quantitative real-time PCR (RT-qPCR arranged in an initial and a two-stage validation sets. Moreover, additional double-blind testing was performed in 20 patients clinically suspected of having DR to evaluate the diagnostic value and accuracy of the serum miRNA profiling system in predicting PDR. Results: Three miRNAs were significantly increased in patients with PDR compared with NPDR after the multiple stages. The areas under the receiver operating characteristic (ROC curves of the validated three-serum miRNAs signature were 0.830, 0.803 and 0.873 in the initial and two validation sets, respectively. Combination of miR-21, miR-181c, and miR-1179 possessed a moderate ability to discrimination between PDR and NPDR with an area under ROC value of 0.89. The accuracy rate of the three-miRNA profile as PDR signature was 82.6%. Conclusions: These data provide evidence that serum miRNAs have the potential to be sensitive, cost-effective biomarkers for the early detection of PDR. These biomarkers could serve as a dynamic monitoring factor for detecting the progression of PDR from NPDR.

  3. Albuminuria and Diabetic Retinopathy in Type 2 Diabetes Mellitus Sankara Nethralaya Diabetic Retinopathy Epidemiology And Molecular Genetic Study (SN-DREAMS, report 12

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    Rani Padmaja K

    2011-05-01

    Full Text Available Abstract Background The concordance of microalbuminuria and diabetic retinopathy (DR has been well reported in persons with type 1 diabetes; however, for type 2 diabetes, there is paucity of data especially from population-based studies. The aim of this study was to estimate the prevalence of albuminuria (micro - and macroalbuminuria among persons with type 2 diabetes and determine its role as a risk factor for presence and severity of DR. Methods A population-based cross sectional study was conducted in cohort of 1414 subjects with type 2 diabetes from Chennai metropolis. All the subjects underwent comprehensive eye examination including 45 degrees four-field stereoscopic digital photography. DR was clinically graded using Early Treatment Diabetic Retinopathy Study scales. A morning urine sample was tested for albuminuria. Subjects were considered to have microalbuminuria, if the urinary albumin excretion was between 30 and 300 mg/24 hours, and macroalbuminuria at more than 300 mg/24 hours. The statistical software used was SPSS for Windows, Chicago, IL. Student t-test for comparing continuous variables, and χ2 test, to compare proportions amongst groups were used. Results The prevalence of microalbuminuria in the study subjects was 15.9% (226/1414, and that of macroalbuminuria, 2.7% (38/1414. Individuals with macroalbuminuria in comparison to micro- or normoalbuminuria showed a greater prevalence of DR (60.5% vs. 31.0% vs. 14.1%, p Conclusions Every 6th individual in the population of type 2 diabetes is likely to have albuminuria. Subjects with microalbuminuria were around 2 times as likely to have DR as those without microalbuminuria, and this risk became almost 6 times in the presence of macroalbuminuria.

  4. 葛根芩连汤联合人羊膜间充质干细胞移植治疗糖尿病早期视网膜病变%Gegen Qin Lian Tang combined with human amniotic mesenchymal stem cell transplantation for early diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    刘亮; 王金梁

    2016-01-01

    immunomodulatory effects. Additional y, it has been clinical y proved that Gegen Qin Lian Tang can lower blood sugar. OBJECTIVE:To investigate the effects of Gegen Qin Lian Tang combined with human amniotic mesenchymal stem cel transplantation on rat early diabetic retinopathy, by detecting pathological changes, levels of blood indicators and expressions of vascular endothelial growth factor in retinal tissues. METHODS:By intraperitoneal injection of streptozotocin, 42 Wistar rat models with diabetes mel itus were prepared and then randomly divided into model group, human amniotic mesenchymal stem cel transplantation group (cel transplantation group) and combination of human amniotic mesenchymal stem cel s and Gegen Qin Lian Tang group (combination group). At 4 weeks after transplantation, levels of blood sugar and serum insulin in diabetic rats were detected;pathological changes of the retina in diabetic rats were observed by hematoxylin-eosin staining. Besides, expressions of CD45 and vascular endothelial growth factor mRNA were detected using immunohistochemistry staining and RT-PCR technology, respectively. RESULTS AND CONCLUSION:Compared with the model group, the levels of blood glucose and serum insulin in both cel transplantation and combination groups were significantly decreased and increased, respectively, and these changes were even more significant in the combination group (P<0.05). In the model group, the retinal edema could be found, accompanied by structural disorder and irregular cel arrangement, while these retinal lesions were relatively milder in the cel transplantation group and significantly improved in the combination group. In addition, the CD45 expression and in the retina was highest in the model group subsequently fol owed by the cel transplantation group (P<0.05) and lowest in the combination group (P<0.05). Furthermore, compared with the model group, the expression of vascular endothelial growth factor mRNA was also significantly lower in the other two

  5. PREVALENCE OF DIABETIC RETINOPATHY IN PATIENTS WITH NEWLY DIAGNOSED TYPE II DIABETES MELLITUS

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    A. Bostak

    2006-11-01

    Full Text Available Diabetic retinopathy is a common complication of type II diabetes mellitus and carries with it the threat of blindness. Accurate information regarding the incidence of diabetic retinopathy and associated risk factors is important in the prevention of its development and of the visual impairment caused by this complication. This study was designed to determine the prevalence of diabetic retinopathy in newly diagnosed patients with type II diabetes mellitus. We have also evaluated the association of diabetic retinopathy with clinical and biochemical variables. In a cross-sectional study, 152 consecutive patients with newly diagnosed type II diabetes mellitus were referred from two outpatient clinics in Tehran for ophthalmologic exam to detect retinopathy. Indirect ophthalmoscopy was performed and data regarding risk factors were extracted from routine medical records. Chi square and Mann Whitney U tests were used to analyze the data. The overall prevalence of diabetic retinopathy was 13.8 %( 21 cases: three cases with microaneurysm only, 10 with mild, 5 with moderate and 2 with severe non proliferative diabetic retinopathy. Only one patient had advanced proliferative retinopathy. The prevalence of diabetic retinopathy was positively associated with age, duration of disease, fasting plasma glucose, HbA1c, and systolic blood pressure. Diabetic retinopathy is common in newly diagnosed type II diabetes mellitus patients. Ophthalmologic consultation is essential at the time of diagnosis for all patients.

  6. Studies on the Pathogenesis of Avascular Retina and Neovascularization into the Vitreous in Peripheral Severe Retinopathy of Prematurity (An American Ophthalmological Society Thesis)

    Science.gov (United States)

    Hartnett, Mary Elizabeth

    2010-01-01

    Purpose: To study vascular endothelial growth factor (VEGF) regulation in the development of intravitreous neovascularization and peripheral avascular retina in peripheral severe retinopathy of prematurity (ROP). Methods: The rat 50/10 model of ROP mimics zone II, stage 3 severe ROP and recreates fluctuations in transcutaneous oxygen levels in preterm infants. On postnatal (p) day ages p0, p8, p11–p14, and p18, retinas from the model or room-air (RA) age-matched pups were analyzed for mRNA of VEGF splice variants and receptors using real-time polymerase chain reaction or VEGF protein using enzyme-linked immunosorbent assay. Results: On p14, when retinas were only 70% vascularized in the model but fully vascularized in RA, VEGF164 expression was threefold greater in the model compared to RA. On p18, intravitreous neovascularization was associated with a 5-fold increase in VEGF164 mRNA in the model compared to RA. By analysis of variance, VEGF164 and VEGFR2 mRNAs were up-regulated in association with increasing developmental age (P<.0001 for both comparisons) or exposure to the model compared to RA (P<.0001 and P=.0247, respectively), whereas increasing developmental age was associated only with up-regulated VEGF120 (P=.0006), VEGF188 (P=.0256), and VEGFR1 (P<.0001) mRNAs. VEGF protein increased significantly in the model and on p14 and p18 compared to RA (P<.0001). Conclusions: The model mimics contemporary severe ROP in the United States unlike other models of oxygen-induced retinopathy. Compared to RA retinas, VEGF significantly increased in association with avascular retina and intravitreous neovascularization. A hypothesis is proposed that VEGF up-regulation plays a role in the development of both important features. PMID:21212851

  7. Detection of diabetic retinopathy and other microvascular complications in patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Rasmussen, Malin Lundberg

    fotografering af nethinden i forhold til guldstandarden med syv sammensatte felter defineret i studiet: Early Treatment Diabetic Retinopathy Study (ETDRS) (Artikel II). Derudover har vi brugt en nyere metode til at undersøge kargeometrien i nethinden for at se om en suboptimal konfiguration i nethindens kar er......Forekomsten af type 1 diabetes er stigende og diabetisk retinopati er fortsat en af de primære årsager til nedsat syn blandt personer i den arbejdsdygtige alder. Derudover er andre mikrovaskulære komplikationer som diabetisk nefropati og neuropati blandt de primære årsager til nedsat nyrefunktion......, dialysebehandling, fodsår og amputationer. Optimal kontrol af blodsukker og blodtryk kan nedsætte risikoen for eller forsinke udviklingen af sene mikrovaskulære komplikationer. Derudover har sen debut alder og kortere varighed af diabetes vist sig at være beskyttende for udviklingen af mikrovaskulære komplikationer...

  8. THE EYE — MIRROR OF CARDIOVASCULAR DISORDERS. EVOLUTION OF PERCEPTION ABOUT HYPERTENSIVE RETINOPATHY

    Directory of Open Access Journals (Sweden)

    V. S. Zadionchenko

    2010-01-01

    Full Text Available Published data often contain conflicting views on the relationship of retina changes in arterial hypertension (HT with cardiovascular disorders and target organs lesions. Along with the classification and pathophysiology of hypertensive retinopathy, evidence for its association with the HT course, target organ lesions and prognosis is presented. Functional disorders of the eyes point at the involvement of retina into the pathological process even in HT early stages and are able to reflect the severity of hypertension. This supports a close relationship of HT with eye disease as a target organ. Available data support also possibility to assess changes on the eye fundus in patients with uncomplicated HT, indicating that it was premature decision to exclude eyes from the list of target organs in HT.

  9. Improvement of the Hard Exudates Detection Method Used For Computer- Aided Diagnosis of Diabetic Retinopathy

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    Feroui Amel

    2012-05-01

    Full Text Available Diabetic retinopathy is a severe and widely spread eye disease. Early diagnosis and timely treatment of these clinical signs such as hard exudates could efficiently prevent blindness. The presence of exudates within the macular region is a main hallmark of diabetic macular edema and allows its detection with high sensitivity. In this paper, we combine the k-means clustering algorithm and mathematical morphology to detect hard exudates (HEs in retinal images of several diabetic patients. This method is tested on a set of 50 ophthalmologic images with variable brightness, color, and forms of HEs. The algorithm obtained a sensitivity of 95.92%, predictive value of 92.28% and accuracy of 99.70% using a lesion-based criterion.

  10. V ISUAL EVOKED POTENTIALS IN TYPE - 1 DIABETES WITHOUT RETINOPATHY: CO - RELATIONS WITH DURATION OF DIABETES

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    Sanjeev Kumar

    2014-01-01

    Full Text Available 20 diabetic (Type 1 patients have been studied in order to investigate the possible effects of the type 1 diabetes mellitus on the central nervous system by means of pattern shift visual evoked potentials. Patients with diabetic retinopathy , glaucoma and cataract were excluded from the study. To evaluate central optic pathways involvement in diabetics , visual evoked po tentials (VEP , in particular the latency of positive peak (P100 , were studied in 20 patients and 20 normal controls using reversal pattern VEP. P100 latency was significantly increased in diabetics. A positive co - relation was also found between latencies of VEP and duration of disease. Relationship between blood sugar level and P 100 wave latencies and amplitudes in diabetic patients was not significant . VEP measurement seems a simple and sensitive method for detecting early involvement and changes in opti c pathways in diabetics

  11. Primary Retinal Cultures as a Tool for Modeling Diabetic Retinopathy: An Overview

    Science.gov (United States)

    Varano, Monica; Mallozzi, Cinzia; Gaddini, Lucia; Formisano, Giuseppe; Pricci, Flavia

    2015-01-01

    Experimental models of diabetic retinopathy (DR) have had a crucial role in the comprehension of the pathophysiology of the disease and the identification of new therapeutic strategies. Most of these studies have been conducted in vivo, in animal models. However, a significant contribution has also been provided by studies on retinal cultures, especially regarding the effects of the potentially toxic components of the diabetic milieu on retinal cell homeostasis, the characterization of the mechanisms on the basis of retinal damage, and the identification of potentially protective molecules. In this review, we highlight the contribution given by primary retinal cultures to the study of DR, focusing on early neuroglial impairment. We also speculate on possible themes into which studies based on retinal cell cultures could provide deeper insight. PMID:25688355

  12. Primary Retinal Cultures as a Tool for Modeling Diabetic Retinopathy: An Overview

    Directory of Open Access Journals (Sweden)

    Andrea Matteucci

    2015-01-01

    Full Text Available Experimental models of diabetic retinopathy (DR have had a crucial role in the comprehension of the pathophysiology of the disease and the identification of new therapeutic strategies. Most of these studies have been conducted in vivo, in animal models. However, a significant contribution has also been provided by studies on retinal cultures, especially regarding the effects of the potentially toxic components of the diabetic milieu on retinal cell homeostasis, the characterization of the mechanisms on the basis of retinal damage, and the identification of potentially protective molecules. In this review, we highlight the contribution given by primary retinal cultures to the study of DR, focusing on early neuroglial impairment. We also speculate on possible themes into which studies based on retinal cell cultures could provide deeper insight.

  13. Retinopathy of prematurity: A study of prevalence and risk factors

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    Abdel H. A. A. Hakeem

    2012-01-01

    Full Text Available Background: Retinopathy of prematurity (ROP is a serious complication of prematurity treatment and can lead to blindness unless recognized and treated early. Objective: The objective was to estimate the prevalence of ROP in preterm infants in the Neonatal Intensive Care Unit (NICU, to identify the risk factors which predispose to ROP, and to assess the outcome of these cases. Materials and Methods: A ROP prospective screening survey was performed enrolling all prematures admitted to the NICU from January 2009 to December 2010, with a gestational age of 32 weeks or less at birth and a birth weight of 1500 g or less. Infants whose gestational age was >32 weeks or birth weight was >1500 g were included if they were exposed to oxygen therapy for more than 7 days. A total of 172 infants (84 males and 88 females had retinal evaluation by indirect ophthalmoscopy from the fourth postnatal week and followed up periodically. Perinatal risk factors for ROP were assessed using univariate and multivariate analysis. Infants who progressed to stage 3 ROP were given laser therapy. Results: Out of the studied 172 infants, 33 infants (19.2% developed ROP in one or both eyes; 18 (54.5% cases stage 1, 9 (27.3% cases stage 2, and 6 (18.2% cases stage 3. None of the studied neonates presented ROP at stages 4 or 5. The six cases diagnosed as ROP stage 3 underwent laser ablative therapy. Univariate analysis showed that there was a significant relationship between the occurrence of ROP and gestational age (P = 0.000, sepsis (P = 0.004, oxygen therapy (P = 0.018, and frequency of blood transfusions (P = 0.030. However, an insignificant relationship was found between the occurrence of ROP and sex, mode of delivery, birth weight, respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, hypotension, phototherapy, duration of oxygen therapy, mechanical ventilation, and CPAP (all P > 0.05. Gestational age, sepsis, oxygen therapy, and frequency of

  14. The modern view on the concept of treatment of active stages of retinopathy of prematurity

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    A. V. Tereshchenko

    2014-07-01

    Full Text Available Purpose: To show the basic regulations of the complex retinopathy of prematurity (ROP treatment with use of retinal pattern scanning laser coagulation and early vitrectomy.Methods: Pascal pattern scanning lasercoagulation is performed for stage 2 ROP type 2, stage 3 ROP type 2 and subclinical stageand early clinical stage of aggressive posterior ROP (S. N. Fyodorov Federal State Institution «IRTC «Eye Microsurgery» Kaluga Branchclassification. Early 3‑ports 25G vitrectomy is performed if ROP progressing 2‑4 weeks after the laser treatment.Results: In 2003‑2011 823 different interventions for infants with active ROP was performed: 737 retinal lasercoagulations, 3‑ports vitrectomy — 72, 3‑ports lensvitrectomy — 14. Treatment efficacy was 98.6 % for stage 2 and stage 3 ROP (regress of the disease occurred in 557 of 565 eyes, and 74.4 % for aggressive posterior ROP (regress of the disease occurred in 128 of 172 eyes. The total efficacy of the complex treatment was 92.9 % (regress of the disease occurred in 685 of 737 eyes.Conclusion: The basic regulations of the complex ROP treatment are early, within first 6 weeks of chronologic age, photocoagulationto delay progression of the retinal detachment and to stabilize vascularity, and early vitrectomy if ROP progressing after the lasertreatment.

  15. Antagonism of CD11b with neutrophil inhibitory factor (NIF) inhibits vascular lesions in diabetic retinopathy.

    Science.gov (United States)

    Veenstra, Alexander A; Tang, Jie; Kern, Timothy S

    2013-01-01

    Leukocytes and proteins that govern leukocyte adhesion to endothelial cells play a causal role in retinal abnormalities characteristic of the early stages of diabetic retinopathy, including diabetes-induced degeneration of retinal capillaries. Leukocyte integrin αmβ2 (CD11b/CD18, MAC1), a protein mediating adhesion, has been shown to mediate damage to endothelial cells by activated leukocytes in vitro. We hypothesized that Neutrophil Inhibitory Factor (NIF), a selective antagonist of integrin αmβ2, would inhibit the diabetes-induced degeneration of retinal capillaries by inhibiting the excessive interaction between leukocytes and retinal endothelial cells in diabetes. Wild type animals and transgenic animals expressing NIF were made diabetic with streptozotocin and assessed for diabetes-induced retinal vascular abnormalities and leukocyte activation. To assess if the leukocyte blocking therapy compromised the immune system, animals were challenged with bacteria. Retinal superoxide production, leukostasis and leukocyte superoxide production were increased in wild type mice diabetic for 10 weeks, as was the ability of leukocytes isolated from diabetic animals to kill retinal endothelial cells in vitro. Retinal capillary degeneration was significantly increased in wild type mice diabetic 40 weeks. In contrast, mice expressing NIF did not develop any of these abnormalities, with the exception that non-diabetic and diabetic mice expressing NIF generated greater amounts of superoxide than did similar mice not expressing NIF. Importantly, NIF did not significantly impair the ability of mice to clear an opportunistic bacterial challenge, suggesting that NIF did not compromise immune surveillance. We conclude that antagonism of CD11b (integrin αmβ2) by NIF is sufficient to inhibit early stages of diabetic retinopathy, while not compromising the basic immune response.

  16. Antagonism of CD11b with neutrophil inhibitory factor (NIF inhibits vascular lesions in diabetic retinopathy.

    Directory of Open Access Journals (Sweden)

    Alexander A Veenstra

    Full Text Available Leukocytes and proteins that govern leukocyte adhesion to endothelial cells play a causal role in retinal abnormalities characteristic of the early stages of diabetic retinopathy, including diabetes-induced degeneration of retinal capillaries. Leukocyte integrin αmβ2 (CD11b/CD18, MAC1, a protein mediating adhesion, has been shown to mediate damage to endothelial cells by activated leukocytes in vitro. We hypothesized that Neutrophil Inhibitory Factor (NIF, a selective antagonist of integrin αmβ2, would inhibit the diabetes-induced degeneration of retinal capillaries by inhibiting the excessive interaction between leukocytes and retinal endothelial cells in diabetes. Wild type animals and transgenic animals expressing NIF were made diabetic with streptozotocin and assessed for diabetes-induced retinal vascular abnormalities and leukocyte activation. To assess if the leukocyte blocking therapy compromised the immune system, animals were challenged with bacteria. Retinal superoxide production, leukostasis and leukocyte superoxide production were increased in wild type mice diabetic for 10 weeks, as was the ability of leukocytes isolated from diabetic animals to kill retinal endothelial cells in vitro. Retinal capillary degeneration was significantly increased in wild type mice diabetic 40 weeks. In contrast, mice expressing NIF did not develop any of these abnormalities, with the exception that non-diabetic and diabetic mice expressing NIF generated greater amounts of superoxide than did similar mice not expressing NIF. Importantly, NIF did not significantly impair the ability of mice to clear an opportunistic bacterial challenge, suggesting that NIF did not compromise immune surveillance. We conclude that antagonism of CD11b (integrin αmβ2 by NIF is sufficient to inhibit early stages of diabetic retinopathy, while not compromising the basic immune response.

  17. New Therapeutic Window of Regenerative Opportunity in Diabetic Retinopathy by VESGEN Analysis

    Science.gov (United States)

    Parsons-Wingert, Patricia A.

    2012-01-01

    Vascular pattern may serve as a useful new biomarker principle of complex, multi-scale signaling in pathological, physiological angiogenesis and microvascular remodeling. Each angiogenesis stimulator or inhibitor we have analyzed, including VEGF, bFGF, TGF-beta1, angiostatin and triamcinolone acetonide, has induced a novel "fingerprint" or "signature" biomarker vascular pattern that is spatio-temporally unique. Remodeling vasculature thereby provides an informative read-out of dominant molecular signaling, when analyzed by innovative, fractal-based VESsel GENeration (VESGEN) Analysis software. Using VESGEN to analyze ophthalmic clinical vascular images, we recently introduced a potential paradigm shift to the understanding of early-stage progression that suggests new regenerative opportunities for human diabetic retinopathy (DR), the major blinding disease for working-aged adults. In a pilot study, we discovered that angiogenesis oscillates as a surprising, homeostatic-like regeneration of retinal vessels during early progression of DR (IOVS 51(1):498). Results suggest that the term non-proliferative DR may be a misnomer. In new studies, normalization of the vasculature will be determined from the response of vascular pattern to therapeutic monitoring and treatment. We have mapped and quantified in vivo experimental models of angiogenesis, lymphangiogenesis and intravital blood flow from cellular/molecular to higher systems levels that include a murine model of infant retinopathy of prematurity (ROP); developing and pathological coronary and placental-like vessel models; progressive intestinal inflammation, growing murine tumors, and other pathological, physiological and therapeutically treated tissues of transgenic mice and avian embryos. Vascular Alterations, Visual Impairments (VIIP) & Increased Intracranial Pressure (ICP), Immunosuppression & Bone Loss: NASA-defined risk categories for human space exploration and ISS Utilization

  18. 癌症相关性视网膜病变在乳腺癌中的研究进展%Progress in the study of cancer-associated retinopathy in breast cancer patients

    Institute of Scientific and Technical Information of China (English)

    Guangyan Ji; Lei Xing; Jianbo Huang; Lingquan Kong; Ziwei Wang; Guosheng Ren; Kainan Wu

    2012-01-01

    Cancer-associated retinopathy (CAR) typically has a sudden or progressive onset of severe visual loss and an ominous association with an occult malignancy which contains breast cancer. Pathologically, CAR is the degeneration of photoreceptors. But the precise mechanism has not been fully established, CAR may result from autoimmune mediated apoptosis. And in recent years, there also have been some results demonstrating that tumor derived angiogenic factors such as VEGF may also confer the development of CAR, which may offer novel avenues for the therapeutic intervention in CAR.Early initiation of immunosuppressive therapy is critical for vision preservation. Future developments in rapid identification and longitudinal quantification of antibody levels would enable individualized management in these patients. The goal of this review was to analyze the epidemiology, the clinical features, the diagnosis and management of retinopathy in the context of recent advances in the elucidation of breast cancer-associated retinopathy (BCAR) pathogenesis.

  19. Does renin-angiotensin system blockade have a role in preventing diabetic retinopathy? A clinical review

    DEFF Research Database (Denmark)

    Sjølie, A K; Dodson, P; Hobbs, F R R

    2011-01-01

    Diabetes management has increasingly focused on the prevention of macrovascular disease, in particular for type 2 diabetes. Diabetic retinopathy, one of the main microvascular complications of diabetes, is also an important public health problem. Much of the care invested in retinopathy relates...... been identified in the eye and found to be upregulated in retinopathy. This has led to specific interest in the role of RAS blockade in retinopathy prevention. The recent DIRECT programme assessed use of the angiotensin receptor blocker (ARB) candesartan in type 1 and type 2 diabetes. Although...... to treatment rather than prevention of disease. Tight glycaemic and blood pressure control helps to reduce the risk of retinopathy, but this is not easy to achieve in practice and additional treatments are needed for both primary and secondary prevention of retinopathy. A renin-angiotensin system (RAS) has...

  20. A Systematic Meta-Analysis of Genetic Association Studies for Diabetic Retinopathy

    OpenAIRE

    Abhary, Sotoodeh; Hewitt, Alex W.; Burdon, Kathryn P.; Craig, Jamie E.

    2009-01-01

    OBJECTIVE Diabetic retinopathy is a sight-threatening microvascular complication of diabetes with a complex multifactorial pathogenesis. A systematic meta-analysis was undertaken to collectively assess genetic studies and determine which previously investigated polymorphisms are associated with diabetic retinopathy. RESEARCH DESIGN AND METHODS All studies investigating the association of genetic variants with the development of diabetic retinopathy were identified in PubMed and ISI Web of Kno...

  1. Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review.

    Science.gov (United States)

    Echouffo-Tcheugui, J B; Ali, M K; Roglic, G; Hayward, R A; Narayan, K M

    2013-11-01

    Screening for diabetic retinopathy can help to prevent this complication, but evidence regarding frequency of screening is uncertain. This paper systematically reviews the published literature on the relationship between screening intervals for diabetic retinopathy and the incidence of visual loss. The PubMed and EMBASE databases were searched until December 2012. Twenty five studies fulfilled the inclusion criteria, as these assessed the incidence/prevalence of sight-threatening diabetic retinopathy in relation to screening frequency. The included studies comprised 15 evaluations of real-world screening programmes, three studies modelling the natural history of diabetic retinopathy and seven cost-effectiveness studies. In evaluations of diabetic retinopathy screening programmes, the appropriate screening interval ranged from one to four years, in people with no retinopathy at baseline. Despite study heterogeneity, the overall tendency observed in these programmes was that 2-year screening intervals among people with no diabetic retinopathy at diagnosis were not associated with high incidence of sight-threatening diabetic retinopathy. The modelling studies (non-economic and economic) assessed a range of screening intervals (1-5 years). The aggregated evidence from both the natural history and cost-effectiveness models favors a screening interval >1 year, but ≤2 years. Such an interval would be appropriate, safe and cost-effective for people with no diabetic retinopathy at diagnosis, while screening intervals ≤1 year would be preferable for people with pre-existing diabetic retinopathy. A 2-year screening interval for people with no sight threatening diabetic retinopathy at diagnosis may be safely adopted. For patients with pre-existing diabetic retinopathy, a shorter interval ≤1 year is warranted.

  2. A case of retinopathy of prematurity treated by pattern scan laser photocoagulation

    Directory of Open Access Journals (Sweden)

    Ota S

    2014-07-01

    Full Text Available Satoshi Ota, Miho Nozaki, Shuichiro Hirahara, Tomoaki Hattori, Munenori Yoshida, Yuichiro Ogura Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan Abstract: We experienced a case of retinopathy of prematurity that was successfully treated with pattern scan laser. Pattern scan laser treatment should be considered as one treatment option for Retinopathy of Prematurity. Keywords: retinopathy of prematurity, PASCAL, slit-lamp delivery

  3. Biomarkers in Diabetic Retinopathy and the Therapeutic Implications

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    Katarzyna Zorena

    2013-01-01

    Full Text Available The main problem both in type 1 (T1DM and type 2 (T2DM diabetes is the development of chronic vascular complications encompassing micro- as well as macrocirculation. Chronic complications lower the quality of life, lead to disability, and are the cause of premature death in DM patients. One of the chronic vascular complications is a diabetic retinopathy (DR which leads to a complete loss of sight in DM patients. Recent trials show that the primary cause of diabetic retinopathy is retinal neovascularization caused by disequilibrium between pro- and antiangiogenic factors. Gaining knowledge of the mechanisms of action of factors influencing retinal neovascularization as well as the search for new, effective treatment methods, especially in advanced stages of DR, puts special importance on research concentrating on the implementation of biological drugs in DR therapy. At present, it is antivascular endothelial growth factor and antitumor necrosis factor that gain particular significance.

  4. Chinese herbal drugs for the treatment of diabetic retinopathy.

    Science.gov (United States)

    Behl, Tapan; Kotwani, Anita

    2017-03-01

    To explore the various pharmacological actions and the molecular mechanisms behind them by which Chinese herbs tend to lower the risk of developing microvascular diabetic complications in retina and prevent its further progression. Several Chinese herbs, indeed, elicit potent anti-inflammatory, antioxidant, anti-angiogenic, anti-apoptotic, peroxisome proliferator-activated receptor-gamma receptor agonistic, platelet-activating factor antagonistic, aldose reductase inhibitory and various other beneficial pharmacological activities, required to counteract the pathological conditions prevalent in retina during diabetes. Chinese herbs can potentially be used for the treatment/prevention of diabetic retinopathy owing to the virtue of numerous properties by which they alleviate several hyperglycaemia-induced pathological occurrences in retina. This would provide a natural and safe therapy for diabetic retinopathy, which currently is clinically limited to destructive techniques like laser photocoagulation and vitrectomy. © 2017 Royal Pharmaceutical Society.

  5. First Reported Case of Proliferative Retinopathy in Hemoglobin SE Disease

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    Paul Baciu

    2014-01-01

    Full Text Available We report the first case of proliferative sickle cell retinopathy in a patient with hemoglobin SE (Hb SE disease. Only a few dozen cases of Hb SE disease have been reported previously, and none had evidence of proliferative retinopathy. A 56-year-old African American man presented to our clinic for routine examination and was found to have sea-fan peripheral neovascularization bilaterally without maculopathy. Hemoglobin analysis revealed Hb SE heterozygosity. Sector laser photocoagulation to areas of nonperfusion in both eyes resulted in regression of the peripheral neovascularization over a period of 6 months. Although Hb SE disease is rare, the incidence of Hb SE disease is postulated to rise in the future. Awareness of its potential ocular complications is needed to appropriately refer these patients for screening.

  6. Interferon-associated retinopathy in a patient with metastatic melanoma

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    Lara Borrego-Sanz

    2014-10-01

    Full Text Available We present the unusual case of a 35 year-old woman with stage IV melanoma and widespread metastases, who was undergoing treatment with interferon alpha-2b and who presented with interferon-associated retinopathy. The patient, who had been taking interferon treatment for three months, complained of a sudden loss of visual acuity in the left eye. An ocular examination revealed multiple cotton wool spots along the retina and macular involvement. Interferon treatment was suspended. Although rare, retinopathy represents a potentially serious adverse effect of interferon treatment. Although normally patients are asymptomatic, complications derived of its use may arise, which can lead to significant visual impairment. We therefore suggest that before initiating treatment with this drug, patients should be informed of its potential ocular risks, and that regular eye examinations are conducted along with the treatment.

  7. Zinc transporter 8 (ZnT8 expression is reduced by ischemic insults: a potential therapeutic target to prevent ischemic retinopathy.

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    Michael Deniro

    Full Text Available The zinc (Zn(++ transporter ZnT8 plays a crucial role in zinc homeostasis. It's been reported that an acute decrease in ZnT8 levels impairs β cell function and Zn(++ homeostasis, which contribute to the pathophysiology of diabetes mellitus (DM. Although ZnT8 expression has been detected in the retinal pigment epithelium (RPE, its expression profile in the retina has yet to be determined. Furthermore, the link between diabetes and ischemic retinopathy is well documented; nevertheless, the molecular mechanism(s of such link has yet to be defined. Our aims were to; investigate the expression profile of ZnT8 in the retina; address the influence of ischemia on such expression; and evaluate the influence of YC-1; (3-(50-hydroxymethyl-20-furyl-1-benzyl indazole, a hypoxia inducible factor-1 (HIF-1 inhibitor, on the status of ZnT8 expression. We used real-time RT-PCR, immunohistochemistry, and Western blot in the mouse model of oxygen-induced retinopathy (OIR and Müller cells to evaluate the effects of ischemia/hypoxia and YC-1 on ZnT8 expression. Our data indicate that ZnT8 was strongly expressed in the outer nuclear layer (ONL, outer plexiform layer (OPL, ganglion cell layer (GCL, and nerve fiber layer (NFL, whereas the photoreceptor layer (PRL, inner nuclear layer (INL and inner plexiform layer (IPL showed moderate ZnT8 immunoreactivity. Furthermore, we demonstrate that retinal ischemic insult induces a significant downregulation of ZnT8 at the message and protein levels, YC-1 rescues the injured retina by restoring the ZnT8 to its basal homeostatic levels in the neovascular retinas. Our data indicate that ischemic retinopathy maybe mediated by aberrant Zn(++ homeostasis caused by ZnT8 downregulation, whereas YC-1 plays a neuroprotective role against ischemic insult. Therefore, targeting ZnT8 provides a therapeutic strategy to combat neovascular eye diseases.

  8. The Effects of Fetal Surgery on Retinopathy of Prematurity Development

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    Sudha Nallasamy

    2009-10-01

    Full Text Available Background: Fetal surgery is selectively offered for severe or life-threatening fetal malformations. These infants are often born prematurely and are thus at risk for retinopathy of prematurity (ROP. It is not known whether fetal surgery confers an increased risk of developing severe ROP relative to published rates in standard premature populations ≤37 weeks of age grouped by birth weight (

  9. Current concepts in intravitreal drug therapy for diabetic retinopathy

    OpenAIRE

    Pai, Anant; Maha M El Shafei; Mohammed, Osman A.Z.; Al Hashimi, Mustafa

    2010-01-01

    Diabetic retinopathy (DR) is a major cause of preventable blindness in the developed countries. Despite the advances in understanding and management of DR, it remains a challenging condition to manage. The standard of care for patients with DR include strict metabolic control of hyperglycemia, blood pressure control, normalization of serum lipids, prompt retinal laser photocoagulation and vitrectomy. For patients who respond poorly and who progressively lose vision in spite of the standard of...

  10. STUDY OF ANTIOXIDANT STATUS IN TYPE - II DIABETIC RETINOPATHY CASES

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    Bhaskar

    2015-07-01

    Full Text Available Diabetic Retinopathy is a progressive disorder. It is the most common cause of blindness in people aged 30 - 60 years . The retina has high content of polyunsaturated fatty acid and glucose oxidation relative to any other tissue. Hyperglycemia and dyslipidem ia in diabetes mellitus induce increased lipid peroxidation and reactive oxygen species formation, an important mechanism in the pathogenesis of micro - angiopathy . The oxidative stress is an imbalance between excess oxidative species formation and impaired removal of the reactive oxygen species by antioxidant defence system like vitamin A, vitamin C, vitamin E, superoxide dismutase, glutathione peroxidise and catalase. Hence the study over a period of one and a half month from 1 st May to June 15 th 2015 with 20 diabetic retinopathy cases and 20 control cases was undertaken to evaluate the oxidative status and serum vitamin antioxidants levels in diabetic retinopathy cases. Our study using descriptive statistical analysis has shown positive correlation between hyperglycemia and MDA levels and oxidative stress with simultaneously decrease in antioxidant levels and serum vitamin like A, C and E

  11. Automated detection of exudates for diabetic retinopathy screening.

    Science.gov (United States)

    Fleming, Alan D; Philip, Sam; Goatman, Keith A; Williams, Graeme J; Olson, John A; Sharp, Peter F

    2007-12-21

    Automated image analysis is being widely sought to reduce the workload required for grading images resulting from diabetic retinopathy screening programmes. The recognition of exudates in retinal images is an important goal for automated analysis since these are one of the indicators that the disease has progressed to a stage requiring referral to an ophthalmologist. Candidate exudates were detected using a multi-scale morphological process. Based on local properties, the likelihoods of a candidate being a member of classes exudate, drusen or background were determined. This leads to a likelihood of the image containing exudates which can be thresholded to create a binary decision. Compared to a clinical reference standard, images containing exudates were detected with sensitivity 95.0% and specificity 84.6% in a test set of 13,219 images of which 300 contained exudates. Depending on requirements, this method could form part of an automated system to detect images showing either any diabetic retinopathy or referable diabetic retinopathy.

  12. Current knowledge on diabetic retinopathy from humandonor tissues

    Institute of Scientific and Technical Information of China (English)

    Jessica H Eisma; Jennifer E Dulle; Patrice E Fort

    2015-01-01

    According to the American Diabetes Association, diabetes was the seventh leading cause of death, and diabetic retinopathy the leading cause of blindness in working age adults in the United States in 2010. Diabetes is characterized by hyperglycemia associated with either hypoinsulinemia or insulin resistance, and over time, this chronic metabolic condition may lead to various complications including kidney failure, heart attacks,and retinal degeneration. In order to better understandthe molecular basis of this disease and its complications,animal models have been the primary approach usedto investigate the effects of diabetes on various tissuesor cell types of the body, including the retina. However,inherent to these animal models are critical limitationsthat make the insight gained from these modelschallenging to apply to the human pathology. Thesedifficulties in translating the knowledge obtained fromanimal studies have led a growing number of researchgroups to explore the diabetes complications, especiallydiabetic retinopathy, on tissues from human donors.This review summarizes the data collected from diabeticpatients at various stages of diabetic retinopathy andclassifies the data based upon their relevance to themain aspects of diabetic retinopathy: retinal vasculaturedysfunction, inflammation, and neurodegeneration. Thisreview discusses the importance of those studies todiscriminate and establish the relevance of the findingsobtained from animal models but also the limitations ofsuch approaches.

  13. Vasoactive neuropeptides in clinical ophthalmology: An association with autoimmune retinopathy?

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    Donald R Staines

    2009-03-01

    Full Text Available Donald R Staines1,2, Ekua W Brenu2, Sonya Marshall-Gradisnik21Queensland Health, Gold Coast Population Health Unit, Southport, Gold Coast, Queensland, Australia; 2Faculty of Health Science and Medicine, Population Health and Neuroimmunology Unit, Bond University, Robina, Queensland, AustraliaAbstract: The mammalian eye is protected against pathogens and inflammation in a relatively immune-privileged environment. Stringent mechanisms are activated that regulate external injury, infection, and autoimmunity. The eye contains a variety of cells expressing vasoactive neuropeptides (VNs, and their receptors, located in the sclera, cornea, iris, ciliary body, ciliary process, and the retina. VNs are important activators of adenylate cyclase, deriving cyclic adenosine monophosphate (cAMP from adenosine triphosphate (ATP. Impairment of VN function would arguably impede cAMP production and impede utilization of ATP. Thus VN autoimmunity may be an etiological factor in retinopathy involving perturbations of purinergic signaling. A sound blood supply is necessary for the existence and functional properties of the retina. This paper postulates that impairments in the endothelial barriers and the blood–retinal barrier, as well as certain inflammatory responses, may arise from disruption to VN function. Phosphodiesterase inhibitors and purinergic modulators may have a role in the treatment of postulated VN autoimmune retinopathy.Keywords: retinopathy, autoimmune, vasoactive neuropeptides, phosphodiesterase inhibitors

  14. Role of endocannabinoids in the progression of diabetic retinopathy.

    Science.gov (United States)

    Behl, Tapan; Kaur, Ishneet; Kotwani, Anita

    2016-03-01

    In the past decades, the role of numerous factors in the pathophysiology of diabetic retinopathy has been explored, following which marked progress has been made in developing several novel therapeutic options, such as anti-vascular endothelial growth factor, anti-tumor necrosis factor-alpha and various other anti-inflammatory and anti-angiogenic agents, for the treatment of diabetic retinopathy. However, the involvement of endocannabinoid system in its pathogenesis has not been much explored. This review aims at unveiling every aspect of association of the endocannabinoid system and its interactions with various physiological and pathological pathways to induce disease progression. The various alterations induced by endocannabinoids, such as anandamide and 2-arachidonylglycerol, in retina during hyperglycaemia clearly demonstrate and verify their involvement in aggravating the pathological conditions, hence leading to the progression of diabetic retinopathy. Exploring this involvement furthermore, in greater depths, might be beneficial in acknowledging and understanding the hidden aspects of the pathogenesis of this complication even better and might provide a therapeutically beneficial alternative target to combat and restrict its progression amongst diabetic patients.

  15. Coordination Skills during Vitrectomy in Treatment of Proliferative Diabetic Retinopathy

    Institute of Scientific and Technical Information of China (English)

    Xuehong Chen; Shanshan Luo; Yanchan Liu

    2014-01-01

    Purpose:.To discuss effective nursing and coordination skills for vitrectomy in the treatment of diabetic retinopathy. Methods: Fifty patients (51 eyes) with diabetic retinopathy required vitrectomy were enrolled in this study..Individual nursing service was delivered by strengthening preoperative preparation, providing psychological nursing, and intraopera-tive observation of the severity of diseases by circulating nurses;meticulous nursing was given postoperatively. Results:All 50 patients underwent surgery successfully..Intra-operatively,.patients had stable physical signs..Five patients had postoperative visual acuity0.3..No complicated infection was seen. Conclusion: For patients diagnosed with proliferative diabetic retinopathy requiring vitrectomy,.full preparations should be made and psychological nursing should be delivered preopera-tively, the severity of diseases and clinical reactions should be closely observed intraoperatively,.and proper processing and nursing measures should be taken postoperatively,.which col-lectively enhance surgical success rate,.decrease surgical com-plications,.and attain favorable treatment efficacy.(Eye Science 2014; 29:55-58).

  16. Retinopatia hipertensiva: revisão Hypertensive retinopathy: review

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    Aurélio Paulo Batista da Silva

    2002-08-01

    Full Text Available O presente estudo faz uma revisão do tema retinopatia hipertensiva. Para tanto propôs-se uma breve revisão dos dados históricos da retinopatia hipertensiva. Este estudo relata as alterações clássicas da retinopatia hipertensiva e suas classificações, bem como os achados mais recentes associados à hipertensão arterial sistêmica, os prováveis mecanismos fisiopatológicos e as alterações histológicas associadas à retinopatia hipertensiva. Abordamos, ainda, os diversos métodos utilizados para a investigação, suas vantagens e desvantagens; uma visão crítica da interpretação dos sinais do envolvimento do bulbo ocular pela hipertensão arterial sistêmica; ainda, baseado na diversidade das metodologias de investigação da retinopatia, comenta-se a repercussão desta, na prevalência da retinopatia hipertensiva e suas implicações, como órgão-alvo da hipertensão arterial sistêmica, em um contexto atualizado da síndrome metabólica e de outros fatores associados à fisiopatologia da HAS, como a leptina e a endotelina.The present study carries out a review of the theme hypertensive retinopathy. Thus it presents a brief review of the historical data on hypertensive retinopathy. The study reports the classical alterations of hypertensive retinopathy and its classifications, as well as the most recent findings associated with systemic arterial hypertension, the likely patho-physiological mechanisms, and the several methods used for investigation, their advantages and disadvantages; a critical view of the interpretation of signs of the ocular bulb involvement by systemic arterial hypertension; furthermore, based on the diversity of methodologies used in the investigation of retinopathy, comments are made on its reverberation, in the prevalence of hypertensive retinopathy and its implications, as a target organ of systemic arterial hypertension, in an updated context of the metabolic syndrome and of other elements associated with

  17. The prevalence of diabetic retinopathy in patients with screen-detected type 2 diabetes in Denmark: the ADDITION study

    DEFF Research Database (Denmark)

    Bek, Toke; Lund-Andersen, Henrik; Hansen, Anja Bech;

    2009-01-01

    with hitherto undiagnosed type 2 diabetes are identified using a stepwise screening strategy in selected general practices. This article reports the occurrence of diabetic retinopathy in this population. METHODS: In Arhus and Copenhagen counties, a total of 12,708 of the persons invited by mail were screened...... and fundus photography). Retinopathy was graded from the photographs by counting all retinopathy lesions. RESULTS: Forty-five (6.8%) of the examined patients had any retinopathy, of which the majority was minimal. No patients had severe non-proliferative or proliferative diabetic retinopathy....... There was no significant difference between age, sex and visual acuity among patients with and without retinopathy. However, the patients with retinopathy had significantly higher HbA1c and systolic and diastolic blood pressure than the patients without retinopathy. CONCLUSION: Patients with screen-detected diabetes have...

  18. Telemedicine for diabetic retinopathy screening using an ultra-widefield fundus camera

    Directory of Open Access Journals (Sweden)

    Hussain N

    2017-08-01

    Full Text Available Nazimul Hussain,1 Maryam Edraki,2 Rima Tahhan,2 Nishanth Sanalkumar,2 Sami Kenz,2 Nagwa Khalil Akasha,2 Brian Mtemererwa,2 Nahed Mohammed2 1Department of Ophthalmology, Al Zahra Hospital, Sharjah, United Arab Emirates; 2Department of Endocrinology, Al Zahra Hospital, Sharjah, United Arab Emirates Objective: Telemedicine reporting of diabetic retinopathy (DR screening using ultra-widefield (UWF fundus camera. Materials and methods: Cross-sectional study of diabetic patients who visited the endocrinology department of a private multi-specialty hospital in United Arab Emirates between April 2015 and January 2017 who underwent UWF fundus imaging. Fundus pictures are then accessed at the Retina Clinic in the Department of Ophthalmology. Primary outcome measure was incidence of any form of DR detected. The secondary outcome measure was failure to take good image and inability to grade. Results: A total of 1,024 diabetic individuals were screened for DR from April 2015 to January 2017 in the department of Endocrinology. Rate of DR was 9.27%; 165 eyes of 95 individuals were diagnosed to have some form of DR. Mild non-proliferative DR (NPDR was seen in 114 of 165 eyes (69.09%, moderate NPDR in 32 eyes (19.39%, severe NPDR in six eyes (3.64%, and proliferative DR (PDR in 13 eyes (7.88%. The secondary outcome measure of poor image acquisition was seen in one individual who had an image acquired in one eye that could not be graded due to bad picture quality. Conclusions: The present study has shown the effectiveness of DR screening using UWF fundus camera. It has shown the effectiveness of trained nursing personnel taking fundus images. This model can be replicated in any private multi-specialty hospital and reduce the burden of DR screening in the retina clinic and enhance early detection of treatable DR. Keywords: telemedicine, ultra-widefield camera, diabetic retinopathy screening

  19. Outcome of retinopathy of prematurity patients following adoption of revised indications for treatment

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    Ingvoldstad David D

    2008-11-01

    Full Text Available Abstract Background The Early Treatment for Retinopathy of Prematurity study (ETROP, published in 2003, established new guidelines for treatment of retinopathy of prematurity (ROP and demonstrated improved outcomes compared to previous guidelines. We examined outcomes before and after implementing the ETROP recommendations. Methods A retrospective chart review was performed using records of infants who had laser ablations for ROP performed from January, 2000 through December, 2005. Data collected included date of birth; birth weight; estimated gestational age (EGA; grading of ROP; date of laser ablation; and outcome of laser surgery. Univariate association with threshold or prethreshold treatment (Pre-ETROP and Post-ETROP, respectively were assessed using t-tests or Wilcoxon tests. Additional comparison between groups was performed using Fisher's exact tests. Results 581 patients were examined before and 464 after December 2003. Of these, 29/581 (5% – Pre-ETROP Group and 53/464 (11% – Post-ETROP Group patients advanced to criteria requiring laser treatment respectively (P = 0.0001. The average estimated gestational age (EGA at birth was 26.3 and 25.2 weeks, with an average birth weight of 888 and 707 grams for Pre and Post-ETROP Groups, respectively. Stage 5 retinal detachment (RD developed in 10.3% of eyes in the Pre-ETROP Group and 1.9% of eyes in the Post-ETROP Group (P = 0.02. Conclusion After the ETROP guidelines were implemented, there was a decrease from 10.3% to 1.9% of eyes developing Stage 5 retinal detachment, despite this group having a lower average EGA and lower average birth weight. These results underscore the importance of adoption of the Revised Indications.

  20. Oscillation of Angiogenesis with Vascular Dropout in Diabetic Retinopathy by VESsel GENeration Analysis (VESGEN)

    Science.gov (United States)

    Parsons-Wingerter, Patricia; Radbakrishnan, Krisbnan; Vickerman, Mary B.; Kaiser, Peter K.

    2010-01-01

    PURPOSE. Vascular dropout and angiogenesis are hallmarks of the progression of diabetic retinopathy (DR). However, current evaluation of DR relies on grading of secondary vascular effects, such as microaneurysms and hemorrhages, by clinical examination instead of by evaluation of actual vascular changes. The purpose of this study was to map and quantify vascular changes during progression of DR by VESsel GENeration Analysis (VESGEN). METHODS. In this prospective cross-sectional study, 15 eyes with DR were evaluated with fluorescein angiography (FA) and color fundus photography, and were graded using modified Early Treatment Diabetic Retinopathy Study criteria. FA images were separated by semiautomatic image processing into arterial and venous trees. Vessel length density (L(sub v)), number density (N(sub v)), and diameter (D(sub v)) were analyzed in a masked fashion with VESGEN software. Each vascular tree was automatically segmented into branching generations (G(sub 1)...G(sub 8) or G(sub 9)) by vessel diameter and branching. Vascular remodeling status (VRS) for N(sub v) and L(sub v) was graded 1 to 4 for increasing severity of vascular change. RESULTS. By N(sub v) and L(sub v), VRS correlated significantly with the independent clinical diagnosis of mild to proliferative DR (13/15 eyes). N(sub v) and L(sub v) of smaller vessels (G(sub >=6) increased from VRS1 to VRS2 by 2.4 X and 1.6 X, decreased from VRS2 to VRS3 by 0.4 X and 0.6X, and increased from VRS3 to VRS4 by 1.7 X and 1.5 X (P vascular dropout were dominated first by remodeling of arteries and subsequently by veins.

  1. Risk of Radiation Retinopathy in Patients With Orbital and Ocular Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kaushik, Megha; Pulido, Jose S. [Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota (United States); Schild, Steven E. [Division of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona (United States); Stafford, Scott, E-mail: stafford.scott@mayo.edu [Division of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States)

    2012-12-01

    Purpose: Radiation retinopathy is a potential long-term complication of radiation therapy to the orbit. The risk of developing this adverse effect is dose dependent; however, the threshold is unclear. The aim of this study was to identify the risk of developing radiation retinopathy at increasing radiation doses. Methods and Materials: A 40-year retrospective review was performed of patients who received external beam radiation therapy for ocular/orbital non-Hodgkin lymphoma (NHL). Results: Sixty-seven patients who had at least one ophthalmic follow-up examination were included in this study. Most patients (52%) were diagnosed with NHL involving the orbit. Patients received external beam radiation therapy at doses between 1886 and 5400 cGy (mean, 3033 {+-} 782 cGy). Radiation retinopathy developed in 12% of patients, and the median time to diagnosis was 27 months (range, 15-241months). The mean prescribed radiation dose in patients with retinopathy was 3309 {+-} 585 cGy, and the estimated retinal dose (derived by reviewing the dosimetry) was 3087 {+-} 1030 cGy. The incidence of retinopathy increased with dose. The average prescribed daily fractionated dose was higher in patients who developed retinopathy than in patients who did not (mean, 202 cGy vs 180 cGy, respectively; P = .04). More patients with radiation retinopathy had comorbid diabetes mellitus type 2 than patients without retinopathy (P = .015). In our study, the mean visual acuity of the eyes that received radiation was worse than that of the eyes that did not (P = .027). Other postradiotherapy ocular findings included keratitis (6%), dry eyes (39%), and cataract (33%). Conclusions: Radiation retinopathy, a known complication of radiotherapy for orbital tumors, relates to vascular comorbidities and dose. Higher total doses and larger daily fractions (>180 cGy) appear to be related to higher rates of retinopathy. Future larger studies are required to identify a statistically significant threshold for the

  2. Salidroside inhibits oxygen glucose deprivation (OGD)/re-oxygenation-induced H9c2 cell necrosis through activating of Akt-Nrf2 signaling.

    Science.gov (United States)

    Zheng, Koulong; Sheng, Zhenqiang; Li, Yefei; Lu, Huihe

    2014-08-15

    Oxygen glucose deprivation (OGD)/re-oxygenation has been applied to cultured cardiomyocytes to create a cellular model of ischemic heart damage. In the current study, we explored the potential role of salidroside against OGD/re-oxygenation-induced damage in H9c2 cardiomyocytes, and studied the underlying mechanisms. We found that OGD/re-oxygenation primarily induced necrosis in H9c2 cells, which was inhibited by salidroside. Salidroside suppressed OGD/re-oxygenation-induced reactive oxygen species (ROS) production, p53 mitochondrial translocation and cyclophilin D (Cyp-D) association as well as mitochondrial membrane potential (MMP) decrease in H9c2 cells. Meanwhile, salidroside activated Akt and promoted transcription of NF-E2-related factor 2 (Nrf2)-regulated genes (heme oxygenase-1 (HO-1) and quinone oxidoreductase 1 (NQO-1)). Significantly, Nrf2 shRNA knockdown or Akt inhibitors (LY 294002 and wortmannin) not only prevented salidroside-induced HO-1/NQO-1 transcription, but also alleviated salidroside-mediated cytoprotective effect against OGD/re-oxygenation in H9c2 cells. These observations suggest that salidroside activates Nrf2-regulated anti-oxidant signaling, and protects against OGD/re-oxygenation-induced H9c2 cell necrosis via activation of Akt signaling.

  3. Predictors for attending annual eye screening for diabetic retinopathy amongst patients with diabetes in an urban community of Beijing

    Directory of Open Access Journals (Sweden)

    Yan-Hong Zou

    2017-07-01

    Full Text Available AIM: To gain a better understanding of possible factors that may influence the decision of diabetes persons to participate in annual eye screening in an urban community setting of China. METHODS: A structured interview including questions on attendance of eye screening, knowledge and awareness of diabetic retinopathy was conducted. The presence and degree of retinopathy were assessed using two field non-mydriatic retinal photography. RESULTS: Totally 720 diabetes persons were recruited and 519 were enrolled in this cross-sectional study. In this urban setting of Beijing, among diabetes patients of average of 10y duration, 77% confirmed having undergone at least one eye examination and 61% reported having at least one eye examination with dilated pupil. As for the last 12mo, the number decreased to 210 (47% and 131 (30% separately. Most of the participants (95% were aware that diabetes could affect their vision and that regular eye examination was necessary. Very few of them (12% however were aware that the early stages of diabetic retinopathy presented without symptoms of vision loss. Having attended patient education on diabetes was effective in building awareness about diabetic eye disease and was a significant positive predictor for attending eye screening [education in a year, Adj. OR=0.47 (0.29-0.74, P<0.001, education years ago, Adj. OR=0.56 (0.33-0.96, P=0.036]. The duration of disease also increased the likelihood of having undergone eye screening (Adj. OR=0.96, P<0.05. CONCLUSION: Being exposed to education about the complications of diabetes increases the probability of attending diabetic eye screening. An appropriate patient knowledge building strategy should be made available to patients from the time of diagnosis.

  4. The impact of improved glycaemic control with GLP-1 receptor agonist therapy on diabetic retinopathy.

    Science.gov (United States)

    Varadhan, Lakshminarayanan; Humphreys, Tracy; Walker, Adrian B; Varughese, George I

    2014-03-01

    Rapid improvement in glycaemic control with GLP-1 receptor agonist (RA) therapy has been reported to be associated with significant progression of diabetic retinopathy. This deterioration is transient, and continuing GLP-1 RA treatment is associated with reversal of this phenomenon. Pre-existent maculopathy, higher grade of retinopathy and longer duration of diabetes may be risk factors for persistent deterioration.

  5. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal

    DEFF Research Database (Denmark)

    Almdal, Thomas Peter; Handlos, Line Neerup; Vistisen, Dorte

    2014-01-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% and in individuals with HbA1c >7.0% the prevalence was 6.0%....

  6. Retinopathy following measles, mumps, and rubella vaccination in an immuno-incompetent girl

    NARCIS (Netherlands)

    Schuil, J.; van de Putte, E.M.; Zwaan, C.M.; Koole, F.D.; Meire, F.M.

    1998-01-01

    We describe a 4-year-old girl with subnormal visual acuity due to a bilateral retinopathy. The child had a history of encephalitis following MMR vaccination. Temporary retinopathy associated with measles, mumps, and rubella (MMR) vaccination has been described. Recently an idiopathic CD4+ T

  7. Prevalence and 25 year incidence of proliferative retinopathy among Danish type 1 diabetic patients

    DEFF Research Database (Denmark)

    Grauslund, J; Green, A; Sjølie, A K

    2009-01-01

    was not associated with baseline duration of diabetes, proteinuria, smoking, body mass index, maculopathy or systolic or diastolic blood pressure. CONCLUSIONS/INTERPRETATION: Retinopathy among long-surviving type 1 diabetic patients is almost universal. Proliferative retinopathy was found in half of these patients...

  8. Eye size in threshold retinopathy of prematurity, based on a Danish preterm infant series

    DEFF Research Database (Denmark)

    Fledelius, Hans Callø; Fledelius, Christian

    2012-01-01

    To validate a hypothesis of restricted postnatal ocular growth associated with advanced retinopathy of prematurity (ROP), with a view also to preceding intrauterine growth retardation.......To validate a hypothesis of restricted postnatal ocular growth associated with advanced retinopathy of prematurity (ROP), with a view also to preceding intrauterine growth retardation....

  9. THE EFFECTS OF AN ALDOSE REDUCTASE INHIBITOR ON THE PROGRESSION OF DIABETIC-RETINOPATHY

    NARCIS (Netherlands)

    TROMP, A; HOOYMANS, JMM; BARENDSEN, BC; VONDOORMAAL, JJ

    1991-01-01

    The polyol pathway has long been associated with diabetic retinopathy. Glucose is converted to sorbitol with the aid of the enzyme aldose reductase. Aldose reductase inhibitors can prevent changes induced by diabetes. A total of 30 patients with minimal background retinopathy were randomly divided i

  10. Increased Vitreous Shedding of Microparticles in Proliferative Diabetic Retinopathy Stimulates Endothelial Proliferation

    OpenAIRE

    Chahed, Sadri; Leroyer, Aurélie S.; Benzerroug, Mounir; Gaucher, David; Georgescu, Adriana; Picaud, Serge; Silvestre, Jean-Sébastien; Gaudric, Alain; Tedgui, Alain; Massin, Pascale; Boulanger, Chantal M.

    2009-01-01

    OBJECTIVE Diabetic retinopathy is associated with progressive retinal capillary activation and proliferation, leading to vision impairment and blindness. Microparticles are submicron membrane vesicles with biological activities, released following cell activation or apoptosis. We tested the hypothesis that proangiogenic microparticles accumulate in vitreous fluid in diabetic retinopathy. RESEARCH DESIGN AND METHODS Levels and cellular origin of vitreous and plasma microparticles from control ...

  11. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal

    DEFF Research Database (Denmark)

    Almdal, Thomas Peter; Handlos, Line Neerup; Vistisen, Dorte

    2014-01-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% and in individuals with HbA1c >7.0% the prevalence was 6.0%....

  12. Retinopathy following measles, mumps, and rubella vaccination in an immuno-incompetent girl

    NARCIS (Netherlands)

    Schuil, J.; van de Putte, E.M.; Zwaan, C.M.; Koole, F.D.; Meire, F.M.

    1998-01-01

    We describe a 4-year-old girl with subnormal visual acuity due to a bilateral retinopathy. The child had a history of encephalitis following MMR vaccination. Temporary retinopathy associated with measles, mumps, and rubella (MMR) vaccination has been described. Recently an idiopathic CD4+ T lymphocy

  13. Validation of a model to estimate personalised screening frequency to monitor diabetic retinopathy

    NARCIS (Netherlands)

    Heijden, A.A. van der; Walraven, I.; Riet, E. van 't; Aspelund, T.; Lund, S.H.; Elders, P.; Polak, B.C.P.; Moll, A.C.; Keunen, J.E.E.; Dekker, J.M.; Nijpels, G.

    2014-01-01

    AIMS/HYPOTHESIS: Our study aimed to validate a model to determine a personalised screening frequency for diabetic retinopathy. METHODS: A model calculating a personalised screening interval for monitoring retinopathy based on patients' risk profile was validated using the data of 3,319 type 2 diabet

  14. Vascular endothelial growth factor gene polymorphisms and vitreous proteome changes in diabetic retinopathy.

    Science.gov (United States)

    Dyer, Kelli H; Silva, Paolo S; Sun, Jennifer K

    2013-01-01

    Ischemic retinal diseases, particularly diabetic retinopathy, continue to significantly impact vision and remain a leading cause of vision loss in working-aged adults. Identifying specific genetic risk factors for ischemic-driven pathways that increase susceptibility to developing diabetic retinopathy is a priority to allow development of accurate risk assessment algorithms, employ earlier intervention, and design novel treatment strategies to reduce the associated visual complications. Single nucleotide polymorphisms (SNPs) in the VEGF gene have been shown to influence the expression of the VEGF protein. Several studies suggest that SNPs in the VEGF gene mediate genetic predisposition to diabetic retinopathy. In addition, alterations in the vitreous proteome, including carbonic anhydrase mediated vascular permeability, have been found to be associated with sight-threatening proliferative diabetic retinopathy and macular edema. Inhibition of these factors could provide new therapeutic opportunities for the treatment of diabetic retinopathy.

  15. Is there any correlation between vitamin D insufficiency and diabetic retinopathy?

    Institute of Scientific and Technical Information of China (English)

    Shokoufeh; Bonakdaran; Nasser; Shoeibi

    2015-01-01

    AIM: To determine a relation between vitamin D level,which is an inhibitor of angiogenesis, and diabetic retinopathy and its risk factorsMETHODS: In a clinic-based cross sectional study two hundred and thirty-five type 2 diabetic patients older than 20 y were selected. Patients were classified according to ophthalmologic examination as following:no diabetic retinopathy(NDR)(n =153), non-proliferative diabetic retinopathy(NPDR)(n =64) and proliferative diabetic retinopathy(PDR)(n =18). Study subjects were tested for fasting blood glucose, glycated hemoglobin A1C(Hb A1C), lipid profile, microalbuminuria, Hs CRP,IGF1, insulin(in patients without history of insulin taking)and 25 hydroxy vitamin D [25(OH) D] levels. Vitamin D insufficiency was defined according to 25(OH) D level less than 30 ng/m L. The relationship between diabetic retinopathy and serum 25(OH) D insufficiency was evaluated.RESULTS: The prevalence of diabetic retinopathy was34.8% in our patients. Long duration of diabetes,hypertension, poor glycemic control, diabetic nephropathy, hyperinsulinemia and insulin resistance were risk factors for diabetic retinopathy but 25(OH) D level was not significant different between NDR, NPDR and PDR groups. Correlation between 25(OH) D level and other known risk factors of diabetic retinopathy was not significant.CONCLUSION: This study did not find any association between diabetic retinopathy and its severity and vitamin D insufficiency. Vitamin D insufficiency is not related to risk factors of diabetic retinopathy.

  16. Asymmetric severity of diabetic retinopathy in Waardenburg syndrome

    Directory of Open Access Journals (Sweden)

    Kashima T

    2011-12-01

    Full Text Available Tomoyuki Kashima, Hideo Akiyama, Shoji KishiDepartment of Ophthalmology, Gunma University School of Medicine, Gunma 371-8511, JapanAbstract: A 30-year-old female patient was referred to our institution due to vitreous hemorrhage. Best corrected visual acuity of her right and left eyes at her initial visit was 10/20 and 20/20, respectively. Although hypochromic iris was observed in the superior iris between the 10 and 2 o’clock positions in her right eye, her entire left eye exhibited hypochromic iris. Hypopigmentation of the fundus was seen in the superior part of her right eye. This eye also had a huge neovascularization on the optic disc that was 7 discs in diameter. Conversely, her left fundi showed hypopigmentation of the fundus in the entire region of the left eye, and dot hemorrhages were observed all over the left fundi, although no neovascularization could be seen microscopically. Fluorescein angiography showed a huge neovascularization in the right eye and a tiny neovascularization in the left eye. Gene analysis revealed the presence of the PAX3 gene homeobox domain mutation, which led to her being diagnosed as Waardenburg syndrome type 1. Magnetic resonance angiography showed there was no obstructive region at either of the internal carotid arteries and ophthalmic arteries. The severity of the diabetic retinopathy appeared to be correlated with the degree of hypopigmentation in the posterior fundus. We speculate that hypopigmentation of the fundus in Waardenburg syndrome may be responsible for the reduction in retinal metabolism, which led to a reduction in oxygen consumption and prevented further aggravation of the diabetic retinopathy. Only laser treatments using short wavelengths was effective in this case. While the extinction coefficient for hemoglobin when using green light is higher than when using yellow light, the differences between these wavelengths tend to disappear when oxygenated hemoglobin is present. To the best of

  17. The omega-3 and retinopathy of prematurity relationship

    Science.gov (United States)

    Malamas, Angelakis; Chranioti, Angeliki; Tsakalidis, Christos; Dimitrakos, Stavros A; Mataftsi, Asimina

    2017-01-01

    The aim of this article is to examine the effect of omega-3 (ω-3) long-chain polyunsaturated fatty acids (LCPUFAs) intake on retinopathy of prematurity (ROP) by reviewing the experimental and clinical trials conducted on animal models and infants. LCPUFAs demonstrate cytoprotective and cytotherapeutic actions contributing to a number of anti-angiogenic and neuroprotective mechanisms within the retina. Their intake appears to have a beneficial effect on ischemia, oxidative stress, inflammation and cellular signaling mechanisms, influencing retinal cell gene expression and cellular differentiation. ω-3 LCPUFAs may modulate metabolic processes that activate molecules implicated in the pathogenesis of vasoproliferative and neurodegenerative retinal diseases such as ROP. PMID:28251092

  18. Associations Between Diabetic Retinopathy and Plasma Levels of High-sensitive C-reactive Protein or Von Willebrand Factor in Long-term Type 1 Diabetic Patients

    DEFF Research Database (Denmark)

    Laursen, Jonas Vejvad Nørskov; Hoffmann, Stine Skovbo; Green, Anders

    2013-01-01

    Treatment Diabetic Retinopathy Study (ETDRS) adaptation of the modified Airlie House classification of DR. Results: Median age and duration of diabetes were 58.7 and 43 years, respectively. Median levels (10th-90th percentile) of hs-CRP and von Willebrand factor antigen were 1.31 mg/l (0.37-13.3 mg/l) and 1...... a population-based cohort from Fyn County, Denmark. Plasma levels of hs-CRP and von Willebrand factor antigen were measured and related to the level of diabetic retinopathy (DR) as evaluated by dilated nine-field 45 degree monoscopic fundus photos captured by Topcon TRC-NWS6 and graded according to the Early.......27 IU/ml (0.79-2.07 IU/ml), respectively. No or minimal DR (ETDRS-levels 10-20) was found in 16.4%, mild DR (ETDRS-level 35) in 19.4%, moderate DR (ETDRS-levels 43-47) in 11.0%, and 53.2% had proliferative diabetic retinopathy (PDR) corresponding to ETDRS-level 60 or more. In an age- and sex...

  19. Automatic Exudate Detection from Non-dilated Diabetic Retinopathy Retinal Images Using Fuzzy C-means Clustering

    Directory of Open Access Journals (Sweden)

    Akara Sopharak

    2009-03-01

    Full Text Available Exudates are the primary sign of Diabetic Retinopathy. Early detection can potentially reduce the risk of blindness. An automatic method to detect exudates from low-contrast digital images of retinopathy patients with non-dilated pupils using a Fuzzy C-Means (FCM clustering is proposed. Contrast enhancement preprocessing is applied before four features, namely intensity, standard deviation on intensity, hue and a number of edge pixels, are extracted to supply as input parameters to coarse segmentation using FCM clustering method. The first result is then fine-tuned with morphological techniques. The detection results are validated by comparing with expert ophthalmologists’ hand-drawn ground-truths. Sensitivity, specificity, positive predictive value (PPV, positive likelihood ratio (PLR and accuracy are used to evaluate overall performance. It is found that the proposed method detects exudates successfully with sensitivity, specificity, PPV, PLR and accuracy of 87.28%, 99.24%, 42.77%, 224.26 and 99.11%, respectively.

  20. Adaptive Neuro-Fuzzy Inference System Approach for the Automatic Screening of Diabetic Retinopathy in Fundus Images

    Directory of Open Access Journals (Sweden)

    S. Kavitha

    2011-01-01

    Full Text Available Problem statement: Diabetic retinopathy is one of the most significant factors contributing to blindness and so early diagnosis and timely treatment is particularly important to prevent visual loss. Approach: An integrated approach for extraction of blood vessels and exudates detection was proposed to screen diabetic retinopathy. An automated classifier was developed based on Adaptive Neuro-Fuzzy Inference System (ANFIS to differentiate between normal and nonproliferative eyes from the quantitative assessment of monocular fundus images. Feature extraction was performed on the preprocessed fundus images. Structure of Blood vessels was extracted using Multiscale analysis. Hard Exudates were detected using CIE Color channel transformation, Entropy Thresholding and Improved Connected Component Analysis from the fundus images. Features like Wall to Lumen ratio in blood vessels, Texture, Homogeneity properties and area occupied by Hard Exudates, were given as input to ANFIS.ANFIS was trained with Back propagation in combination with the least squares method. Proposed method was evaluated on 200 real time images comprising 70 normal and 130 retinopathic eyes. Results and Conclusion: All of the results were validated with ground truths obtained from expert ophthalmologists. Quantitative performance of the method, detected exudates with an accuracy of 99.5%. Receiver operating characteristic curve evaluated for real time images produced better results compared to the other state of the art methods. ANFIS provides best classification and can be used as a screening tool in the analysis and diagnosis of retinal images.

  1. Diabetic Retinopathy Screening Ratio Is Improved When Using a Digital, Nonmydriatic Fundus Camera Onsite in a Diabetes Outpatient Clinic

    Directory of Open Access Journals (Sweden)

    Pia Roser

    2016-01-01

    Full Text Available Objective. To evaluate the effect of onsite screening with a nonmydriatic, digital fundus camera for diabetic retinopathy (DR at a diabetes outpatient clinic. Research Design and Methods. This cross-sectional study included 502 patients, 112 with type 1 and 390 with type 2 diabetes. Patients attended screenings for microvascular complications, including diabetic nephropathy (DN, diabetic polyneuropathy (DP, and DR. Single-field retinal imaging with a digital, nonmydriatic fundus camera was used to assess DR. Prevalence and incidence of microvascular complications were analyzed and the ratio of newly diagnosed to preexisting complications for all entities was calculated in order to differentiate natural progress from missed DRs. Results. For both types of diabetes, prevalence of DR was 25.0% (n=126 and incidence 6.4% (n=32 (T1DM versus T2DM: prevalence: 35.7% versus 22.1%, incidence 5.4% versus 6.7%. 25.4% of all DRs were newly diagnosed. Furthermore, the ratio of newly diagnosed to preexisting DR was higher than those for DN (p=0.12 and DP (p=0.03 representing at least 13 patients with missed DR. Conclusions. The results indicate that implementing nonmydriatic, digital fundus imaging in a diabetes outpatient clinic can contribute to improved early diagnosis of diabetic retinopathy.

  2. Epigenetic Modifications and Potential New Treatment Targets in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Lorena Perrone

    2014-01-01

    Full Text Available Retinopathy is a debilitating vascular complication of diabetes. As with other diabetic complications, diabetic retinopathy (DR is characterized by the metabolic memory, which has been observed both in DR patients and in DR animal models. Evidences have provided that after a period of poor glucose control insulin or diabetes drug treatment fails to prevent the development and progression of DR even when good glycemic control is reinstituted (glucose normalization, suggesting a metabolic memory phenomenon. Recent studies also underline the role of epigenetic chromatin modifications as mediators of the metabolic memory. Indeed, epigenetic changes may lead to stable modification of gene expression, participating in DR pathogenesis. Moreover, increasing evidences suggest that environmental factors such as chronic hyperglycemia are implicated DR progression and may also affect the epigenetic state. Here we review recent findings demonstrating the key role of epigenetics in the progression of DR. Further elucidation of epigenetic mechanisms, acting both at the cis- and trans-chromatin structural elements, will yield new insights into the pathogenesis of DR and will open the way for the discovery of novel therapeutic targets to prevent DR progression.

  3. Language barrier and its relationship to diabetes and diabetic retinopathy.

    Science.gov (United States)

    Zheng, Yingfeng; Lamoureux, Ecosse L; Chiang, Pei-Chia Peggy; Anuar, Ainur Rahman; Ding, Jie; Wang, Jie Jin; Mitchell, Paul; Tai, E-Shyong; Wong, Tien Y

    2012-09-13

    Language barrier is an important determinant of health care access and health. We examined the associations of English proficiency with type-2 diabetes (T2DM) and diabetic retinopathy (DR) in Asian Indians living in Singapore, an urban city where English is the predominant language of communication. This was a population-based, cross-sectional study. T2DM was defined as HbA1c ≥6.5%, use of diabetic medication or a physician diagnosis of diabetes. Retinal photographs were graded for the severity of DR including vision-threatening DR (VTDR). Presenting visual impairment (VI) was defined as LogMAR visual acuity > 0.30 in the better-seeing eye. English proficiency at the time of interview was assessed. The analyses included 2,289 (72.1%) English-speaking and 885 (27.9%) Tamil-speaking Indians. Tamil-speaking Indians had significantly higher prevalence of T2DM (46.2 vs. 34.7%, p language-related discrepancies (defined as the difference in prevalence between persons speaking different languages) in T2DM, DR, and VTDR could not be fully explained by socioeconomic measures. In an English dominant society, Tamil-speaking Indians are more likely to have T2DM and diabetic retinopathy. Social policies and health interventions that address language-related health disparities may help reduce the public health impact of T2DM in societies with heterogeneous populations.

  4. Identification of vitreous proteins in retinopathy of prematurity.

    Science.gov (United States)

    Sugioka, Koji; Saito, Akio; Kusaka, Shunji; Kuniyoshi, Kazuki; Shimomura, Yoshikazu

    2017-07-01

    Retinopathy of prematurity (ROP) is a disorder of blood vessels in the retina developed in premature infants and the leading cause of the blindness in children. Proteomic analysis was performed to identify vitreous proteins specific to patients with ROP. Vitreous humor samples were obtained from three patients with ROP and two patients with congenital cataract, the latter included as a control group. The vitreous samples were separated by 2D-PAGE and the proteins running as definitive spots were identified by MALDI-TOF MS spectrometry. We identified 13 and 6 proteins in the vitreous from ROP and cataract patients, respectively. Albumin, transferrin, pigment epithelium-derived factor (PEDF) and transthyretin were found in both patient groups. In the samples from ROP patients, PEDF and transthyretin levels were lower than in those from cataract patients, and retinol binding protein 3 and prostaglandin D synthase were not detected. Of the 13 proteins, 9 proteins including α-2-macroglobulin, ceruloplasmin, α-fetoprotein, vitamin D-binding protein, α-1-antitrypsin, α-1-β-glycoprotein, hemopexin, apolipoprotein A-1 and A-lV were found in vitreous samples of only the ROP patients. PEDF has anti-angiogenic and neurotrophic functions. Whether PEDF is increased or decreased in diabetic retinopathy has been controversial but we observed lower PEDF in the ROP samples than in the controls. The proteins specific to or decreased in ROP, if confirmed in future studies, may provide clue to understanding its pathogenesis. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Intravitreal Bevacizumab (Avastin for Diabetic Retinopathy: The 2010 GLADAOF Lecture

    Directory of Open Access Journals (Sweden)

    J. Fernando Arevalo

    2011-01-01

    Full Text Available This paper demonstrates multiple benefits of intravitreal bevacizumab (IVB on diabetic retinopathy (DR including diabetic macular edema (DME and proliferative diabetic retinopathy (PDR at 24 months of followup. This is a retrospective multicenter interventional comparative case series of intravitreal injections of 1.25 or 2.5 mg of bevacizumab for DME, PDR without tractional retinal detachment (TRD, and patients who experienced the development or progression of TRD after an intravitreal injection of 1.25 or 2.5 mg of bevacizumab before vitrectomy for the management of PDR. The results indicate that IVB injections may have a beneficial effect on macular thickness and visual acuity (VA in diffuse DME. Therefore, in the future this new therapy could complement focal/grid laser photocoagulation in DME. In PDR, this new option could be an adjuvant agent to panretina photocoagulation so that more selective therapy may be applied. Finally, TRD in PDR may occur or progress after IVB used as an adjuvant to vitrectomy. Surgery should be performed 4 days after IVB. Most patients had poorly controlled diabetes mellitus associated with elevated HbA1c, insulin administration, PDR refractory to panretinal photocoagulation, and longer time between IVB and vitrectomy.

  6. MANAGEMENT OF DIABETIC RETINOPATHY, PREVALENCE AND CLINICAL CLASSIFICATION.

    Science.gov (United States)

    Ajvazi, Alil; Lutaj, Pajtim; Goranci, Ilhami

    2014-01-01

    To ascertain the prevalence of diabetic retinopathy--DR, based on the duration of the diabetes mellitus--DM and to compare it with data from relevant literature and other referent clinics. In this study are included the patients with diabetes mellitus type 1 insulin-dependent--DMID and diabetes mellitus type 2 non-insulin-dependent--DMNID. The duration of diabetes in the examined patients varied from 5 till 30 years. We have applied examination by ophthalmoscope, slit lamp bio-microscopy with Volk and Goldman lens, optical coherence tomography--OCT as well as fluorescein angiography--FAG. Have been included the treated patients with DR, from September 2004-2014. In diabetic patients suffering for a period of 5 years, the prevalence of DR is 10%. In diabetic patients suffering over 30 years, the prevalence of DR is varied from 82% until 97%. Diabetic retinopathy, undertakes a multidisciplinary approach in all patients with diabetes to achieve optimal blood glucose control HbA1c levels 7.0% or lower and to adequately manage systolic blood pressure less than 140 mmHg and serum LDL cholesterol of less than 2.5 mmol/L and triglycerides of less than 2.0 mmol/L. Always should be assessed visual acuity at the time of DR examination.

  7. Automatic detection of retinal anatomy to assist diabetic retinopathy screening

    Energy Technology Data Exchange (ETDEWEB)

    Fleming, Alan D [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom); Goatman, Keith A [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom); Philip, Sam [Grampian Diabetes Retinal Screening Programme, Woolmanhill Hospital, Aberdeen, AB25 1LD (United Kingdom); Olson, John A [Grampian Diabetes Retinal Screening Programme, Woolmanhill Hospital, Aberdeen, AB25 1LD (United Kingdom); Sharp, Peter F [Biomedical Physics, University of Aberdeen, Aberdeen, AB25 2ZD (United Kingdom)

    2007-01-21

    Screening programmes for diabetic retinopathy are being introduced in the United Kingdom and elsewhere. These require large numbers of retinal images to be manually graded for the presence of disease. Automation of image grading would have a number of benefits. However, an important prerequisite for automation is the accurate location of the main anatomical features in the image, notably the optic disc and the fovea. The locations of these features are necessary so that lesion significance, image field of view and image clarity can be assessed. This paper describes methods for the robust location of the optic disc and fovea. The elliptical form of the major retinal blood vessels is used to obtain approximate locations, which are refined based on the circular edge of the optic disc and the local darkening at the fovea. The methods have been tested on 1056 sequential images from a retinal screening programme. Positional accuracy was better than 0.5 of a disc diameter in 98.4% of cases for optic disc location, and in 96.5% of cases for fovea location. The methods are sufficiently accurate to form an important and effective component of an automated image grading system for diabetic retinopathy screening.

  8. Automatic detection of retinal anatomy to assist diabetic retinopathy screening.

    Science.gov (United States)

    Fleming, Alan D; Goatman, Keith A; Philip, Sam; Olson, John A; Sharp, Peter F

    2007-01-21

    Screening programmes for diabetic retinopathy are being introduced in the United Kingdom and elsewhere. These require large numbers of retinal images to be manually graded for the presence of disease. Automation of image grading would have a number of benefits. However, an important prerequisite for automation is the accurate location of the main anatomical features in the image, notably the optic disc and the fovea. The locations of these features are necessary so that lesion significance, image field of view and image clarity can be assessed. This paper describes methods for the robust location of the optic disc and fovea. The elliptical form of the major retinal blood vessels is used to obtain approximate locations, which are refined based on the circular edge of the optic disc and the local darkening at the fovea. The methods have been tested on 1056 sequential images from a retinal screening programme. Positional accuracy was better than 0.5 of a disc diameter in 98.4% of cases for optic disc location, and in 96.5% of cases for fovea location. The methods are sufficiently accurate to form an important and effective component of an automated image grading system for diabetic retinopathy screening.

  9. Central retinal artery occlusion resembling Purtscher-like retinopathy

    Directory of Open Access Journals (Sweden)

    Etomi T

    2011-08-01

    Full Text Available Takuji Kurimoto1, Norio Okamoto2, Hidehiro Oku1, Yuko Kanbara1, Tomohiko Etomi1, Masahiro Tonari1, Tsunehiko Ikeda11Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan; 2Okamoto Eye Clinic, Suita, Osaka, JapanAbstract: This paper reports three cases of central retinal artery occlusion (CRAO with Purtscher-like retinopathy and good recovery of visual function. The three cases of CRAO had similar fundus changes, ie, cotton wool patches surrounding the optic disc and whitening of the retina surrounding the fovea with a cherry red spot. Fluorescein angiography showed a delay of arm-to-retina circulation time and a partial defect of choroid circulation. Although the three cases were treated by different regimens of steroid pulse therapy and antiplatelet therapy, visual function recovered well and all disturbances of the retinal and choroid circulations resolved. Although eyes with a CRAO normally have a poor visual prognosis, our three cases responded well to the treatments and recovered good visual function. Thus, cases showing fundus changes similar to our three cases may have a pathogenesis different from that of a complete CRAO.Keywords: central retinal artery occlusion, cotton wool patches, Purtscher retinopathy, steroid therapy

  10. Genetic and Environmental Influences on Retinopathy of Prematurity

    Directory of Open Access Journals (Sweden)

    J. M. Ortega-Molina

    2015-01-01

    Full Text Available Objective. The goals were to isolate and study the genetic susceptibility to retinopathy of prematurity (ROP, as well as the gene-environment interaction established in this disease. Methods. A retrospective study (2000–2014 was performed about the heritability of retinopathy of prematurity in 257 infants who were born at a gestational age of ≤32 weeks. The ROP was studied and treated by a single pediatric ophthalmologist. A binary logistic regression analysis was completed between the presence or absence of ROP and the predictor variables. Results. Data obtained from 38 monozygotic twins, 66 dizygotic twins, and 153 of simple birth were analyzed. The clinical features of the cohorts of monozygotic and dizygotic twins were not significantly different. Genetic factors represented 72.8% of the variability in the stage of ROP, environmental factors 23.08%, and random factors 4.12%. The environmental variables representing the highest risk of ROP were the number of days of tracheal intubation (p < 0.001, postnatal weight gain (p = 0.001, and development of sepsis (p = 0.0014. Conclusion. The heritability of ROP was found to be 0.73. The environmental factors regulate and modify the expression of the genetic code.

  11. Intravitreal Bevacizumab (Avastin) for Diabetic Retinopathy: The 2010 GLADAOF Lecture

    Science.gov (United States)

    Arevalo, J. Fernando; Sanchez, Juan G.; Lasave, Andres F.; Wu, Lihteh; Maia, Mauricio; Bonafonte, Sergio; Brito, Miguel; Alezzandrini, Arturo A.; Restrepo, Natalia; Berrocal, Maria H.; Saravia, Mario; Farah, Michel Eid; Fromow-Guerra, Jans; Morales-Canton, Virgilio

    2011-01-01

    This paper demonstrates multiple benefits of intravitreal bevacizumab (IVB) on diabetic retinopathy (DR) including diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) at 24 months of followup. This is a retrospective multicenter interventional comparative case series of intravitreal injections of 1.25 or 2.5 mg of bevacizumab for DME, PDR without tractional retinal detachment (TRD), and patients who experienced the development or progression of TRD after an intravitreal injection of 1.25 or 2.5 mg of bevacizumab before vitrectomy for the management of PDR. The results indicate that IVB injections may have a beneficial effect on macular thickness and visual acuity (VA) in diffuse DME. Therefore, in the future this new therapy could complement focal/grid laser photocoagulation in DME. In PDR, this new option could be an adjuvant agent to panretina photocoagulation so that more selective therapy may be applied. Finally, TRD in PDR may occur or progress after IVB used as an adjuvant to vitrectomy. Surgery should be performed 4 days after IVB. Most patients had poorly controlled diabetes mellitus associated with elevated HbA1c, insulin administration, PDR refractory to panretinal photocoagulation, and longer time between IVB and vitrectomy. PMID:21584260

  12. A UNIQUE CASE OF PHEOCHROMOCYTOMA PRESENTING WITH HYPERTENSIVE RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Maji.S, Saha. ML, Kanwar KS, Das S, Bhagat P, Bhar P

    2015-04-01

    Full Text Available ABSTRACT Pheochromocytoma is an extremely uncommon tumor of childhood and there are several features that distinguish its presentation between adults and children. The incidence of pheochromocytoma in childhood is 10% of the adult incidence, occurring in approximately 1 in 500,000 children compared with 1 in 50,000 adults. Around 10% of childhood tumors are familial which is 4times the frequency in adults. Whereas only 7% of pheochromocytomas are bilateral in adults, the reported incidence of the same in children range from 24 % to as high as &70%.These tumors are known for their great diversity in clinical presentation. Greater than 50% of children present with headaches, fever, palpitation, thirst, polyuria, sweating, nausea and weight loss. However the commonest mode of presentation is sustained hypertension. Pheochromocytoma accounts for 0.5% of children with hypertension and must be considered once other causes have been eliminated. We here in report a unique case of a 13 year old girl who initially presented with bilateral hypertensive retinopathy and later found to have a pheochromocytoma on subsequent workup. Hypertensive retinopathy secondary to pheochromocytoma is itself a rare entity whose exact incidence in children is still unknown. This case highlights the importance of routine history, physical examination and measurement of bp. Prompt surgery can reverse the effect of hypertension and lead to good outcome as was evident in our case.

  13. Mean trombosit volume in patients with retinopathy of prematurity

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    Harun Yüksel

    2014-06-01

    Full Text Available Objective: We aimed to evaluate the mean platelet volume (MPV in patients with retinopathy of prematurity (ROP with respect to development of type 1 ROP Methods: The medical records of the premature infants were evaluated. Babies with a birth weight under 1500 g and a gestational age under 32 weeks were enrolled to the study. Birth weight, gestational age, onset and grade of retinopathy, presence of plus disease were analyzed. At the time of type 1 ROP diagnosis, blood samples were obtained. In the patients without type 1 ROP the blood samples were also obtained at similar gestational age. Hemoglobin, hematocrit, platelet count, and MPV results were recorded. Results: Sixty-three infants were studied. 22 of them had type 1 ROP and 41 had not developed type 1 ROP. The mean gestational age and the mean birth weight between groups were not statistically significant. The mean MPV values in patients with type 1 ROP and without type 1 ROP was 9,1±2,0 fL and 9,4±1,8 fL, respectively (p=0.61. Conclusion: The results demonstrated that MPV values were not associated with severity of ROP in our study population. J Clin Exp Invest 2014; 5 (2: 443-446

  14. Diabetic Retinopathy Clinical Practice Guidelines: Customized for Iranian Population

    Science.gov (United States)

    Rajavi, Zhale; Safi, Sare; Javadi, Mohammad Ali; Azarmina, Mohsen; Moradian, Siamak; Entezari, Morteza; Nourinia, Ramin; Ahmadieh, Hamid; Shirvani, Armin; Shahraz, Saeid; Ramezani, Alireza; Dehghan, Mohammad Hossein; Shahsavari, Mohsen; Soheilian, Masoud; Nikkhah, Homayoun; Ziaei, Hossein; Behboudi, Hasan; Farrahi, Fereydoun; Falavarjani, Khalil Ghasemi; Parvaresh, Mohammad Mehdi; Fesharaki, Hamid; Abrishami, Majid; Shoeibi, Nasser; Rahimi, Mansour; Javadzadeh, Alireza; Karkhaneh, Reza; Riazi-Esfahani, Mohammad; Manaviat, Masoud Reza; Maleki, Alireza; Kheiri, Bahareh; Golbafian, Faegheh

    2016-01-01

    Purpose: To customize clinical practice guidelines (CPGs) for management of diabetic retinopathy (DR) in the Iranian population. Methods: Three DR CPGs (The Royal College of Ophthalmologists 2013, American Academy of Ophthalmology [Preferred Practice Pattern 2012], and Australian Diabetes Society 2008) were selected from the literature using the AGREE tool. Clinical questions were designed and summarized into four tables by the customization team. The components of the clinical questions along with pertinent recommendations extracted from the above-mentioned CPGs; details of the supporting articles and their levels of evidence; clinical recommendations considering clinical benefits, cost and side effects; and revised recommendations based on customization capability (applicability, acceptability, external validity) were recorded in 4 tables, respectively. Customized recommendations were sent to the faculty members of all universities across the country to score the recommendations from 1 to 9. Results: Agreed recommendations were accepted as the final recommendations while the non-agreed ones were approved after revision. Eventually, 29 customized recommendations under three major categories consisting of screening, diagnosis and treatment of DR were developed along with their sources and levels of evidence. Conclusion: This customized CPGs for management of DR can be used to standardize the referral pathway, diagnosis and treatment of patients with diabetic retinopathy. PMID:27994809

  15. Colour Doppler ultrasound evaluation of orbital vessels in diabetic retinopathy.

    Science.gov (United States)

    Baydar, S; Adapinar, B; Kebapci, N; Bal, C; Topbas, S

    2007-06-01

    The aim of this study was to determine the role of colour Doppler imaging in the retrobulbar vascular circulation in diabetic retinopathy (DR). Maximum (V(max)), end-diastolic (V(min)) and average (V(mean)) velocities of blood flows and pulsatility index and resistivity index (RI) in central retinal artery (CRA), short branches of posterior ciliary artery (PCA) and ophthalmic artery of the 65 diabetic and 22 control eyes were measured. The CRA V(max) level in the control group was significantly higher than in DR groups. The CRA V(mean) level was also significantly higher in the control group than in the mild nonproliferative diabetic retinopathy (NPDR) and the moderate NPDR groups. The CRA RI value was significantly higher in the control group than in the nonretinopathy group. The CRA V(min) and the ophthalmic artery RI values were found significantly higher in the nonretinopathy group than in the moderate NPDR group. There were significant decreases in the some CRA and PCA values as glycated haemoglobin (HbA1c) levels increase in diabetic group. There was a positive correlation between the duration of diabetes and HbA1c levels. This study showed the presence of some dynamic circulatory alterations in the nonretinopathy group with diabetes and DR groups. It was also shown that there is a negative correlation between HbA1c and some orbital vascular velocities.

  16. Decreased angiogenin concentration in vitreous and serum in proliferative diabetic retinopathy.

    Science.gov (United States)

    Marek, Natalia; Raczyńska, Krystyna; Siebert, Janusz; Myśliwiec, Małgorzata; Zorena, Katarzyna; Myśliwska, Jolanta; Reiwer-Gostomska, Magdalena; Trzonkowski, Piotr

    2011-07-01

    Diabetic retinopathy is the most common cause of vision loss in young adults in developed countries. The disease therapy with anti-vascular endothelial growth factor (VEGF) agents gives some positive results, but is associated with retinal ischemia and vasoconstriction. Therefore, determination of factors involved in the physiological and pathological angiogenesis in the diabetic eye is of great importance for understanding of the pathogenesis of diabetic retinopathy and its effective treatment. Previously, we found that diabetic patients were characterized by increased serum concentration of VEGF, but decreased levels of other proangiogenic factor-angiogenin. The involvement of VEGF in pathogenesis of diabetic retinopathy is well established, but there is lack of data regarding angiogenin in retinopathy. Therefore, in the present study we measured angiogenin concentration in vitreous and serum samples of the patients with type 1 diabetes to determine its role in diabetic retinopathy. In addition, in each time, we compared the level of angiogenin with level of VEGF as a known factor involved in the pathogenesis of the disease. Angiogenin was found to be significantly more abundant in serum than in vitreous in both diabetic groups. In addition, patients with retinopathy had twofold lower vitreous angiogenin levels than diabetic individuals without complications. On the contrary, vitreous concentration of VEGF was dramatically increased only in participants with retinopathy. Patients without diabetic complications had significantly lower VEGF levels in vitreous than in serum and were characterized by high local and systemic concentration of angiogenin. These data suggest a local imbalance between two proangiogenic factors-VEGF and angiogenin in retinopathy. Low vitreous concentration of angiogenin in diabetic patients suggests that this factor is not responsible for pathological neovascularization in diabetic eye. Further studies will elucidate if angiogenin can be

  17. A systematic meta-analysis of genetic association studies for diabetic retinopathy.

    Science.gov (United States)

    Abhary, Sotoodeh; Hewitt, Alex W; Burdon, Kathryn P; Craig, Jamie E

    2009-09-01

    Diabetic retinopathy is a sight-threatening microvascular complication of diabetes with a complex multifactorial pathogenesis. A systematic meta-analysis was undertaken to collectively assess genetic studies and determine which previously investigated polymorphisms are associated with diabetic retinopathy. All studies investigating the association of genetic variants with the development of diabetic retinopathy were identified in PubMed and ISI Web of Knowledge. Crude odds ratios (ORs) and 95% CIs were calculated for single nucleotide polymorphisms and microsatellite markers previously investigated in at least two published studies. Twenty genes and 34 variants have previously been studied in multiple cohorts. The aldose reductase (AKR1B1) gene was found to have the largest number of polymorphisms significantly associated with diabetic retinopathy. The z-2 microsatellite was found to confer risk (OR 2.33 [95% CI 1.49-3.64], P = 2 x 10(-4)) in type 1 and type 2 diabetes and z+2 to confer protection (0.58 [0.36-0.93], P = 0.02) against diabetic retinopathy in type 2 diabetes regardless of ethnicity. The T allele of the AKR1B1 promoter rs759853 variant is also significantly protective against diabetic retinopathy in type 1 diabetes (0.5 [0.35-0.71], P = 1.00 x 10(-4)), regardless of ethnicity. These associations were also found in the white population alone (P NOS3, VEGF, ITGA2, and ICAM1 are also associated with diabetic retinopathy after meta-analysis. Variations within the AKR1B1 gene are highly significantly associated with diabetic retinopathy development irrespective of ethnicity. Identification of genetic risk factors in diabetic retinopathy will assist in further understanding of this complex and debilitating diabetes complication.

  18. Grade III or Grade IV Hypertensive Retinopathy with Severely Elevated Blood Pressure

    Directory of Open Access Journals (Sweden)

    Amanda D Henderson

    2012-12-01

    Full Text Available Introduction: Hypertensive retinopathy describes a spectrum of retinal changes in patients with elevated blood pressure (BP. It is unknown why some patients are more likely to develop acute ocular end-organ damage than others with similar BP. We examined risk factors for grade III/IV hypertensive retinopathy among patients with hypertensive urgency in the emergency department (ED and compared healthcare utilization and mortality between patients with and without grade III/IV hypertensive retinopathy.Methods: A preplanned subanalysis of patients who presented to a university hospital ED with diastolic BP > 120 mmHg and who enrolled in the Fundus Photography versus Ophthalmoscopy Trial Outcomes in the ED study was performed. Bilateral nonmydriatic ocular fundus photographs, vital signs, and demographics were obtained at presentation. Past medical history, laboratory values, healthcare utilization, and mortality were ascertained from medical record review at least 8 months after initial ED visit.Results: Twenty-one patients with diastolic BP > 120 mmHg, 7 of whom (33% had grade III/IV hypertensive retinopathy, were included. Patients with retinopathy were significantly younger than those without (median 33 vs 50 years, P = 0.02. Mean arterial pressure (165 vs 163 mmHg was essentially equal in the 2 groups. Patients with retinopathy had substantially increased but nonsignificant rates of ED revisit (57% vs 29%, P = 0.35 and hospital admission after ED discharge (43% vs 14%, P = 0.28. One of the patients with retinopathy died, but none without.Conclusion: Younger patients may be at higher risk for grade III/IV hypertensive retinopathy among patients with hypertensive urgency. Chronic compensatory mechanisms may have not yet developed in these younger patients. Alternatively, older patients with retinopathy may be underrepresented secondary to increased mortality among these patients at a younger age (survivorship bias. Further research is needed to

  19. Prevalence of Diabetic Retinopathy in Urban Slums: The Aditya Jyot Diabetic Retinopathy in Urban Mumbai Slums Study-Report 2.

    Science.gov (United States)

    Sunita, Mohan; Singh, Arvind Kumar; Rogye, Ashwini; Sonawane, Manish; Gaonkar, Ravina; Srinivasan, Radhika; Natarajan, Sundaram; Stevens, Fred C J; Scherpbier, A J J A; Kumaramanickavel, Govindasamy; McCarty, Catherine

    2017-10-01

    The aims of the study were to estimate the prevalence of diabetic retinopathy (DR) and enumerate history-based risk factors in the urban slums of Western India. The population-based study was conducted in seven wards of Mumbai urban slums, where we screened 6569 subjects of ≥ 40 years age, with a response rate of 98.4%, for type 2 diabetes mellitus (T2DM) based on American Diabetes Association criteria. All subjects with T2DM underwent dilated 30° seven-field stereo-fundus-photography for DR severity grading based on modified Airlie House classification. A multivariate logistic regression model was used to assess the correlation of DR with the history-based risk factors. The prevalence of DR in the general population of Mumbai urban slums was 1.41% (95% CI 0.59-2.23) and in the T2DM population it was 15.37% (95% CI 8.87-21.87). The positive associations with DR were the longer duration of DM (≥ 11 years: OR, 12.77; 95% CI 2.93-55.61) and male gender (OR, 2.05; 95% CI 1.08-3.89); increasing severity of retinopathy was also significantly associated with longer duration of DM (p urban slums. Duration of DM and male gender were significantly associated with DR. The slums in Western India show the trends of urban lifestyle influences similar to the rest of urban India.

  20. Foveal slope measurements in diabetic retinopathy: Can it predict development of sight-threatening retinopathy? Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SN-DREAMS II, Report no 8

    Directory of Open Access Journals (Sweden)

    Laxmi Gella

    2015-01-01

    Full Text Available Aim: The aim was to assess the foveal slope configuration in subjects with type 2 diabetes in a population-based study. Materials and Methods: A subset of 668 subjects from Sankara Nethralaya Diabetic Retinopathy (DR Epidemiology and Molecular Genetics Study II, a population-based study, were included in the current study. All the subjects underwent comprehensive ophthalmic evaluation including spectral domain optical coherence tomography. Foveal thickness was assessed in five central early treatment DR study quadrants from the three-dimensional scan and foveal slope was calculated in all the four quadrants. Results: Subjects with sight-threatening DR (STDR had significantly shallow foveal slope in inferior quadrant (STDR: 7.33 ± 6.26 vs. controls: 10.31 ± 3.44; P = 0.021 when compared to controls and in superior (STDR: 7.62 ± 5.81 vs. no DR: 9.11 ± 2.82; P = 0.033, inferior (STDR: 7.33 ± 6.26 vs. no DR: 8.81 ± 2.81; P = 0.048, and temporal quadrants (STDR: 6.69 ± 5.70 vs. no DR: 7.97 ± 2.33; P = 0.030 when compared to subjects with no DR. Foveal slope was significantly shallow among the older age groups in subjects with no DR (P < 0.001 and non-STDR (P = 0.027. Average foveal slope in the diabetic subjects was independently and significantly correlated with increase in age (r = −0.241; P < 0.001 and central subfield thickness (r = −0.542; P < 0.001. Conclusion: Changes in foveal slope were seen with increasing age; however, in diabetes these segmental slope changes can be seen in late DR (STDR.

  1. Prevalence of retinopathy of prematurity in Latin America

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    Carrion JZ

    2011-12-01

    Full Text Available Juliana Zimmermann Carrion1, João Borges Fortes Filho2, Marcia Beatriz Tartarella3, Andrea Zin4, Ignozy Dorneles Jornada Jr41Program for the Prevention of Blindness due to Retinopathy of Prematurity, Hospital de Clínicas de Porto Alegre, Porto Alegre, 2Department of Ophthalmology, Medical School, Federal University of Rio Grande do Sul and Hospital de Clínicas de Porto Alegre, Porto Alegre, 3Federal University of São Paulo, São Paulo, 4Departament of Neonatology, Instituto Fernandes Figueira, Rio de Janeiro, 5University Luterana do Brasil School of Medicine, Canoas, BrazilAbstract: The purpose of this work was to review the studies published over the last 10 years concerning the prevalence of retinopathy of prematurity (ROP in Latin American countries, to determine if there was an improvement in ROP prevalence rates in that period, and to identify the inclusion criteria for patients at risk of developing ROP in the screening programs. A total of 33 studies from ten countries published between 2000 and 2010 were reviewed. Prevalence of any ROP stage in the regions considered ranged from 6.6% to 82%; ROP severe enough to require treatment ranged from 1.2% to 23.8%. There was no routine screening for ROP, and there was a lack of services for treatment of the disease in many countries. Inclusion criteria for patients in the studies ranged between birth weight ≤1500 g and ≤2000 g and gestational age ≤32 and <37 weeks. Use of different inclusion criteria regarding birth weight and gestational age in several Latin American studies hindered comparative analysis of the published data. Highly restrictive selection criteria for ROP screening in relation to birth weight and gestational age should not be used throughout most Latin American countries because of their different social characteristics and variable neonatal care procedures. The studies included in this review failed to provide adequate information to determine if the prevalence of ROP

  2. Sickle cell retinopathy: improving care with a multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    Menaa F

    2017-08-01

    Full Text Available Farid Menaa,1,2 Barkat Ali Khan,3 Bushra Uzair,4 Abder Menaa2 1Department of Pharmaceutical Sciences and Nanomedicine, California Innovations Corporation, San Diego, CA, USA; 2Departments of Clinical Medicine and Laser Therapy, Centre Médical des Guittières, Saint-Philbert-de-Grand-Lieu, Loire-Atlantique, France; 3Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, 4Department of Bioinformatics and Biotechnology, International Islamic University, Islamabad, Pakistan Abstract: Sickle cell retinopathy (SCR is the most representative ophthalmologic complication of sickle cell disease (SCD, a hemoglobinopathy affecting both adults and children. SCR presents a wide spectrum of manifestations and may even lead to irreversible vision loss if not properly diagnosed and treated at the earliest. Over the past decade, multidisciplinary research developments have focused upon systemic, genetic, and ocular risk factors of SCR, enabling the clinician to better diagnose and manage these patients. In addition, newer imaging and testing modalities, such as spectral domain-optical coherence tomography angiography, have resulted in the detection of subclinical retinopathy related to SCD. Innovative therapy includes intravitreal injection of an anti-vascular endothelial growth factor (eg, Lucentis® [ranibizumab] or Eylea® [aflibercept] which appears comparatively safe and efficient, and may be combined with laser photocoagulation (LPC for proliferative SCR. The effect of LPC alone does not significantly lead to the regression of advanced SCR, although it helps in avoiding hemorrhage and sight loss. This comprehensive article is based on 10-years retrospective (2007–2017 studies. It aims to present advances and recommendations in SCR theranostics while pointing out the requirement of combinatorial approaches for better management of SCR patients. To reach this goal, we identified and analyzed randomized original and

  3. Sixteen-year Incidence of Diabetic Retinopathy and Proliferative Diabetic Retinopathy in a Nationwide Cohort of Young Danish Type 1 Diabetic Patients

    DEFF Research Database (Denmark)

    Pedersen, Rebecca Broe

    and diabetes duration. Results: The mean age and diabetes duration at baseline were 21.1±3.1 and 13.3±3.5 years, respectively. At baseline 31.8% had no retinopathy, 67.4% had non-PDR and 0.8% had PDR. At follow-up, the prevalence of diabetic retinopathy was 96.9%. Thirty-eight patients with no DR at baseline......Design of study: Prospective cohort-study Purpose: The aim of this study was to assess long-term incidence of diabetic retinopathy (DR) and proliferative diabetic retinopathy (PDR) and associated risk factors in a Danish population-based cohort of young type 1 diabetic patients. Methods: Eighty...... percent of all Danish type 1 diabetic patients below the age of 18 (n=1033) were examined in 1986-89. In 1995, baseline retinopathy was graded and other risk factors were assessed in 324 patients (31.4% of the original cohort). Of these, 132 (40.7%) were re-examined at follow-up in 2011. At baseline two...

  4. c-Src and neural Wiskott-Aldrich syndrome protein (N-WASP promote low oxygen-induced accelerated brain invasion by gliomas.

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    Zhuo Tang

    Full Text Available Malignant gliomas remain associated with poor prognosis and high morbidity because of their ability to invade the brain; furthermore, human gliomas exhibit a phenotype of accelerated brain invasion in response to anti-angiogenic drugs. Here, we study 8 human glioblastoma cell lines; U251, U87, D54 and LN229 show accelerated motility in low ambient oxygen. Src inhibition by Dasatinib abrogates this phenotype. Molecular discovery and validation studies evaluate 46 molecules related to motility or the src pathway in U251 cells. Demanding that the molecular changes induced by low ambient oxygen are reversed by Dasatinib in U251 cells, identifies neural Wiskott-Aldrich syndrome protein (NWASP, Focal adhesion Kinase (FAK, [Formula: see text]-Catenin, and Cofilin. However, only Src-mediated NWASP phosphorylation distinguishes the four cell lines that exhibit enhanced motility in low ambient oxygen. Downregulating c-Src or NWASP by RNA interference abrogates the low-oxygen-induced enhancement in motility by in vitro assays and in organotypic brain slice cultures. The findings support the idea that c-Src and NWASP play key roles in mediating the molecular pathogenesis of low oxygen-induced accelerated brain invasion by gliomas.

  5. c-Src and neural Wiskott-Aldrich syndrome protein (N-WASP) promote low oxygen-induced accelerated brain invasion by gliomas.

    Science.gov (United States)

    Tang, Zhuo; Araysi, Lita M; Fathallah-Shaykh, Hassan M

    2013-01-01

    Malignant gliomas remain associated with poor prognosis and high morbidity because of their ability to invade the brain; furthermore, human gliomas exhibit a phenotype of accelerated brain invasion in response to anti-angiogenic drugs. Here, we study 8 human glioblastoma cell lines; U251, U87, D54 and LN229 show accelerated motility in low ambient oxygen. Src inhibition by Dasatinib abrogates this phenotype. Molecular discovery and validation studies evaluate 46 molecules related to motility or the src pathway in U251 cells. Demanding that the molecular changes induced by low ambient oxygen are reversed by Dasatinib in U251 cells, identifies neural Wiskott-Aldrich syndrome protein (NWASP), Focal adhesion Kinase (FAK), [Formula: see text]-Catenin, and Cofilin. However, only Src-mediated NWASP phosphorylation distinguishes the four cell lines that exhibit enhanced motility in low ambient oxygen. Downregulating c-Src or NWASP by RNA interference abrogates the low-oxygen-induced enhancement in motility by in vitro assays and in organotypic brain slice cultures. The findings support the idea that c-Src and NWASP play key roles in mediating the molecular pathogenesis of low oxygen-induced accelerated brain invasion by gliomas.

  6. Study of the relationship of MMP-9 and serum fructosamine levels in diabetic retinopathy patients

    Directory of Open Access Journals (Sweden)

    Chong Wang

    2014-05-01

    Full Text Available AIM: To explore the relationship of MMP-9 and serum fructosamine levels and further illustrate the role of the development in diabetic retinopathy patients.METHODS: Serum MMP-9 levels were measured using enzyme-linkedimmunosorbent assays a in 30 health controls and 30 diabetic retinopathy patients, the relationship of MMP-9 and serum fructosamine levels were analyzed。RESULTS: Compared with healthy controls. The expression levels of MMP-9 indiabetic retinopathy patients were significantly increased \\〖(8.14±2.28pmol/L, vs(2.47±1.41pmol/L\\〗, MMP-9 were positive correlation with fructosamine(r=0.94, PCONCLUSION:The occurrence and progress of diabetic retinopathy might be closely related to the expression level of MMP-9, and the abnormal expression of MMP-9 in patients' serum might be associated with the secretion of fructosamine.

  7. The course of diabetic retinopathy during treatment with continuous subcutaneous insulin infusion

    NARCIS (Netherlands)

    Hooymans, Johanna Martina Maria

    1986-01-01

    The aim of this prospective study was to investigate the effect of normalization of blood sugar regulation by continuous subcutaneous insulin infusion (CSII) on the course of diabetic retinopathy in insulin-dependent (type I) diabetic patients. Zie: Summary

  8. Physical inactivity as a risk factor for diabetic retinopathy? A review.

    Science.gov (United States)

    Dirani, Mohamed; Crowston, Jonathan G; van Wijngaarden, Peter

    2014-08-01

    Physical inactivity and sedentary behaviour have been identified as modifiable risk factors for diabetes. However, little is known of the associations between physical activity, sedentary behaviour and diabetic retinopathy. The development of diabetic retinopathy is associated with longer duration of diabetes, elevated blood pressure and poor glycaemic control. However these factors only explain a proportion of the risk of retinopathy in individuals with diabetes. Several studies have suggested a protective role for physical activity in diabetic retinopathy. Other work has shown that the time spent watching television is independently associated with abnormal retinal vascular signs. Limitations of the existing studies, such as the absence of objective measures of physical activity, a lack of sedentary behaviour measures, the inclusion of only those with type 1 diabetes and a lack of longitudinal data, make it difficult to draw firm conclusions about the strength of these associations.

  9. Treatment of 98 Cases of Diabetic Retinopathy by Combined Acupuncture and Herbs

    Institute of Scientific and Technical Information of China (English)

    邢桂霞; 肖元春

    2010-01-01

    @@ Diabetic retinopathy (DR) is a difficult condition in which microvascular tumor,edema,effusion,hemorrhage or neovascularization develops in the eyeground in diabetics,subsequently leading to the vision diminishment.

  10. Clinical Study on HIV-related Retinopathy%HIV 相关视网膜病的临床研究

    Institute of Scientific and Technical Information of China (English)

    李雪琴; 黄爱春; 刘升; 卢祥婵

    2012-01-01

    Objective To explore the pathogenesis,fundus characteristics,diagnosis and therapeutic principle oi HTV-related retinopathy. Methods Data of 30 patients with HTV-related retinopathy were analyzed retrospectively. Results Thirty patients were found with HTV-related retinopathy in 300 HTV/AIDS patients( 600 eyes ), the detection rate was 10.00% ,including 5 patients with vision changing;There were 26( 86.67% ) patients with CD4+ T cell count below 100 cell/uJ and 4 patients with CD4 + T cell count above 100 cell/jxl. The CD4 + T cell count of the patients with HTV-related retinopathy was significantly lower than that of the patients without HIV-related retinopathy( P < 0. 01 ). Cotton-wool spots,retinal hemorrhage and microangioma could be seen by fundus fluorescein angiography. The fundus changes of all the patients were improved after the treatment with antiretroviral therapy. Conclusion The clinical manifestation of HIV-related retinopathy is always nonspecific and easy to be missed diagnosis. Routine fundus examinatior is important for early detection and early treatment of HIV-related retinopathy in HTV/AIDS patients in the first visit.%目的 分析HIV相关视网膜病发病机制、眼底表现特点、诊断与治疗原则.方法 对30例HIV相关视网膜病患者的临床资料进行回顾性分析.结果 共筛查300例(600只眼)HIV/AIDS患者,检出HIV相关视网膜病30例,检出率为10.0%,其中有视力改变5例;CD4+T淋巴细胞计数≤100个/μl 26例(86.7%),CD4+T>100个/μl 4例(13.3%),HIV视网膜病变组CD4+T细胞计数低于无视网膜病变组(P<0.01).荧光素眼底血管造影显示棉絮斑、视网膜出血及微血管瘤.抗反转录病毒治疗后30例患者复查眼底病变好转、消失.结论 HIV相关视网膜病临床表现无特异性,漏诊率高;应对HIV/AIDS患者进眼底筛查,以早发现、早治疗.

  11. Retinopathy of prematurity: review of a seven-year period in a Danish neonatal intensive care unit

    DEFF Research Database (Denmark)

    Arrøe, M; Peitersen, Birgit

    1994-01-01

    of the hospital. One hundred and eighty survived to at least 8 weeks of age and 170 had eye examinations. Forty-five of the 170 infants examined (26.5%) had retinopathy of prematurity (ROP) and 18 (40%) of these developed blindness or severely impaired vision, a higher incidence than reported in other studies....... Significant differences were found between infants with and without ROP for: birth weight, gestational age, Apgar score at 1 min, resuscitation, ventilator treatment, duration of supplementary oxygen, severe complications in the neonatal period and sequels from the central nervous system. Statistical analysis......, corrected for correlations, showed that the occurrence of ROP was related significantly to early intubation, hypotension, persistent ductus arteriosus and necrotizing enterocolitis....

  12. Rhodopsin in plasma from patients with diabetic retinopathy - development and validation of digital ELISA by Single Molecule Array (Simoa) technology

    DEFF Research Database (Denmark)

    Petersen, Eva Rabing Brix; Olsen, Dorte Aalund; Christensen, Henry

    2017-01-01

    BACKGROUND: Diabetic retinopathy (DR) is the most frequent cause of blindness among younger adults in the western world. No blood biomarkers exist to detect DR. Hypothetically, Rhodopsin concentrations in blood has been suggested as an early marker for retinal damage. The aim of this study...... was therefore to develop and validate a Rhodopsin assay by employing digital ELISA technology, and to investigate whether Rhodopsin concentrations in diabetes patients with DR are elevated compared with diabetes patients without DR. METHODS: A digital ELISA assay using a Simoa HD-1 Analyzer (Quanterix......©, Lexington, MA 02421, USA) was developed and validated and applied on a cohort of diabetes patients characterised with (n=466) and without (n=144) DR. RESULTS: The Rhodopsin assay demonstrated a LOD of 0.26ng/l, a LLOQ of 3ng/l and a linear measuring range from 3 to 2500ng/l. Total CV% was 32%, 23%, 19...

  13. Diabetic retinopathy: recent advances towards understanding neurodegeneration and vision loss.

    Science.gov (United States)

    Barber, Alistair J

    2015-06-01

    Diabetic retinopathy (DR) is one of the most common retinal diseases world-wide. It has a complex pathology that involves the vasculature of the inner retina and breakdown of the blood-retinal barrier. Extensive research has determined that DR is not only a vascular disease but also has a neurodegenerative component and that essentially all types of cells in the retina are affected, leading to chronic loss of visual function. A great deal of work using animal models of DR has established the loss of neurons and pathology of other cell types, including supporting glial cells. There has also been an increased emphasis on measuring retinal function in the models, as well as further validation and extension of the animal studies by clinical and translational research. This article will attempt to summarize the more recent developments in research towards understanding the complexities of retinal neurodegeneration and functional vision loss in DR.

  14. Risk factors of diabetic retinopathy in type 2 diabetic patients

    Institute of Scientific and Technical Information of China (English)

    CAI Xiao-ling; WANG Fang; JI Li-nong

    2006-01-01

    Background Advances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.Methods Totally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.Results A total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09±72.51) months vs (143.71 ±93.27) months vs (174.30±81.91)months, P=0.00], systolic blood pressure [(131.95±47.20) mmHg vs (138.71 ±21.36) mmHg vs (147.58±24.10)mmHg, P=0.01], urine albumin [(32.79± 122.29) mg/L vs (190.96±455.65) mg/L vs (362.00±552.51) mg/L,P=0.00], glycated hemoglobin (HbA1c) [(8.68 ± 2.26)% vs (9.42±1.84)% vs (9.42±1.96)%, P=0.04],C-reactive protein (CRP) [(3.19±7.37) mg/L vs (6.36± 23.59) mg/L vs (3.02±4.34) mg/L, P=0.03],high-density lipoprotein cholesterol (HDL-C) [(1.23±0.37) mmol/L vs (1.33±0.35) mmol/L vs (1.24±0.33)mmol/L, P=0.01], uric acid (UA) [(288.51 ±90.85) mmol/L vs (300.29±101.98) mmol/L vs (337.57±115.09)mmol/L, P=0.00], creatinine (CREA) [(84.22±16.31) μmol/L vs (89.35±27.45) μmol/L vs (103.28±48.64)μmol/L, P=0.00], blood urine nitrogen (BUN) [(5.62± 1.62) mmol/L vs (6.55±2.74) mmol/L vs (8.11±3.60)mmol/L, P=0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).Conclusions Diabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.

  15. Profile of asymmetrical retinopathy of prematurity in twins

    Directory of Open Access Journals (Sweden)

    Azad Rajvardhan

    2010-01-01

    Full Text Available Background: In twin births, both babies have the same gestational age and pre-natal conditions. However, twins may develop a varied retinopathy of prematurity (ROP course depending on birth weight and other systemic factors. Objective: To study the profile of asymmetric ROP in twins Design: Retrospective study Setting: Tertiary ROP referral eye hospital. Materials and Methods: The profile of 56 pairs of twins with ROP were studied and analyzed for differences in zone or need for treatment, while studying possible causes for the varied outcome. Results: In 45 pairs of twins (80% the disease progressed identically in both eyes, while in 11 pairs (20% the ROP showed differences in zone or need for treatment. Four of these pairs were discordant. In 3 of these 4 pairs, the heavier birth weight twin had a more severe ROP course. Conclusions: Twins can present with asymmetric ROP course, and it is therefore essential to examine both twins as per screening protocols.

  16. Acute Zonal Occult Outer Retinopathy with Atypical Findings

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    Dimitrios Karagiannis

    2014-01-01

    Full Text Available Background. To report a case of acute zonal occult outer retinopathy (AZOOR with atypical electrophysiology findings. Case Presentation. A 23-year-old-female presented with visual acuity deterioration in her right eye accompanied by photopsia bilaterally. Corrected distance visual acuity at presentation was 20/50 in the right eye and 20/20 in the left eye. Fundus examination was unremarkable. Visual field (VF testing revealed a large scotoma. Pattern and full-field electroretinograms (PERG and ERG revealed macular involvement associated with generalized retinal dysfunction. Electrooculogram (EOG light rise and the Arden ratio were within normal limits bilaterally. The patient was diagnosed with AZOOR due to clinical findings, visual field defect, and ERG findings. Conclusion. This is a case of AZOOR with characteristic VF defects and clinical symptoms presenting with atypical EOG findings.

  17. Automated detection of exudates in colored retinal images for diagnosis of diabetic retinopathy.

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    Akram, M Usman; Tariq, Anam; Anjum, M Almas; Javed, M Younus

    2012-07-10

    Medical image analysis is a very popular research area these days in which digital images are analyzed for the diagnosis and screening of different medical problems. Diabetic retinopathy (DR) is an eye disease caused by the increase of insulin in blood and may cause blindness. An automated system for early detection of DR can save a patient's vision and can also help the ophthalmologists in screening of DR. The background or nonproliferative DR contains four types of lesions, i.e., microaneurysms, hemorrhages, hard exudates, and soft exudates. This paper presents a method for detection and classification of exudates in colored retinal images. We present a novel technique that uses filter banks to extract the candidate regions for possible exudates. It eliminates the spurious exudate regions by removing the optic disc region. Then it applies a Bayesian classifier as a combination of Gaussian functions to detect exudate and nonexudate regions. The proposed system is evaluated and tested on publicly available retinal image databases using performance parameters such as sensitivity, specificity, and accuracy. We further compare our system with already proposed and published methods to show the validity of the proposed system.

  18. Cost-Utility Analysis of Screening Strategies for Diabetic Retinopathy in Korea.

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    Kim, Sang-Won; Kang, Gil-Won

    2015-12-01

    This study involved a cost-utility analysis of early diagnosis and treatment of diabetic retinopathy depending on the screening strategy used. The four screening strategies evaluated were no screening, opportunistic examination, systematic fundus photography, and systematic examination by an ophthalmologists. Each strategy was evaluated in 10,000 adults aged 40 yr with newly diagnosed diabetes mellitus (hypothetical cohort). The cost of each strategy was estimated in the perspective of both payer and health care system. The utility was estimated using quality-adjusted life years (QALY). Incremental Cost Effectiveness Ratio (ICER) for the different screening strategies was analyzed. After exclusion of the weakly dominating opportunistic strategy, the ICER of systematic photography was 57,716,867 and that of systematic examination by ophthalmologists was 419,989,046 from the perspective of the healthcare system. According to the results, the systematic strategy is preferable to the opportunistic strategy from the perspective of both a payer and a healthcare system. Although systematic examination by ophthalmologists may have higher utility than systematic photography, it is associated with higher cost. The systematic photography is the best strategy in terms of cost-utility. However systematic examination by ophthalmologists can also be a suitable policy alternative, if the incremental cost is socially acceptable.

  19. Advances in retinal imaging for diabetic retinopathy and diabetic macular edema.

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    Tan, Colin Siang Hui; Chew, Milton Cher Yong; Lim, Louis Wei Yi; Sadda, Srinivas R

    2016-01-01

    Diabetic retinopathy and diabetic macular edema (DME) are leading causes of blindness throughout the world, and cause significant visual morbidity. Ocular imaging has played a significant role in the management of diabetic eye disease, and the advent of advanced imaging modalities will be of great value as our understanding of diabetic eye diseases increase, and the management options become increasingly varied and complex. Color fundus photography has established roles in screening for diabetic eye disease, early detection of progression, and monitoring of treatment response. Fluorescein angiography (FA) detects areas of capillary nonperfusion, as well as leakage from both microaneurysms and neovascularization. Recent advances in retinal imaging modalities complement traditional fundus photography and provide invaluable new information for clinicians. Ultra-widefield imaging, which can be used to produce both color fundus photographs and FAs, now allows unprecedented views of the posterior pole. The pathologies that are detected in the periphery of the retina have the potential to change the grading of disease severity, and may be of prognostic significance to disease progression. Studies have shown that peripheral ischemia may be related to the presence and severity of DME. Optical coherence tomography (OCT) provides structural detail of the retina, and the quantitative and qualitative features are useful in the monitoring of diabetic eye disease. A relatively recent innovation, OCT angiography, produces images of the fine blood vessels at the macula and optic disc, without the need for contrast agents. This paper will review the roles of each of these imaging modalities for diabetic eye disease.

  20. Modulation of microglia in the retina: new insights into diabetic retinopathy.

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    Arroba, Ana I; Valverde, Ángela M

    2017-03-27

    During last decades, the diagnosis of diabetes has been associated with several chronic complications such as diabetic retinopathy (DR). Recent studies of DR have revealed an inflammatory component, which precedes the detection of alterations in the visual function. During DR, the inflammatory process presents two opposite roles depending on the polarization of resident immune cells of the retina triggering proinflammatory (M1) or antiinflammatory (M2) actions. In an early stage of DR, the M2 response concurs with the M1 and is able to ameliorate inflammation and delay the progression of the disease. However, during the progression of DR, the M1 response is maintained whereas the M2 declines and, in this scenario, the classical proinflammatory signaling pathways are chronically activated leading to retinal neurodegeneration and the loss of visual function. The M1/M2 responses are closely related to the activation and polarization of microglial cells. This review aims to offer an overview of the recent insights into the role of microglial cells during inflammation in DR. We have focused on the possibility of modulating microglia polarization as a new therapeutic strategy in DR treatments.

  1. Usefulness of the Vitreous Fluid Analysis in the Translational Research of Diabetic Retinopathy

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    Olga Simó-Servat

    2012-01-01

    Full Text Available Diabetic retinopathy (DR is the major cause of acquired blindness in working-age adults. Current treatments for DR (laser photocoagulation, intravitreal corticosteroids, intravitreal antivascular endothelial growth factor (VEGF agents, and vitreo-retinal surgery are applicable only at advanced stages of the disease and are associated with significant adverse effects. Therefore, new pharmacological treatments for the early stages of the disease are needed. Vitreous fluid obtained from diabetic patients undergoing vitreoretinal surgery is currently used to explore the events that are taking place in the retina for clinical research. However, several confounding factors such as vitreous haemorrhage and concentration of vitreous proteins should be considered in the analysis of the results. In this paper we will focus on the vitreous fluid as a tool for exploring the mediators of DR and in particular the molecules related to inflammatory pathways. In addition, their role in the pathogenesis of DR will be discussed. The usefulness of new technologies such as flow cytometry and proteomics in identifying new candidates involved in the inflammatory process that occurs in DR will be overviewed. Finally, a more personalized treatment based on vitreous fluid analysis aiming to reduce the burden associated with DR is suggested.

  2. Combined Methods for Diabetic Retinopathy Screening, Using Retina Photographs and Tear Fluid Proteomics Biomarkers

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    Zsolt Torok

    2015-01-01

    Full Text Available Background. It is estimated that 347 million people suffer from diabetes mellitus (DM, and almost 5 million are blind due to diabetic retinopathy (DR. The progression of DR can be slowed down with early diagnosis and treatment. Therefore our aim was to develop a novel automated method for DR screening. Methods. 52 patients with diabetes mellitus were enrolled into the project. Of all patients, 39 had signs of DR. Digital retina images and tear fluid samples were taken from each eye. The results from the tear fluid proteomics analysis and from digital microaneurysm (MA detection on fundus images were used as the input of a machine learning system. Results. MA detection method alone resulted in 0.84 sensitivity and 0.81 specificity. Using the proteomics data for analysis 0.87 sensitivity and 0.68 specificity values were achieved. The combined data analysis integrated the features of the proteomics data along with the number of detected MAs in the associated image and achieved sensitivity/specificity values of 0.93/0.78. Conclusions. As the two different types of data represent independent and complementary information on the outcome, the combined model resulted in a reliable screening method that is comparable to the requirements of DR screening programs applied in clinical routine.

  3. Combined Methods for Diabetic Retinopathy Screening, Using Retina Photographs and Tear Fluid Proteomics Biomarkers

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    Csosz, Eva; Molnar, Agnes M.; Berta, Andras; Hajdu, Andras; Nagy, Valeria; Domokos, Balint

    2015-01-01

    Background. It is estimated that 347 million people suffer from diabetes mellitus (DM), and almost 5 million are blind due to diabetic retinopathy (DR). The progression of DR can be slowed down with early diagnosis and treatment. Therefore our aim was to develop a novel automated method for DR screening. Methods. 52 patients with diabetes mellitus were enrolled into the project. Of all patients, 39 had signs of DR. Digital retina images and tear fluid samples were taken from each eye. The results from the tear fluid proteomics analysis and from digital microaneurysm (MA) detection on fundus images were used as the input of a machine learning system. Results. MA detection method alone resulted in 0.84 sensitivity and 0.81 specificity. Using the proteomics data for analysis 0.87 sensitivity and 0.68 specificity values were achieved. The combined data analysis integrated the features of the proteomics data along with the number of detected MAs in the associated image and achieved sensitivity/specificity values of 0.93/0.78. Conclusions. As the two different types of data represent independent and complementary information on the outcome, the combined model resulted in a reliable screening method that is comparable to the requirements of DR screening programs applied in clinical routine. PMID:26221613

  4. Glaucoma and Diabetic Retinopathy in patients with diabetes mellitus type 2. Review.

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    I. V. Vorobyeva

    2014-10-01

    Full Text Available Glaucoma and diabetic retinopathy (DR are the most frequent reasons of visual loss and disability. Combination of glaucoma and DR causes worse prognosis. Similarity of pathogenetic mechanisms of DR and glaucoma allows consideration of more frequent development of primary open-angle glaucoma among patients suffering diabetes mellitus. To reveal these diseases at the earliest stages is one of the most difficult ophthalmological problems. The contemporary methods of DR and glaucoma diagnostics are optical coherence tomography and Heidelberg retina tomography. They give an opportunity to estimate the dynamics of pathological process and the efficiency of surgical and pharmacological treatment. Optical scanning of an optic disk and peripapillary retina gives a chance to estimate up to 20 morphometric parameters. Determination of retinal nerve fiber layer (RNFL thickness in peripapillary zone reflects a condition of nerve fibers and extent of their defeat. It is shown that in glaucoma there is a thinning of RNFL and a neuroretinal rim. In early diagnostics of glaucoma the parameters of optic disk characterizing neuroretinal rim are considered the most informative. OCT considerably expands diagnostic research possibilities of structural and morphological retinal changes in a macular zone in patients with DR and DME. Measurement of retinal thickness in macular area is a key point in diagnostics and tactics of treatment. The standard method of DR therapy is retinal laser coagulation. However, laser photocoagulation as monotherapy is not effective enough in patients with diffuse and cystoid macular edema. It is more reasonable to use retinal laser photocoagulation in combination with antiangiogenic therapy for treatment of the diabetic macular edema (DME and DR. The special emphasis is put on development of treatment algorithm of combination of glaucoma and diabetic retinopathy. Therapy of neovascular glaucoma in patients with diabetes

  5. Ocular surface changes in type II diabetic patients with proliferative diabetic retinopathy

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    Yan; Gao; Yan; Zhang; Yu-Sha; Ru; Xiao-Wu; Wang; Ji-Zhong; Yang; Chun-Hui; Li; Hong-Xing; Wang; Xiao-Rong; Li; Bing; Li

    2015-01-01

    AIM: To detect and analyze the changes on ocular surface and tear function in type II diabetic patients with proliferative diabetic retinopathy(PDR), an advanced stage of diabetic retinopathy(DR), using conventional ophthalmic tests and the high-resolution laser scanning confocal microscopy.METHODS: Fifty-eight patients with type II diabetes were selected. Based on the diagnostic criteria and stage classification of DR, the patients were divided into the non-DR(NDR) group and the PDR group. Thirty-six patients with cataract but no other ocular and systemic disease were included as non-diabetic controls. All the patients were subjected to the conventional clinical tests of corneal sensitivity, Schirmer I test, and corneal fluorescein staining. The non-invasive tear film break-up time(NIBUT) and tear interferometry were conducted by a Tearscope Plus. The morphology of corneal epithelia and nerve fibers was examined using the high-resolution confocal microscopy.RESULTS: The NDR group exhibited significantly declined corneal sensitivity and Schirmer I test value, as compared to the non-diabetic controls(P <0.001). The PDR group showed significantly reduced corneal sensitivity, Schirmer I test value, and NIBUT in comparison to the non-diabetic controls(P <0.001).Corneal fluorescein staining revealed the progressively injured corneal epithelia in the PDR patients. Moreover,significant decrease in the corneal epithelial density andmorphological abnormalities in the corneal epithelia and nerve fibers were also observed in the PDR patients.CONCLUSION: Ocular surface changes, including blunted corneal sensitivity, reduced tear secretion, tear film dysfunction, progressive loss of corneal epithelia and degeneration of nerve fibers, are common in type II diabetic patients, particularly in the diabetic patients with PDR. The corneal sensitivity, fluorescein staining scores,and the density of corneal epithelial cells and nerve fibers in the diabetic patients correlate with the

  6. Oscillation of Angiogenesis with Vascular Dropout in Diabetic Retinopathy by VESsel GENeration Analysis (VESGEN)

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    Parsons-Wingerter, Patricia; Radbakrishnan, Krisbnan; Vickerman, Mary B.; Kaiser, Peter K.

    2010-01-01

    PURPOSE. Vascular dropout and angiogenesis are hallmarks of the progression of diabetic retinopathy (DR). However, current evaluation of DR relies on grading of secondary vascular effects, such as microaneurysms and hemorrhages, by clinical examination instead of by evaluation of actual vascular changes. The purpose of this study was to map and quantify vascular changes during progression of DR by VESsel GENeration Analysis (VESGEN). METHODS. In this prospective cross-sectional study, 15 eyes with DR were evaluated with fluorescein angiography (FA) and color fundus photography, and were graded using modified Early Treatment Diabetic Retinopathy Study criteria. FA images were separated by semiautomatic image processing into arterial and venous trees. Vessel length density (L(sub v)), number density (N(sub v)), and diameter (D(sub v)) were analyzed in a masked fashion with VESGEN software. Each vascular tree was automatically segmented into branching generations (G(sub 1)...G(sub 8) or G(sub 9)) by vessel diameter and branching. Vascular remodeling status (VRS) for N(sub v) and L(sub v) was graded 1 to 4 for increasing severity of vascular change. RESULTS. By N(sub v) and L(sub v), VRS correlated significantly with the independent clinical diagnosis of mild to proliferative DR (13/15 eyes). N(sub v) and L(sub v) of smaller vessels (G(sub >=6) increased from VRS1 to VRS2 by 2.4 X and 1.6 X, decreased from VRS2 to VRS3 by 0.4 X and 0.6X, and increased from VRS3 to VRS4 by 1.7 X and 1.5 X (P < 0.01). Throughout DR progression, the density of larger vessels (G(sub 1-5)) remained essentially unchanged, and D(sub v1-5) increased slightly. CONCLUSIONS. Vessel density oscillated with the progression of DR. Alternating phases of angiogenesis/neovascularization and vascular dropout were dominated first by remodeling of arteries and subsequently by veins.

  7. Panretinal photocoagulation versus panretinal photocoagulation plus intravitreal bevacizumab for high-risk proliferative diabetic retinopathy

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    Zhou, Ai-Yi; Zhou, Chen-Jing; Yao, Jing; Quan, Yan-Long; Ren, Bai-Chao; Wang, Jian-Ming

    2016-01-01

    AIM To evaluate the effects of panretinal photocoagulation (PRP) compared with PRP plus intravitreal bevacizumab (IVB) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria. METHODS The data were collected retrospectively from the eyes of high-risk PDR patients, which were divided into two groups. After treated with standard PRP, the eyes were randomly assigned to receive only PRP (PRP group) or PRP plus intravitreal injection of 1.25 mg of bevacizumab (PRP-Plus group). Patients underwent complete ophthalmic evaluation, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and new vessel size in fluorescein angiography (FA) and optical coherence tomography for the assessment of central subfield macular thickness (CSMT) at baseline and at weeks 12 (±2), 16 (±2), 24 (±2) and 48 (±2). Main outcome measures also included vitreous clear-up time and neovascularization on the disc (NVD) regression time. Adverse events associated with intravitreal injection were investigated. RESULTS Thirty consecutive patients (n=36 eyes) completed the 48-week follow-up. There was no significant difference between the PRP and PRP-Plus groups with respect to age, gender, type or duration of diabetes, area of fluorescein leakage from active neovascularizations (NVs), BCVA or CSMT at baseline. The mean vitreous clear-up time was 12.1±3.4wk after PRP and 8.4±3.5wk after PRP combined with IVB. The mean time interval from treatment to complete NVD regression on FA examination was 15.2±3.5wk in PRP group and 12.5±3.1wk in PRP-Plus group. No significant difference in CSMT was observed between the groups throughout the study period. However, the total area of actively leaking NVs was significantly reduced in the PRP-Plus group compared with the PRP group (P<0.05). Patients received an average of 1.3 injections (range: 1-2). Ten eyes (27.8%) underwent 2 injections. Two eyes had ocular

  8. Oscillation of Angiogenesis with Vascular Dropout in Diabetic Retinopathy by VESsel GENeration Analysis (VESGEN)

    Science.gov (United States)

    Parsons-Wingerter, Patricia; Radbakrishnan, Krisbnan; Vickerman, Mary B.; Kaiser, Peter K.

    2010-01-01

    PURPOSE. Vascular dropout and angiogenesis are hallmarks of the progression of diabetic retinopathy (DR). However, current evaluation of DR relies on grading of secondary vascular effects, such as microaneurysms and hemorrhages, by clinical examination instead of by evaluation of actual vascular changes. The purpose of this study was to map and quantify vascular changes during progression of DR by VESsel GENeration Analysis (VESGEN). METHODS. In this prospective cross-sectional study, 15 eyes with DR were evaluated with fluorescein angiography (FA) and color fundus photography, and were graded using modified Early Treatment Diabetic Retinopathy Study criteria. FA images were separated by semiautomatic image processing into arterial and venous trees. Vessel length density (L(sub v)), number density (N(sub v)), and diameter (D(sub v)) were analyzed in a masked fashion with VESGEN software. Each vascular tree was automatically segmented into branching generations (G(sub 1)...G(sub 8) or G(sub 9)) by vessel diameter and branching. Vascular remodeling status (VRS) for N(sub v) and L(sub v) was graded 1 to 4 for increasing severity of vascular change. RESULTS. By N(sub v) and L(sub v), VRS correlated significantly with the independent clinical diagnosis of mild to proliferative DR (13/15 eyes). N(sub v) and L(sub v) of smaller vessels (G(sub >=6) increased from VRS1 to VRS2 by 2.4 X and 1.6 X, decreased from VRS2 to VRS3 by 0.4 X and 0.6X, and increased from VRS3 to VRS4 by 1.7 X and 1.5 X (P < 0.01). Throughout DR progression, the density of larger vessels (G(sub 1-5)) remained essentially unchanged, and D(sub v1-5) increased slightly. CONCLUSIONS. Vessel density oscillated with the progression of DR. Alternating phases of angiogenesis/neovascularization and vascular dropout were dominated first by remodeling of arteries and subsequently by veins.

  9. The Prevalence of Diabetic Retinopathy Among Known Diabetic Population in Nepal.

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    Mishra, S K; Pant, B P; Subedi, P

    2016-01-01

    Background The worldwide prevalence of diabetic retinopathy (DR) was found to be 34.6%. WHO estimates that DR is responsible for 4.8% of the 37 million cases of blindness throughout the world. In a study undertaken in urban population in Nepal, M.D. Bhattarai found the prevalence of diabetes among people aged 20 years and above to be 14.6% and the prevalence among people aged 40 years and above to be 19%. Studies on DR, to our knowledge, have mostly been hospital based in Nepal. Little information is available about prevalence of DR at the community level in Nepal. Objective To investigate the prevalence of diabetic retinopathy and associated risk factors among known diabetic population of Nepal. Method A descriptive cross sectional study was conducted among individuals aged 30 and more using cluster sampling method. The study sites were Kathmandu metropolitan city and Birgunj sub-metropolitan city. A sample size of 5400 was calculated assuming 5% prevalence rate with 95% confidence level, 5% worst acceptable level and 1.5 cluster sampling design effect. Study participants were interviewed, anthropometric measurements and fundus photograph was taken from participants with diabetes. Fundus photographs were used to grade retinopathy. Result Around 12% of the respondents were diabetic, mean age 55.43±11.86 years, of which slightly more than half were females (50.2%). Among these diabetic respondents 9.9% had some forms of diabetic retinopathy, mean age 54.08±10.34 years, 56.7% were male. When severe grade of retinopathy in any eye was considered as overall grade of retinopathy for the individual, prevalence of Non-proliferative Diabetic Retinopathy, Proliferative Diabetic Retinopathy and complete vision loss was found to be 9.1%, 0.5% and 0.3%. Prevalence of Diabetic Macular Edema was 5.5%. Duration of diabetes, family history of diabetes and blood pressure at the day of survey was found to be associated with having any retinopathy. Conclusion Diabetic retinopathy

  10. Visual functions and disability in diabetic retinopathy patients.

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    Shrestha, Gauri Shankar; Kaiti, Raju

    2014-01-01

    This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. A cross-sectional study was carried out among 38 visually impaired diabetic retinopathy subjects at the Low Vision Clinic of B.P. Koirala Lions Centre for Ophthalmic Studies, Kathmandu. The subjects underwent assessment of distance and near visual acuity, objective and subjective refraction, contrast sensitivity, color vision, and central and peripheral visual fields. The visual disabilities of each subject in their daily lives were evaluated using a standard questionnaire. Multiple regression analysis between visual functions and visual disabilities index was assessed. The majority of subjects (42.1%) were of the age group 60-70 years. Best corrected visual acuity was found to be 0.73±0.2 in the better eye and 0.93±0.27 in the worse eye, which was significantly different at p=0.002. Visual disability scores were significantly higher for legibility of letters (1.2±0.3) and sentences (1.4±0.4), and least for clothing (0.7±0.3). Visual disability index for legibility of letters and sentences was significantly correlated with near visual acuity and peripheral visual field. Contrast sensitivity was also significantly correlated with the visual disability index, and total scores. Impairment of near visual acuity, contrast sensitivity, and peripheral visual field correlated significantly with different types of visual disability. Hence, these clinical tests should be an integral part of the visual assessment of diabetic eyes. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  11. Patient preferences in the treatment of diabetic retinopathy

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    Wirostko B

    2011-05-01

    Full Text Available Barbara Wirostko1, Kathleen Beusterien2, Jessica Grinspan2, Thomas Ciulla3, John Gonder4, Alexandra Barsdorf1, Andreas Pleil51Pfizer, New York, NY, USA; 2Oxford Outcomes, Bethesda, MD, USA; 3Midwest Eye Institute, Indianapolis, IN, USA; 4Ivey Eye Institute, London, Ontario, Canada; 5Pfizer Inc, San Diego, CA, USAObjective: Accounting for patient preferences may be especially important in diabetes mellitus, given the challenge in identifying factors associated with treatment adherence. Although preference studies have been performed in diabetes, none have examined treatments used in diabetic retinopathy (DR. The objective of this study was to elicit patient preferences for attributes associated with antivascular endothelial growth factor, focal and panretinal laser, and steroid therapy used in DR management.Methods: A cross-sectional conjoint survey was administered to DR patients at three Canadian eye centers. The survey involved making tradeoffs among 11 DR treatment attributes, including the chance of improving vision and risks of adverse events over a 1-year treatment period. Attribute utilities were summed for each product profile to determine the most preferred treatment.Results: Based on the results from 161 patients, attributes affecting visual functioning, including improving visual acuity and reducing adverse events (eg, chance of cataracts, were more important than those not directly affecting vision (eg, administration. Overall, 52%, 20%, 17%, and 11% preferred the product profiles matching to the antivascular endothelial growth factor, steroid, focal laser, and panretinal laser therapies. Preferences did not vary substantially by previous treatment experience, age, or type of DR (macular edema, proliferative DR, both or neither, with the exception that more macular edema only patients preferred focal laser over steroid treatment (19% versus 14%, respectively.Conclusions: When considering the potential effects of treatment over a 1

  12. Suppression of diabetic retinopathy with GLUT1 siRNA.

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    You, Zhi-Peng; Zhang, Yu-Lan; Shi, Ke; Shi, Lu; Zhang, Yue-Zhi; Zhou, Yue; Wang, Chang-Yun

    2017-08-07

    To investigate the effect of glucose transporter-1 (GLUT1) inhibition on diabetic retinopathy, we divided forty-eight mice into scrambled siRNA, diabetic scrambled siRNA, and GLUT1 siRNA (intravitreally injected) groups. Twenty-one weeks after diabetes induction, we calculated retinal glucose concentrations, used electroretinography (ERG) and histochemical methods to assess photoreceptor degeneration, and conducted immunoblotting, leukostasis and vascular leakage assays to estimate microangiopathy. The diabetic scrambled siRNA and GLUT1 siRNA exhibited higher glucose concentrations than scrambled siRNA, but GLUT1 siRNA group concentrations were only 50.05% of diabetic scrambled siRNA due to downregulated GLUT1 expression. The diabetic scrambled siRNA and GLUT1 siRNA had lower ERG amplitudes and ONL thicknesses than scrambled siRNA. However, compared with diabetic scrambled siRNA, GLUT1 siRNA group amplitudes and thicknesses were higher. Diabetic scrambled siRNA cones were more loosely arranged and had shorter outer segments than GLUT1 siRNA cones. ICAM-1 and TNF-α expression levels, adherent leukocyte numbers, fluorescence leakage areas and extravasated Evans blue in diabetic scrambled siRNA were higher than those in scrambled siRNA. However, these parameters in the GLUT1 siRNA were lower than diabetic scrambled siRNA. Together, these results demonstrate that GLUT1 siRNA restricted glucose transport by inhibiting GLUT1 expression, which decreased retinal glucose concentrations and ameliorated diabetic retinopathy.

  13. The role of serum apelin in retinopathy of prematurity

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    Ali YF

    2017-02-01

    Full Text Available Yasser F Ali,1 Salah El-Morshedy,1 Abdulbasit Abdulhalim Imam,2 Nasser Ismai A Abdelrahman,1 Riad M Elsayed,3 Usama M Alkholy,1 Nermin Abdalmonem,1 Mohammed M Shehab1 1Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, 2Department of Pediatrics, Al-Azhar Faculty of Medicine-Girls, Cairo, 3Pediatric Neurology Unit, Pediatric Department, Mansoura University, Mansoura, Egypt Objective: To evaluate the role of serum apelin as a diagnostic tool in retinopathy of prematurity (ROP disease.Patients and methods: Thirty-eight preterm infants (60% male with gestational age ranging from 30 to 36 weeks admitted to the neonatal intensive care unit, KJO Hospital, Saudi Arabia with proven diagnosis of ROP were included in the study. In addition, 27 preterm infants without ROP served as controls. All newborn infants in the study were subjected to adequate history taking, full clinical examination, and fundus examination by indirect ophthalmoscope (at 4–6 weeks as well as determination of serum apelin at birth and at 4–6 weeks of age.Results: The study revealed that oxygen therapy longer than 7 days’ duration, cesarean section (as a mode of delivery, sepsis, mechanical ventilation, blood transfusion, premature rupture of membranes, pneumothorax, perinatal asphyxia, cardiac problems, and neonatal jaundice were considered as risk factors related to development of ROP. Serum apelin levels were significantly lower in patients than controls (P<0.001 at time of diagnosis of the disease (4–6 weeks while no significant differences were observed in levels at birth.Conclusion: Serum apelin was found to be of significant diagnostic value in the occurrence of ROP. Keywords: retinopathy of prematurity, preterm infants, serum apelin

  14. Association between assisted reproductive technology and advanced retinopathy of prematurity

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    RV Paul Chan

    2010-11-01

    Full Text Available RV Paul Chan1, Yoshihiro Yonekawa1, Margaux A Morrison2,3, Grace Sun1, Ryan K Wong1, Jeffrey M Perlman4, Michael F Chiang5,6, Thomas C Lee7, M Elizabeth Hartnett3, Margaret M DeAngelis2,31Department of Ophthalmology, Weill Cornell Medical College, New York; 2Ocular Molecular Genetics Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts; 3University of Utah School of Medicine, Moran Eye Center, Salt Lake City, Utah; 4Department of Pediatrics, Weill Cornell Medical College, New York; Departments of 5Ophthalmology and 6Biomedical Informatics, Columbia University College of Physicians and Surgeons, New York; 7The Vision Center, Children’s Hospital Los Angeles, California, USAPurpose: To investigate the associations between assisted reproductive technology (ART and severe retinopathy of prematurity (ROP requiring treatment. Methods: Retrospective analyses of inborn preterm infants screened for severe ROP at the Weill Cornell Medical Center Neonatal Intensive Care Unit at the New York-Presbyterian Hospital by single factor logistic regression and multifactor models.Results: Of 399 ethnically diverse infants, 253 were conceived naturally and 146 by ART. Eight (3.16% patients conceived naturally, and 11 (7.53% with ART required laser treatment. In multifactor analyses, significant risks for severe ROP requiring treatment included both gestational age (odds ratio [OR] 0.34; 95% confidence interval [CI] 0.23–0.52; P< 0.001 and ART ([OR] 4.70; [CI], 1.52–4.57; P = 0.007.Conclusions: ART is associated with severe ROP requiring treatment in this cohort. This is the first report that demonstrates a statistically significant association between ART and severe ROP requiring treatment in infants in the US.Keywords: retinopathy of prematurity, low birth rate, blindness, assisted reproductive technology

  15. Automated detection of proliferative retinopathy in clinical practice

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    Audrey Karperien

    2008-03-01

    Full Text Available Audrey Karperien1, Herbert F Jelinek1,2, Jorge JG Leandro3, João VB Soares3, Roberto M Cesar Jr3, Alan Luckie41School of Community Health, Charles Sturt University, Albury, Australia; 2Centre for Research in Complex Systems, Charles Sturt University, Albury, Australia; 3Creative Vision Research Group, Department of Computer Science, IME – University of São Paulo, Brazil; 4Albury Eye Clinic, Albury, AustraliaAbstract: Timely intervention for diabetic retinopathy (DR lessens the possibility of blindness and can save considerable costs to health systems. To ensure that interventions are timely and effective requires methods of screening and monitoring pathological changes, including assessing outcomes. Fractal analysis, one method that has been studied for assessing DR, is potentially relevant in today’s world of telemedicine because it provides objective indices from digital images of complex patterns such as are seen in retinal vasculature, which is affected in DR. We introduce here a protocol to distinguish between nonproliferative (NPDR and proliferative (PDR changes in retinal vasculature using a fractal analysis method known as local connected dimension (Dconn analysis. The major finding is that compared to other fractal analysis methods, Dconn analysis better differentiates NPDR from PDR (p = 0.05. In addition, we are the first to show that fractal analysis can be used to differentiate between NPDR and PDR using automated vessel identification. Overall, our results suggest this protocol can complement existing methods by including an automated and objective measure obtainable at a lower level of expertise that experts can then use in screening for and monitoring DR.Keywords: diabetes, proliferative retinopathy, automated clinical assessment, fractal dimension, complex systems

  16. Mitochondrial Haplogroups Affect Severity But Not Prevalence of Diabetic Retinopathy

    Science.gov (United States)

    Bregman, Jana A.; Herren, David J.; Estopinal, Christopher B.; Chocron, Isaac M.; Harlow, Paula A.; Warden, Cassandra; Brantley, Milam A.; Samuels, David C.

    2017-01-01

    Purpose We previously reported European mitochondrial haplogroup H to be a risk factor for and haplogroup UK to be protective against proliferative diabetic retinopathy (PDR) among Caucasian patients with diabetic retinopathy (DR). The purpose of this study was to determine whether these haplogroups are also associated with the risk of having DR among Caucasian patients with diabetes. Methods Deidentified medical records for 637 Caucasian patients with diabetes (223 with DR) were obtained from BioVU, Vanderbilt University's electronic, deidentified DNA databank. An additional 197 Caucasian patients with diabetes (98 with DR) were enrolled from the Vanderbilt Eye Institute (VEI). We tested for an association between European mitochondrial haplogroups and DR status. Results The percentage of diabetes patients with DR did not differ across the haplogroups (P = 0.32). The percentage of patients with nonproliferative DR (NPDR; P = 0.0084) and with PDR (P = 0.027) significantly differed across the haplogroups. In logistic regressions adjusting for sex, age, diabetes type, duration of diabetes, and hemoglobin A1c, neither haplogroup H nor haplogroup UK had a significant effect on DR compared with diabetic controls. Haplogroup UK was a significant risk factor (OR = 1.72 [1.13–2.59], P = 0.010) for NPDR compared with diabetic controls in the unadjusted analysis, but not in the adjusted analysis (OR = 1.29 [0.79–2.10], P = 0.20). Conclusions Mitochondrial haplogroups H and UK were associated with severity, but not presence, of DR. These data argue that the effect of these haplogroups is related to ischemia and neovascularization, the defining features of PDR. PMID:28245487

  17. Automated detection of retinal whitening in malarial retinopathy

    Science.gov (United States)

    Joshi, V.; Agurto, C.; Barriga, S.; Nemeth, S.; Soliz, P.; MacCormick, I.; Taylor, T.; Lewallen, S.; Harding, S.

    2016-03-01

    Cerebral malaria (CM) is a severe neurological complication associated with malarial infection. Malaria affects approximately 200 million people worldwide, and claims 600,000 lives annually, 75% of whom are African children under five years of age. Because most of these mortalities are caused by the high incidence of CM misdiagnosis, there is a need for an accurate diagnostic to confirm the presence of CM. The retinal lesions associated with malarial retinopathy (MR) such as retinal whitening, vessel discoloration, and hemorrhages, are highly specific to CM, and their detection can improve the accuracy of CM diagnosis. This paper will focus on development of an automated method for the detection of retinal whitening which is a unique sign of MR that manifests due to retinal ischemia resulting from CM. We propose to detect the whitening region in retinal color images based on multiple color and textural features. First, we preprocess the image using color and textural features of the CMYK and CIE-XYZ color spaces to minimize camera reflex. Next, we utilize color features of the HSL, CMYK, and CIE-XYZ channels, along with the structural features of difference of Gaussians. A watershed segmentation algorithm is used to assign each image region a probability of being inside the whitening, based on extracted features. The algorithm was applied to a dataset of 54 images (40 with whitening and 14 controls) that resulted in an image-based (binary) classification with an AUC of 0.80. This provides 88% sensitivity at a specificity of 65%. For a clinical application that requires a high specificity setting, the algorithm can be tuned to a specificity of 89% at a sensitivity of 82%. This is the first published method for retinal whitening detection and combining it with the detection methods for vessel discoloration and hemorrhages can further improve the detection accuracy for malarial retinopathy.

  18. Neuroimaging findings in children with retinopathy-confirmed cerebral malaria

    Energy Technology Data Exchange (ETDEWEB)

    Potchen, Michael J. [Michigan State University, Department of Radiology, 184 Radiology Building, East Lansing, MI 48824-1303 (United States)], E-mail: mjp@rad.msu.edu; Birbeck, Gretchen L. [Michigan State University, International Neurologic and Psychiatric Epidemiology Program, 324 West Fee Hall, East Lansing, MI 48824 (United States)], E-mail: Gretchen.Birbeck@ht.msu.edu; DeMarco, J. Kevin [Michigan State University, Department of Radiology, 184 Radiology Building, East Lansing, MI 48824-1303 (United States)], E-mail: jkd@rad.msu.edu; Kampondeni, Sam D. [University of Malawi, Department of Radiology, Queen Elizabeth Central Hospital, Blantyre (Malawi)], E-mail: kamponde@msu.edu; Beare, Nicholas [St. Paul' s Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP (United Kingdom)], E-mail: nbeare@btinternet.com; Molyneux, Malcolm E. [Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine (Malawi); School of Tropical Medicine, University of Liverpool, Liverpool (United Kingdom)], E-mail: mmolyneux999@google.com; Taylor, Terrie E. [Michigan State University, College of Osteopathic Medicine, B309-B West Fee Hall, East Lansing, MI 48824 (United States); University of Malawi, College of Medicine, Blantyre Malaria Project, Blantyre (Malawi)], E-mail: taylort@msu.edu

    2010-04-15

    Purpose: To describe brain CT findings in retinopathy-confirmed, paediatric cerebral malaria. Materials and methods: In this outcomes study of paediatric cerebral malaria, a subset of children with protracted coma during initial presentation was scanned acutely. Survivors experiencing adverse neurological outcomes also underwent a head CT. All children had ophthalmological examination to confirm the presence of the retinopathy specific for cerebral malaria. Independent interpretation of CT images was provided by two neuroradiologists. Results: Acute brain CT findings in three children included diffuse oedema with obstructive hydrocephalus (2), acute cerebral infarctions in multiple large vessel distributions with secondary oedema and herniation (1), and oedema of thalamic grey matter (1). One child who was reportedly normal prior to admission had parenchymal atrophy suggestive of pre-existing CNS injury. Among 56 survivors (9-84 months old), 15 had adverse neurologic outcomes-11/15 had a follow-up head CT, 3/15 died and 1/15 refused CT. Follow-up head CTs obtained 7-18 months after the acute infection revealed focal and multifocal lobar atrophy correlating to regions affected by focal seizures during the acute infection (5/11). Other findings were communicating hydrocephalus (2/11), vermian atrophy (1/11) and normal studies (3/11). Conclusions: The identification of pre-existing imaging abnormalities in acute cerebral malaria suggests that population-based studies are required to establish the rate and nature of incidental imaging abnormalities in Malawi. Children with focal seizures during acute cerebral malaria developed focal cortical atrophy in these regions at follow-up. Longitudinal studies are needed to further elucidate mechanisms of CNS injury and death in this common fatal disease.

  19. A 7 YEAR-7-MONTH OLD BOY WITH LEUKEMIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Ni Made Rini Suari

    2013-10-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 Ocular problems in patient with leukemia which are called leukemic retinopathy and subhyaloid hemorrhage is one of its feature. Subhyaloid hemorrhage in children with acute lymphoblastic leukemia (ALL is rarely happened. We reported a boy 7 year 7 month old, complained sudden blurred vision on his both eyes and diagnosed with acute lymphoblastic leukemia. When patient had complained his vision, result of routine hematology showed anemia, thrombocytopenia, and leukocytosis. Treatment of leukemic retinopathy in this patient was supportive and causal therapy with transfusion of thrombocyte concentrate, hydration for leukocytosis, giving chemotherapy intrathecal methotrexate and systemic (vincristine, daunorubicin, L-asparginase. We found gradually undergone resolution of subhyaloid hemorrhages, visible flame shaped thin, and his vision recovered nearly completely to 6/6 OD and 6/20 OS /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  20. 糖尿病视网膜病变激光治疗术后的超声生物显微镜观察%Investigation of Ultrasound Bimicroscopy after Laser of Diabetic Retinopathy

    Institute of Scientific and Technical Information of China (English)

    刘丽娜; 刘利莉; 化金凤; 琚雁琼

    2012-01-01

    目的 应用超声生物显微镜( ultrasound bimicroscopy,UBM)观察糖尿病视网膜病变(diabetic retinopathy,DR)激光治疗术后眼前节变化. 方法 收集糖尿病视网膜病变激光治疗患者116例(197眼),激光治疗术前、术后均经UBM检查,观察术前术后睫状体结构. 结果 应用UBM观察显示,DR患者术前均无睫状体脱离,激光术后并发睫状体脱离者81例(134眼),发生率为68%. 结论 DR激光术后易发生睫状体脱离,应重视激光术后早期眼前段结构的观察.%Objective To observe the variation of the front part of the eye after the laser of diabetic retinopathy by ultrasound bimicroscopy. Methods One hundred and sixteen patients(197 eyes) with diabetic retinopathy who need laser treatment were collected to observe the cillarybody by ultrasound bimicroscopy before and after the laser. Results Of all the diabetic retinopathy patients by ultrasound bimicroscopy, before the laser there was no ciliaryboby detachment,eighty-one patients(134 eyes) with the ciliarybody detachment (68%) after the laser. Conclusions Ciliaryboby detachment happened easily after the laser of diabeiic retinopathy, we should pay attention to the variation of the front part of the eye early after the laser.

  1. Management of Diabetic Retinopathy (Recent Advances in Research and Treatment of Diabetes Mellitus)

    OpenAIRE

    安藤, 伸朗; Ando, Noburo

    1994-01-01

    Medical and Ophthalmic management of diabetic retinopathy are reviewed. In my study, to keep in the good glycemic control can be proved to prevent from occurrence and progression of diabetic retinopathy in both IDDM and NIDDM patients. Diabetic macular edema is one of the major causes of severe visual disturbance in diabetics. So far several treatments were reported, such as macular photocoagulation, aspirin therapy, hyperbaric therapy. Vitreous surgery is evaluated to reduce macular edema in...

  2. Glycaemic threshold for diabetes-specific retinopathy among individuals from Saudi Arabia, Algeria and Portugal.

    Science.gov (United States)

    Almdal, T P; Handlos, L N; Valerius, M; Juul, E; Nielsen, K E; Vistisen, D; Nielsen, L B; Sheikh, A; Belhadj, M; Nadir, D; Zinai, S; Raposo, J; Lund-Andersen, H; Witte, D R

    2014-03-01

    We studied the glycaemic threshold and prevalence of diabetic retinopathy in screen-detected diabetes in Saudi Arabia, Algeria and Portugal. The prevalence of diabetes-specific retinopathy started to increase at an HbA1c level of 6-6.4% (42-47 mmol/mol) and in individuals with HbA(1c) >7.0% the prevalence was 6.0%.

  3. Comparison of Manual Refraction Versus Autorefraction in 60 Diabetic Retinopathy Patients

    OpenAIRE

    Shirzadi, Keyvan; Shahraki, Kourosh; Yahaghi, Emad; Makateb, Ali; Khosravifard, Keivan

    2016-01-01

    Aim: The purpose of the study was to evaluate the comparison of manual refraction versus autorefraction in diabetic retinopathy patients. Material and Methods: The study was conducted at the Be’sat Army Hospital from 2013-2015. In the present study differences between two common refractometry methods (manual refractometry and Auto refractometry) in diagnosis and follow up of retinopathy in patients affected with diabetes is investigated. Results: Our results showed that there is a significant...

  4. Retinopathy risk factors in type II diabetic patients using factor analysis and discriminant analysis

    OpenAIRE

    Tazhibi, Mahdi; Sarrafzade, Sheida; Amini, Masoud

    2014-01-01

    Introduction: Diabetes is one of the most common chronic diseases in the world. Incidence and prevalence of diabetes are increasing in developing countries as well as in Iran. Retinopathy is the most common chronic disorder in diabetic patients. Materials and Methods: In this study, we used the information of diabetic patients’ reports that refer to endocrine and metabolism research center of Isfahan University of Medical Sciences to determine diabetic retinopathy risk factors. We used factor...

  5. Screening for Diabetic Retinopathy and Nephropathy in Patients with Diabetes: A Nationwide Survey in Korea

    OpenAIRE

    Sang-Ho Byun; Seung Hyun Ma; Jae Kwan Jun; Kyu-Won Jung; Boyoung Park

    2013-01-01

    This study was performed to identify factors associated with screening for diabetic retinopathy and nephropathy. Data from the Korean National Health and Nutrition Examination Survey between 2007 and 2009 were analyzed. Of 24,871 participants, 1,288 patients diagnosed with diabetes at ≥30 years of age were included. 36.3% received screening for diabetic retinopathy, and 40.5% received screening for diabetic nephropathy during the previous year. Patients living in rural areas, those with less ...

  6. Concurrent healthy behavior adoption and diabetic retinopathy in the United States

    OpenAIRE

    Loprinzi, Paul D.

    2015-01-01

    Objective: Emerging work suggests an independent association of physical activity and healthy eating on diabetic retinopathy. No study, however, has examined whether physical activity and healthy eating have an additive and/or additive interaction effect on diabetic retinopathy. Methods: Data from 2005–2006 NHANES were used (N = 223). Physical activity was assessed via accelerometry; healthy eating was assessed from an interview with the Healthy Eating Index calculated to represent healthy...

  7. Serum Lipids and Diabetic Retinopathy in Newly Diagnosed Type 2 Diabetic Subjects

    Directory of Open Access Journals (Sweden)

    Shahana Shermin

    2011-07-01

    Full Text Available Background: Diabetic retinopathy is the commonest and usually the first observable vascular complication of diabetes mellitus. Along with hyperglycaemia, dyslipidaemia is a contributing factor for the occurrence of diabetic retinopathy. It is postulated that dyslipidaemia results in formation of hard exudate by increasing blood viscosity and altering the fibrinolytic system. A case control study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka during the period of January 2006 to December 2007 to evaluate the serum lipid profile in newly diagnosed type 2 diabetic subjects with diabetic retinopathy. Materials and Methods: Total 85 newly diagnosed type 2 diabetic subjects were included in this study, 40 were cases having retinopathy and 45 were age and sex matched controls without retinopathy. Serum triglyceride (TG, total cholesterol (TC, low density lipoprotein cholesterol (LDL-C and high density lipoprotein cholesterol (HDL-C were compared between cases and controls. Unpaired t-test and chi-square test were done between groups as tests of significance. Results: All the parameters of lipid profile showed dyslipidaemic trend both in cases and controls. In the cases TG was significantly higher and HDL-C was significantly lower than that of controls (p < 0.05 whereas no significant difference was found between cases and controls with respect to serum TC and LDL-C. Conclusion: It can be concluded that high TG and low HDL-C are associated with diabetic retinopathy in newly diagnosed type 2 diabetes.

  8. Periodontitis is associated with diabetic retinopathy in non-obese adults.

    Science.gov (United States)

    Song, Su Jeong; Lee, Seong-Su; Han, Kyungdo; Park, Jun-Beom

    2017-04-01

    Patients with diabetes retinopathy appear to show increased susceptibility to periodontal disease. This study was performed to assess the relationship between periodontitis and the prevalence of diabetic retinopathy in a large probability sample of the Korean population. A subgroup analysis was performed using body mass index periodontitis and presence of retinopathy categorized by body mass index (periodontitis and diabetic retinopathy after adjustment with variables, including age, sex, smoking, drinking, exercise, hypertension, metabolic syndrome, HbA1c, and duration of diabetes mellitus. There was a statistically significant increase in the prevalence of periodontitis in individuals who had proliferative diabetic retinopathy. The odds ratios [95% confidence intervals] of prevalence of diabetic retinopathy were 1.193 [0.757-1.881] for the whole population after adjustments with confounding factors. Subgroup analysis after adjustments with confounding factors showed that the odds ratios [95% confidence intervals] of prevalence were 2.206 [1.114-4.366] and 0.588 [0.326-1.061] among participants with body mass index periodontitis in non-obese diabetic Korean adults after adjustment with confounding variables. Our findings suggest that when a periodontist finds the presence of periodontitis in non-obese diabetic patients, timely evaluation of the patient's ophthalmic evaluation should be 44 recommended.

  9. The correlation of albuminuria and glomerular filtration rate with diabetic retinopathy in type 2 diabetes%尿白蛋白、肾小球滤过率与2型糖尿病视网膜病变的相关性研究

    Institute of Scientific and Technical Information of China (English)

    蔡芸莹; 马中书; 邱明才

    2012-01-01

    目的 比较T2DM视网膜病变(DR)不同时期,尿蛋白、肾小球滤过率(GFR)变化,寻找早期筛查DR的指标. 方法 采用回顾性病历研究,根据散瞳眼底检查分组,同期测定各组24h尿白蛋白定量,以MDRD公式计算GFR. 结果 与正常眼底组相比,DR组患者的GFR明显减低(P<0.05),且尿白蛋白(UAlb)、GFR均与DR呈显著独立相关(P<0.05). 结论 UAlb、GFR均与DR密切相关,其联合筛查有利于DR早期检出.%Objective To compare changes of urinary albumin and eGFR between different stages of diabetic retinopathy(DR) to look for early screening diabetic retinopathy indicators. Methods The clinical data were analyzed retrospectively. Diabetic retinopathy was assessed by mydriatic ophthalmoscopy. While determinating the urinary albumin quantitative for 24 hours, the estimated glomerular filtration rate(GFR) was measured by MDRD formula Results The levels of GFR were significantly lower in two DR groups than in normal retina group(P< 0. 05). Both urinary albumin(Ualb) and GFR were independently risks for diabetic retinopathy. Conclusion Ualb and GFR are closely associated with diabetic retinopathy. Clinicians need to check both urinary albumin and eGFR to screen for early diabetic retinopathy.

  10. Characterisation of human non-proliferative diabetic retinopathy using the fractal analysis

    Institute of Scientific and Technical Information of China (English)

    Stefan; Tǎlu; Dan; Mihai; Cǎlugǎru; Carmen; Alina; Lupascu

    2015-01-01

    · AIM: To investigate and quantify changes in the branching patterns of the retina vascular network in diabetes using the fractal analysis method.·METHODS: This was a clinic-based prospective study of 172 participants managed at the Ophthalmological Clinic of Cluj-Napoca, Romania, between January 2012 and December 2013. A set of 172 segmented and skeletonized human retinal images, corresponding to both normal(24 images) and pathological(148 images)states of the retina were examined. An automatic unsupervised method for retinal vessel segmentation was applied before fractal analysis. The fractal analyses of the retinal digital images were performed using the fractal analysis software Image J. Statistical analyses were performed for these groups using Microsoft Office Excel2003 and Graph Pad In Stat software.·RESULTS: It was found that subtle changes in the vascular network geometry of the human retina are influenced by diabetic retinopathy(DR) and can be estimated using the fractal geometry. The average of fractal dimensions D for the normal images(segmented and skeletonized versions) is slightly lower than the corresponding values of mild non-proliferative DR(NPDR) images(segmented and skeletonized versions).The average of fractal dimensions D for the normal images(segmented and skeletonized versions) is higher than the corresponding values of moderate NPDR images(segmented and skeletonized versions). The lowestvalues were found for the corresponding values of severe NPDR images(segmented and skeletonized versions).· CONCLUSION: The fractal analysis of fundus photographs may be used for a more complete understanding of the early and basic pathophysiological mechanisms of diabetes. The architecture of the retinal microvasculature in diabetes can be quantitative quantified by means of the fractal dimension.Microvascular abnormalities on retinal imaging may elucidate early mechanistic pathways for microvascular complications and distinguish patients with DR from

  11. Retinopathy of prematurity: Revisiting incidence and risk factors from Oman compared to other countries

    Science.gov (United States)

    Reyes, Zenaida Soriano; Al-Mulaabed, Sharef Waadallah; Bataclan, Flordeliz; Montemayor, Cheryl; Ganesh, Anuradha; Al-Zuhaibi, Sanaa; Al-Waili, Huda; Al-Wahibi, Fatma

    2017-01-01

    Purpose: The purpose of this study is to determine the incidence of retinopathy of prematurity (ROP) and the maternal/neonatal risk factors at a tertiary care hospital in Oman, compared to other countries. Patients and Methods: A retrospective analysis of premature neonates born with gestational age (GA) 24–32 weeks at Sultan Qaboos University Hospital, Oman, from January 2007 to December 2010. Maternal and neonatal in-hospital course was retrieved. The incidence of ROP was reported. Risk factors analyses were performed using univariate and multivariate statistics. Results: A total of 171 neonates (57% males, 43% females) were included for analysis. The incidence of ROP (any stage) was 69/171 (40.4%). Infants with ROP had significantly lower GA (27.7±2 weeks) compared to non-ROP group (30.2±1.7 weeks), P patent ductus arteriosus, seizures, and number of blood transfusions. There was no significant difference in maternal characteristics between the ROP and non-ROP groups except that mothers of infants with ROP were found to be significantly younger. Logistic regression analysis revealed early GA, low BW, duration of Oxygen therapy, and late-onset clinical or proven sepsis as independent risk factors. Conclusion: ROP is still commonly encountered in neonatal practice in Oman and other countries. Early GA, low BW, and prolonged oxygen therapy continue to be the main risk factors associated with the occurrence of ROP in our setting. In addition, an important preventable risk factor identified in our cohort includes clinical or proven late-onset sepsis. PMID:28298861

  12. Peripapillary retinal nerve fiber layer changes in preclinical diabetic retinopathy: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Xiaofei Chen

    Full Text Available Diabetic retinopathy is a microvascular neurodegenerative disorder in diabetic patients. Peripapillary retinal nerve fiber layer changes have been described in patients with preclinical diabetic retinopathy, but study results have been inconsistent.To assess changes in peripapillary retinal nerve fiber layer thickness in diabetic patients with preclinical diabetic retinopathy.A literature search was conducted through PubMed, EMBASE, Web of Science and Cochrane Library. Case-control studies on RNFL thickness in preclinical diabetic retinopathy patients and healthy controls were retrieved. A meta-analysis of weighted mean difference and a sensitivity analysis were performed using RevMan 5.2 software.Thirteen case-control studies containing 668 diabetic patients and 556 healthy controls were selected. Peripapillary RNFL thickness was significantly reduced in patients with preclinical diabetic retinopathy compared to healthy controls in studies applying Optical Coherence Tomography (-2.88 μm, 95%CI: -4.44 to -1.32, P = 0.0003 and in studies applying Scanning Laser Polarimeter (-4.21 μm, 95%CI: -6.45 to -1.97, P = 0.0002. Reduction of RNFL thickness was significant in the superior quadrant (-3.79 μm, 95%CI: -7.08 to -0.50, P = 0.02, the inferior quadrant (-2.99 μm, 95%CI: -5.44 to -0.54, P = 0.02 and the nasal quadrant (-2.88 μm, 95%CI: -4.93 to -0.82, P = 0.006, but was not significant in the temporal quadrant (-1.22 μm, 95%CI: -3.21 to 0.76, P = 0.23, in diabetic patients.Peripapillary RNFL thickness was significantly decreased in preclinical diabetic retinopathy patients compared to healthy control. Neurodegenerative changes due to preclinical diabetic retinopathy need more attention.

  13. TO STUDY THE EFFECT OF ANGIOTENSIN RECEPTOR BLOCKERS ON DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Chakravarthy K

    2017-05-01

    Full Text Available BACKGROUND Diabetic Retinopathy (DR is the most common microvascular complication of Diabetes Mellitus (DM and is the leading cause of blindness in working age adults of patients with type 1 and 2 DM. Large observational and randomised studies shown that optimal blood glucose and blood pressure control halt or regress the disease and limit the risk of progression to the proliferative stage and visual loss. Recently, evidence has also emerged that Renin-Angiotensin System (RAS inhibitors may electively prevent or delay progression of retinopathy by acting on local RAS. Thus, metabolic and blood pressure control by RAS inhibition is to prevent or limit the onset of retinopathy and its progression towards visual-threatening stages. The aim of the study is to categorise and analyse grading of DR who are on currently ACE and ARBs unchanged for at least 2 years. MATERIALS AND METHODS 178 patients with type 1 and 2 DM of both genders on ARBs and ACEI unchanged for at least 2 years are divided into two groups as follows- 1. ARB group, which includesa 28 patients on losartan (50 mg. b 32 patients on losartan (50 mg + hydrochlorothiazide (12.5 mg. c 28 patients on telmisartan (40 mg. d 32 patients on telmisartan (40 mg + hydrochlorothiazide (12.5 mg. 2. ACE inhibitor group includesa 30 patients on enalapril (5 mg. b 28 patients on ramipril (2.5 mg + hydrochlorothiazide (12.5 mg. Retinopathy grading assessed by indirect ophthalmoscope and comparison of retinopathy grading between ARBs and ACEI groups have done. Two-tailed Chi-square test, GraphPad Prism Software used for statistical calculations. RESULTS Losartan and telmisartan (ARB group showed significant protection from diabetic retinopathy than enalapril and ramipril (ACEI group (p<0.05. CONCLUSION ARBs help in preventing the progression of DR and vision loss in those belonging to mild and moderate nonproliferative diabetic retinopathy patients.

  14. Retinopathy in African Americans and whites with insulin-dependent diabetes mellitus.

    Science.gov (United States)

    Arfken, C L; Salicrup, A E; Meuer, S M; Del Priore, L V; Klein, R; McGill, J B; Rucker, C S; White, N H; Santiago, J V

    1994-11-28

    The development and progression of diabetic retinopathy in African Americans with insulin-dependent diabetes mellitus is not known. Two hundred subjects with insulin-dependent diabetes mellitus with duration of diabetes 16 years or less at first visit were studied; 58 were African Americans and 142 were whites. All had gradable stereoscopic color fundus photographs (seven standard fields) from at least two visits (mean time between first and second visit was 4.1 years). Subjects with hemoglobinopathy or proliferative retinopathy or subjects who had evidence of treatment for proliferative retinopathy at first visit were excluded. Masked grading of photographs was conducted using the modified Airlie House classification scheme. African Americans were older, heavier, had higher systolic blood pressure (all P < .05), and marginally higher hemoglobin A1 (HbA1) values (P = .06) than the whites at first visit. African Americans had a lower rate of two steps or more progression from preexistent retinopathy (19%) than whites (43%). Progression to proliferative retinopathy or treatment was similar by race. Multivariate analysis predicting development oe progression of retinopathy, while controlling for length of follow-up, found higher HbA1 (odds ratio [OR] = 2.15), longer duration of insulin-dependent diabetes mellitus (OR = 1.69), higher serum creatinine concentration (OR = 1.59), and white race (OR = 2.62) to be independent risk factors. These data suggest a previously unsuspected reduction in the adjusted risk for development and progression of retinopathy in African Americans. The reason for this apparently reduced risk are not known.

  15. Retinopathy of prematurity: an epidemic in the making

    Institute of Scientific and Technical Information of China (English)

    Graham E. Quinn; Clare Gilbert; Brian A. Darlow; Andrea Zin

    2010-01-01

    Objective To explore the etiology, incidence and methods to prevent and treat severe retinopathy of prematurity (ROP),which is rapidly becoming a threat to the vision of babies in areas of the world where increasing numbers of premature babies are surviving.Data sources The data used in this review were mainly from Medline and PubMed published in English. The search term was "retinopathy of prematurity and premature birth".Study selection We discuss the historical perspectives, prevalence and incidence, classification and treatment methods of ROP in premature babies.Results Peripheral retinal ablation for eyes with severe ROP can help prevent progression to blindness and several large clinical trials have shown the effectiveness of this treatment in high risk eyes. As a greater proportion of VLBW and ELBW babies survive, the population of babies at risk increases. In various regions of the world, different identification criteria are used to determine which babies are at risk of blindness in order to provide timely diagnostic examinations and treatment as needed. Methods for preventiing ROP include better ante-natal and obstetric care leading to a reduction in the rate of prematurity, the use of ante-natal corticosteroids, and better neonatal care practices. Recent developments have indicated that management of oxygen supplementation is important for the prevention of severe ROP; however,there is not yet known what oxygen saturation target should be adopted. Sepsis increases severe ROP in very preterm infants. Genetic associations and a telemedicine approach may be explored to detect ROP. Treatment of anti-VEGF therapy are potentially useful in eyes with severe ROP, but long term effects are not yet known and such treatment should be used with great caution.Conclusions ROP is a potentially binding disease for premature babies which is becoming more prevalent with the development improving neonatal services in many countries in recent years. High priority should be

  16. Long-term Results of Treatment of Patients with Non-proliferative Diabetic Retinopathy Angioprotectors

    Directory of Open Access Journals (Sweden)

    I. V. Vorobyeva

    2017-01-01

    Full Text Available Purpose: Optimization of approaches to the treatment of early stages diabetic retinopathy based on modern diagnosis and monitoring of patients with type 2 diabetes.Patients and methods: It was examined 90 patients (180 eyes with type 2 diabetes with DR: women (74.4% and men (25.6%, age 63,7±2,3 years. All groups matched by sex and age: Group 1 — control (healthy individuals without diabetes; Group 2 — Patients with DR0 (30 patients, 60 eyes with type 2 diabetes without DR; 3 group — patients with DR I without DMO with type 2 diabetes (30 patients, 60 eyes. Patients 2 and 3 groups was treated with conservative treatment angioprotectors drug-Doxi-Hem® registered in Russia. The drug was administered in a dose of 500 mg three times a day for six months. Monitor patients for six months of receiving Doxi-Hem® preparation consisted of monthly conventional ophthalmic examination, including further analysis of BCVA (BCVA, light sensitivity of the macula (SM as a result of fundusmikroperimetrii MAIA, central retinal thickness (PZT based on the results of the optical coherence tomography (OCT. We take into account the compensation of diabetes on the level of glycated hemoglobin (HbA1C blood.Results: When monitoring patients with type 2 diabetes to optimize the treatment of established efficacy and safety of drug therapy Doxi-Hem® in the prevention and treatment of pre-clinical and early manifestations of DR (DR0, DR1, which is confirmed by reliable positive dynamics of visual functions (BCVA, p <0.05, before treatment 0,8±0,02, after treatment increased to 0,92±0,02, morphological reduction in retinal thickness (PZT, p <0.05; before treatment 272,3±5,8 mm, after treatment 241.5±15.8 um, increased sensitivity of the macula (CM, p <0.05, before treatment 22.2±1.5 dB, after treatment 27.0±3.2 dB. Required control the severity of type 2 diabetes on the target level of blood glycosylated hemoglobin (HbA1C.Conclusion: Optimization approaches to

  17. Effect of candesartan on prevention (DIRECT-Prevent 1) and progression (DIRECT-Protect 1) of retinopathy in type 1 diabetes: randomised, placebo-controlled trials

    DEFF Research Database (Denmark)

    Chaturvedi, N.; Porta, M.; Klein, R.;

    2008-01-01

    BACKGROUND: Results of previous studies suggest that renin-angiotensin system blockers might reduce the burden of diabetic retinopathy. We therefore designed the DIabetic REtinopathy Candesartan Trials (DIRECT) Programme to assess whether candesartan could reduce the incidence and progression of ...

  18. Assessment of diabetic retinopathy using nonmydriatic ultra-widefield scanning laser ophthalmoscopy (Optomap) compared with ETDRS 7-field stereo photography.

    Science.gov (United States)

    Kernt, Marcus; Hadi, Indrawati; Pinter, Florian; Seidensticker, Florian; Hirneiss, Christoph; Haritoglou, Christos; Kampik, Anselm; Ulbig, Michael W; Neubauer, Aljoscha S

    2012-12-01

    To compare the diagnostic properties of a nonmydriatic 200° ultra-widefield scanning laser ophthalmoscope (SLO) versus mydriatic Early Treatment of Diabetic Retinopathy Study (ETDRS) 7-field photography for diabetic retinopathy (DR) screening. A consecutive series of 212 eyes of 141 patients with different levels of DR were examined. Grading of DR and clinically significant macular edema (CSME) from mydriatic ETDRS 7-field stereo photography was compared with grading obtained by Optomap Panoramic 200 SLO images. All SLO scans were performed through an undilated pupil, and no additional clinical information was used for evaluation of all images by the two independent, masked, expert graders. Twenty-two eyes from ETDRS 7-field photography and 12 eyes from Optomap were not gradable by at least one grader because of poor image quality. A total of 144 eyes were analyzed regarding DR level and 155 eyes regarding CSME. For ETDRS 7-field photography, 22 eyes (18 for grader 2) had no or mild DR (ETDRS levels ≤ 20) and 117 eyes (111 for grader 2) had no CSME. A highly substantial agreement between both Optomap DR and CSME grading and ETDRS 7-field photography existed with κ = 0.79 for DR and 0.73 for CSME for grader 1, and κ = 0.77 (DR) and 0.77 (CSME) for grader 2. Determination of CSME and grading of DR level from Optomap Panoramic 200 nonmydriatic images show a positive correlation with mydriatic ETDRS 7-field stereo photography. Both techniques are of sufficient quality to assess DR and CSME. Optomap Panoramic 200 images cover a larger retinal area and therefore may offer additional diagnostic properties.

  19. The investigation of prevalence and risk factors of diabetic retinopathy in in-patients with type 2 diabetes mellitus in Jinan city%住院糖尿病人视网膜病变发生率调查及其危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王玉; 范传峰; 舒相汶; 张华; 盛艳娟; 吴昌龙; 谭瑞礼; 张同河

    2009-01-01

    Objective To study clinical epidemioiogy of diabetic retinopathy in-patients with type 2 diabetes mellitus in Jinan city and analyze its related factors.Methods A total of 250 diabetics were investigated in detail by filling informs, ocular examination including ophthalmoscopy and physical examination and laboratory testing.These cases were divided into 2 groups according to their diabetic retinopathy.The relations between diabetic retinopathy and various parameters in two groups were observed and analyzed by statistical methods.Results The prevalence of diabetic retinopathy was 56.4%, and proliferative diabetic retinopathy was 10.8 %.Duration of diabetes, HbA1C, hypertension, hyperlipidemia and early renal damage were the risk factors for diabetic retinopathy.Conclusions The prevalence of diabetic retinopathy was higher in Jinan city. The ocular examination should be strengthened in the patients with longer duration of diabetes or early renal damage. To prevent or reduce the occurrence of diabetic retinopathy, blood pressure, blood glucose and blood lipid should be under good control.%目的 调查济南市住院糖尿病患者中糖尿病视网膜病变的发生率,对其相关的危险因素进行分析.方法 对济南市多家医院的250例住院糖尿病患者进行问卷调查、实验室检查、眼部检查等,并按照国际最新糖尿病视网膜病变分期标准对调查资料进行分析.结果 住院糖尿病患者中糖尿病视网膜病变的发生率为56.4%,其中增殖性糖尿病视网膜病变占10.8%.多因素分析显示其危险因素为高血脂、肾损害、高血压、高糖化血红蛋白和糖尿病病程.结论 济南市住院糖尿病人中糖尿病视网膜病变的发生率较高.应加强对糖尿病病程较长、已出现早期肾损害的患者的随访和治疗,除控制好血糖外,还应重视对其血脂、血压的控制.

  20. Introduction of multicenter clinical trials for retinopathy of retinopathy: LIGHT-ROP, STOP-ROP and BEAT-ROP%早产儿视网膜病变多中心临床试验介绍—LIGHT-ROP、STOP-ROP和BEAT-ROP

    Institute of Scientific and Technical Information of China (English)

    李蓉; 王雨生

    2012-01-01

    Evidence-based medicine is very important to clinical prevention and treatment tor retinopathy of prematurity(ROP).Although retianl ablation including cryotherapy and laser has been proved to be effective in treating ROP,it can be destructive to the peripheral retina to some extent.Therefore,better and safer therapies are desired.After the two influential clinical trials—" Cryotherapy forretinopathy of prematurity(CRYO-ROP) " and "Early treatment for retinopathy of prematurity study(ET-ROP) ",other significant muhicenter clinical trials has been initiated successively in the United States in order to explore novel therapeutic ways,such as "The effects of light reduction on retinopathy of prematurity (LIGHT-ROP) ","Supplemental therapeutic oxygen for prethreshold retinopathy of prematurity (STOP-ROP)" and " Bevacizumab eliminates the angiogenic threat of retinopathy of prematurity(BEAT-ROP) ".In this article,we reviewed the goals,designs,main results and conclusions of the three trials.%循证医学证据对于临床防治早产儿视网膜病变(ROP)具有重要意义.已证实视网膜消融术(冷冻和激光)治疗ROP有效,但对周边视网膜具有一定的破坏性,因而需要寻找更安全的治疗方法.继“冷冻治疗ROP(CRYO-ROP)”和“早期治疗ROP(ET-ROP)”临床试验之后,美国又先后发起了“减少光照对ROP的效应(LIGHT-ROP)”、“阈值前ROP补充氧疗(STOP-ROP)”和“贝伐单抗消除ROP的血管生成威胁(BEAT-ROP)”等多项重要的多中心临床试验,旨在探索新的治疗途径.本文综述了ROP多中心临床试验LIGHT-ROP、STOP-ROP和BEAT-ROP的目的、试验设计、主要结果和结论.

  1. Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

    Directory of Open Access Journals (Sweden)

    Stela Vujosevic

    2016-01-01

    Full Text Available In Italy, the number of people living with diabetes is about 3.5 million (5.5% of the population, with an increase by about 60% in the last 20 years and with 1 person out of 3 older than 65 years. The Italian Health Service system estimates that 10 billion euros is spent annually on caring for patients with diabetes, a figure that increases yearly. No national data on prevalence and incidence of legal blindness in patients with diabetes and no national registry of patients with diabetic retinopathy (DR are currently available. However, the available epidemiological data (in several locations throughout the country are consistent with those reported in other European countries. The use of telemedicine for the screening of DR in Italy is confined to geographically limited locations. The available data in the literature on implementation and use of telematic screening proved to be successful from patient, caregiver, and authorities point of view. This review addresses the available epidemiological data on DR and telematic screening realities in Italy and thus may help in establishing a national screening program.

  2. Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

    Science.gov (United States)

    Eszes, Dóra J.; Szabó, Dóra J.; Russell, Greg; Kirby, Phil; Paulik, Edit; Nagymajtényi, László

    2016-01-01

    Introduction. Diabetic retinopathy (DR) is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients' satisfaction when using such tools (fundus camera examination) and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants' experience during fundus examination (comfort, reliability, and future interest in participation), as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software). Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening. PMID:28078306

  3. Characterisation of the vitreous proteome in proliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Wang Hao

    2012-03-01

    Full Text Available Abstract Background Diabetes can lead to serious microvascular complications such as proliferative diabetic retinopathy (PDR, which results in severe vision loss. The diabetes-induced alterations in the vitreous protein composition in diabetic patients with PDR may be responsible for the presence of PDR. The vitreous humour can be utilised in a variety of studies aimed toward the discovery of new targets for the treatment or prevention of PDR and the identification of novel disease mechanisms. The aim of this study was to compare the protein profile of vitreous humour from diabetic patients with PDR with that of vitreous humour from normal human eyes donated for corneal transplant. Results Vitreous humour from type 2 diabetic patients with PDR (n = 10 and from normal human eyes donated for corneal transplant (n = 10 were studied. The comparative proteomic analysis was performed using two-dimensional fluorescence difference gel electrophoresis (2-D DIGE. Differentially produced proteins (abundance ratio > 2 or p Conclusions These data provide an in-depth analysis of the human vitreous proteome and reveal protein alterations that are possibly involved in the pathogenesis of PDR. Further investigation of these special proteins may provide potential new targets for the treatment or the prevention of PDR.

  4. Spectrally optimal illuminations for diabetic retinopathy detection in retinal imaging

    Science.gov (United States)

    Bartczak, Piotr; Fält, Pauli; Penttinen, Niko; Ylitepsa, Pasi; Laaksonen, Lauri; Lensu, Lasse; Hauta-Kasari, Markku; Uusitalo, Hannu

    2017-01-01

    Retinal photography is a standard method for recording retinal diseases for subsequent analysis and diagnosis. However, the currently used white light or red-free retinal imaging does not necessarily provide the best possible visibility of different types of retinal lesions, important when developing diagnostic tools for handheld devices, such as smartphones. Using specifically designed illumination, the visibility and contrast of retinal lesions could be improved. In this study, spectrally optimal illuminations for diabetic retinopathy lesion visualization are implemented using a spectrally tunable light source based on digital micromirror device. The applicability of this method was tested in vivo by taking retinal monochrome images from the eyes of five diabetic volunteers and two non-diabetic control subjects. For comparison to existing methods, we evaluated the contrast of retinal images taken with our method and red-free illumination. The preliminary results show that the use of optimal illuminations improved the contrast of diabetic lesions in retinal images by 30-70%, compared to the traditional red-free illumination imaging.

  5. Diabetic retinopathy: variations in patient therapeutic outcomes and pharmacogenomics

    Directory of Open Access Journals (Sweden)

    Agarwal A

    2014-12-01

    Full Text Available Aniruddha Agarwal, Mohamed K Soliman, Yasir J Sepah, Diana V Do, Quan Dong Nguyen Ocular Imaging Research and Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, USA Abstract: Diabetes and its microvascular complications in patients poses a significant challenge and constitutes a major health problem. When it comes to manifestations in the eye, each case of diabetic retinopathy (DR is unique, in terms of the phenotype, genotype, and, more importantly, the therapeutic response. It is therefore important to identify factors that distinguish one patient from another. Personalized therapy in DR is a new trend aimed at achieving maximum therapeutic response in patients by identifying genotypic and phenotypic factors that may result in less than optimal response to conventional therapy, and consequently, lead to poorer outcome. With advances in the identification of these genetic markers, such as gene polymorphisms and human leucocyte antigen associations, as well as development of drugs that can target their effects, the future of personalized medicine in DR is promising. In this comprehensive review, data from various studies have been analyzed to present what has been achieved in the field of pharmacogenomics thus far. An insight into future research is also provided. Keywords: personalized medicine, therapeutic variation, genomic markers, genotype, phenotype, VEGF mutation, polymorphism, linkage, mutation, responder

  6. Increased choroidal thickness in patient with high-altitude retinopathy

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    Kyoko Hirukawa-Nakayama

    2014-01-01

    Full Text Available We report a case of high-altitude retinopathy with increased choroidal thickness detected by spectral-domain optical coherence tomography (SD-OCT. A 36-year-old Japanese man developed an acute vision decrease in his left eye after he had trekked at an altitude of 4600 m in Tibet for 1 week. His visual acuity was 20/20 OD and 20/200 OS with refractive errors of − 0.25 diopters (D OD and − 0.50 D OS 3 weeks after the onset of the visual decrease. Funduscopic examinations revealed multiple intraretinal hemorrhages bilaterally and a macular hemorrhage in the left eye. SD-OCT showed that the thickness of choroidal layer at the fovea was 530 μm OD and 490 μm OS which is thicker than that in normal subjects of approximately 300 μm. We suggest that the increase in the retinal blood flow under hypoxic conditions may be associated with an increase in the choroidal blood flow resulting in an increase in choroidal thickness.

  7. [Reliability of retinal imaging screening in retinopathy of prematurity].

    Science.gov (United States)

    Navarro-Blanco, C; Peralta-Calvo, J; Pastora-Salvador, N; Alvarez-Rementería, L; Chamorro, E; Sánchez-Ramos, C

    2014-09-01

    The retinopathy of prematurity (ROP) is a potentially avoidable cause of blindness in children. The advances in neonatal care make the survival of extremely premature infants, who show a greater incidence of the disease, possible. The aim of the study is to evaluate the reliability of ROP screening using retinography imaging with the RetCam 3 wide-angle camera and also study the variability of ROP diagnosis depending on the evaluator. The indirect ophthalmoscopy exam was performed by a Pediatric ROP-Expert Ophthalmologist. The same ophthalmologist and a technician specialized in digital image capture took retinal images using the RetCam 3 wide-angle camera. A total of 30 image sets were analyzed by 3 masked groups: group A (8 ophthalmologists), group B (5 experts in vision), and group C (2 ROP-expert ophthalmologists). According to the diagnosis using indirect ophthalmoscopy, the sensitivity (26-93), Kappa (0.24-0.80), and the percent agreement were statistically significant in group C for the diagnosis of ROP Type 1. In the diagnosis of ROP Type 1+Type 2, Kappa (0.17-0.33) and the percent agreement (58-90) were statistically significant, with higher values in group C. The diagnosis, carried out by ROP-expert ophthalmologists, using the wide-angle camera RetCam 3 has proved to be a reliable method. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary

    Directory of Open Access Journals (Sweden)

    Dóra J. Eszes

    2016-01-01

    Full Text Available Introduction. Diabetic retinopathy (DR is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients’ satisfaction when using such tools (fundus camera examination and the effect of demographic and socioeconomic factors on participation in screening. Methods. Pilot study involving fundus camera screening and self-administered questionnaire on participants’ experience during fundus examination (comfort, reliability, and future interest in participation, as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary. Results. Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software. Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation. Discussion. Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening.

  9. Current Concepts of Oxygen Management in Retinopathy of Prematurity

    Directory of Open Access Journals (Sweden)

    Leah A Owen

    2014-01-01

    Full Text Available Retinopathy of prematurity (ROP is a potentially blinding disorder in premature infants. The underlying pathophysiology is incompletely understood, limiting the prevention and treatment of this devastating condition. Current therapies are directed toward management of aberrant neovascularization thought to result from retinal ischemia in the developing preterm retina. The molecular mediators important for development of retinal ischemia and subsequent neovascular pathology are not fully understood. However, oxygen has been shown to be a key mediator of disease and the oxygen environment for preterm infants has been extensively studied. Despite this, the optimal oxygen environment for preterm infants remains unclear and recent works seeking to clarify this relationship demonstrate somewhat disparate findings. These data further substantiate that ROP is a complex disease with multifactorial etiology including genetic and environmental factors. Therefore, while environmental factors such as oxygen are important to our understanding of the disease process and care of preterm infants, identification of the molecular mediators downstream of oxygen which are necessary for development of ROP pathology will be critical to improve prevention, diagnosis and treatment strategies.

  10. Effect of Trace Elements on Retinopathy of Prematurity

    Institute of Scientific and Technical Information of China (English)

    YANG Hong; DING Yi; CHEN Ling

    2007-01-01

    The effect of the trace elements on retinopathy of prematurity (ROP) were studied. Thirty preterm infants who had potential high risk factors Of ROP were selected as observation group and 18 normal infants as control groups. By using atom spectrophotometer, the contents of serum trace ele-ments (Mg, Cu, Zn, Mn, Se) were measured and analyzed statistically. The contents of serum Zn, Cu and Se in observation group were 0.75±0.22, 0.41±0.20 and (134.07±71.57)×10-3 mg/L respectively,and 0.55±0.12, 0.65±0.194 and (202.92±44.71)×10-3 mg/L in control group respectively (P0.05). It was concluded that the contents of serum Cu and Se in preterm infants who had high risk factors of ROP were obviously lower than in the controls. The contents of serum Cu and Se in the ROP infants were also much lower while contents of Zn much higher. Attention should be paid to the detection of the trace elements in preterm infants in order to prevent the deficiencies of Cu and Se. Only in this way can we prevent the deficiencies of Cu and Se, so as to decrease the ROP risk factors and prevent the disease.

  11. Diabetic Retinopathy in Italy: Epidemiology Data and Telemedicine Screening Programs

    Science.gov (United States)

    Midena, Edoardo

    2016-01-01

    In Italy, the number of people living with diabetes is about 3.5 million (5.5% of the population), with an increase by about 60% in the last 20 years and with 1 person out of 3 older than 65 years. The Italian Health Service system estimates that 10 billion euros is spent annually on caring for patients with diabetes, a figure that increases yearly. No national data on prevalence and incidence of legal blindness in patients with diabetes and no national registry of patients with diabetic retinopathy (DR) are currently available. However, the available epidemiological data (in several locations throughout the country) are consistent with those reported in other European countries. The use of telemedicine for the screening of DR in Italy is confined to geographically limited locations. The available data in the literature on implementation and use of telematic screening proved to be successful from patient, caregiver, and authorities point of view. This review addresses the available epidemiological data on DR and telematic screening realities in Italy and thus may help in establishing a national screening program. PMID:27990441

  12. Prevalence of retinopathy of prematurity in Latin America

    Science.gov (United States)

    Carrion, Juliana Zimmermann; Filho, João Borges Fortes; Tartarella, Marcia Beatriz; Zin, Andrea; Jornada, Ignozy Dorneles

    2011-01-01

    The purpose of this work was to review the studies published over the last 10 years concerning the prevalence of retinopathy of prematurity (ROP) in Latin American countries, to determine if there was an improvement in ROP prevalence rates in that period, and to identify the inclusion criteria for patients at risk of developing ROP in the screening programs. A total of 33 studies from ten countries published between 2000 and 2010 were reviewed. Prevalence of any ROP stage in the regions considered ranged from 6.6% to 82%; ROP severe enough to require treatment ranged from 1.2% to 23.8%. There was no routine screening for ROP, and there was a lack of services for treatment of the disease in many countries. Inclusion criteria for patients in the studies ranged between birth weight ≤1500 g and ≤2000 g and gestational age ≤32 and <37 weeks. Use of different inclusion criteria regarding birth weight and gestational age in several Latin American studies hindered comparative analysis of the published data. Highly restrictive selection criteria for ROP screening in relation to birth weight and gestational age should not be used throughout most Latin American countries because of their different social characteristics and variable neonatal care procedures. The studies included in this review failed to provide adequate information to determine if the prevalence of ROP has decreased in Latin America. PMID:22174577

  13. Timely implementation of a retinopathy of prematurity telemedicine system.

    Science.gov (United States)

    Quinn, Graham E; Ying, Gui-Shuang; Repka, Michael X; Siatkowski, R Michael; Hoffman, Robert; Mills, Monte D; Morrison, David; Daniel, Ebenezer; Baumritter, Agnieshka; Hildebrand, P Lloyd; Schron, Eleanor B; Ells, Anna L; Wade, Kelly; Kemper, Alex R

    2016-10-01

    To examine the feasibility of a retinopathy of prematurity (ROP) telemedicine evaluation system of providing timely feedback to a neonatal intensive care unit (NICU) with at-risk premature infants. This was a prospective observational study of premature infants with birth weights of return of the grading results to the clinical center was 10.1 ± 11.3 hours (standard deviation), with a median of 12.0 hours (1st quartile, 0.9 hours; 3rd quartile, 16 hours). Overall, 95.5% of gradings (95% CI, 93.9%-96.7%) were returned within 24 hours. Subgroup analyses found, for image sets submitted to the reading center before 2 p.m. Eastern Standard Time, median time to report was 1.7 hours (1st quartile, 0.7 hours; 3rd quartile, 15.5 hours) compared with those submitted after 2pm (median, 14.1 hours; 1st quartile, 11.2, hours; 3rd quartile, 16.3 hours). An ROP telemedicine approach can provide timely feedback to the NICU regarding the detection of potentially serious ROP and thus referral to an ophthalmologist for examination and consideration of treatment. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  14. Comprehensive Retinal Image Analysis for Aggressive Posterior Retinopathy of Prematurity

    Science.gov (United States)

    2016-01-01

    Computer aided analysis plays a nontrivial role in assisting the diagnosis of various eye pathologies. In this paper, we propose a framework to help diagnose the presence of Aggressive Posterior Retinopathy Of Prematurity (APROP), a pathology that is characterised by rapid onset and increased tortuosity of blood vessels close to the optic disc (OD). We quantify vessel characteristics that are of clinical relevance to APROP such as tortuosity and the extent of branching i.e., vessel segment count in the defined diagnostic region. We have adapted three vessel segmentation techniques: matched filter response, scale space theory and morphology with local entropy based thresholding. The proposed feature set equips us to build a linear discriminant classifier to discriminate APROP images from clinically healthy images. We have studied 36 images from 21 APROP subjects against a control group of 15 clinically healthy age matched infants. All subjects are age matched ranging from 33−40 weeks of post menstrual age. Experimental results show that we attain 100% recall and 95.45% precision, when the vessel network obtained from morphology is used for feature extraction. PMID:27711231

  15. Scientometric Analysis and Mapping of Scientific Articles on Diabetic Retinopathy.

    Science.gov (United States)

    Ramin, Shahrokh; Gharebaghi, Reza; Heidary, Fatemeh

    2015-01-01

    Diabetic retinopathy (DR) is the major cause of blindness among the working-age population globally. No systematic research has been previously performed to analyze the research published on DR, despite the need for it. This study aimed to analyze the scientific production on DR to draw overall roadmap of future research strategic planning in this field. A bibliometric method was used to obtain a view on the scientific production about DR by the data extracted from the Institute for Scientific Information (ISI). Articles about DR published in 1993-2013 were analyzed to obtain a view of the topic's structure, history, and to document relationships. The trends in the most influential publications and authors were analyzed. Most highly cited articles addressed epidemiologic and translational research topics in this field. During the past 3 years, there has been a trend toward biomarker discovery and more molecular translational research. Areas such as gene therapy and micro-RNAs are also among the recent hot topics. Through analyzing the characteristics of papers and the trends in scientific production, we performed the first scientometric report on DR. Most influential articles have addressed epidemiology and translational research subjects in this field, which reflects that globally, the earlier diagnosis and treatment of this devastating disease still has the highest global priority.

  16. Noninvasive Retinal Markers in Diabetic Retinopathy: Advancing from Bench towards Bedside

    Directory of Open Access Journals (Sweden)

    Søren Leer Blindbæk

    2017-01-01

    Full Text Available The retinal vascular system is the only part of the human body available for direct, in vivo inspection. Noninvasive retinal markers are important to identity patients in risk of sight-threatening diabetic retinopathy. Studies have correlated structural features like retinal vascular caliber and fractals with micro- and macrovascular dysfunction in diabetes. Likewise, the retinal metabolism can be evaluated by retinal oximetry, and higher retinal venular oxygen saturation has been demonstrated in patients with diabetic retinopathy. So far, most studies have been cross-sectional, but these can only disclose associations and are not able to separate cause from effect or to establish the predictive value of retinal vascular dysfunction with respect to long-term complications. Likewise, retinal markers have not been investigated as markers of treatment outcome in patients with proliferative diabetic retinopathy and diabetic macular edema. The Department of Ophthalmology at Odense University Hospital, Denmark, has a strong tradition of studying the retinal microvasculature in diabetic retinopathy. In the present paper, we demonstrate the importance of the retinal vasculature not only as predictors of long-term microvasculopathy but also as markers of treatment outcome in sight-threatening diabetic retinopathy in well-established population-based cohorts of patients with diabetes.

  17. Inflammation, haemostatic disturbance, and obesity: possible link to pathogenesis of diabetic retinopathy in type 2 diabetes.

    Science.gov (United States)

    Tomić, Martina; Ljubić, Spomenka; Kaštelan, Snježana; Gverović Antunica, Antonela; Jazbec, Anamarija; Poljičanin, Tamara

    2013-01-01

    The pathogenesis of diabetic retinopathy (DR) is insufficiently understood but may possibly involve chronic, low-grade inflammation. The aim of this cross-sectional study was to investigate the relationship between inflammatory and haemostatic markers, other markers of endothelial dysfunction and anthropometric parameters, and their association with DR in patients with type 2 diabetes. According to the DR status patients were divided into three groups: no retinopathy, mild/moderate nonproliferative (NPDR), and severe NPDR/proliferative retinopathy (PDR). The groups did not differ in the levels of inflammatory and haemostatic markers, other markers of endothelial dysfunction, and anthropometric parameters. After dividing the patients according to the level of obesity (defined by BMI, WC, and WHR) into three groups ANOVA showed the differences in C-reactive protein according to the WC (P = 0.0265) and in fibrinogen according to the WHR (P = 0.0102) as well as in total cholesterol (P = 0.0109) and triglycerides (P = 0.0133) according to the BMI. Logistic regression analyses showed that diabetes duration and prolonged poor glycemic control are the main predictors of retinopathy in patients with type 2 diabetes. Interrelations between obesity, inflammation, haemostatic disturbance, and other risk factors may possibly play an important additional role in endothelial dysfunction involved in the pathogenesis of diabetic retinopathy.

  18. Retinopathy during interferon-β treatment for multiple sclerosis: case report and review of the literature.

    Science.gov (United States)

    Gaetani, Lorenzo; Menduno, Paola S; Cometa, Francesco; Di Gregorio, Maria; Sarchielli, Paola; Cagini, Carlo; Calabresi, Paolo; Di Filippo, Massimiliano

    2016-03-01

    The onset of new visual symptoms in patients with multiple sclerosis is often associated with a neuro-ophthalmologic manifestation of the disease. However, other possible differential diagnoses need to be ruled out, including drug-induced retinal side effects. Although uncommon, retinal side effects of interferon-beta formulations may occur, and need to be promptly recognized and treated by neurologists. In this manuscript, we report the case of a 37-year-old woman affected by multiple sclerosis diagnosed with interferon beta-associated retinopathy and we review the literature with regard to the epidemiology, clinical presentation, management and follow-up of interferon beta-associated retinopathy. Interferon-beta induced retinopathy seems to be an uncommon and a dose-related side effect in multiple sclerosis patients. Retinopathy tends to completely resolve after treatment discontinuation. Neurologists must be aware that immune-modulatory drugs, in particular interferon beta, have been reported to cause retinal side effects. In multiple sclerosis patients complaining of new visual symptoms during interferon-beta treatment, it is thus advisable to perform an ophthalmological assessment to rule out and properly manage retinopathy.

  19. Inflammation, Haemostatic Disturbance, and Obesity: Possible Link to Pathogenesis of Diabetic Retinopathy in Type 2 Diabetes

    Science.gov (United States)

    Tomić, Martina; Ljubić, Spomenka; Kaštelan, Snježana; Gverović Antunica, Antonela; Jazbec, Anamarija; Poljičanin, Tamara

    2013-01-01

    Purpose. The pathogenesis of diabetic retinopathy (DR) is insufficiently understood but may possibly involve chronic, low-grade inflammation. The aim of this cross-sectional study was to investigate the relationship between inflammatory and haemostatic markers, other markers of endothelial dysfunction and anthropometric parameters, and their association with DR in patients with type 2 diabetes. Methods. According to the DR status patients were divided into three groups: no retinopathy, mild/moderate nonproliferative (NPDR), and severe NPDR/proliferative retinopathy (PDR). Results. The groups did not differ in the levels of inflammatory and haemostatic markers, other markers of endothelial dysfunction, and anthropometric parameters. After dividing the patients according to the level of obesity (defined by BMI, WC, and WHR) into three groups ANOVA showed the differences in C-reactive protein according to the WC (P = 0.0265) and in fibrinogen according to the WHR (P = 0.0102) as well as in total cholesterol (P = 0.0109) and triglycerides (P = 0.0133) according to the BMI. Logistic regression analyses showed that diabetes duration and prolonged poor glycemic control are the main predictors of retinopathy in patients with type 2 diabetes. Conclusion. Interrelations between obesity, inflammation, haemostatic disturbance, and other risk factors may possibly play an important additional role in endothelial dysfunction involved in the pathogenesis of diabetic retinopathy. PMID:24363502

  20. Automatic screening and classification of diabetic retinopathy and maculopathy using fuzzy image processing.

    Science.gov (United States)

    Rahim, Sarni Suhaila; Palade, Vasile; Shuttleworth, James; Jayne, Chrisina

    2016-12-01

    Digital retinal imaging is a challenging screening method for which effective, robust and cost-effective approaches are still to be developed. Regular screening for diabetic retinopathy and diabetic maculopathy diseases is necessary in order to identify the group at risk of visual impairment. This paper presents a novel automatic detection of diabetic retinopathy and maculopathy in eye fundus images by employing fuzzy image processing techniques. The paper first introduces the existing systems for diabetic retinopathy screening, with an emphasis on the maculopathy detection methods. The proposed medical decision support system consists of four parts, namely: image acquisition, image preprocessing including four retinal structures localisation, feature extraction and the classification of diabetic retinopathy and maculopathy. A combination of fuzzy image processing techniques, the Circular Hough Transform and several feature extraction methods are implemented in the proposed system. The paper also presents a novel technique for the macula region localisation in order to detect the maculopathy. In addition to the proposed detection system, the paper highlights a novel online dataset and it presents the dataset collection, the expert diagnosis process and the advantages of our online database compared to other public eye fundus image databases for diabetic retinopathy purposes.

  1. Relationship between Type 2 Diabetic Retinopathy and Periodontal Disease in Iranian Adults

    Science.gov (United States)

    Amiri, Ahmad Ahmadzadeh; Maboudi, Avideh; Bahar, Adele; Farokhfar, Asadollah; Daneshvar, Fatemeh; Khoshgoeian, Hamid Reza; Nasohi, Mehdi; Khalilian, Alireza

    2014-01-01

    Background: Periodontal disease in diabetic patients can compromise a patient's ability to maintain a proper metabolic control and may be associated with diabetic complication. Aims: This study was designed to evaluate the frequency of periodontal disease in patients with type 2 diabetes mellitus (DM) and how this was related with the presence of diabetic retinopathy (DR). Materials and Methods: A comparison was made of periodontal parameters (plaque index (PI), community periodontal index of treatment needs (CPITN), periodontal disease severity measured in quartiles of probing depth (PD), and clinical attachment loss (CAL)) in a group of diabetic patients with retinopathy (n = 84) versus a group of diabetic patients without retinopathy (n = 129). In addition, 73 age- and sex-matched individuals were selected to serve as the control group. Analysis was performed to evaluate the relationships between periodontal disease and DR. Results: In terms of PI, no statistically significant differences were observed, so, oral hygiene was similar in both groups. Diabetic patients with retinopathy had greater CPITN (P periodontal disease (P periodontal disease. Conclusions: The patients with diabetes retinopathy appear to show increased periodontal disease susceptibility. PMID:24741553

  2. Endoplasmic reticulum stress in pathogenesis of diabetic retinopathy and effect of calcium dobesilate

    Institute of Scientific and Technical Information of China (English)

    Yu-Min Gui; Ming Zhao; Jie Ding

    2016-01-01

    Objective:To study the mechanism of endoplasmic reticulum stress in the pathogenesis of diabetic retinopathy and effect of calcium dobesilate.Methods:A total of 120 diabetic retinopathy patients treated in our hospital from January 2010 to September 2015 were enrolled in this article. The serum endoplasmic reticulum stress protein and interleukin protein expression levels were analyzed before and after calcium dobesilate treatment. A total of 55 cases of healthy subjects receiving physical examination in our hospital during the same period were taken as control group.Results:Serum endoplasmic reticulum stress proteins PERK, CHOP and IRE as well as interleukin proteins IL1, IL2, IL6 and IL10 expression significantly increased, serum MDA level significantly increased while SOD, CAT and GSHpx levels significantly decreased in diabetic retinopathy patients, and compared with control group (P<0.01); after calcium dobesilate treatment, above factors were significantly restored (P<0.01).Conclusions: Diabetic retinopathy is closely related to endoplasmic reticulum stress and calcium dobesilate treatment may improve diabetic retinopathy by inhibiting endoplasmic reticulum stress.

  3. Detection of neovascularization based on fractal and texture analysis with interaction effects in diabetic retinopathy.

    Directory of Open Access Journals (Sweden)

    Jack Lee

    Full Text Available Diabetic retinopathy is a major cause of blindness. Proliferative diabetic retinopathy is a result of severe vascular complication and is visible as neovascularization of the retina. Automatic detection of such new vessels would be useful for the severity grading of diabetic retinopathy, and it is an important part of screening process to identify those who may require immediate treatment for their diabetic retinopathy. We proposed a novel new vessels detection method including statistical texture analysis (STA, high order spectrum analysis (HOS, fractal analysis (FA, and most importantly we have shown that by incorporating their associated interactions the accuracy of new vessels detection can be greatly improved. To assess its performance, the sensitivity, specificity and accuracy (AUC are obtained. They are 96.3%, 99.1% and 98.5% (99.3%, respectively. It is found that the proposed method can improve the accuracy of new vessels detection significantly over previous methods. The algorithm can be automated and is valuable to detect relatively severe cases of diabetic retinopathy among diabetes patients.

  4. Is hypertension a major independent risk factor for retinopathy in type 1 diabetes?

    DEFF Research Database (Denmark)

    Nørgaard, K; Feldt-Rasmussen, B; Deckert, T

    1991-01-01

    Hypertension is an established risk factor for retinopathy. Whether it is an independent risk factor or acts only by association with nephropathy is not known. Therefore, we studied 273 Type 1 diabetic patients. They were divided into four groups. Group 1 (n = 55) were normotensive and normoalbum......Hypertension is an established risk factor for retinopathy. Whether it is an independent risk factor or acts only by association with nephropathy is not known. Therefore, we studied 273 Type 1 diabetic patients. They were divided into four groups. Group 1 (n = 55) were normotensive...... and normoalbuminuric, group 2 (n = 51) had hypertension but were normoalbuminuric, group 3 (n = 33) had nephropathy but were normotensive, and group 4 (n = 134) had nephropathy and hypertension. Hypertensive patients with normoalbuminuria (blood pressure 146 +/- 19 (+/-SD)/87 +/- 12 mmHg) had the same prevalence...... of retinopathy as normoalbuminuric normotensive patients (123 +/- 12/75 +/- 5 mmHg). Hypertensive nephropathic patients (blood pressure 147 +/- 18/87 +/- 8 mmHg) had more retinopathy than hypertensive normoalbuminuric patients despite similar blood pressure (normal retina/advanced retinopathy: 3%/73% vs 46...

  5. Diabetic retinopathy in pregnancy: a population-based study of women with pregestational diabetes.

    LENUS (Irish Health Repository)

    Egan, Aoife M

    2015-04-01

    The aim of this observational study was to evaluate screening and progression of diabetic retinopathy during pregnancy in women with pregestational diabetes attending five antenatal centres along the Irish Atlantic seaboard. An adequate frequency of screening was defined as at least two retinal evaluations in separate trimesters. Progression was defined as at least one stage of deterioration of diabetic retinopathy and\\/or development of diabetic macular edema on at least one eye. Women with pregestational diabetes who delivered after 22 gestational weeks (n = 307) were included. In total, 185 (60.3%) had an adequate number of retinal examinations. Attendance at prepregnancy care was associated with receiving adequate screening (odds ratio 6.23; CI 3.39-11.46 (P < 0.001)). Among those who received adequate evaluations (n = 185), 48 (25.9%) had retinopathy progression. Increasing booking systolic blood pressure (OR 1.03, CI 1.01-1.06, P = 0.02) and greater drop in HbA1c between first and third trimesters of pregnancy (OR 2.05, CI 1.09-3.87, P = 0.03) significantly increased the odds of progression. A significant proportion of women continue to demonstrate retinopathy progression during pregnancy. This study highlights the role of prepregnancy care and the importance of close monitoring during pregnancy and identifies those patients at the highest risk for retinopathy progression.

  6. 早产儿视网膜病变的发病率及防治%Incidence Rate and Prevention and Cure of Retinopathy of Prematurity

    Institute of Scientific and Technical Information of China (English)

    田丽敏; 闫安; 吴素英

    2016-01-01

    早产儿视网膜病变(ROP)是儿童致盲的主要原因之一,无论在发达国家或发展中国家,都普遍存在视网膜致盲问题。随着新生儿重症监护技术的改善和新生儿护理技术的提高,早产儿及低出生体重儿的生存率逐步提高,早产儿视网膜病变的发病率呈逐年上升趋势。为提早预防、降低ROP发病率、改善预后提供科学的依据,现对各国ROP的发病率及防治进行综述。%The retinopathy of prematurity is one of the major causes of occoecatio in children, no matter in the developed country or in the developing country, and the retinopathy of prematurity issue is common, with the improvement of neonatal intensive care technologies and neonatal nursing technologies, the survival rate of premature and low birth weight infants gradually increases, and the incidence rate of retinopathy of prematurity shows an increasing trend annually, the paper pro-vides a scientific basis for early prevention, reducing the incidence rate of ROP and improving the prognosis and summa-rizes the incidence rate of ROP and prevention and cure.

  7. Web-based screening for diabetic retinopathy in a primary care population: The EyeCheck Project

    NARCIS (Netherlands)

    Abramoff, M.D.; Suttorp-Schulten, M.S.A.

    2005-01-01

    The objective of this study was to evaluate the feasibility of ATA category 2 Web-based screening for diabetic retinopathy in a primary care population in the Netherlands. A total of 1,676 patients in a primary care setting, with diabetes, without known diabetic retinopathy, and without previous scr

  8. Lipoprotein(a as a risk factor for diabetic retinopathy in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Chopra Rupali

    2007-01-01

    Full Text Available Aims: To estimate serum lipoprotein(a [Lp(a] levels in patients with type 2 diabetes mellitus with and without diabetic retinopathy and to determine the correlation, if any, between serum Lp(a levels and severity of diabetic retinopathy. Materials and Methods: The study included a total of 200 patients of type 2 diabetes mellitus out of which 100 patients who had no retinopathy served as the control group and 100 patients with diabetic retinopathy formed the study group. A detailed fundus examination was done with dilated pupil. The Lp(a levels were measured quantitatively in fasting venous samples by an immunoturbidimetric method using commercially available kits (Clonital. Statistical Analysis Used: Group comparisons involving qualitative measures were carried out using Chi square test. ANOVA procedure was applied for comparing group means. Logistic regression analysis was performed for independent factors associated with diabetic retinopathy. Results: The average Lp(a levels in the study group (68.5 mg/dl were significantly higher than in the control group (25.1 mg/dl ( P < 0.001. The Lp(a levels were found to increase with increasing severity of diabetic retinopathy. Conclusions: Serum Lp(a levels are significantly raised in patients with diabetic retinopathy as compared to those with no retinopathy.

  9. Association between new onset diabetic retinopathy and monocyte chemoattractant protein-1 (MCP-1) polymorphism in Japanese type 2 diabetes.

    Science.gov (United States)

    Ninomiya, Hiroyo; Katakami, Naoto; Osonoi, Takeshi; Saitou, Miyoko; Yamamoto, Yuichi; Takahara, Mitsuyoshi; Kawamori, Dan; Matsuoka, Taka-aki; Yamasaki, Yoshimitsu; Shimomura, Iichiro

    2015-06-01

    We longitudinally evaluated the association between monocyte chemoattractant protein-1 (MCP-1) A-2518G polymorphism and new onset of diabetic retinopathy in 758 type 2 diabetic patients. The new onset of retinopathy increased with the increase of the number of G alleles, even after adjustment for age, HbA1c levels, and duration of diabetes.

  10. Planning and developing services for diabetic retinopathy in Sub-Saharan Africa.

    Science.gov (United States)

    Poore, Sophie; Foster, Allen; Zondervan, Marcia; Blanchet, Karl

    2015-01-01

    Over the past few decades diabetes has emerged as an important non-communicable disease in Sub-Saharan Africa (SSA). Sight loss from Diabetic Retinopathy (DR) can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services. A multiple-case study approach was used to analyse five DR screening services in Botswana, Ghana, Tanzania and Zambia. Cases included: two regional screening programmes, two hospital-based screening services and one nationwide screening service. Data was collected using qualitative methodologies including: document analysis, in-depth interviews and observation. The World Health Organization (WHO) Health Systems Framework was adopted as the conceptual framework for analysis. Planning for a sustainable and integrated DR screening programme demanded a health systems approach. Collaboration with representatives from a variety of ministerial departments and professional bodies was required. Evolution of DR screening services may occur in a variety of ways including: increasing geographical coverage, integration into the general healthcare system, and stepwise progression from a passive, opportunistic service to one that systematically and proactively seeks to prevent DR. Lessons learned from the implementation of cervical cancer prevention programmes in resource-poor settings may assist the development of DR programmes in similar settings. To promote good planning of DR screening services and ensure limited resources are used effectively, there is a need to learn from screening programmes in other medical specialities and a need to share experiences between newly-developing DR programmes in resource-poor countries. The WHO Health Systems Framework presents an invaluable tool to ensure a systematic approach to planning DR screening services.

  11. Planning and Developing Services for Diabetic Retinopathy in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Sophie Poore

    2015-01-01

    Full Text Available Background Over the past few decades diabetes has emerged as an important non-communicable disease in SubSaharan Africa (SSA. Sight loss from Diabetic Retinopathy (DR can be prevented with screening and early treatment. The objective of this paper is to outline the required actions and considerations in the planning and development of DR screening services. Methods A multiple-case study approach was used to analyse five DR screening services in Botswana, Ghana, Tanzania and Zambia. Cases included: two regional screening programmes, two hospital-based screening services and one nationwide screening service. Data was collected using qualitative methodologies including: document analysis, indepth interviews and observation. The World Health Organization (WHO Health Systems Framework was adopted as the conceptual framework for analysis. Results Planning for a sustainable and integrated DR screening programme demanded a health systems approach. Collaboration with representatives from a variety of ministerial departments and professional bodies was required. Evolution of DR screening services may occur in a variety of ways including: increasing geographical coverage, integration into the general healthcare system, and stepwise progression from a passive, opportunistic service to one that systematically and proactively seeks to prevent DR. Lessons learned from the implementation of cervical cancer prevention programmes in resource-poor settings may assist the development of DR programmes in similar settings. Conclusion To promote good planning of DR screening services and ensure limited resources are used effectively, there is a need to learn from screening programmes in other medical specialities and a need to share experiences between newly-developing DR programmes in resource-poor countries. The WHO Health Systems Framework presents an invaluable tool to ensure a systematic approach to planning DR screening services.

  12. Treatment for retinopathy of prematurity in Denmark in a ten-year period (1996-2005): Is the incidence increasing?

    DEFF Research Database (Denmark)

    Slidsborg, C.; Olesen, H.B.; Jensen, Peter Koch

    2008-01-01

    OBJECTIVE. The objective of this study was to analyze the population incidence of retinopathy of prematurity treatment in Denmark in the 10-year period from 1996 to 2005. METHODS. Patient charts of infants treated for retinopathy of prematurity and the national birth registry provide information...... about neonatal parameters. These parameters, along with birth in the latter half of the period (2001-2005), were analyzed as risk factors for retinopathy of prematurity. The national registry for blind and visually impaired children was accessed to obtain information about visual impairment attributable....... The incidence of treated retinopathy of prematurity cases increased significantly from 1.3% in 1996 to 2000 to 3.5% in 2001 to 2005. Significant risk factors for retinopathy of prematurity treatment were low gestational age, small for gestational age, male gender, and multiple birth. Other, yet unknown factors...

  13. Comparison of Manual Refraction Versus Autorefraction in 60 Diabetic Retinopathy Patients

    Science.gov (United States)

    Shirzadi, Keyvan; Shahraki, Kourosh; Yahaghi, Emad; Makateb, Ali; Khosravifard, Keivan

    2016-01-01

    Aim: The purpose of the study was to evaluate the comparison of manual refraction versus autorefraction in diabetic retinopathy patients. Material and Methods: The study was conducted at the Be’sat Army Hospital from 2013-2015. In the present study differences between two common refractometry methods (manual refractometry and Auto refractometry) in diagnosis and follow up of retinopathy in patients affected with diabetes is investigated. Results: Our results showed that there is a significant difference in visual acuity score of patients between manual and auto refractometry. Despite this fact, spherical equivalent scores of two methods of refractometry did not show a significant statistical difference in the patients. Conclusion: Although use of manual refraction is comparable with autorefraction in evaluating spherical equivalent scores in diabetic patients affected with retinopathy, but in the case of visual acuity results from these two methods are not comparable. PMID:27703289

  14. (Unreceptiveness in interactions with professionals: experiences of parents of children with retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Beatriz Castanheira Facio

    Full Text Available Abstract OBJECTIVE To analyze the influence of health professionals' receptiveness on parental care of children with retinopathy of prematurity (ROP. METHOD A qualitative study developed under the theoretical framework of Symbolic Interactionism and using a narrative research methodology. Six women and three men, being parents of children with retinopathy of prematurity were individually interviewed in depth. RESULTS From the scope of information, emotions and their rights, the parents experienced receptiveness from some professionals and unreceptiveness from others. The predominance of unreceptive attitudes in the parental narratives originated the following analysis themes: Informational (unreceptiveness, Emotional (unreceptiveness, and (Unreceptiveness of rights. CONCLUSION The study supports human and comprehensive healthcare in the context of retinopathy of prematurity by pointing out the interactive process with health professionals as a potential stressor of parental care. The results signal a nuclear of attitudinal changes and reinforce challenges to the child and family-centered approach.

  15. Circulating thrombomodulin and hematological alterations in type 2 diabetic patients with retinopathy.

    Science.gov (United States)

    Fujiwara, Y; Tagami, S; Kawakami, Y

    1998-01-01

    To clarify the relationship between circulating thrombomodulin (TM) and endothelial cell damage in diabetes mellitus, plasma levels of TM were quantitated by an enzyme linked immunoabsorbant assay (ELISA) in 164 type 2 diabetes mellitus and 72 normal control subjects, and these levels were compared with those of von Willebrand factor antigen (vWf: Ag), thrombin antithrombin III complexes (TAT), plasmin-alpha2-plasmin inhibitor complexes (PIC), fibrinogen, D-dimer, urinary albumin excretion rate (AER), intima-media thickness (IMT) and plaque score of the common carotid artery assessed with high resolution B-mode ultrasonography. Plasma levels of TM, vWf: Ag, TAT, PIC, AER, IMT and plaque score were significantly increased in the diabetic patients compared to the normal control subjects. Plasma TM levels showed significant correlation with vWf: Ag (r=0.350, pPIC (r = 0.450, p sex, systolic and diastolic blood pressure levels, HbA,1c, or plasma lipid levels, although the plasma levels of TM, vWf: Ag, TAT, PIC, AER, IMT and the plaque score in the patients with proliferative retinopathy were significantly higher than those of the healthy controls and patients with simple retinopathy. Among the 43 normoalbuminuric patients without intima-media thickness or thickened plaque (AERPIC were significantly higher in those patients with retinopathy than in those without retinopathy. Multivariate analysis showed TM, TAT and PIC levels to be independent predictors of diabetic retinopathy. In conclusion, circulating TM reflects endothelial cell damage in patients with diabetic retinopathy, and hypercoagulability might play an important role in endothelial cell damage.

  16. Genome-wide association study of retinopathy in individuals without diabetes.

    Directory of Open Access Journals (Sweden)

    Richard A Jensen

    Full Text Available BACKGROUND: Mild retinopathy (microaneurysms or dot-blot hemorrhages is observed in persons without diabetes or hypertension and may reflect microvascular disease in other organs. We conducted a genome-wide association study (GWAS of mild retinopathy in persons without diabetes. METHODS: A working group agreed on phenotype harmonization, covariate selection and analytic plans for within-cohort GWAS. An inverse-variance weighted fixed effects meta-analysis was performed with GWAS results from six cohorts of 19,411 Caucasians. The primary analysis included individuals without diabetes and secondary analyses were stratified by hypertension status. We also singled out the results from single nucleotide polymorphisms (SNPs previously shown to be associated with diabetes and hypertension, the two most common causes of retinopathy. RESULTS: No SNPs reached genome-wide significance in the primary analysis or the secondary analysis of participants with hypertension. SNP, rs12155400, in the histone deacetylase 9 gene (HDAC9 on chromosome 7, was associated with retinopathy in analysis of participants without hypertension, -1.3±0.23 (beta ± standard error, p = 6.6×10(-9. Evidence suggests this was a false positive finding. The minor allele frequency was low (∼2%, the quality of the imputation was moderate (r(2 ∼0.7, and no other common variants in the HDAC9 gene were associated with the outcome. SNPs found to be associated with diabetes and hypertension in other GWAS were not associated with retinopathy in persons without diabetes or in subgroups with or without hypertension. CONCLUSIONS: This GWAS of retinopathy in individuals without diabetes showed little evidence of genetic associations. Further studies are needed to identify genes associated with these signs in order to help unravel novel pathways and determinants of microvascular diseases.

  17. Classification of diabetic retinopathy using fractal dimension analysis of eye fundus image

    Science.gov (United States)

    Safitri, Diah Wahyu; Juniati, Dwi

    2017-08-01

    Diabetes Mellitus (DM) is a metabolic disorder when pancreas produce inadequate insulin or a condition when body resist insulin action, so the blood glucose level is high. One of the most common complications of diabetes mellitus is diabetic retinopathy which can lead to a vision problem. Diabetic retinopathy can be recognized by an abnormality in eye fundus. Those abnormalities are characterized by microaneurysms, hemorrhage, hard exudate, cotton wool spots, and venous's changes. The diabetic retinopathy is classified depends on the conditions of abnormality in eye fundus, that is grade 1 if there is a microaneurysm only in the eye fundus; grade 2, if there are a microaneurysm and a hemorrhage in eye fundus; and grade 3: if there are microaneurysm, hemorrhage, and neovascularization in the eye fundus. This study proposed a method and a process of eye fundus image to classify of diabetic retinopathy using fractal analysis and K-Nearest Neighbor (KNN). The first phase was image segmentation process using green channel, CLAHE, morphological opening, matched filter, masking, and morphological opening binary image. After segmentation process, its fractal dimension was calculated using box-counting method and the values of fractal dimension were analyzed to make a classification of diabetic retinopathy. Tests carried out by used k-fold cross validation method with k=5. In each test used 10 different grade K of KNN. The accuracy of the result of this method is 89,17% with K=3 or K=4, it was the best results than others K value. Based on this results, it can be concluded that the classification of diabetic retinopathy using fractal analysis and KNN had a good performance.

  18. HELLP Syndrome Complicated with Postpartum Subcapsular Ruptured Liver Hematoma and Purtscher-Like Retinopathy

    Directory of Open Access Journals (Sweden)

    Daniela Cernea

    2012-01-01

    Full Text Available Purtscher's retinopathy is usually associated with trauma, acute pancreatitis, vasculitis, lupus, and bone fractures. It was rarely described postpartum in patients with preeclampsia as well as associated with HELLP syndrome. We present a case of a multiparous patient aged 44 with severe preeclampsia and postpartum HELLP syndrome complicated with Purtscher-like retinopathy and large ruptured subcapsular liver hematoma that required emergency abdominal surgery after premature delivery of a dead fetus. Postsurgical outcome was favorable regarding both liver function and visual acuity.

  19. Pigmentary retinopathy due to Bardet-Biedl syndrome: case report and literature review.

    Science.gov (United States)

    Andrade, Luis Jesuino de Oliveira; Andrade, Rafael; França, Caroline Santos; Bittencourt, Alcina Vinhaes

    2009-01-01

    Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disorder with clinical and genetic heterogeneity. This syndrome was first described by Laurence and Moon in 1866 and additional cases were described by Bardet and Biedl between 1920 and 1922. The main features are obesity, polydactyly, pigmentary retinopathy, learning disabilities, various degrees of intellectual impairment, hypogonadism, and renal abnormalities. Bardet-Biedl syndrome is both phenotypically and genetically heterogeneous. Clinical diagnosis is based on the presence of 4 of the 5 cardinal features. The authors present a typical case of pigmentary retinopathy due to Bardet-Biedl syndrome and made a brief commentary about the disease's cardinal manifestations.

  20. Is Smoking a Risk Factor for Proliferative Diabetic Retinopathy in Type 1 Diabetes?

    DEFF Research Database (Denmark)

    Gaedt Thorlund, Mie; Borg Madsen, Mette; Green, Anders

    2013-01-01

    Aim: The aim was to evaluate if smoking was a risk factor for proliferative retinopathy (PDR) in a 25-year follow-up study. Methods: 201 persons from a population-based cohort of Danish type 1 diabetic patients were examined at baseline and again 25 years later. At both examinations the patients...... were asked about their smoking habits. The level of retinopathy was evaluated by ophthalmoscopy at baseline and by nine 45-degree colour field fundus photos at the follow-up. Results: In multivariate analyses there was a trend that current smokers at baseline were more likely to develop PDR...

  1. Relationship between retinal vessel diameters and retinopathy in the Inter99 Eye Study

    DEFF Research Database (Denmark)

    Drobnjak, Dragana; Munch, Inger Christine; Glümer, Charlotte

    2017-01-01

    .001), and decreased with higher HDL cholesterol (p  diabetes, but not in participants without diabetes......© 2017 The Authors Purpose To examine the association between retinal vessel diameters and retinopathy in participants with and without type 2 diabetes in a Danish population-based cohort. Methods The study included 878 persons aged 30 to 60 years from the Inter99 Eye Study. Retinopathy was defined...... as a presence of one or more retinal hemorrhages or one or more microaneurysms. Vessel diameters were expressed as central retinal artery equivalent diameter (CRAE) and central retinal vein equivalent diameter (CRVE). Multiple linear regression analyses were performed. Results Among participants with diabetes...

  2. Sub-Tenon′s triamcinolone for post-partum Purtscher′s-like retinopathy

    Directory of Open Access Journals (Sweden)

    Jeffrey Olson

    2008-03-01

    Full Text Available Jeffrey Olson, Behnaz Rouhani, Naresh MandavaRocky Mountain Lions Eye Institute, University of Colorado Health Sciences Center, Department of Ophthalmology, Denver, CO, USAAbstract: Sub-Tenon’s injection of triamcinolone was performed in the right eye of a patient with bilateral Purtscher’s-like retinopathy after childbirth. The response of macular edema to local triamcinolone was investigated with optical coherence tomography. Five weeks following the injection, optical coherence tomography improvement was seen following unilateral sub-Tenon’s triamcinolone injection.Keywords: Purtscher’s-like retinopathy; triamcinolone; post-partum decreased vision

  3. The course of nonproliferative diabetic retinopathy following ECCE with posterior chamber IOL implantation.

    Science.gov (United States)

    Raniel, Y; Teichner, Y; Friedman, Z

    1994-01-01

    A prospective study on the effect of ECCE + IOL implantation on the course of diabetic retinopathy (DR) in 59 eyes showed that in one to three years following surgery, progression of DR, including the development of newly formed one, occurred in 28.8% of the eyes. This was more marked in patient with IDDM (IDDM-46%, NIDDM-24%) as well as in eyes with pre-operative BDR (pre-operative BDR-62.5%, no pre-operative BDR-16.3%). Final visual acuity was better in eyes without pre-operative DR as well as in eyes that did not show progression of the retinopathy.

  4. A Case of Proliferative Retinopathy Complicated with Tuberous Sclerosis Treated by Vitreous Surgery

    Science.gov (United States)

    Nemoto, Emika; Morishita, Seita; Akashi, Mari; Kohmoto, Ryohsuke; Fukumoto, Masanori; Suzuki, Hiroyuki; Kobayashi, Takatoshi; Kida, Teruyo; Sugasawa, Jun; Ikeda, Tsunehiko

    2016-01-01

    We report a case of proliferative retinopathy complicated with retinal hamartoma in a tuberous sclerosis patient. This study involved a 16-year-old female patient who was diagnosed as having tuberous sclerosis at birth. Ophthalmic examination revealed retinal hamartoma surrounding the optic disc in both eyes. Vitreous surgery involving a vitrectomy and resection of the proliferative membranes was performed for proliferative retinopathy in her right eye. Postoperative fundus findings showed improvement and decreased exudative changes. The proliferative and exudative changes appeared to be due to the retinal hamartoma, and vitreous surgery proved effective in this case. PMID:28101046

  5. Anti-VEGF in a Marathon Runner’s Retinopathy Case

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    Alexander Kahjun Soon

    2016-01-01

    Full Text Available Central retinal vein occlusion (CRVO is one of the most common retinal vascular disorders. Intense exercise associated CRVO have been described in otherwise healthy young patients. We describe a case of a young male ultramarathoner who presented with a CRVO, presumably associated with dehydration, making part of a marathon runner’s retinopathy. Resolution of macular edema and subretinal fluid, with visual acuity improvement, was observed after 3 monthly injections of ranibizumab. Our case suggests that dehydration could be involved in the mechanism of CRVO in healthy young patients and ranibizumab may be an effective treatment option for marathon runner’s retinopathy.

  6. Intravitreal bevacizumab for persistent macular edema with proliferative diabetic retinopathy.

    Science.gov (United States)

    Gulkilik, Gokhan; Taskapili, Muhittin; Kocabora, Selim; Muftuoglu, Gulipek; Demirci, Goktug

    2010-12-01

    To evaluate the effectiveness of an intravitreal bevacizumab injection on retinal neovascularization and diabetic macular edema (DME) refractory to laser photocoagulation therapy. Thirty-four eyes of 22 patients with proliferative diabetic retinopathy and DME refractory to laser photocoagulation therapy received an intravitreal injection of 1.25 mg/0.05 ml of bevazicumab. Changes in mean best-corrected visual acuity (BCVA), central macular thickness (CMT), regression of neovascularization over time, and correlation between BCVA and CMT were evaluated. Follow-up visits were at weeks 1, 2 and 4 and months 3 and 6. Mean BCVA was significantly better than baseline only at week 2 (P = 0.036). Mean CMT decreased significantly from baseline at weeks 1, 2, and 4 (P = 0.001). At months 3 and 6, mean CMT increased, albeit insignificantly (P = 0.804 and P = 1.0). The decrease in fluorescein leakage was moderate in all eyes at the end of week 1. At week 2, there was total resolution of fluorescein leakage in 24 (70.5%) eyes and moderate resolution in 10 (29.5%) eyes. At the end of month 3, the fluorescein leakage was fully resolved in 5 (14.7%) eyes, moderately resolved in 24 (70.5%) eyes, and was similar to baseline in 5 (14.7%) eyes. At month 6, the fluorescein leakage was fully resolved in 3 (8.8%) eyes, moderately resolved in 20 (58.8%) eyes, and was similar to baseline in 11 (32.4%) eyes. A moderate but insignificant negative correlation was found between visual acuity and CMT (P > 0.05). Persistence or recurrence of neovascular tissue after panretinal photocoagulation may be attributed to the production of vascular endothelial growth factor by the residual ischemic retina, which also results in persistent or recurrent DME despite macular grid photocoagulation.

  7. Progression of diabetic retinopathy: the Beijing Eye Study

    Institute of Scientific and Technical Information of China (English)

    TU Ying; XU Liang; WEI Wen-bin; WANG Shuang; WANG Ya-xing; Jost B Jonas

    2011-01-01

    Background Diabetic retinopathy (DR) has emerged as a leading cause of visual impairment and blindness in the working-aged population worldwide.This study aimed to assess frequency and associated factors of progression of DR in subjects with known diabetes in a population-based setting.Methods The Beijing Eye Study is a population based study performed in Greater Beijing in 2001 and 2006.The present investigation included all subjects with known diabetes mellitus in 2001,who participated in the follow-up examination in 2006.Fundus photographs were assessed.Results The study included 170 subjects; 51 (30%) subjects showed signs of DR in 2001 and were re-examined in 2006,36 (21.2%) subjects (18 subjects with DR present at baseline,18 subjects with newly diagnosed DR in 2006)showed a progression of DR during follow-up.Progression of DR was associated with rural region (odds ratio (OR):5.43,P=0.001) and self-reported arterial hypertension (OR:3.85,P=0.023).In the non-progressive subgroup,presence of DR was associated with different levels of education (<middle school,middle school,college or higher,OR:0.30,P=0.023),treatment modes of diabetes mellitus (OR:10.24,P=0.003) and cataract surgery (OR:9.14,P=0.007).Conclusions In a population-based setting in Greater Beijing,progression of DR occurred in 35% of subjects with pre-existing DR and overall in 21% of subjects with known diabetes within a 5-year period.Progression of DR was significantly associated with rural region and self-reported arterial hypertension.In the stable subjects,presence of DR was significantly associated with poor educational level,insulin treatment of diabetes and cataract surgery.

  8. Neurotrophins and neurotrophin receptors in proliferative diabetic retinopathy.

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    Ahmed M Abu El-Asrar

    Full Text Available Neurotrophins (NTs are emerging as important mediators of angiogenesis and fibrosis. We investigated the expression of the NTs nerve growth factor (NGF, brain-derived neurotrophic factor (BDNF, neurotrophin-3 (NT-3, and neurotrophin-4 (NT-4 and their receptors TrkA, TrkB, and TrkC in proliferative diabetic retinopathy (PDR. As a comparison, we examined the expression of NTs and their receptors in the retinas of diabetic rats. Vitreous samples from 16 PDR and 15 nondiabetic patients were studied by Western blot analysis and enzyme-linked immunosorbent assay (ELISA. Epiretinal membranes from 17 patients with PDR were studied by immunohistochemistry. Rats were made diabetic with a single high dose of streptozotocin and retinas of rats were examined by Western blot analysis. Western blot analysis revealed a significant increase in the expression of NT-3 and NT-4 and the shedding of receptors TrkA and TrkB in vitreous samples from PDR patients compared to nondiabetic controls, whereas NGF and BDNF and the receptor TrkC were not detected with the use of Western blot analysis and ELISA. In epiretinal membranes, vascular endothelial cells and myofibroblasts expressed NT-3 and the receptors TrkA, TrkB and TrkC in situ, whereas NT-4 was not detected. The expression levels of NT-3 and NT-4 and the receptors TrkA and TrkB, both in intact and solubilized forms, were upregulated in the retinas of diabetic rats, whereas the receptor TrkC was not detected. Co-immunoprecipitation studies revealed binding between NT-3 and the receptors TrkA and TrkB in the retinas of diabetic rats. Our findings in diabetic eyes from humans and rats suggest that the increased expression levels within the NT-3 and NT-4/Trk axis are associated with the progression of PDR.

  9. Retinopathy of prematurity screening and treatment cost in Brazil.

    Science.gov (United States)

    Zin, Andrea A; Magluta, Cynthia; Pinto, Márcia F T; Entringer, Aline P; Mendes-Gomes, Maria A; Moreira, Maria E L; Gilbert, Clare

    2014-07-01

    To assess the additional cost of incorporating the detection and treatment of retinopathy of prematurity (ROP) into neonatal care services of Brazil's Unified Health System (SUS). A deterministic decision-tree simulation model was built to estimate the direct costs of screening for and treating ROP in neonatal intensive-care units (NICUs), based on data for 869 preterm infants with birth weight less than 1 500 g examined in six governmental NICUs in the capital city of Rio de Janeiro, where coverage was 52% and 8% of infants were treated. All of the parameters from this study were extrapolated to Brazilian newborn estimates in 2010. Costs of screening and treatment were estimated considering staff, equipment and maintenance, and training based on published data and expert opinion. A budget impact analysis was performed considering the population of preterm newborns, screening coverage, and the incidence of treatable ROP. One- and two-way sensitivity analyses were performed. In Rio de Janeiro, unit costs per newborn were US$ 18 for each examination, US$ 398 per treatment, and US$ 29 for training. The estimated cost of ROP diagnosis and treatment for all at-risk infants NICUs was US$ 80 per infant. The additional cost to the SUS for one year would be US$ 556 640 for a ROP program with 52% coverage, increasing to US$ 856 320 for 80% coverage, and US$ 1.07 million or 100% coverage. The results of this study indicate that providing ROP care is affordable within the framework of the SUS in Brazil, and might be feasible elsewhere in Latin America, considering the evidence of the effectiveness of ROP treatment and the social benefits achieved.

  10. A review of malarial retinopathy in severe malaria

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    H. L. Sithole

    2011-12-01

    Full Text Available The ocular manifestations of severe malaria in patients with cerebral malaria (CM include retinal whitening, vessel discolouration, retinal haemorrhages and papilloedema. A large prospective study of Malawian children with CM found that the severity of retinal signs, including the number of retinal haemorrhages, was related to the outcome and length of coma in survivors of malaria. In a smaller number of Kenyan children with cerebral malaria, retinal haemorrhages were associated with deep coma and severe anaemia. A study on the effect of malarial retinopathy on vision found no detectable effect on visual acuity (VA but where malaria isaggravated by failure to receive treatment this may possibly affect VA. The failure to receive treatment may be directly linked to the socio-economic status (SES of those affected and this may occur in the KwaZulu-Natal, Mpumalanga and Limpopo provinces of South Africa where malaria is endemic. This suggests the need for effective health education and health promotion amongst those affected by malaria especially in severely affected provinces of South Africa. Also, in view of the direct ocular consequences of severe malaria, optometrists should engage communities in health education and health promotion. This is particularly relevant because in some communities, a large majority of those suffering from malarial infections do not visit formal health facilities for treatment. In so doing, optometrists in South Africa will be contributing positively to the Millennium Development Goals which seek, amongst others, to reduce unwarranted sources of morbidity worldwide. (S Afr Optom 2011 70(3 129-135 

  11. Screening for diabetic retinopathy using computer vision and physiological markers.

    Science.gov (United States)

    Hann, Christopher E; Revie, James A; Hewett, Darren; Chase, J Geoffrey; Shaw, Geoffrey M

    2009-07-01

    Hyperglycemia and diabetes result in vascular complications, most notably diabetic retinopathy (DR). The prevalence of DR is growing and is a leading cause of blindness and/or visual impairment in developed countries. Current methods of detecting, screening, and monitoring DR are based on subjective human evaluation, which is also slow and time-consuming. As a result, initiation and progress monitoring of DR is clinically hard. Computer vision methods are developed to isolate and detect two of the most common DR dysfunctions-dot hemorrhages (DH) and exudates. The algorithms use specific color channels and segmentation methods to separate these DR manifestations from physiological features in digital fundus images. The algorithms are tested on the first 100 images from a published database. The diagnostic outcome and the resulting positive and negative prediction values (PPV and NPV) are reported. The first 50 images are marked with specialist determined ground truth for each individual exudate and/or DH, which are also compared to algorithm identification. Exudate identification had 96.7% sensitivity and 94.9% specificity for diagnosis (PPV = 97%, NPV = 95%). Dot hemorrhage identification had 98.7% sensitivity and 100% specificity (PPV = 100%, NPV = 96%). Greater than 95% of ground truth identified exudates, and DHs were found by the algorithm in the marked first 50 images, with less than 0.5% false positives. A direct computer vision approach enabled high-quality identification of exudates and DHs in an independent data set of fundus images. The methods are readily generalizable to other clinical manifestations of DR. The results justify a blinded clinical trial of the system to prove its capability to detect, diagnose, and, over the long term, monitor the state of DR in individuals with diabetes. Copyright 2009 Diabetes Technology Society.

  12. Reduced levels of brain derived neurotrophic factor (BDNF) in the serum of diabetic retinopathy patients and in the retina of diabetic rats.

    Science.gov (United States)

    Ola, M Shamsul; Nawaz, Mohd Imtiaz; El-Asrar, Ahmed Abu; Abouammoh, Marwan; Alhomida, Abdullah S

    2013-04-01

    Diabetic retinopathy (DR) is widely recognized as a neurovascular disease. Retina, being a neuronal tissue of the eye, produces neurotrophic factors for its maintenance. However, diabetes dysregulates their levels and thereby may damage the retina. Among neurotrophins, brain derived neurotrophic factor (BDNF) is the most abundant in the retina. In this study, we investigated the level of BDNF in the serum of patients with DR and also in the serum and retina of streptozotocin-induced diabetic rats. The level of BDNF was significantly decreased in the serum of proliferative diabetic retinopathy patients as compared to that of non-diabetic healthy controls (25.5 ± 8.5-10.0 ± 8.1 ng/ml, p BDNF in the serum and retina of diabetic rats were also significantly reduced compared to that of non-diabetic controls (p TrkB) was significantly decreased in diabetic rat retina compared to that of non-diabetic controls as determined by Western blotting technique. Caspase-3 activity was increased in diabetic rat retina after 3 weeks of diabetes and remained elevated until 10 weeks, which negatively correlated with the level of BDNF (r = -0.544, p = 0.013). Our results indicate that reduced levels of BDNF in diabetes may cause apoptosis and neurodegeneration early in diabetic retina, which may lead to neuro-vascular damage later in DR.

  13. Update on Diagnosis and Treatment of Diabetic Retinopathy: A Consensus Guideline of the Working Group of Ocular Health (Spanish Society of Diabetes and Spanish Vitreous and Retina Society

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    Borja Corcóstegui

    2017-01-01

    Full Text Available A group of members of the Spanish Retina and Vitreous Society (SERV and of the Working Group of Ocular Health of the Spanish Society of Diabetes (SED updated knowledge regarding the diagnosis and treatment of diabetic retinopathy (DR based on recent evidence reported in the literature. A synthesis of this consensus forms the basis of the present review, which is intended to inform clinicians on current advances in the field of DR and their clinical applicability to patients with this disease. Aspects presented in this article include screening procedures of DR, new technologies in the early diagnosis of DR, control of risk factors in the different stages of the disease, indications of panretinal laser photocoagulation, efficacy of intravitreal antiangiogenic agents and steroids, and surgical options for treating DR-related complications. Practical information regarding periodicity of screening procedures in patients with type 1 and type 2 diabetes, ophthalmological controls according to the stage of retinopathy and complications, and criteria and degree of urgency for referral of a DR patient to the ophthalmologist are also presented.

  14. Research progress in treatment of retinopathy of prematurity%早产儿视网膜病变治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    欧阳丽娟; 皮练鸿

    2015-01-01

    早产儿视网膜病变(retinopathy of prematurity,ROP)是全世界儿童致盲的主要原因之一,早期发现和及时治疗可以有效地终止大部分患儿病变的进展。阈值期和高危阈值前期 ROP 是 ROP 是否需要治疗的分水岭。目前 ROP 主要的治疗方式为激光治疗,新型的药物抗血管内皮生成因子(Anti-VEGF)成为近年来研究的热点。本文就 ROP 的治疗进展作一综述。%Retinopathy of prematurity (ROP) is one of the major causes of childhood blindness. in the world,early identification and treatment could end the progress of most patients effectively. Threshold and high-risk prethreshold disease are the boundary to decide whether treatment or not. Nowadays the main therapy of ROP is photocoagulation, Anti-vascular endothelial growth factor(Anti-VEGF)as a new drug has been a research hotspot in recent years. The main aim of this review is to introduce the new progress in the studies on ROP.

  15. A CLINICAL STUDY ON INCIDENCE OF RETINOPATHY OF PREMATURITY CHANGES IN PRETERM INFANTS AND ASSOCIATED RISK FACTORS IN A TERTIARY CENTRE

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    Sneha

    2014-03-01

    Full Text Available OBJECTIVE: This is a hospital based, prospective clinical study on incidence of retinopathy of prematurity changes in preterm infants and associated risk factors. METHODS: Neonates with gestational age <37wks and/ or birth weight ≤ 2500gms born over one year period were examined by indirect ophthalmoscopy between 2 to 4 weeks after birth, and followed up till retinal vascularization was complete. Maternal and neonatal risk factors were noted and data analyzed by statistical package SPSS-15. RESULTS: 100 babies were thus examined. The overall incidence of retinopathy of prematurity was 40%, 22%in babies’ ≤34wks of gestation and 52% in babies with a birth weight1500-2000g. Majority were in stage 2. Gestational age (<32weeks, Birth weight (<1500g, RDS, surfactant therapy, PDA were found to be risk factors. CONCLUSION: Meticulous fundus examination with indirect ophthalmoscopy in all preterm babies with gestational age<37weeks and birth weight ≤ 2500gms is essential noninvasive method for early detection of ROP and its progression. Screening should be intensified in the presence of factors like RDS, oxygen administration and presence of PDA

  16. Indocyanine Green Angiographic and Multifocal Electroretinographic Features in the Diffuse and Regional Form of Bietti′s Crystalline Retinopathy

    Institute of Scientific and Technical Information of China (English)

    Libin Jiang; Feng Wen; Lezheng Wu; Hong Yan; Shixing Hu

    2002-01-01

    Prpose: To observe different features of indocyanine green angiography(ICGA) andtifocal electroretinography (ERG) in the diffuse and regional type of Bieti′sc stalline retinopathy (BCR). Thods: ICGA and the multifocal ERG were performed in two cases of the diffuse andregional type of BCR respectively. These data were compared with fluoresceinangiography (FA), standard Ganzfeld ERG, and visual field testing. Results: In the regional case, ICGA revealed reduced perfusion of the choroidalcirculation in the early phase and multiple hypofluorescent spots in the posterior pole in the late phase, due to choriocapillaris filling defect; the extent of choroiocapillaris losswas shown in early phase of ICGA and there were multifocal hyperfluorescent dotssurrounding hypofluorescent spots in late phase in the diffuse case. The multifocal ERGshowed that the central responses were markedly depressed, corresponding to the visualfield defects, while the findings of Ganzfeld ERG were normal in the regional BCR;however, both the multifocal ERG and Ganzfeld ERG were severely subnormal in thediffuse case.Conclusions: The features of ICGA and multifocal ERG are different between the diffuseand regional BCR. In the meantime, the two tools are also useful to differentiate the typeand assess the extentof evolution in BCR.

  17. Changing Clinical Presentation, Current Knowledge-Attitude-Practice, and Current Vision Related Quality of Life in Self-Reported Type 2 Diabetes Patients with Retinopathy in Eastern India: The LVPEI Eye and Diabetes Study.

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    Das, Taraprasad; Wallang, Batriti; Semwal, Preeti; Basu, Soumyava; Padhi, Tapas R; Ali, Mohd Hasnat

    2016-01-01

    Purpose. To document the changing clinical presentation of diabetic retinopathy (DR) over a decade, the current knowledge-attitude-practice (KAP) of known type 2 diabetes mellitus (DM) patients, and the current vision related quality of life (VR-QOL) of patients with DR in a tertiary eye care center in Eastern India. Methods. Two hundred and forty patients with known type-2 DM were evaluated. The evaluation included status of DR (n = 240), KAP (n = 232), and VR-QOL (n = 75). International classification of DR was used in the study. The DR status was compared with another cohort (n = 472) examined a decade earlier, in year 2001. The KAP-25 questions were designed after literature review. The National Eye Institute Visual Function Questionnaire (NEI-VFQ; including optional items) was validated by Rasch analysis. Both KAP and VR-QOL were analyzed according to degree of DR, duration of known DM, and educational qualification. Results. Average age of the current cohort (n = 240) was 57.16 ± 9.03 years; there were 205 (85.4%) male patients and 143 (59.6%) patients had received less than graduate qualification. The mean duration of DM since diagnosis was 10 ± 7.8 months (range 8 months to 30 years); 118 (49.16%) patients had DR. In a decade time, 2001 to 2011, there was a change of retinopathy status at presentation (more often nonproliferative diabetic retinopathy, NPDR). One-third of NPDR patients had poor vision and half of them were hypertensive. KAP was better in patients with higher education and those having DR. VFQ score was higher in better seeing patients. Conclusion. Patients currently presenting at earlier stage of retinopathy are probably related to poor vision. Early detection and treatment of DR is likely to preserve and/or improve vision.

  18. Changing Clinical Presentation, Current Knowledge-Attitude-Practice, and Current Vision Related Quality of Life in Self-Reported Type 2 Diabetes Patients with Retinopathy in Eastern India: The LVPEI Eye and Diabetes Study

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    Taraprasad Das

    2016-01-01

    Full Text Available Purpose. To document the changing clinical presentation of diabetic retinopathy (DR over a decade, the current knowledge-attitude-practice (KAP of known type 2 diabetes mellitus (DM patients, and the current vision related quality of life (VR-QOL of patients with DR in a tertiary eye care center in Eastern India. Methods. Two hundred and forty patients with known type-2 DM were evaluated. The evaluation included status of DR (n=240, KAP (n=232, and VR-QOL (n=75. International classification of DR was used in the study. The DR status was compared with another cohort (n=472 examined a decade earlier, in year 2001. The KAP-25 questions were designed after literature review. The National Eye Institute Visual Function Questionnaire (NEI-VFQ; including optional items was validated by Rasch analysis. Both KAP and VR-QOL were analyzed according to degree of DR, duration of known DM, and educational qualification. Results. Average age of the current cohort (n=240 was 57.16 ± 9.03 years; there were 205 (85.4% male patients and 143 (59.6% patients had received less than graduate qualification. The mean duration of DM since diagnosis was 10 ± 7.8 months (range 8 months to 30 years; 118 (49.16% patients had DR. In a decade time, 2001 to 2011, there was a change of retinopathy status at presentation (more often nonproliferative diabetic retinopathy, NPDR. One-third of NPDR patients had poor vision and half of them were hypertensive. KAP was better in patients with higher education and those having DR. VFQ score was higher in better seeing patients. Conclusion. Patients currently presenting at earlier stage of retinopathy are probably related to poor vision. Early detection and treatment of DR is likely to preserve and/or improve vision.

  19. The relationship of the subtypes of preterm birth with retinopathy of prematurity.

    Science.gov (United States)

    Lynch, Anne M; Wagner, Brandie D; Hodges, Jennifer K; Thevarajah, Tamara S; McCourt, Emily A; Cerda, Ashlee M; Mandava, Naresh; Gibbs, Ronald S; Palestine, Alan G

    2017-09-01

    Retinopathy of prematurity is an adverse outcome of preterm birth and is a leading cause of childhood blindness. The relationship between the subtypes of preterm birth with retinopathy of prematurity is understudied. To investigate whether there is a difference in the incidence of type 1 or type 2 retinopathy of prematurity in infants with preterm birth resulting from spontaneous preterm labor, a medical indication of preterm birth, or preterm premature rupture of the membranes. A retrospective cohort study was conducted of 827 infants screened for retinopathy of prematurity who were delivered at a single tertiary care center in Colorado. All infants fulfilled the American Academy of Pediatrics 2013 screening criteria for retinopathy of prematurity defined as "infants with a birth weight of ≤1500 g or gestational age of 30 weeks or less (as defined by the attending neonatologist) and selected infants with a birth weight between 1500 and 2000 g or gestational age of >30 weeks with an unstable clinical course, including those requiring cardiorespiratory support and who are believed by their attending pediatrician or neonatologist to be at high risk for retinopathy of prematurity." Two independent reviewers masked to retinopathy of prematurity outcomes determined whether preterm birth resulted from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes. Discrepancies were resolved by a third reviewer. Data were analyzed with univariate and multivariable logistic regression. In our cohort, the frequency of preterm birth resulting from spontaneous preterm labor, medical indication of preterm birth, or preterm premature rupture of the membranes was 34%, 40%, and 26%, respectively. The mean gestational age (weeks, days) ± SD (range) in the cohort and across the preterm birth subtypes was as follows: entire cohort, 28 weeks, 6 days ± 2 weeks, 3 days (23 weeks, 3 days - 36 weeks, 4 days); spontaneous preterm labor

  20. GSTT1 Null Genotype Is a Risk Factor for Diabetic Retinopathy in Caucasians with Type 2 Diabetes, whereas GSTM1 Null Genotype Might Confer Protection against Retinopathy

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    Ines Cilenšek

    2012-01-01

    Full Text Available Aim: Substantial data indicate that oxidative stress is involved in the development of diabetic retinopathy (DR. The aim of the present study was to investigate whether the genetic polymorphisms: polymorphic deletions of glutathione S-transferases M1 (GSTM1 and T1 (GSTT1 and Ile105Val of the GSTP1 are associated with DR in Slovenian patients with type 2 diabetes.

  1. Data collection on retinopathy as a public health tool: The Hubble telescope equivalent of looking back in time.

    Science.gov (United States)

    Constantino, Maria I; Molyneaux, Lynda; Wu, Ted; Twigg, Stephen M; Wong, Jencia; Yue, Dennis K

    2017-04-01

    To test whether the rate of diabetic retinopathy development in a population calculated from the prevalence of retinopathy and duration of diabetes can be used to assess their prior glycemic control. 9281 patients with type 2 diabetes (T2DM) were grouped by duration of diabetes and plotted against the % of retinopathy in each band. The slope was used to calculate retinopathy development/year (RD/y). We correlated the RD/y with updated HbA1c within groups of different ethnicity, age of diabetes onset, year of the eye examination, socio-economic status and fluency in English. Differences in ethnicity, age of diabetes onset and year of the eye examination affect RD/y to a degree predictable from their respective updated HbA1c. No such relationship with updated HbA1c was evident when a factor has no apparent effect on RD/y. This relationship between prevalence of retinopathy and duration of diabetes can be used to assess future retinopathy burden. Perhaps more intriguing, the camera can be reversed to allow an estimate of prior glycemic control of a population from its retinopathy prevalence. Health care organizations can use this method to project future needs and to assess adequacy of prior glycemic control. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs

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    Lap-kin Chiang

    2016-12-01

    Full Text Available Objective: The objective is to estimate the prevalence and grading of hypertensive retinopathy in the primary care setting; examine the patient characteristics associated with hypertensive retinopathy; and examine the association of hypertensive retinopathy and other hypertension complications. Methods: This is a retrospective cross-sectional study. Subjects included adult hypertensive patients with available and gradable retinal photographs. Results: Two hundred fifty-six male hypertensive patients (34.3% and 491 female hypertensive patients (65.7% were included. The average duration of hypertension was 7.2 years, and 49.8% and 41.2% of patients were taking one or two antihypertensive medications respectively. Among 1491 qualified retinal photographs (744 right eye and 747 left eye, 24.9%, 62.6%, and 12.5% were classified as showing normal, mild, and moderate hypertensive retinopathy respectively. The three commonest retinal signs were generalized or focal arteriolar narrowing (650 cases, 43.6%, hard exudates (168 cases, 11.3%, and opacity (copper or silver wiring of the arteriolar wall (166 cases, 11.1%. Patients older than 61 years, having hypertension for more than 15 years, or taking three or more antihypertensive medications were significantly associated with hypertensive retinopathy (P<0.05. Conclusion: In a primary care clinic in Hong Kong, 77.1% of hypertensive patients had hypertensive retinopathy. Advanced hypertensive retinopathy was the commonest target organ damage for hypertensive patients in a primary care clinic.

  3. Risk factors for retinopathy associated with interferon α-2b and ribavirin combination therapy in patients with chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Chiaki Okuse; Hiroshi Yotsuyanagi; Yoshihiko Nagase; Yuhtaro Kobayashi; Kiyomi Yasuda; Kazuhiko Koike; Shiro Iino; Michihiro Suzuki; Fumio Itoh

    2006-01-01

    AIM: To elucidate the frequency and risk factors for retinopathy in patients with chronic hepatitis C who are treated by interferon-ribavirin combination therapy.METHODS: We prospectively analyzed 73 patients with histologically confirmed chronic hepatitis C, who underwent combination therapy for 24 wk. Optic fundi were examined before, and 2, 4, 12 and 24 wk after the start of combination therapy.RESULTS: Fourteen patients (19%) developed retinopathy, which was initially diagnosed by the appearance of a cotton wool spot in 12 patients. Retinal hemorrhage was observed in 5 patients. No patient complained of visual disturbance. Retinopathy disappeared in 9 patients (64%)despite the continuation of combination therapy. However, retinopathy persisted in 5 patients with retinal hemorrhage. A comparison of the clinical background between the groups with and without retinopathy showed no significant differences in age, gender, viral genotype, RNA level, white blood cell count, platelet count, prothrombin time, complications by diabetes mellitus or hypertension,or pretreatment arteriosclerotic changes in the optic fundj. However, multiple logistic regression analysis revealed that complication by hypertension was observed with a high frequency in the group with retinopathy (P=0.004,OR=245.918, 95% CI=5.6-10786.2).CONCLUSION: Retinopathy associated with combination therapy of interferon α-2b and ribavirin tends to develop in patients with hypertension.

  4. Pericyte migration - A novel mechanism of pericyte loss in experimental diabetic retinopathy

    NARCIS (Netherlands)

    Pfister, Frederick; Feng, Yuxi; Hagen, Franziska vom; Hoffmann, Sigrid; Molema, Grietje; Hillebrands, Jan-Luuk; Shani, Moshe; Deutsch, Urban; Hammes, Hans-Peter

    2008-01-01

    OBJECTIVE-The mechanism underlying pericyte loss during incipient diabetic retinopathy remains controversial. Hyperglycemia induces angiopoietin-2 (Ang-2) transcription, which modulates capillary pericyte coverage. In this study, we assessed loss of pericyte subgroups and the contribution of Ang-2 t

  5. Why does diabetic retinopathy happen, and how can we stop it?

    Directory of Open Access Journals (Sweden)

    Zoe Ockrim

    2011-09-01

    Full Text Available Diabetic retinopathy (DR is a complication of diabetes. We can prevent DR both by preventing diabetes (primary prevention and by improving the management of diabetes to slow down the onset, and reduce the severity, of DR (secondary prevention.

  6. Detailed histopathologic characterization of the retinopathy, globe enlarged (rge) chick phenotype.

    NARCIS (Netherlands)

    Montiani-Ferreira, F.; Fischer, A.; Cernuda-Cernuda, R.; Kiupel, M.; Grip, W.J. de; Sherry, D.; Cho, S.S.; Shaw, G.C.; Evans, M.G.; Hocking, P.; Petersen-Jones, S.M.

    2005-01-01

    PURPOSE: The purpose of this study was to characterize the morphological abnormalities in the retinas of chicks (Gallus gallus) suffering from the autosomal recessive disease, retinopathy, globe enlarged (rge/rge). METHODS: rge/rge affected and age matched control retinas were examined from hatch up

  7. Effect of software manipulation (Photoshop) of digitised retinal images on the grading of diabetic retinopathy.

    Science.gov (United States)

    George, L D; Lusty, J; Owens, D R; Ollerton, R L

    1999-08-01

    To determine whether software processing of digitised retinal images using a "sharpen" filter improves the ability to grade diabetic retinopathy. 150 macula centred retinal images were taken as 35 mm colour transparencies representing a spectrum of diabetic retinopathy, digitised, and graded in random order before and after the application of a sharpen filter (Adobe Photoshop). Digital enhancement of contrast and brightness was performed and a X2 digital zoom was utilised. The grades from the unenhanced and enhanced digitised images were compared with the same retinal fields viewed as slides. Overall agreement in retinopathy grade from the digitised images improved from 83.3% (125/150) to 94.0% (141/150) with sight threatening diabetic retinopathy (STDR) correctly identified in 95.5% (84/88) and 98.9% (87/88) of cases when using unenhanced and enhanced images respectively. In total, five images were overgraded and four undergraded from the enhanced images compared with 17 and eight images respectively when using unenhanced images. This study demonstrates that the already good agreement in grading performance can be further improved by software manipulation or processing of digitised retinal images.

  8. Aspectos patológicos da retinopatia diabética Pathological features of diabetic retinopathy

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    Zélia Maria da Silva Corrêa

    2005-06-01

    Full Text Available A retinopatia diabética continua sendo importante causa de cegueira entre adultos americanos e brasileiros. Existem fatores ambientais determinantes para o desenvolvimento da retinopatia diabética apesar de número crescente de evidências sugerirem um componente genético na retinopatia diabética. Os avanços realizados nas últimas décadas com o objetivo de melhorar o entendimento dos mecanismos envolvidos no desenvolvimento e progressão da retinopatia diabética estimularam esta revisão. Este artigo tem como objetivo revisar e atualizar conceitos acerca da fisiopatologia ocular do diabetes mellitus.Diabetic retinopathy continues to be an important cause of adult blindness among Americans and Brazilians. There are determinant environmental factors in the development of diabetic retinopathy although increasing evidence suggests a genetic component in diabetic retinopathy. The advances made during the last two decades with the purpose of improving the understanding of the mechanisms involved in the development and progression of diabetic retinopathy have prompted this review. This article has the purpose of revising and updating concepts about the ocular physiopathology of diabetes mellitus.

  9. A proposed new classification for diabetic retinopathy: The concept of primary and secondary vitreopathy

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    Dubey Arvind

    2008-01-01

    Full Text Available Background: Many eyes with proliferative diabetic retinopathy (PDR require vitreous surgery despite complete regression of new vessels with pan retinal laser photocoagulation (PRP. Changes in the vitreous caused by diabetes mellitus and diabetic retinopathy may continue to progress independent of laser regressed status of retinopathy. Diabetic vitreopathy can be an independent manifestation of the disease process. Aim: To examine this concept by studying the long-term behavior of the vitreous in cases of PDR regressed with PRP. Materials and Methods: Seventy-four eyes with pure PDR (without clinically evident vitreous traction showing fundus fluorescein angiography (FFA proven regression of new vessels following PRP were retrospectively studied out of a total of 1380 eyes photocoagulated between March 2001 and September 2006 for PDR of varying severity. Follow-up was available from one to four years. Results: Twenty-three percent of eyes showing FFA-proven regression of new vessels with laser required to undergo surgery for indications produced by vitreous traction such as recurrent vitreous hemorrhage, tractional retinal detachment, secondary rhegmatogenous retinal detachment and tractional macular edema within one to four years. Conclusion: Vitreous changes continued to progress despite regression of PDR in many diabetics. We identifies this as "clinical diabetic vitreopathy" and propose an expanded classification for diabetic retinopathy to signify these changes and to redefine the indications for surgery.

  10. Body Mass Index: A Risk Factor for Retinopathy in Type 2 Diabetic Patients

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    Snježana Kaštelan

    2013-01-01

    Full Text Available The aim of the study was to investigate whether body mass index (BMI independently or in correlation with other risk factors is associated with diabetic retinopathy (DR progression. The study included 545 patients with type 2 diabetes. According to DR status, they were divided into three groups: group 1 (no retinopathy; n=296, group 2 (mild/moderate nonproliferative DR; n=118, and group 3 (severe/very severe NPDR or proliferative DR; n=131. Patients without DR were younger than those with signs of retinopathy at time of diabetes onset whilst diabetes duration was longer in groups with severe NPDR and PDR. DR progression was correlated with diabetes duration, BMI, HbA1c, hypertension, and cholesterol. Statistical analyses showed that the progression of retinopathy increased significantly with higher BMI (gr. 1: 26.50 ± 2.70, gr. 2: 28.11 ± 3.00, gr. 3: 28.69 ± 2.50; P<0.01. We observed a significant deterioration of HbA1c and a significant increase in cholesterol and hypertension with an increase in BMI. Correlation between BMI and triglycerides was not significant. Thus, BMI in correlation with HbA1c cholesterol and hypertension appears to be associated with the progression of DR in type 2 diabetes and may serve as a predictive factor for the development of this important cause of visual loss in developed countries.

  11. Differential Plasmodium falciparum surface antigen expression among children with Malarial Retinopathy

    Science.gov (United States)

    Abdi, Abdirahman I.; Kariuki, Symon M; Muthui, Michelle K.; Kivisi, Cheryl A.; Fegan, Gregory; Gitau, Evelyn; Newton, Charles R; Bull, Peter C.

    2015-01-01

    Retinopathy provides a window into the underlying pathology of life-threatening malarial coma (“cerebral malaria”), allowing differentiation between 1) coma caused by sequestration of Plasmodium falciparum-infected erythrocytes in the brain and 2) coma with other underlying causes. Parasite sequestration in the brain is mediated by PfEMP1; a diverse parasite antigen that is inserted into the surface of infected erythrocytes and adheres to various host receptors. PfEMP1 sub-groups called “DC8” and “DC13” have been proposed to cause brain pathology through interactions with endothelial protein C receptor. To test this we profiled PfEMP1 gene expression in parasites from children with clinically defined cerebral malaria, who either had or did not have accompanying retinopathy. We found no evidence for an elevation of DC8 or DC13 PfEMP1 expression in children with retinopathy. However, the proportional expression of a broad subgroup of PfEMP1 called “group A” was elevated in retinopathy patients suggesting that these variants may play a role in the pathology of cerebral malaria. Interventions targeting group A PfEMP1 may be effective at reducing brain pathology. PMID:26657042

  12. Association between alcohol consumption and diabetic retinopathy and visual acuity-the AdRem Study

    NARCIS (Netherlands)

    Lee, C. C.; Stolk, R. P.; Adler, A. I.; Patel, A.; Chalmers, J.; Neal, B.; Poulter, N.; Harrap, S.; Woodward, M.; Marre, M.; Grobbee, D. E.; Beulens, J. W.

    2010-01-01

    Aims We investigated the association between alcohol consumption and diabetic retinopathy and deterioration of visual acuity in individuals with Type 2 diabetes. Methods We conducted a cohort analysis of 1239 participants with Type 2 diabetes aged 55-81 years enrolled in the AdRem study, a sub-study

  13. Assessing diabetic retinopathy using two-field digital photography and the influence of JPEG-comoression

    NARCIS (Netherlands)

    Stellingwerf, C; Hardus, PLLJ; Hooymans, JMM

    2004-01-01

    Objective: To study the effectiveness of two digital 50degrees photographic fields per eye, stored compressed or integrally, in the grading of diabetic retinopathy, in comparison to 35-mm colour slides. Subjects and methods: Two-field digital non-stereoscopic retinal photographs and two-field 35-mm

  14. Matrix metalloproteinase-2 in the development of diabetic retinopathy and mitochondrial dysfunction.

    Science.gov (United States)

    Mohammad, Ghulam; Kowluru, Renu A

    2010-09-01

    In the pathogenesis of diabetic retinopathy, retinal mitochondria become dysfunctional resulting in accelerated apoptosis of its capillary cells. Matrix metalloproteinase-2 (MMP2) is considered critical in cell integrity and cell survival, and diabetes activates MMP2 in the retina and its capillary cells. This study aims at elucidating the mechanism by which MMP2 contributes to the development of diabetic retinopathy. Using isolated bovine retinal endothelial cells, the effect of regulation of MMP2 (by its siRNA and pharmacological inhibitor) on superoxide accumulation and mitochondrial dysfunction was evaluated. The effect of inhibiting diabetes-induced retinal superoxide accumulation on MMP2 and its regulators was investigated in diabetic mice overexpressing mitochondrial superoxide dismutase (MnSOD). Inhibition of MMP2 ameliorated glucose-induced increase in mitochondrial superoxide and membrane permeability, prevented cytochrome c leakage from the mitochondria, and inhibited capillary cell apoptosis. Overexpression of MnSOD protected the retina from diabetes-induced increase in MMP2 and its membrane activator (MT1-MMP), and decrease in its tissue inhibitor (TIMP-2). These results implicate that, in diabetes, MMP2 activates apoptosis of retinal capillary cells by mitochondrial dysfunction increasing their membrane permeability. Understanding the role of MMP2 in the pathogenesis of diabetic retinopathy should help lay ground for MMP2-targeted therapy to retard the development of retinopathy in diabetic patients.

  15. Screening for diabetic retinopathy: the utility of nonmydriatic retinal photography in Egyptian adults.

    Science.gov (United States)

    Penman, A D; Saaddine, J B; Hegazy, M; Sous, E S; Ali, M A; Brechner, R J; Herman, W H; Engelgau, M M; Klein, R

    1998-09-01

    Although regular screening for diabetic retinopathy with ophthalmoscopy or retinal photography is widely recommended in the United States and Europe, few reports of its use in developing countries are available. We compared the performance of screening by retinal photography with that of indirect ophthalmoscopy by using data from a population-based survey of diabetes and its complications in Egypt. During that project, 427 persons with diabetes underwent an eye examination and fundus photography with a non-mydriatic camera through a dilated pupil. Data from the examinations of the right eye of each patient are presented. Ninety-two (22%) of the 427 retinal photographs were ungradable; in 58 eyes (63%), this was due to media opacity (42 eyes with cataract, 3 with corneal opacity, and 13 with both). Agreement between retinal photography and indirect ophthalmoscopy was poor (kappa = 0.33; 95% CI = 0.27-0.39) and primarily due to the large number of eyes (n = 79) with ungradable photographs that could be graded by ophthalmoscopy. None of these eyes was judged by ophthalmoscopy to have sight-threatening retinopathy. Fifty-four photographs were diagnosed with greater retinopathy than found on ophthalmoscopy. Retinal photography with the nonmydriatic camera through a dilated pupil is a useful method to screen for diabetic retinopathy in most adults in Egypt. However, such screening strategies have limited use in older persons and in persons with corneal disease or cataract.

  16. APOLIPOPROTEIN E GENE POLYMORPHISMS ARE NOT ASSOCIATED WITH DIABETIC RETINOPATHY: THE ATHEROSCLEROSIS RISK IN COMMUNITIES STUDY

    Science.gov (United States)

    PURPOSE: Polymorphism of the apolipoprotein E (APOE) gene has been associated with dyslipidemia and cardiovascular disease. This study examines the association of APOE polymorphisms and diabetic retinopathy. DESIGN: Population-based cross-sectional study. METHODS: We studied 1,398 people aged 49 to ...

  17. Florida Model Task Force on Diabetic Retinopathy: Development of an Interagency Network.

    Science.gov (United States)

    Groff, G.; And Others

    1990-01-01

    This article describes the development of a mechanism to organize a network in Florida for individuals who are at risk for diabetic retinopathy. The task force comprised representatives from governmental, academic, professional, and voluntary organizations. It worked to educate professionals, patients, and the public through brochures, resource…

  18. Bilateral Hypertensive Retinopathy Complicated with Retinal Neovascularization: Panretinal Photocoagulation or Intravitreal Anti-VEGF Treatment

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    Odysseas Georgiadis

    2014-07-01

    Full Text Available Purpose: To present the case of a patient with bilateral hypertensive retinopathy complicated with retinal neovascularization who received anti-VEGF intravitreal injection in one eye and panretinal photocoagulation (PRP in the fellow eye. Methods: A 33-year-old male patient presented with gradual visual loss in both eyes for the last 5 months. At that time, he was examined by an ophthalmologist and occlusive retinopathy due to malignant systematic hypertension was diagnosed. He was put on antihypertensive treatment but no ophthalmic treatment was undertaken. At presentation, 5 months later, best-corrected visual acuity (BCVA was 0.1 in the right eye (RE and 0.9 in the left eye (LE. Fundus examination was compatible with hypertensive retinopathy complicated with retinal neovascularization. Fluorescein angiography (FFA revealed macular ischemia mainly in the RE and large areas of peripheral retinal ischemia and neovascularization with vascular leakage in both eyes. The patient was treated with two anti-VEGF (ranibizumab injections with 2 months interval in the RE and PRP laser in the LE. Results: Follow-up examination after 12 months showed mild improvement in BCVA, and FFA documented regression of retinal neovascularization in both eyes. Conclusion: Hypertensive retinopathy can be rarely complicated with retinal neovascularization. Treatment with PRP can be undertaken. In our case, the use of an intravitreal anti-VEGF agent seemed to halt its progression satisfactorily.