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Sample records for outer retinopathy azoor

  1. 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...

  2. Acute Zonal Occult Outer Retinopathy with Atypical Findings

    Directory of Open Access Journals (Sweden)

    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.

  3. Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy.

    Science.gov (United States)

    Fujiwara, Takamitsu; Imamura, Yutaka; Giovinazzo, Vincent J; Spaide, Richard F

    2010-09-01

    The purpose of this study was to investigate the fundus autofluorescence and optical coherence tomography findings in eyes with acute zonal occult outer retinopathy (AZOOR). A retrospective observational case series of the fundus autofluorescence and spectral domain optical coherence tomography in a series of patients with AZOOR. There were 19 eyes of 11 patients (10 women), who had a mean age of 49.1 +/- 13.9 years. Fundus autofluorescence abnormalities were seen in 17 of the 19 eyes, were more common in the peripapillary area, and were smaller in extent than the optical coherence tomography abnormalities. Nine eyes showed progression of hypoautofluorescence area during the mean follow-up of 69.7 months. The mean thickness of the photoreceptor layer at fovea was 177 microm in eyes with AZOOR, which was significantly thinner than controls (193 microm, P = 0.049). Abnormal retinal laminations were found in 12 eyes and were located over areas of loss of the photoreceptors. The subfoveal choroidal thickness was 243 microm, which is normal. Fundus autofluorescence abnormalities in AZOOR showed distinct patterns of retinal pigment epithelial involvement, which may be progressive. Thinning of photoreceptor cell layer with loss of the outer segments and abnormal inner retinal lamination in the context of a normal choroid are commonly found in AZOOR.

  4. Quantitative Autofluorescence Intensities in Acute Zonal Occult Outer Retinopathy vs Healthy Eyes

    Science.gov (United States)

    Boudreault, Katherine; Schuerch, Kaspar; Zhao, Jin; Lee, Winston; Cabral, Thiago; Yannuzzi, Lawrence A.; Tsang, Stephen H.; Sparrow, Janet R.

    2018-01-01

    IMPORTANCE Acute zonal occult outer retinopathy (AZOOR) remains a challenging diagnosis. Early recognition of the disease depends on advances in imaging modalities that can improve phenotyping and contribute to the understanding of the underlying pathogenesis. OBJECTIVES To expand the range of approaches available to assist in the identification of AZOOR by multimodal imaging and to analyze the fundus lesions by quantifying short-wavelength fundus autofluorescence (quantitative fundus autofluorescence [qAF]) and spectral-domain optical coherence tomography. DESIGN, SETTING, AND PARTICIPANTS In this observational study, patients underwent imaging at Columbia University Medical Center between November 2010 and March 2016 and were analyzed between September 2015 and August 2016. Six patients diagnosed as having AZOOR were studied by qAF and spectral-domain optical coherence tomography and were compared with 30 age and race/ethnicity–matched controls from a database of 277 healthy control eyes. MAIN OUTCOMES AND MEASURES In unaffected regions of the macula, qAF was calculated within predetermined circularly arranged segments (qAF8). In addition, qAF was measured within specified regions of interest positioned at the autofluorescent lesion border (AZOOR line). Electroretinograms and electro-oculograms were recorded in 5 of 6 patients. RESULTS Among 6 patients (age range, 26–61 years; 4 female; 4 of white race/ethnicity, 1 Asian, and 1 Hispanic), 5 exhibited an autofluorescent AZOOR line in short-wavelength fundus autofluorescence images, delineating the peripapillary lesion. The mean (SD) region-of-interest qAF measured on the AZOOR line was 60 (26) times higher than in healthy control eyes (P = .03) at equivalent fundus locations. The qAF8 within nondiseased macular regions were within the normal range. At the lesion border, spectral-domain optical coherence tomography revealed a loss of outer retinal integrity in all patients. Single-flash cone b-wave latency and

  5. ULTRA-WIDE-FIELD FUNDUS AUTOFLUORESCENCE FINDINGS IN PATIENTS WITH ACUTE ZONAL OCCULT OUTER RETINOPATHY.

    Science.gov (United States)

    Shifera, Amde Selassie; Pennesi, Mark E; Yang, Paul; Lin, Phoebe

    2017-06-01

    To determine whether ultra-wide-field fundus autofluorescence (UWFFAF) findings in acute zonal occult outer retinopathy correlated well with perimetry, optical coherence tomography, and electroretinography findings. Retrospective observational study on 16 eyes of 10 subjects with AZOOR seen at a single referral center from October 2012 to March 2015 who had UWFFAF performed. Chi-square analysis was performed to compare categorical variables, and Mann-Whitney U test used for comparisons of nonparametric continuous variables. All eyes examined within 3 months of symptom onset (five of the five eyes) had diffusely hyperautofluorescent areas on UWFFAF. The remaining eyes contained hypoautofluorescent lesions with hyperautofluorescent borders. In 11/16 (68.8%) eyes, UWFFAF showed the full extent of lesions that would not have been possible with standard fundus autofluorescence centered on the fovea. There were 3 patterns of spread: centrifugal spread (7/16, 43.8%), centripetal spread (5/16, 31.3%), and centrifugal + centripetal spread (4/16, 25.0%). The UWFFAF lesions corresponded well with perimetric, optical coherence tomography, and electroretinography abnormalities. The UWFFAF along with optical coherence tomography can be useful in the evaluation and monitoring of acute zonal occult outer retinopathy patients.

  6. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

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

    2008-01-01

    appearance were examined using optical coherence tomography (OCT), automated perimetry and electroretinography (ERG). RESULTS: Both patients demonstrated photoreceptor atrophy corresponding to partial or complete scotomata with reduced or extinct electroretinographic responses. Attenuation or complete loss...... of all the segments composing the photoreceptor layer was found by OCT. Full-field ERG revealed affection of the 30 Hz flicker responses and subnormal photopic responses in both patients and subnormal scotopic responses in case 1. Multifocal electroretinography (mERG) revealed localized outer retinal...

  7. Photoreceptor atrophy in acute zonal occult outer retinopathy

    DEFF Research Database (Denmark)

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

    2008-01-01

    examined using optical coherence tomography (OCT), automated perimetry and electroretinography (ERG). Both patients demonstrated photoreceptor atrophy corresponding to partial or complete scotomata with reduced or extinct electroretinographic responses. Attenuation or complete loss of all the segments...... composing the photoreceptor layer was found by OCT. Full-field ERG revealed affection of the 30 Hz flicker responses and subnormal photopic responses in both patients and subnormal scotopic responses in case 1. Multifocal electroretinography (mERG) revealed localized outer retinal dysfunction. The field...

  8. ACUTE ZONAL OCCULT OUTER RETINOPATHY: Structural and Functional Analysis Across the Transition Zone Between Healthy and Diseased Retina.

    Science.gov (United States)

    Duncker, Tobias; Lee, Winston; Jiang, Fan; Ramachandran, Rithambara; Hood, Donald C; Tsang, Stephen H; Sparrow, Janet R; Greenstein, Vivienne C

    2018-01-01

    To assess structure and function across the transition zone (TZ) between relatively healthy and diseased retina in acute zonal occult outer retinopathy. Six patients (6 eyes; age 22-71 years) with acute zonal occult outer retinopathy were studied. Spectral-domain optical coherence tomography, fundus autofluorescence, near-infrared reflectance, color fundus photography, and fundus perimetry were performed and images were registered to each other. The retinal layers of the spectral-domain optical coherence tomography scans were segmented and the thicknesses of two outer retinal layers, that is, the total receptor and outer segment plus layers, and the retinal nerve fiber layer were measured. All eyes showed a TZ on multimodal imaging. On spectral-domain optical coherence tomography, the TZ was in the nasal retina at varying distances from the fovea. For all eyes, it was associated with loss of the ellipsoid zone band, significant thinning of the two outer retinal layers, and in three eyes with thickening of the retinal nerve fiber layer. On fundus autofluorescence, all eyes had a clearly demarcated peripapillary area of abnormal fundus autofluorescence delimited by a border of high autofluorescence; the latter was associated with loss of the ellipsoid zone band and with a change from relatively normal to markedly decreased or nonrecordable visual sensitivity on fundus perimetry. The results of multimodal imaging clarified the TZ in acute zonal occult outer retinopathy. The TZ was outlined by a distinct high autofluorescence border that correlated with loss of the ellipsoid zone band on spectral-domain optical coherence tomography. However, in fundus areas that seemed healthy on fundus autofluorescence, thinning of the outer retinal layers and thickening of the retinal nerve fiber layer were observed near the TZ. The TZ was also characterized by a decrease in visual sensitivity.

  9. Recovery of outer retinal laminations on optical coherence tomography after treatment of cancer associated retinopathy

    Directory of Open Access Journals (Sweden)

    Francisco J. Irizarry

    2017-12-01

    Conclusions and importance: Cancer associated retinopathy is a paraneoplastic disease that results in damage to retinal structures through an autoimmune response. The damage is generally considered to be irreversible; however, in rare cases, such as observed here, retinal structures may demonstrate recovery after treatment.

  10. Thickness of the retinal photoreceptor outer segment layer in healthy volunteers and in patients with diabetes mellitus without retinopathy, diabetic retinopathy, or diabetic macular edema

    Directory of Open Access Journals (Sweden)

    Abdullah Ozkaya

    2017-04-01

    Conclusion: The PROS layer at the foveal center was thinner in patients who had diabetic retinopathy or diabetic macular edema than both the healthy volunteers and diabetic patients without retinopathy.

  11. Diabetic Retinopathy

    Science.gov (United States)

    ... pregnancy may have rapid onset or worsening of diabetic retinopathy. Symptoms and Detection What are the symptoms of diabetic retinopathy and ... with diabetes protect their vision? Vision lost to diabetic retinopathy is ... However, early detection and treatment can reduce the risk of blindness ...

  12. HYPERAUTOFLUORESCENT RING IN AUTOIMMUNE RETINOPATHY

    Science.gov (United States)

    LIMA, LUIZ H.; GREENBERG, JONATHAN P.; GREENSTEIN, VIVIENNE C.; SMITH, R. THEODORE; SALLUM, JULIANA M. F.; THIRKILL, CHARLES; YANNUZZI, LAWRENCE A.; TSANG, STEPHEN H.

    2015-01-01

    Purpose To report the presence of a hyperautofluorescent ring and corresponding spectral-domain optical coherence tomography (SD-OCT) features seen in patients with autoimmune retinopathy. Methods All eyes were evaluated by funduscopic examination, full-fleld electroretinography, fundus autofluorescence, and SD-OCT. Further confirmation of the diagnosis was obtained with immunoblot and immunohistochemistry testing of the patient’s serum. Humphrey visual fields and microperimetry were also performed. Results Funduscopic examination showed atrophic retinal pigment epithelium (RPE) associated with retinal artery narrowing but without pigment deposits. The scotopic and photopic full-field electroretinograms were nondetectable in three patients and showed a cone–rod pattern of dysfunction in one patient. Fundus autofluorescence revealed a hyperautofluorescent ring in the parafoveal region, and the corresponding SD-OCT demonstrated loss of the photoreceptor inner segment–outer segment junction with thinning of the outer nuclear layer from the region of the hyperautofluorescent ring toward the retinal periphery. The retinal layers were generally intact within the hyperautofluorescent ring, although the inner segment–outer segment junction was disrupted, and the outer nuclear layer and photoreceptor outer segment layer were thinned. Conclusion This case series revealed the structure of the hyperautofluorescent ring in autoimmune retinopathy using SD-OCT. Fundus autofluorescence and SD-OCT may aid in the diagnosis of autoimmune retinopathy and may serve as a tool to monitor its progression. PMID:22218149

  13. Radiation retinopathy

    International Nuclear Information System (INIS)

    Lumbroso, L.; Desjardins, L.; Dendale, R.; Fourquet, A.

    2002-01-01

    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)

  14. Hydroxychloroquine retinopathy.

    Science.gov (United States)

    Yusuf, I H; Sharma, S; Luqmani, R; Downes, S M

    2017-06-01

    Hydroxychloroquine (HCQ; Plaquenil) is used increasingly in the management of a variety of autoimmune disorders, with well established roles in dermatology and rheumatology and emerging roles in oncology. Hydroxychloroquine has demonstrated a survival benefit in patients with systemic lupus erythematosus; some clinicians advocate its use in all such patients. However, Hydroxychloroquine and chloroquine (CQ) have been associated with irreversible visual loss due to retinal toxicity. Hydroxychloroquine retinal toxicity is far more common than previously considered; an overall prevalence of 7.5% was identified in patients taking HCQ for greater than 5 years, rising to almost 20% after 20 years of treatment. This review aims to provide an update on HCQ/CQ retinopathy. We summarise emerging treatment indications and evidence of efficacy in systemic disease, risk factors for retinopathy, prevalence among HCQ users, diagnostic tests, and management of HCQ retinopathy. We highlight emerging risk factors such as tamoxifen use, and new guidance on safe dosing, reversing the previous recommendation to use ideal body weight, rather than actual body weight. We summarise uncertainties and the recommendations made by existing HCQ screening programmes. Asian patients with HCQ retinopathy may demonstrate an extramacular or pericentral pattern of disease; visual field testing and retinal imaging should include a wider field for screening in this group. HCQ is generally safe and effective for the treatment of systemic disease but because of the risk of HCQ retinal toxicity, modern screening methods and ideal dosing should be implemented. Guidelines regarding optimal dosing and screening regarding HCQ need to be more widely disseminated.

  15. Radiation retinopathy

    International Nuclear Information System (INIS)

    Parker, R.G.; Withers, H.R.

    1988-01-01

    A letter to the editor discusses the effectiveness and risk of radiation treatment of Grave's ophthalmopathy. The authors are unable to document a single instance in which retinopathy can be attributed to therapy with a total dose of 2000 cGy when delivered in daily increments of 180 to 200 cGy

  16. What Is Diabetic Retinopathy?

    Science.gov (United States)

    ... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Retinopathy Diagnosis Diabetic Retinopathy Treatment Proliferative Diabetic Retinopathy Vision Simulator Non-Proliferative Diabetic ...

  17. Radiation retinopathy

    International Nuclear Information System (INIS)

    Wara, W.M.; Irvine, A.R.; Neger, R.E.; Howes, E.L. Jr.; Phillips, T.L.

    1979-01-01

    The records were reviewed of all patients treated with irradiation to the eye at the University of California, San Francisco, between 1960 and 1975. Eight patients were identified who had developed radiation retinopathy 1 to 3 years postrirradiation. Lesions included retinal vascular occlusions, hemorrhages, microaneurysms, exudates, neovascularization, vitreous hemorrhage, retinal detachments, and optic atrophy with blindness. Four patients had received less than 5000 rad in 6 weeks to the retina, a dose usually considered within normal tissue tolerance

  18. Neovascularization in Purtscher's retinopathy

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    Chan A

    2011-11-01

    Full Text Available Annie Chan, Douglas R Fredrick, Theodore Leng Department of Ophthalmology, Byers Eye Institute at Stanford University, Stanford University School of Medicine, Stanford, CA, USA Abstract: We report a case of neovascularization secondary to Purtscher's retinopathy that showed minimal improvement with photocoagulation treatment. A 14-year-old boy with a history of cerebellar medulloblastoma presented with blurry vision and floaters after being struck by a motor vehicle while riding his bike. At presentation, visual acuity was 20/400 in his right eye and counting fingers in his left eye. Fundus examination showed disk edema, retinal whitening, and retinal hemorrhages in both eyes. Optical coherence tomography demonstrated thinning of the temporal retina and disruption of the inner segment–outer segment junction of the photoreceptor layer in the right eye and thickening and edema of the nasal macula, as well as a central foveal hyper-reflectivity, in the left eye. At the initial visit, there was no ischemia or neovascularization (NV. One month later, the patient developed NV of the disk and ischemia in the mid-periphery of the left eye. The patient underwent treatment with pan-retinal photocoagulation. The NV regressed, but visual outcome remained poor at his 5-month follow-up visit. Keywords: Purtscher's retinopathy, neovascularization, laser photocoagulation, disk edema

  19. Solar Retinopathy: A Multimodal Analysis

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    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.

  20. Diabetic retinopathy

    DEFF Research Database (Denmark)

    Wong, Tien Y; Cheung, Chui Ming Gemmy; Larsen, Michael

    2016-01-01

    Diabetic retinopathy (DR) is a common complication of diabetes mellitus and is a major cause of vision loss in middle-aged and elderly people. One-third of people with diabetes have DR. Severe stages of DR include proliferative DR, caused by the abnormal growth of new retinal blood vessels......, and diabetic macular oedema, in which there is exudation and oedema in the central part of the retina. DR is strongly associated with a prolonged duration of diabetes, hyperglycaemia and hypertension. It is traditionally regarded as a microvascular disease, but retinal neurodegeneration is also involved...... (VEGF). Optimal control of blood glucose and blood pressure in individuals with diabetes remains the cornerstone for preventing the development and arresting the progression of DR. Anti-VEGF therapy is currently indicated for diabetic macular oedema associated with vision loss, whereas laser...

  1. Hypertensive retinopathy (image)

    Science.gov (United States)

    ... retina from high blood pressure is called hypertensive retinopathy. It occurs as the existing high blood pressure ... flame hemorrhages and cotton wool spots. As hypertensive retinopathy progresses, hard exudates can appear around the macula ...

  2. 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)

  3. Retinopathy of Prematurity

    Science.gov (United States)

    Steinweg, Sue Byrd; Griffin, Harold C.; Griffin, Linda W.; Gingras, Happy

    2005-01-01

    The eyes of premature infants are especially vulnerable to injury after birth. A serious complication is called retinopathy of prematurity (ROP), which is abnormal growth of the blood vessels in an infant's eye. Retinopathy of prematurity develops when abnormal blood vessels grow and spread throughout the retina, which is the nerve tissue at the…

  4. 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...... cohort. All type 1 diabetic patients from Fyn County, Denmark, were identified as of 1 July 1973. One hundred and eighty four patients were examined in 1981-1982 (baseline) and in 2007-2008 (follow-up). The level of retinopathy was graded by ophthalmoscopy at baseline and nine-field digital colour fundus...... and proliferative retinopathy, respectively. In conclusion, proliferative retinopathy is an independent marker of long-term nephropathy in type 1 diabetes. Upcoming studies should examine whether these microvascular complications are also causally linked in type 1 diabetes....

  5. Outer magnetosphere

    International Nuclear Information System (INIS)

    Schardt, A.W.; Behannon, K.W.; Lepping, R.P.; Carbary, J.F.; Eviatar, A.; Siscoe, G.L.

    1984-01-01

    Similarities between the Saturnian and terrestrial outer magnetosphere are examined. Saturn, like earth, has a fully developed magnetic tail, 80 to 100 RS in diameter. One major difference between the two outer magnetospheres is the hydrogen and nitrogen torus produced by Titan. This plasma is, in general, convected in the corotation direction at nearly the rigid corotation speed. Energies of magnetospheric particles extend to above 500 keV. In contrast, interplanetary protons and ions above 2 MeV have free access to the outer magnetosphere to distances well below the Stormer cutoff. This access presumably occurs through the magnetotail. In addition to the H+, H2+, and H3+ ions primarily of local origin, energetic He, C, N, and O ions are found with solar composition. Their flux can be substantially enhanced over that of interplanetary ions at energies of 0.2 to 0.4 MeV/nuc

  6. Recessive Stargardt Disease Phenocopying Hydroxychloroquine Retinopathy

    Science.gov (United States)

    Noupuu, Kalev; Lee, Winston; Zernant, Jana; Greenstein, Vivienne C.; Tsang, Stephen; Allikmets, Rando

    2015-01-01

    Purpose To describe a series of Stargardt disease (STGD1) patients exhibiting a phenotype usually associated with hydroxychloroquine (HCQ) retinopathy on spectral domain-optical coherence tomography (SD-OCT). Methods Observational case series from Columbia University Medical Center involving 8 patients with genetically-confirmed STGD1. Patients selected for the study presented no history of HCQ use. Horizontal macular SD-OCT scans and accompanying 488nm autofluorescence (AF) images, color fundus photographs, and full-field electroretinograms were analyzed. Results All study patients exhibited an abrupt thinning of the parafoveal region or disruption of the outer retinal layers on SD-OCT resembling the transient HCQ retinopathy phenotype. Funduscopy and AF imaging revealed variations of bull’s eye maculopathy (BEM). Five patients exhibited local fleck-like deposits around the lesion. Genetic screening confirmed two disease-causing ABCA4 mutations in 5 patients and one mutation in 3 patients. Conclusions A transient SD- OCT phenotype ascribed to patients with HCQ retinopathy is associated with an early subtype of STGD1. This finding may also present with HCQ retinopathy-like BEM lesions on AF imaging and funduscopy. A phenotypic overlap may not be surprising given certain shared mechanistic disease processes between the two conditions. A thorough work-up, including screening of genes that are causal in retinal dystrophies associated with foveal sparing, may prevent the misdiagnoses of more ambiguous cases. PMID:26311262

  7. 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)

  8. Biomarkers in Diabetic Retinopathy

    Science.gov (United States)

    Jenkins, Alicia J.; Joglekar, Mugdha V.; Hardikar, Anandwardhan A.; Keech, Anthony C.; O'Neal, David N.; Januszewski, Andrzej S.

    2015-01-01

    There is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat

  9. Biomarkers in Diabetic Retinopathy.

    Science.gov (United States)

    Jenkins, Alicia J; Joglekar, Mugdha V; Hardikar, Anandwardhan A; Keech, Anthony C; O'Neal, David N; Januszewski, Andrzej S

    2015-01-01

    There is a global diabetes epidemic correlating with an increase in obesity. This coincidence may lead to a rise in the prevalence of type 2 diabetes. There is also an as yet unexplained increase in the incidence of type 1 diabetes, which is not related to adiposity. Whilst improved diabetes care has substantially improved diabetes outcomes, the disease remains a common cause of working age adult-onset blindness. Diabetic retinopathy is the most frequently occurring complication of diabetes; it is greatly feared by many diabetes patients. There are multiple risk factors and markers for the onset and progression of diabetic retinopathy, yet residual risk remains. Screening for diabetic retinopathy is recommended to facilitate early detection and treatment. Common biomarkers of diabetic retinopathy and its risk in clinical practice today relate to the visualization of the retinal vasculature and measures of glycemia, lipids, blood pressure, body weight, smoking, and pregnancy status. Greater knowledge of novel biomarkers and mediators of diabetic retinopathy, such as those related to inflammation and angiogenesis, has contributed to the development of additional therapeutics, in particular for late-stage retinopathy, including intra-ocular corticosteroids and intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') agents. Unfortunately, in spite of a range of treatments (including laser photocoagulation, intraocular steroids, and anti-VEGF agents, and more recently oral fenofibrate, a PPAR-alpha agonist lipid-lowering drug), many patients with diabetic retinopathy do not respond well to current therapeutics. Therefore, more effective treatments for diabetic retinopathy are necessary. New analytical techniques, in particular those related to molecular markers, are accelerating progress in diabetic retinopathy research. Given the increasing incidence and prevalence of diabetes, and the limited capacity of healthcare systems to screen and treat

  10. 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.

  11. [Diabetic retinopathy during pregnancy.

    DEFF Research Database (Denmark)

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

    2008-01-01

    INTRODUCTION: The aim was to evaluate the prevalence and progression of diabetic retinopathy during pregnancy in women with type 1 or type 2 diabetes. MATERIAL AND METHODS: Dilated fundal photography was performed at approximately 10 and 28 gestational weeks in 58 and 18 women with type 1 and type...... 2 diabetes, respectively. Retinopathy was classified as five stages +/- macular oedema. Progression was defined as deterioration corresponding to at least one stage between the two examinations. Clinical parameters were obtained from the medical records. RESULTS: Diabetic retinopathy was found in 36...... (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...

  12. Radiation retinopathy in diabetes mellitus

    International Nuclear Information System (INIS)

    Dhir, S.P.; Joshi, A.V.; Banerjee, A.K.

    1982-01-01

    A case of radiation retinopathy in a diabetic individual who received a total dose of 45 Gy for lymphoblastic lymphoma of the orbit is reported. The relationship between radiation retinopathy and diabetes mellitus is discussed. (Auth.)

  13. Spectral domain optical coherence tomography findings in tamoxifen retinopathy--a case report.

    Science.gov (United States)

    Nair, Sandhya Narayanan; Anantharaman, Giridhar; Gopalakrishnan, Mahesh; Vyas, Jyothiprakash

    2013-01-01

    To report spectral domain optical coherence tomography findings in a case of typical tamoxifen retinopathy. In this observational case report, a patient with tamoxifen retinopathy was imaged with spectral domain optical coherence tomography and fundus auto fluorescence. Spectral domain optical coherence tomography showed numerous hyperreflective spots within the retina, mainly in the inner retinal layers in both the eyes. The external limiting membrane, the Inner Segment-Outer Segment junction, and the photoreceptors were not discernable at the fovea in the right eye. In the left eye, there was foveal atrophy with total loss of photoreceptors. The autofluorescent images showed macular hypofluorescence with foveal hyperfluorescence. Spectral domain optical coherence tomography demonstrated abnormalities in the outer retinal layers in tamoxifen retinopathy. There were also characteristic alterations in the autofluorescence pattern at the macula in tamoxifen retinopathy.

  14. Arginase in Retinopathy

    Science.gov (United States)

    Narayanan, S. Priya; Rojas, Modesto; Suwanpradid, Jutamas; Toque, Haroldo A.; Caldwell, R. William; Caldwell, Ruth B.

    2013-01-01

    Ischemic retinopathies, such as diabetic retinopathy (DR), retinopathy of prematurity and retinal vein occlusion are a major cause of blindness in developed nations worldwide. Each of these conditions is associated with early neurovascular dysfunction. However, conventional therapies target clinically significant macula edema or neovascularization, which occur much later. Intraocular injections of anti-VEGF show promise in reducing retinal edema, but the effects are usually transient and the need for repeated injections increases the risk of intraocular infection. Laser photocoagulation can control pathological neovascularization, but may impair vision and in some patients the retinopathy continues to progress. Moreover, neither treatment targets early stage disease or promotes repair. This review examines the potential role of the ureahydrolase enzyme arginase as a therapeutic target for the treatment of ischemic retinopathy. Arginase metabolizes L-arginine to form proline, polyamines and glutamate. Excessive arginase activity reduces the L-arginine supply for nitric oxide synthase (NOS), causing it to become uncoupled and produce superoxide and less NO. Superoxide and NO react and form the toxic oxidant peroxynitrite. The catabolic products of polyamine oxidation and glutamate can induce more oxidative stress and DNA damage, both of which can cause cellular injury. Studies indicate that neurovascular injury during retinopathy is associated with increased arginase expression/activity, decreased NO, polyamine oxidation, formation of superoxide and peroxynitrite and dysfunction and injury of both vascular and neural cells. Furthermore, data indicate that the cytosolic isoform arginase I (AI) is involved in hyperglycemia-induced dysfunction and injury of vascular endothelial cells whereas the mitochondrial isoform arginase II (AII) is involved in neurovascular dysfunction and death following hyperoxia exposure. Thus, we postulate that activation of the arginase

  15. Quantitative analysis of macular retinal thickness and macular volume in diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Ying Zhao

    2017-12-01

    Full Text Available AIM: To evaluate and characterize the macular thickness and macular volume in patients of different stages of diabetic retinopathy with special-domain optical coherence tomography(SD-OCT. METHODS: Totally 40 patients(78 eyeswith diabetic retinopathy were recruited in the study from January 2016 to January 2017 in our hospital. According to the international clinical classification of diabetic retinopathy, 20 cases(40 eyeswere categorized as non-proliferative diabetic retinopathy(NPDRgroup and 20 cases proliferative diabetic retinopathy(PDRgroup(38 eyes. All subjects were examined and analyzed with Early Treatment Diabetic Retinopathy Study(ETDRSsubfields, which were embedded in HS(Haag-Streitwith diameter of 1, 3 and 6mm.The changes of retinal thickness and volume of the macular center were measured. RESULTS: The thickness of macular foveolar in NPDR group and PDR group were 252.57±31.36μm, 362.47±20.81μm. The retinal thickness of inner superior subfield(ISMand inner nasal subfield(INMwere the thickest; that of inner inferior subfield(IIMwas next to ISM and INM, and that of inner temporal subfield was the thinnest. Of the outer subfields, the retinal thickness of outer superior subfield(OSMwas the thickest; that of outer nasal subfield(ONMwas next to OSM, and that of outer temporal subfield(OTMand outer inferior subfield(OIMwas the thinnest. The value of macular central concave thickness and retinal thickness in each quadrant of the NPDR group were less than those of the PDR group, the difference was statistically significant(P3, 0.28±0.16mm3, the upper and nasal sides of the middle part of the partition were the largest, the inferior and the temporal side were the smallest. The nasal side of the outer loop was the largest, the upper was the second, the temporal side and the inferior were the smallest. The volume of macular central fovea and the retinal volume in each quadrant of the NPDR group were smaller than those of the PDR group, the

  16. 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.

  17. Non-Proliferative Diabetic Retinopathy Vision Simulator

    Science.gov (United States)

    ... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Retinopathy Diagnosis Diabetic Retinopathy Treatment Proliferative Diabetic Retinopathy Vision Simulator Non-Proliferative Diabetic ...

  18. Inflammation in Diabetic Retinopathy

    Science.gov (United States)

    Tang, Johnny; Kern, Timothy S.

    2012-01-01

    Diabetes causes a number of metabolic and physiologic abnormalities in the retina, but which of these abnormalities contribute to recognized features of diabetic retinopathy (DR) is less clear. Many of the molecular and physiologic abnormalities that have been found to develop in the retina in diabetes are consistent with inflammation. Moreover, a number of anti-inflammatory therapies have been found to significantly inhibit development of different aspects of DR in animal models. Herein, we review the inflammatory mediators and their relationship to early and late DR, and discuss the potential of anti-inflammatory approaches to inhibit development of different stages of the retinopathy. We focus primarily on information derived from in vivo studies, supplementing with information from in vitro studies were important. PMID:21635964

  19. Retinopathy of prematurity

    International Nuclear Information System (INIS)

    Benavides Vargas, Ana Maria

    2013-01-01

    Retinopathy of prematurity has been the leading cause of childhood blindness. Early and effective screening has helped to diagnose the visual target of an infant by the difference between growing up with a disability or not. A joint effort between ophthalmologists and neonatologists is proposed to control this disease, ensuring success. An appropriate, early, effective and timely treatment has been the laser and cryotherapy like good choices for the neonate to prevent disease progression. Evaluation of screening program, to determine the incidence, compare statistics variables have been measures as other medical pathologies should be encouraged as research topics. A decrease in the incidence of retinopathy of prematurity is expected, controlling the risk factors during the child's stay in intrahospital neonatal unit [es

  20. Linezolid induced retinopathy.

    Science.gov (United States)

    Park, Dae Hyun; Park, Tae Kwann; Ohn, Young-Hoon; Park, Jong Sook; Chang, Jee Ho

    2015-12-01

    While optic neuropathy is a well-known cause of visual disturbances in linezolid-treated patients, the possibility of linezolid-related retinopathy has not been investigated. Here, we report a case of retinopathy demonstrated by multifocal electroretinogram (mfERG) in a linezolid-treated patient. A 61-year-old man with extensively drug-resistant pulmonary tuberculosis treated with linezolid for 5 months presented with painless loss of vision in both eyes. The patient's best corrected visual acuity was 20/50 in the right eye and 20/100 in the left eye. Fundus examination revealed mild disc edema, and color vision was defective in both eyes. Humphrey visual field tests showed a superotemporal field defect in the right eye and central and pericentral field defect in the left eye. Optical coherence tomography (OCT) revealed only mild optic disc swelling. In mfERG, central amplitudes were depressed in both eyes. Four months after the cessation of linezolid, visual acuity was restored to 20/20 right eye and 20/25 left eye. The color vision and visual field had improved. The OCT and mfEFG findings improved as well. Although the clinical features were similar to linezolid-induced optic neuropathy, the mfERG findings suggest the possibility of a retinopathy through cone dysfunction.

  1. Lipasin, a biomarker of diabetic retinopathy.

    Science.gov (United States)

    Fang, Chen; Huang, Yun; Guo, Heming; Gao, Yan; Ji, Xiaoyan; Hu, Ji

    2016-05-01

    The present study recruited 74 participants with type 2 diabetes, among which 23 had retinopathy. Those with retinopathy had a longer duration of diabetes and higher levels of lipasin compared with those without retinopathy. Logistic regression revealed that lipasin was independently and significantly associated with retinopathy even after adjustments for confounders. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Scotoma analysis of 10–2 visual field testing with a red target in screening for hydroxychloroquine retinopathy

    Directory of Open Access Journals (Sweden)

    Browning DJ

    2015-08-01

    Full Text Available David J Browning, Chong LeeDepartment of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, NC, USAObjective: To quantify the variability of scotomas detected by 10–2 visual field (VF testing with a red target in patients taking hydroxychloroquine without and with retinopathy.Design: Retrospective review of clinical charts and VFs.Methods: Twenty-four patients taking hydroxychloroquine without retinopathy, and eight patients taking hydroxychloroquine with retinopathy were tested in this study. Retinopathy was defined by annular scotomas on 10–2 VF testing with corroborative spectral domain optical coherence tomographic outer retinal changes and multifocal electroretinographic changes leading to cessation of hydroxychloroquine or chloroquine. Location and depth of scotoma points on 10–2 VF testing were recorded and their fates followed in serial, reliable 10–2 VFs performed with a red target over time. The main outcome measures for this study were the number of scotoma points and locations, percentage of persistent scotoma points, size of scotomas, location of scotomas, and percentage of scotomas deepening. Results: A median of 3, interquartile range (IQR (2, 5, scotoma points per VF occurred in patients without retinopathy. A median of 86%, IQR (77, 100, of these resolved on the subsequent field. For patients with retinopathy, a median of 50%, IQR (46, 79, resolved, a difference compared to patients without retinopathy that was significant (P=0.0158. The median percentage of scotoma points in the zone from 2° to 8° from fixation in eyes with retinopathy was 72%, IQR (54, 100, compared to 49%, IQR (40, 54, in eyes without retinopathy (P=0.0069. The number of persistent scotoma locations at the last visit was higher in eyes with retinopathy: 3, IQR (1, 3, versus 0, IQR (0, 1, in patients without retinopathy, P=0.0156.Conclusion: Point scotomas are common and variable in 10–2 VF testing with a red target for

  3. Automated screening for retinopathy

    Directory of Open Access Journals (Sweden)

    A. S. Rodin

    2014-07-01

    Full Text Available Retinal pathology is a common cause of an irreversible decrease of central vision commonly found amongst senior population. Detection of the earliest signs of retinal diseases can be facilitated by viewing retinal images available from the telemedicine networks. To facilitate the process of retinal images, screening software applications based on image recognition technology are currently on the various stages of development.Purpose: To develop and implement computerized image recognition software that can be used as a decision support technologyfor retinal image screening for various types of retinopathies.Methods: The software application for the retina image recognition has been developed using C++ language. It was tested on dataset of 70 images with various types of pathological features (age related macular degeneration, chorioretinitis, central serous chorioretinopathy and diabetic retinopathy.Results: It was shown that the system can achieve a sensitivity of 73 % and specificity of 72 %.Conclusion: Automated detection of macular lesions using proposed software can significantly reduce manual grading workflow. In addition, automated detection of retinal lesions can be implemented as a clinical decision support system for telemedicine screening. It is anticipated that further development of this technology can become a part of diagnostic image analysis system for the electronic health records.

  4. Endocrinological disturbances in diabetic retinopathy

    International Nuclear Information System (INIS)

    Hafiez, A.A.; Shalaby, E.; Atia, H.; Abdel-Hafez, M.A.; Hammad, A.B.

    1985-01-01

    Microvascular complications of diabetes mellitus were extensively studied from various points of view. The aim was to elucidate the possible interaction of insulin, glucagon, prolactin, growth hormone, T 3 , and T 4 in the pathogenesis of diabetic retinopathy. Forty patients with diabetic retinopathy (group II) and twenty age-matched controls (group I) were investigated. Plasma levels of both insulin and glucagon were significantly elevated in group II versus group I, whereas other hormones were insignificantly changed. This shows the role that might be played by T 3 , T 4 , growth hormone, and prolactin in the established cases of diabetic retinopathy. (author)

  5. Acute Zonal Cone Photoreceptor Outer Segment Loss.

    Science.gov (United States)

    Aleman, Tomas S; Sandhu, Harpal S; Serrano, Leona W; Traband, Anastasia; Lau, Marisa K; Adamus, Grazyna; Avery, Robert A

    2017-05-01

    The diagnostic path presented narrows down the cause of acute vision loss to the cone photoreceptor outer segment and will refocus the search for the cause of similar currently idiopathic conditions. To describe the structural and functional associations found in a patient with acute zonal occult photoreceptor loss. A case report of an adolescent boy with acute visual field loss despite a normal fundus examination performed at a university teaching hospital. Results of a complete ophthalmic examination, full-field flash electroretinography (ERG) and multifocal ERG, light-adapted achromatic and 2-color dark-adapted perimetry, and microperimetry. Imaging was performed with spectral-domain optical coherence tomography (SD-OCT), near-infrared (NIR) and short-wavelength (SW) fundus autofluorescence (FAF), and NIR reflectance (REF). The patient was evaluated within a week of the onset of a scotoma in the nasal field of his left eye. Visual acuity was 20/20 OU, and color vision was normal in both eyes. Results of the fundus examination and of SW-FAF and NIR-FAF imaging were normal in both eyes, whereas NIR-REF imaging showed a region of hyporeflectance temporal to the fovea that corresponded with a dense relative scotoma noted on light-adapted static perimetry in the left eye. Loss in the photoreceptor outer segment detected by SD-OCT co-localized with an area of dense cone dysfunction detected on light-adapted perimetry and multifocal ERG but with near-normal rod-mediated vision according to results of 2-color dark-adapted perimetry. Full-field flash ERG findings were normal in both eyes. The outer nuclear layer and inner retinal thicknesses were normal. Localized, isolated cone dysfunction may represent the earliest photoreceptor abnormality or a distinct entity within the acute zonal occult outer retinopathy complex. Acute zonal occult outer retinopathy should be considered in patients with acute vision loss and abnormalities on NIR-REF imaging, especially if

  6. Automatic diabetic retinopathy classification

    Science.gov (United States)

    Bravo, María. A.; Arbeláez, Pablo A.

    2017-11-01

    Diabetic retinopathy (DR) is a disease in which the retina is damaged due to augmentation in the blood pressure of small vessels. DR is the major cause of blindness for diabetics. It has been shown that early diagnosis can play a major role in prevention of visual loss and blindness. This work proposes a computer based approach for the detection of DR in back-of-the-eye images based on the use of convolutional neural networks (CNNs). Our CNN uses deep architectures to classify Back-of-the-eye Retinal Photographs (BRP) in 5 stages of DR. Our method combines several preprocessing images of BRP to obtain an ACA score of 50.5%. Furthermore, we explore subproblems by training a larger CNN of our main classification task.

  7. Preventing radiation retinopathy with hyperfractionation

    International Nuclear Information System (INIS)

    Monroe, Alan T.; Bhandare, Niranjan; Morris, Christopher G.; Mendenhall, William M.

    2005-01-01

    Purpose: The purpose of this study was to determine factors associated with the development of radiation retinopathy in a large series of patients with head-and-neck cancer. In particular, we addressed whether the use of hyperfractionated radiation therapy was effective in reducing the risk of retinopathy. Methods and materials: One hundred eighty-six patients received a significant dose to the retina as part of curative radiotherapy. Primary sites included: nasopharynx, 46; paranasal sinus, 64; nasal cavity, 69; and palate, 7. Prescription doses varied depending on primary site and histology. Hyperfractionated (twice-daily) radiation was delivered to 42% of the patients in this study, typically at 1.10 to 1.20 Gy per fraction. The remainder were treated once-daily. Retinal doses were determined from computerized dosimetry plans when available. For all other patients, retinal doses were retrospectively calculated using reconstructed off-axis dosimetry taken from contours through the center of the globes. Retinal dose was defined as the minimum dose received by at least 25% of the globe. The median retinal dose was 56.85 Gy. Patients were followed for a median of 7.6 years. Results: Thirty-one eyes in 30 patients developed radiation retinopathy, resulting in monocular blindness in 25, bilateral blindness in 1, and decreased visual acuity in 4. The median time to the diagnosis of retinopathy was 2.6 years (range, 11 months to 5.3 years). The actuarial incidence of developing radiation retinopathy was 20% at both 5 and 10 years. The incidence of developing ipsilateral blindness due to retinopathy was 16% at 5 years and 17% at 10 years. Site-specific incidences varied considerably, with ethmoid sinus (9 of 25, 36%), nasal cavity (13 of 69, 19%), and maxillary sinus (6 of 35, 17%) being the most common sites associated with radiation retinopathy. Three of 72 patients (4%) receiving retinal doses less than 50 Gy developed retinopathy. Higher retinal doses resulted in a

  8. 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

  9. 'Teaching corner': Management of Diabetic Retinopathy

    African Journals Online (AJOL)

    based interventions in three areas: primary prevention of retinopathy by optimum ... disease and management of established retinopathy to prevent or mitigate visual loss. ... of retinopathy and timely treatment all diminish the risk of ... types: macular oedema and macular ischaemia which may .... Variation in age of onset.

  10. Scotoma analysis of 10-2 visual field testing with a white target in screening for hydroxychloroquine retinopathy

    Directory of Open Access Journals (Sweden)

    Browning DJ

    2015-05-01

    Full Text Available David J Browning, Chong Lee Department of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, Charlotte, NC, USA Objective: To quantify the variability of scotomas detected by 10-2 visual field (VF testing in patients taking hydroxychloroquine without and with retinopathy.Design: Retrospective review of clinical charts and visual fields.Subjects: Twenty-one patients taking hydroxychloroquine without retinopathy, and nine patients taking hydroxychloroquine and one patient taking chloroquine with retinopathy.Methods: Retinopathy was defined by annular scotomas on 10-2 VF testing with corroborative spectral domain optical coherence tomographic outer retinal changes and multifocal electroretinographic changes leading to cessation of hydroxychloroquine or chloroquine. Location and depth of scotoma points on 10-2 VF testing were recorded and their fates followed in serial, reliable 10-2 VFs performed with a white target over time.Main outcome measures: Number of scotoma points and locations, percentage of persistent scotoma points, size of scotomas, location of scotomas, and percentage of scotomas deepening.Results: A median of five, interquartile range (IQR 3–8 scotoma points per VF occurred in patients without retinopathy. A median of 86%, IQR 63%–100% of these points resolve on the subsequent field. For patients with retinopathy, a median of 22%, IQR 10%–59% resolve. The median percentage of scotoma points in the zone 2–8 degrees from fixation in eyes with retinopathy was 79%, IQR 68%–85% compared to 60%, IQR 54%–75% in eyes without retinopathy (P=0.0094. Single-point scotomas were more common in eyes without than with retinopathy. Scotomas consisting of more than four contiguous scotoma points were generally indicative of retinopathy.Conclusion: Point scotomas are common and variable in 10-2 VF testing with a white target for hydroxychloroquine retinopathy in subjects without retinopathy. The annular zone 2 to 8

  11. Posterior microphthalmos pigmentary retinopathy syndrome.

    Science.gov (United States)

    Pehere, Niranjan; Jalali, Subhadra; Deshmukh, Himanshu; Kannabiran, Chitra

    2011-04-01

    Posterior Microphthalmos Pigmentary Retinopathy Syndrome (PMPRS). Posterior microphthalmos (PM) is a relatively infrequent type of microphthalmos where posterior segment is predominantly affected with normal anterior segment measurements. Herein, we report two siblings with posterior microphthalmos retinopathy syndrome with postulated autosomal recessive mode of inheritance. A 13-year-old child had PM and retinitis pigmentosa (RP) and his 7-year-old sister had PM, RP, and foveoschisis. The genetics of this syndrome and variable phenotype is discussed. Importance of being aware of posterior microphthalmos and its posterior segment associations is highlighted.

  12. Photocoagulation treatment of radiation retinopathy

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Chittum, M.E.; Wells, C.G.

    1988-01-01

    We studied the visual and anatomic effects of focal photocoagulation for clinically significant radiation macular edema in five eyes of four patients and panretinal photocoagulation for proliferative radiation retinopathy in six eyes of three patients. Focal and limited scatter photocoagulation was successful in preventing further vision loss in all five eyes treated for macular edema. Three eyes treated with panretinal photocoagulation had regression of neovascularization. The other three eyes treated for proliferative retinopathy subsequently had dense vitreous hemorrhages that required vitrectomy for restoration of useful vision

  13. Clinical features of radiation retinopathy

    International Nuclear Information System (INIS)

    Tabuchi, Shoko; Oda, Itsuo; Okawa, Tomohiko

    1977-01-01

    The clinical features of 25 cases with radiation retinopathy are described. Retinopathy was induced following therapeutic irradiation of paraobital malignancies with megavoltage Linac x-ray of 3,000 rads or more. Retinal vessels, particularly the proximal portion of retinal arteries, seemed to be the primary site of damage due to radiation. According to the type of lesion and dosage, fundus features simulated papillitis, retinal angiosclerosis, or hard exudates due to capillary obliteration. Acute obstruction of the central retinal artery and ischemic optic neuropathy could result from heavy irradiation of over 5,000 rads. (Evans, J.)

  14. [Retinopathy of prematurity].

    Science.gov (United States)

    Promelle, V; Milazzo, S

    2017-05-01

    Retinopathy of prematurity is a retinal vasoproliferative disease affecting extremely preterm infants exposed to high concentrations of oxygen therapy. Infants born before 32 post-menstrual weeks or with a birth weight of less than 1500g should systematically have a dilated fundus examination. The time of screening and schedule for follow-up are guided by the various risk factors. This disease results from immaturity of the peripheral retinal vessels at the time of premature birth. The classification of ROP depends on the anteroposterior extent of involvement (from center to periphery: zone I, II and III), its extension in 30° sectors (clock hours) and its stage (stage 1 to 5). "Plus" disease is defined as dilation and tortuosity of the retinal blood vessels in the posterior pole of the eye and represents a major risk factor for rapid unfavorable progression. A majority of patients will spontaneously recover, but patients with a high risk of progression will require treatment to prevent retinal detachment and blindness. The indications for treatment are threshold disease and type 1 pre-threshold disease. The current treatment of choice is peripheral retinal ablation with transpupillary laser, but ab externo cryotherapy may be used instead. Intravitreal injection of vascular endothelial growth factor inhibitors may be an attractive therapeutic option and is currently under investigation. After laser treatment, unfavorable outcomes occur in only 9 to 14 % of eyes, but at the price of peripheral retinal destruction. For all patients, whether treated or not, a regular fundus examination should be insured until complete retinal vascularization has occurred. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Epigenetic Modifications and Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Renu A. Kowluru

    2013-01-01

    Full Text Available Diabetic retinopathy remains one of the most debilitating chronic complications, but despite extensive research in the field, the exact mechanism(s responsible for how retina is damaged in diabetes remains ambiguous. Many metabolic pathways have been implicated in its development, and genes associated with these pathways are altered. Diabetic environment also facilitates epigenetics modifications, which can alter the gene expression without permanent changes in DNA sequence. The role of epigenetics in diabetic retinopathy is now an emerging area, and recent work has shown that genes encoding mitochondrial superoxide dismutase (Sod2 and matrix metalloproteinase-9 (MMP-9 are epigenetically modified, activates of epigenetic modification enzymes, histone lysine demethylase 1 (LSD1, and DNA methyltransferase are increased, and the micro RNAs responsible for regulating nuclear transcriptional factor and VEGF are upregulated. With the growing evidence of epigenetic modifications in diabetic retinopathy, better understanding of these modifications has potential to identify novel targets to inhibit this devastating disease. Fortunately, the inhibitors and mimics targeted towards histone modification, DNA methylation, and miRNAs are now being tried for cancer and other chronic diseases, and better understanding of the role of epigenetics in diabetic retinopathy will open the door for their possible use in combating this blinding disease.

  16. 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.

  17. The Neural Retina in Retinopathy of Prematurity

    Science.gov (United States)

    Hansen, Ronald M.; Moskowitz, Anne; Akula, James D.; Fulton, Anne B.

    2016-01-01

    Retinopathy of prematurity (ROP) is a neurovascular disease that affects prematurely born infants and is known to have significant long term effects on vision. We conducted the studies described herein not only to learn more about vision but also about the pathogenesis of ROP. The coincidence of ROP onset and rapid developmental elongation of the rod photoreceptor outer segments motivated us to consider the role of the rods in this disease. We used noninvasive electroretinographic (ERG), psychophysical, and retinal imaging procedures to study the function and structure of the neurosensory retina. Rod photoreceptor and post-receptor responses are significantly altered years after the preterm days during which ROP is an active disease. The alterations include persistent rod dysfunction, and evidence of compensatory remodeling of the post-receptor retina is found in ERG responses to full-field stimuli and in psychophysical thresholds that probe small retinal regions. In the central retina, both Mild and Severe ROP delay maturation of parafoveal scotopic thresholds and are associated with attenuation of cone mediated multifocal ERG responses, significant thickening of post-receptor retinal laminae, and dysmorphic cone photoreceptors. These results have implications for vision and control of eye growth and refractive development and suggest future research directions. These results also lead to a proposal for noninvasive management using light that may add to the currently invasive therapeutic armamentarium against ROP. PMID:27671171

  18. Automated classifiers for early detection and diagnosis of retinopathy in diabetic eyes.

    Science.gov (United States)

    Somfai, Gábor Márk; Tátrai, Erika; Laurik, Lenke; Varga, Boglárka; Ölvedy, Veronika; Jiang, Hong; Wang, Jianhua; Smiddy, William E; Somogyi, Anikó; DeBuc, Delia Cabrera

    2014-04-12

    Artificial neural networks (ANNs) have been used to classify eye diseases, such as diabetic retinopathy (DR) and glaucoma. DR is the leading cause of blindness in working-age adults in the developed world. The implementation of DR diagnostic routines could be feasibly improved by the integration of structural and optical property test measurements of the retinal structure that provide important and complementary information for reaching a diagnosis. In this study, we evaluate the capability of several structural and optical features (thickness, total reflectance and fractal dimension) of various intraretinal layers extracted from optical coherence tomography images to train a Bayesian ANN to discriminate between healthy and diabetic eyes with and with no mild retinopathy. When exploring the probability as to whether the subject's eye was healthy (diagnostic condition, Test 1), we found that the structural and optical property features of the outer plexiform layer (OPL) and the complex formed by the ganglion cell and inner plexiform layers (GCL + IPL) provided the highest probability (positive predictive value (PPV) of 91% and 89%, respectively) for the proportion of patients with positive test results (healthy condition) who were correctly diagnosed (Test 1). The true negative, TP and PPV values remained stable despite the different sizes of training data sets (Test 2). The sensitivity, specificity and PPV were greater or close to 0.70 for the retinal nerve fiber layer's features, photoreceptor outer segments and retinal pigment epithelium when 23 diabetic eyes with mild retinopathy were mixed with 38 diabetic eyes with no retinopathy (Test 3). A Bayesian ANN trained on structural and optical features from optical coherence tomography data can successfully discriminate between healthy and diabetic eyes with and with no retinopathy. The fractal dimension of the OPL and the GCL + IPL complex predicted by the Bayesian radial basis function network provides better

  19. The Outer Space Treaty

    Science.gov (United States)

    Johnson, Christopher Daniel

    2018-01-01

    Negotiated at the United Nations and in force since 1967, the Outer Space Treaty has been ratified by over 100 countries and is the most important and foundational source of space law. The treaty, whose full title is "Treaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space, Including the Moon and Other Celestial Bodies," governs all of humankind's activities in outer space, including activities on other celestial bodies and many activities on Earth related to outer space. All space exploration and human spaceflight, planetary sciences, and commercial uses of space—such as the global telecommunications industry and the use of space technologies such as position, navigation, and timing (PNT), take place against the backdrop of the general regulatory framework established in the Outer Space Treaty. A treaty is an international legal instrument which balances rights and obligations between states, and exists as a kind of mutual contract of shared understandings, rights, and responsibilities between them. Negotiated and drafted during the Cold War era of heightened political tensions, the Outer Space Treaty is largely the product of efforts by the United States and the USSR to agree on certain minimum standards and obligations to govern their competition in "conquering" space. Additionally, the Outer Space Treaty is similar to other treaties, including treaties governing the high seas, international airspace, and the Antarctic, all of which govern the behavior of states outside of their national borders. The treaty is brief in nature and only contains 17 articles, and is not comprehensive in addressing and regulating every possible scenario. The negotiating states knew that the Outer Space Treaty could only establish certain foundational concepts such as freedom of access, state responsibility and liability, non-weaponization of space, the treatment of astronauts in distress, and the prohibition of non-appropriation of

  20. Review of the mechanisms and therapeutic avenues for retinal and choroidal vascular dysfunctions in retinopathy of prematurity.

    Science.gov (United States)

    Rivera, José Carlos; Madaan, Ankush; Zhou, Tianwei Ellen; Chemtob, Sylvain

    2016-12-01

    Retinopathy of prematurity (ROP) is a multifactorial disease and the main cause of visual impairment and blindness in premature neonates. The inner retina has been considered the primary region affected in ROP, but choroidal vascular degeneration and progressive outer retinal dysfunctions have also been observed. This review focuses on observations regarding neurovascular dysfunctions in both the inner and outer immature retina, the mechanisms and the neuronal-derived factors implicated in the development of ROP, as well potential therapeutic avenues for this disorder. Alterations in the neurovascular integrity of the inner and outer retina contribute to the development of ROP. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. Saturn's outer magnetosphere

    Science.gov (United States)

    Schardt, A. W.; Behannon, K. W.; Carbary, J. F.; Eviatar, A.; Lepping, R. P.; Siscoe, G. L.

    1983-01-01

    Similarities between the Saturnian and terrestrial outer magnetosphere are examined. Saturn, like Earth, has a fully developed magnetic tail, 80 to 100 RS in diameter. One major difference between the two outer magnetospheres is the hydrogen and nitrogen torus produced by Titan. This plasma is, in general, convected in the corotation direction at nearly the rigid corotation speed. Energies of magnetospheric particles extend to above 500 keV. In contrast, interplanetary protons and ions above 2 MeV have free access to the outer magnetosphere to distances well below the Stormer cutoff. This access presumably occurs through the magnetotail. In addition to the H+, H2+, and H3+ ions primarily of local origin, energetic He, C, N, and O ions are found with solar composition. Their flux can be substantially enhanced over that of interplanetary ions at energies of 0.2 to 0.4 MeV/nuc.

  2. The Diabetic Retinopathy Screening Workflow

    Science.gov (United States)

    Bolster, Nigel M.; Giardini, Mario E.; Bastawrous, Andrew

    2015-01-01

    Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems’ use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound. PMID:26596630

  3. Two cases of radiation retinopathy

    International Nuclear Information System (INIS)

    Shoda, Miho; Yuzawa, Mitsuko; Matsui, Mizuo; Kaneko, Akihiro.

    1992-01-01

    Radiation retinopathy is characterized by retinal micovascular abnormalities after radiation therapy of the eye and its surrounding structures. The authors performed focal laser photocoagulation in two cases of radiation retinopathy. Case 1 was a 16 year old woman with radiation retinopathy who had been treated for retioblastoma in her right eye using cobalt 60-applicator 16 years prior to the first visit. Her corrected visual acuity of the right eye was 0.4. Ophthalmoscopy revealed large macular deposits, soft exudates, and retinal hemorrhage. Fluorescein angiography showed hyperpermeability of capillaries in the vicinity of the lower temporal retinal vessels. The visual acuity improved to 1.2 after the photocoagulation. Case 2 was a 16 year old man who had received 50 gray of external beam for a primary rhabdo-myosarcoma in the temporal region. Retinal avascular areas in the posterior pole of his both eyes were observed and the area showed increased retinal vessel permeability in the right eye was photocoagulated. The visual acuity in his right eye increased from 0.08 to 1.0 following the treatment. (author)

  4. Educational paper: Retinopathy of prematurity.

    Science.gov (United States)

    Casteels, Ingele; Cassiman, Catherine; Van Calster, Joachim; Allegaert, Karel

    2012-06-01

    Retinopathy of prematurity (ROP) is a proliferative retinal vascular disease affecting the premature infant with an incompletely vascularized retina. The spectrum of ophthalmological findings in ROP exists from minimal sequelae, which do not affect vision, to bilateral retinal detachment and total blindness. With the increased survival of very small infants, retinopathy of prematurity has become one of the leading causes of childhood blindness. Over the past two decades, major advances have been made in understanding the pathogenesis of ROP, to a large extent as a result of changes in clinical risk factors (oxygen and non-oxygen related) and characteristics observed in ROP cases. This article provides a literature review on the evolution in clinical characteristics, classification and treatment modalities and indications of ROP. Special attention is hereby paid to the neonatal factors influencing the development of ROP and to the necessity for everyone caring for premature babies to have a well-defined screening and treatment protocol for ROP. Such screening protocol needs to be based on a unit-specific ROP risk profile and, consequently, may vary between different European regions. Retinopathy of prematurity is an important cause of ocular morbidity and blindness in children. With better understanding of the pathogenesis, screening and treatment guidelines have changed over time and are unit specific.

  5. Role of macular xanthophylls in prevention of common neovascular retinopathies: retinopathy of prematurity and diabetic retinopathy.

    Science.gov (United States)

    Gong, Xiaoming; Rubin, Lewis P

    2015-04-15

    Retinopathy of prematurity (ROP) and diabetic retinopathy (DR) are important causes of blindness among children and working-age adults, respectively. The development of both diseases involves retinal microvascular degeneration, vessel loss and consequent hypoxic and inflammatory pathologic retinal neovascularization. Mechanistic studies have shown that oxidative stress and subsequent derangement of cell signaling are important factors in disease progression. In eye and vision research, role of the dietary xanthophyll carotenoids, lutein and zeaxanthin, has been more extensively studied in adult onset macular degeneration than these other retinopathies. These carotenoids also may decrease severity of ROP in preterm infants and of DR in working-age adults. A randomized controlled clinical trial of carotenoid supplementation in preterm infants indicated that lutein has functional effects in the neonatal eye and is anti-inflammatory. Three multicenter clinical trials all showed a trend of decreased ROP severity in the lutein supplemented group. Prospective studies on patients with non-proliferative DR indicate serum levels of lutein and zeaxanthin are significantly lower in these patients compared to normal subjects. The present review describes recent advances in lutein and zeaxanthin modulation of oxidative stress and inflammation related to ROP and DR and discusses potential roles of lutein/zeaxanthin in preventing or lessening the risks of disease initiation or progression. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Screening for diabetic retinopathy | Rice | Continuing Medical ...

    African Journals Online (AJOL)

    Good glucose control and the treatment of hypertension and hyperlipidaemia remain the key strategies in preventing diabetic retinopathy and its progression. Unfortunately, some degree of retinopathy will eventually develop in almost all type 1 diabetics and over 60% of type 2 diabetics over a 20-year period.

  7. Automated early detection of diabetic retinopathy

    NARCIS (Netherlands)

    Abràmoff, M.D.; Reinhardt, J.M.; Russell, S.R.; Folk, J.C.; Mahajan, V.B.; Niemeijer, M.; Quellec, G.

    2010-01-01

    Purpose To compare the performance of automated diabetic retinopathy (DR) detection, using the algorithm that won the 2009 Retinopathy Online Challenge Competition in 2009, the Challenge2009, against that of the one currently used in EyeCheck, a large computer-aided early DR detection project.

  8. 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....

  9. Low Vision Rehabilitation and Diabetic Retinopathy

    International Nuclear Information System (INIS)

    Khan, Sarfaraz A.

    2007-01-01

    Diabetic retinopathy is emerging as a major cause of blindness. Diabetic retinopathy calls for a multidisciplinary to the patients. Management of the patient requires a team work by the internist, diabetologist, dietician, ophthalmologist and low vision therapist. Diabetic retinopathy very often results in vision loss. It is important for ophthalmologist to recognize the importance of low vision rehabilitation in formulating appropriate treatment strategies. People with low vision loss due to diabetic retinopathy usually experience difficulty in daily life. Most people with diabetic retinopathy (who have remaining useful vision) can be helped with low vision devices. However, often one low vision device may not be suitable for all purposes. A comprehensive low vision evaluation is required to assess the person's current visual status, identify the goals and the visual needs, and then design an individualized vision rehabilitation program to meet these needs. (author)

  10. Cytomegalovirus implicated in a case of progressive outer retinal necrosis (PORN).

    Science.gov (United States)

    Sfeir, Maroun

    2015-08-01

    Progressive outer retinal necrosis, also known as PORN, has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with acquired immune deficiency syndrome (AIDS). Although the etiologic organism has been reported to be Varicella-zoster virus, cytomegalovirus (CMV) can be an etiologic agent. Our case illustrates the occurrence of two opportunistic infections: PORN associated with CMV and Mycobacterium avium intracellulare duodenitis in a patient with uncontrolled HIV infection. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. TPS for Outer Planets

    Science.gov (United States)

    Venkatapathy, Ethiraj; Ellerby, D.; Gage, P.; Gasch, M.; Hwang, H.; Prabhu, D.; Stackpoole, M.; Wercinski, Paul

    2018-01-01

    This invited talk will provide an assessment of the TPS needs for Outer Planet In-situ missions to destinations with atmosphere. The talk will outline the drivers for TPS from destination, science, mission architecture and entry environment. An assessment of the readiness of the TPS, both currently available and under development, for Saturn, Titan, Uranus and Neptune are provided. The challenges related to sustainability of the TPS for future missions are discussed.

  12. Diabetic Retinopathy Grading by Digital Curvelet Transform

    Directory of Open Access Journals (Sweden)

    Shirin Hajeb Mohammad Alipour

    2012-01-01

    Full Text Available One of the major complications of diabetes is diabetic retinopathy. As manual analysis and diagnosis of large amount of images are time consuming, automatic detection and grading of diabetic retinopathy are desired. In this paper, we use fundus fluorescein angiography and color fundus images simultaneously, extract 6 features employing curvelet transform, and feed them to support vector machine in order to determine diabetic retinopathy severity stages. These features are area of blood vessels, area, regularity of foveal avascular zone, and the number of micro-aneurisms therein, total number of micro-aneurisms, and area of exudates. In order to extract exudates and vessels, we respectively modify curvelet coefficients of color fundus images and angiograms. The end points of extracted vessels in predefined region of interest based on optic disk are connected together to segment foveal avascular zone region. To extract micro-aneurisms from angiogram, first extracted vessels are subtracted from original image, and after removing detected background by morphological operators and enhancing bright small pixels, micro-aneurisms are detected. 70 patients were involved in this study to classify diabetic retinopathy into 3 groups, that is, (1 no diabetic retinopathy, (2 mild/moderate nonproliferative diabetic retinopathy, (3 severe nonproliferative/proliferative diabetic retinopathy, and our simulations show that the proposed system has sensitivity and specificity of 100% for grading.

  13. Outer Continental Shelf Lands Act

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data represents geographic terms used within the Outer Continental Shelf Lands Act (OCSLA or Act). The Act defines the United States outer continental shelf...

  14. Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme.

    Science.gov (United States)

    Looker, H C; Nyangoma, S O; Cromie, D T; Olson, J A; Leese, G P; Philip, S; Black, M W; Doig, J; Lee, N; Briggs, A; Hothersall, E J; Morris, A D; Lindsay, R S; McKnight, J A; Pearson, D W M; Sattar, N A; Wild, S H; McKeigue, P; Colhoun, H M

    2013-08-01

    The aim of our study was to identify subgroups of patients attending the Scottish Diabetic Retinopathy Screening (DRS) programme who might safely move from annual to two yearly retinopathy screening. This was a retrospective cohort study of screening data from the DRS programme collected between 2005 and 2011 for people aged ≥12 years with type 1 or type 2 diabetes in Scotland. We used hidden Markov models to calculate the probabilities of transitions to referable diabetic retinopathy (referable background or proliferative retinopathy) or referable maculopathy. The study included 155,114 individuals with no referable diabetic retinopathy or maculopathy at their first DRS examination and with one or more further DRS examinations. There were 11,275 incident cases of referable diabetic eye disease (9,204 referable maculopathy, 2,071 referable background or proliferative retinopathy). The observed transitions to referable background or proliferative retinopathy were lower for people with no visible retinopathy vs mild background retinopathy at their prior examination (respectively, 1.2% vs 8.1% for type 1 diabetes and 0.6% vs 5.1% for type 2 diabetes). The lowest probability for transitioning to referable background or proliferative retinopathy was among people with two consecutive screens showing no visible retinopathy, where the probability was <0.3% for type 1 and <0.2% for type 2 diabetes at 2 years. Transition rates to referable diabetic eye disease were lowest among people with type 2 diabetes and two consecutive screens showing no visible retinopathy. If such people had been offered two yearly screening the DRS service would have needed to screen 40% fewer people in 2009.

  15. Determining diabetic retinopathy screening interval based on time from no retinopathy to laser therapy.

    Science.gov (United States)

    Hughes, Daniel; Nair, Sunil; Harvey, John N

    2017-12-01

    Objectives To determine the necessary screening interval for retinopathy in diabetic patients with no retinopathy based on time to laser therapy and to assess long-term visual outcome following screening. Methods In a population-based community screening programme in North Wales, 2917 patients were followed until death or for approximately 12 years. At screening, 2493 had no retinopathy; 424 had mostly minor degrees of non-proliferative retinopathy. Data on timing of first laser therapy and visual outcome following screening were obtained from local hospitals and ophthalmology units. Results Survival analysis showed that very few of the no retinopathy at screening group required laser therapy in the early years compared with the non-proliferative retinopathy group ( p retinopathy at screening group required laser therapy, and at three years 0.2% (cumulative), lower rates of treatment than have been suggested by analyses of sight-threatening retinopathy determined photographically. At follow-up (mean 7.8 ± 4.6 years), mild to moderate visual impairment in one or both eyes due to diabetic retinopathy was more common in those with retinopathy at screening (26% vs. 5%, p diabetes occurred in only 1 in 1000. Conclusions Optimum screening intervals should be determined from time to active treatment. Based on requirement for laser therapy, the screening interval for diabetic patients with no retinopathy can be extended to two to three years. Patients who attend for retinal screening and treatment who have no or non-proliferative retinopathy now have a very low risk of eventual blindness from diabetes.

  16. Management of outer space

    Science.gov (United States)

    Perek, Lubos

    1993-10-01

    Various aspects of space-environment management are discussed. Attention is called to the fact that, while space radio communications are already under an adequate management by the International Communications Union, the use of nuclear power sources is regulated by the recently adopted set of principles, and space debris will be discussed in the near future at the UN COPUOS, other aspects of management of outer space received little or no attention of the international community. These include the competency of crews and technical equipment of spacecraft launched by newcomers to space exploration; monitoring of locations and motions of space objects (now in national hands), with relevant data made accessible through a computer network; and the requirement to use space only for beneficial purposes and not for promoting narrow and debatable interests damaging the outer space environment and impeding on astronomical observations. It is suggested that some of these tasks would be best performed by an international space agency within the UN system of organizations.

  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 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...... 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...

  18. DIABETIC RETINOPATHY AND THE EFFECT OF PREGNANCY

    Directory of Open Access Journals (Sweden)

    SYED ALWI SAR

    2010-01-01

    Full Text Available Pregnancy is associated with increased risk of development and progression of diabetic retinopathy (DR. Although pregnancy does not have any long term effect on DR, progression of retinopathy changes occur in 50%-70% of cases. The greatest risk of worsening occurs during the second trimester and persists as long as 12 months postpartum. The other factors found to be associated with its progression include duration of the diabetes, severity of retinopathy at conception, hyperglycaemic control, anaemia and progression of coexisting hypertension. Because of the increased risk of progression of the disease inpregnancy, conception should be delayed till the ocular disease is treated and stabilized and laser photocoagulation should be promptly instituted in all cases of severe non-proliferative retinopathy and should not be delayed till the patient develops early proliferative changes. Good diabetic control before and during pregnancy can help prevent this increase in the progression and serious vision loss.

  19. xidative Stress and Retinopathy of Prematurity

    OpenAIRE

    Ümeyye Taka Aydın; Hatip Aydın; Osman Çekiç

    2014-01-01

    Oxidative stress plays an important role in the etiology of retinopathy of prematurity. Insufficient antioxidant system and increased oxidative stress in premature infants lead to the development of the disease. Understanding the mechanism of oxidative stress and antioxidant system and the related signaling pathways contribute to the development of novel options for diagnosis and treatment of retinopathy of prematurity. The current review aimed to evaluate the relationship between ox...

  20. A case of early-onset radiation retinopathy

    International Nuclear Information System (INIS)

    Sato, Yoko; Den, Seika; Shimizu, Kazuhiro; Ikeda, Tsunehiko

    2001-01-01

    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)

  1. A case of early-onset radiation retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    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)

  2. Antiretinal antibody- proven autoimmune retinopathy

    Directory of Open Access Journals (Sweden)

    Sharanya Abraham

    2017-01-01

    Full Text Available A young female presented with bilateral subacute onset of progressive decrease in night vision and reduced peripheral field of vision. The short duration and rapid progression of symptoms along with the lack of family history of night blindness prompted a diagnosis of autoimmune retinopathy (AIR. Fundus fluorescein angiography, optical coherence tomography, visual fields, and electroretinogram were suggestive of AIR. A differential diagnosis of retinitis pigmentosa (RP was also made. Antiretinal autoantibodies were detected in the blood sample. Treatment was with oral steroids and subsequently oral immunosuppressive agents. Visual acuity was maintained, fundus examination reverted to normal, and investigations repeated at every visit were stable with improvement in visual fields. Our case suggests that AIR, if diagnosed early and treated appropriately, may have a good outcome and should be considered in patients with an atypical presentation of RP.

  3. Diabetic retinopathy screening: global and local perspective.

    Science.gov (United States)

    Gangwani, R A; Lian, J X; McGhee, S M; Wong, D; Li, K Kw

    2016-10-01

    Diabetes mellitus has become a global epidemic. It causes significant macrovascular complications such as coronary artery disease, peripheral artery disease, and stroke; as well as microvascular complications such as retinopathy, nephropathy, and neuropathy. Diabetic retinopathy is known to be the leading cause of blindness in the working-age population and may be asymptomatic until vision loss occurs. Screening for diabetic retinopathy has been shown to reduce blindness by timely detection and effective laser treatment. Diabetic retinopathy screening is being done worldwide either as a national screening programme or hospital-based project or as a community-based screening programme. In this article, we review different methods of screening including grading used to detect the severity of sight-threatening retinopathy and the newer screening methods. This review also includes the method of systematic screening being carried out in Hong Kong, a system that has helped to identify diabetic retinopathy among all attendees in public primary care clinics using a Hong Kong-wide public patients' database.

  4. Diabetic retinopathy screening using deep neural network.

    Science.gov (United States)

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

    2017-09-07

    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. Retrospective audit. 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). Area under the receiver operating characteristic curve, sensitivity and specificity. For detecting referable diabetic retinopathy, the deep neural network had an area under receiver operating characteristic curve of 0.901 (95% confidence interval 0.807-0.995), with 84.6% sensitivity and 79.7% specificity for Otago and 0.980 (95% confidence interval 0.973-0.986), with 96.0% sensitivity and 90.0% specificity for Messidor. 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. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

  5. 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

  6. Outer atmospheric research

    International Nuclear Information System (INIS)

    Anderson, J.L.

    1988-01-01

    The region above the earth from about 90 km to 150 km is a major part of the upper or outer atmosphere. It is relatively unexplored, being too high for balloons or aircraft and too low for persistent orbiting spacecraft. However, the concept of a tethered subsatellite, deployed downward from an orbiting, more massive craft such as the Space Shuttle, opens the possibility of a research capability that could provide global mapping of this region. The need for research in this thick spherical shell above the earth falls into two major categories: (1) scientific data for understanding and modeling the global atmosphere and thereby determining its role in the earth system, and (2) engineering data for the design of future aerospace vehicles that will operate there. This paper presents an overview and synthesis of the currently perceived research needs and the state-of-the-art of the proposed tethered research capability. 16 references

  7. A degenerative retinal process in HIV-associated non-infectious retinopathy.

    Science.gov (United States)

    Kozak, Igor; Sasik, Roman; Freeman, William R; Sprague, L James; Gomez, Maria Laura; Cheng, Lingyun; El-Emam, Sharif; Mojana, Francesca; Bartsch, Dirk-Uwe; Bosten, Jenny; Ayyagari, Radha; Hardiman, Gary

    2013-01-01

    HIV retinopathy is the most common non-infectious complication in the eyes of HIV-positive individuals. Oncotic lesions in the retinal nerve fiber layer, referred to as cotton wool spots (CWS), and intraretinal (IR) hemorrhages are frequently observed but are not unique to this pathology. HIV-positive patients have impaired color vision and contrast sensitivity, which worsens with age. Evidence of inner-retinal lesions and damage have been documented ophthalmoscopically, however their long term structural effect has not been investigated. It has been hypothesized that they may be partially responsible for loss of visual function and visual field. In this study we utilized clinical data, retinal imaging and transcriptomics approaches to comprehensively interrogate non-infectious HIV retinopathy. The methods employed encompassed clinical examinations, fundus photography, indirect ophthalmoscopy, Farmsworth-Munsell 100 hue discrimination testing and Illumina BeadChip analyses. Here we show that changes in the outer retina, specifically in the retinal pigment epithelium (RPE) and photoreceptor outer segments (POS) contribute to vision changes in non-infectious HIV retinopathy. We find that in HIV-positive retinae there is an induction of rhodopsin and other transcripts (including PDE6A, PDE6B, PDE6G, CNGA1, CNGB1, CRX, NRL) involved in visual transduction, as well as structural components of the rod photoreceptors (ABCA4 and ROM1). This is consistent with an increased rate of renewal of rod outer segments induced via increased phagocytosis by HIV-infected RPE previously reported in culture. Cone-specific transcripts (OPN1SW, OPN1LW, PDE6C, PDE6H and GRK7) are uniformly downregulated in HIV positive retina, likely due to a partial loss of cone photoreceptors. Active cotton wool spots and intraretinal hemorrhages (IRH) may not affect photoreceptors directly and the interaction of photoreceptors with the aging RPE may be the key to the progressive vision changes in HIV

  8. Hydroxychloroquine retinopathy after short-term therapy.

    Science.gov (United States)

    Phillips, Brandon N; Chun, Dal W

    2014-01-01

    To report an unusual case of hydroxychloroquine toxicity after short-term therapy. Observational case report. A 56-year-old woman presented to the Ophthalmology Clinic at Walter Reed Army Medical Center (WRAMC) with a 6-month history of gradually decreasing vision in both eyes. The patient had been taking hydroxychloroquine for the preceding 48 months for the treatment of rheumatoid arthritis. Examination of the posterior segment revealed bilateral "bull's eye" macular lesions. Fundus autofluorescence revealed hyperfluorescence of well-defined bull's eye lesions in both eyes. Optical coherence tomography revealed corresponding parafoveal atrophy with a loss of the retinal inner segment/outer segment junction. Humphrey visual field 10-2 white showed significant central and paracentral defects with a generalized depression. The patient was on a standard dose of 400 mg daily, which was above her ideal dose. The patient had no history of kidney or liver dysfunction. There were no known risk factors but there were several possible confounding factors. The patient was started on high-dose nabumetone, a nonsteroidal antiinflammatory drug, at the same time she was started on hydroxychloroquine. She also reported taking occasional ibuprofen. Retinal toxicity from chloroquine has been recognized for decades with later reports showing retinopathy from long-term hydroxychloroquine (Plaquenil) use for the treatment of antiinflammatory diseases. Hydroxychloroquine is now widely used and retinal toxicity is relatively uncommon. However, it can cause serious vision loss and is usually irreversible. The risk of hydroxychloroquine toxicity rises to nearly 1% with a total cumulative dose of 1,000 g, which is ∼5 years to 7 years of normal use. Toxicity is rare under this dose. For this reason, the American Academy of Ophthalmology has revised its recommendations such that annual screenings begin 5 years after therapy with hydroxychloroquine has begun unless there are known risk

  9. Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy.

    Science.gov (United States)

    Scanlon, P H; Aldington, S J; Stratton, I M

    2014-04-01

    To assess whether there is a relationship between delay in retinopathy screening after diagnosis of type 2 diabetes and level of retinopathy detected. Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team. Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy. The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of type 2 diabetes. © 2013 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  10. barriers to an effective diabetic retinopathy service in ibadan, nigeria

    African Journals Online (AJOL)

    like UK and USA,6,7 barriers identified include fear of ... blindness as well as the cost of attending clinic. Diabetic retinopathy .... cost of treatment for diabetic retinopathy - laser treatment ..... harness compliance to diabetic care, treatment and.

  11. 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.

  12. Choroidal Thinning Associated With Hydroxychloroquine Retinopathy.

    Science.gov (United States)

    Ahn, Seong Joon; Ryu, So Jung; Joung, Joo Young; Lee, Byung Ro

    2017-11-01

    To investigate choroidal thickness in patients using hydroxychloroquine (HCQ) and compare choroidal thickness between eyes with and without HCQ retinopathy. Retrospective case series. Setting: Institutional. We included 124 patients with systemic lupus erythematosus or rheumatoid arthritis who were treated with HCQ. The patients were divided into an HCQ retinopathy group and a control group, according to the presence or absence of HCQ retinopathy. Total choroidal thickness and choriocapillaris-equivalent thickness were measured manually by 2 independent investigators using swept-source optical coherence tomography (SS-OCT; DRI-OCT, Topcon Inc, Tokyo, Japan). These measurements were made at the fovea and at nasal and temporal locations 0.5, 1.5, and 3 mm from the fovea. Medium-to-large vessel layer thickness was calculated accordingly. The thicknesses were compared between the HCQ retinopathy and control groups. We performed correlation analyses between choroidal thicknesses and details regarding HCQ use. Total choroidal thickness and choriocapillaris-equivalent thickness. Choroidal thicknesses were significantly decreased (P < .05) in the HCQ retinopathy group compared to the control group, except at the temporal choroid 1.5 mm from the fovea. Choriocapillaris-equivalent thicknesses were significantly different in all choroidal locations between the groups. In contrast, the medium-to-large vessel layer thickness was only significantly different at a few locations. The cumulative dose/body weight was significantly correlated with subfoveal choroidal and choriocapillaris-equivalent thicknesses (both P = .001). The association between presence of HCQ retinopathy and choroidal thicknesses was also statistically significant after adjusting for age, diagnosis for HCQ use, refractive errors, and duration of HCQ use (P = .001 and P = .003 for subfoveal choroidal and choriocapillaris-equivalent thickness, respectively). These results all suggest that HCQ retinopathy is

  13. Fundus fluorescence Angiography in diagnosing diabetic retinopathy.

    Science.gov (United States)

    Wang, Shuhui; Zuo, Yuqin; Wang, Ning; Tong, Bin

    2017-01-01

    To investigate the manifestation characteristics of fundus fluorescence angiography (FFA) and its values in diagnosing diabetic retinopathy through comparing direct ophthalmoscopy. Two hundred fifty patients (500 eyes) who were suspected as diabetic retinopathy and admitted to the hospital between February 2015 and December 2016 were selected. They underwent direct ophthalmoscopy and FFA. The manifestation characteristics of FFA in the diagnosis of diabetic retinopathy were summarized. The two examination methods were compared. In the diagnosis with direct ophthalmoscopy, 375 eyes out of 500 eyes were diagnosed as diabetic retinopathy (75%); there were 74 eyes at stage I, 88 eyes at stage II, 92 eyes at stage III, 83 eyes of stage IV, 28 eyes of stage V and 10 eyes of stage VI. In the diagnosis with FFA, 465 eyes out of 500 eyes were diagnosed as diabetic retinopathy (93%); there were 94 eyes at stage I, 110 eyes at stage II, 112 at stage III, 92 eyes at stage IV, 41 eyes at stage V and 16 eyes at stage VI. The detection rate of diabetic retinopathy using FFA was significantly higher than that using direct ophthalmoscopy (Pretinopathy (67.96%), 75 eyes had pre-proliferative lesions (16.13%), 149 eyes had proliferative lesions (32.04%), 135 eyes had diabetic maculopathy (29.03%) and 31 eyes had diabetic optic disc lesions (6.67%). The detection rate of diabetic retinopathy using FFA is higher than that using direct ophthalmoscopy. FFA could accurately determine clinical stage. Therefore, it is an important approach in treatment efficacy evaluation and treatment guidance, suggesting a significant application value.

  14. Vacuum Outer-Gap Structure in Pulsar Outer Magnetospheres

    International Nuclear Information System (INIS)

    Gui-Fang, Lin; Li, Zhang

    2009-01-01

    We study the vacuum outer-gap structure in the outer magnetosphere of rotation-powered pulsars by considering the limit of trans-field height through a pair production process. In this case, the trans-field height is limited by the photon-photon pair production process and the outer boundary of the outer gap can be extended outside the light cylinder. By solving self-consistently the Poisson equation for electrical potential and the Boltzmann equations of electrons/positrons and γ-rays in a vacuum outer gap for the parameters of Vela pulsar, we obtain an approximate geometry of the outer gap, i.e. the trans-field height is limited by the pair-production process and increases with the radial distance to the star and the width of the outer gap starts at the inner boundary (near the null charge surface) and ends at the outer boundary which locates inside or outside the light cylinder depending on the inclination angle. (geophysics, astronomy, and astrophysics)

  15. Progressive outer retinal necrosis in immunocompromised kidney allograft recipient.

    Science.gov (United States)

    Turno-Kręcicka, A; Boratyńska, M; Tomczyk-Socha, M; Mazanowska, O

    2015-06-01

    Ocular complications in patients who underwent renal transplantation are attributed to side effects of the immunosuppressive regimen. Progressive outer retinal necrosis (PORN) syndrome is a clinical variant of necrotizing herpetic retinopathy and it occurs almost exclusively in patients with acquired immunodeficiency syndrome. We present a case of a human immunodeficiency virus-negative patient who underwent renal transplant and, after a few years, developed bilateral PORN associated with viral infections. Varicella zoster virus (VZV) and BK virus were identified by polymerase chain reaction from the vitreous fluid. It is unclear which of the viruses identified had the dominant role in the pathogenesis of PORN and other organ damage, or whether their actions were synergistic. Adequate antiviral immune surveillance, as well as pre-transplant vaccination against VZV, may reduce the incidence of VZV infection and its complications. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Awareness of diabetic retinopathy among patients with diabetes ...

    African Journals Online (AJOL)

    Background: Diabetic retinopathy is a major cause of blindness worldwide. The associated loss of productivity and quality of life of the patients with diabetic retinopathy will lead to additional socioeconomic burden. This study aims to determine the level of awareness of diabetic retinopathy among diabetic patients. Materials ...

  17. Predictors of Diabetic Retinopathy in Patients with Type 2 Diabetes ...

    African Journals Online (AJOL)

    Predictors of Diabetic Retinopathy in Patients with Type 2 Diabetes Who Have Normoalbuminuria. R Karoli, J Fatima, V Shukla, P Garg, A Ali. Abstract. Background: Microalbuminuria is an independent predictor of retinopathy, so absence of microalbuminuria may tend clinician not to screen for diabetic retinopathy (DR).

  18. Role of Inflammation in Diabetic Retinopathy

    Science.gov (United States)

    Rübsam, Anne; Parikh, Sonia; Fort, Patrice E.

    2018-01-01

    Diabetic retinopathy is a common complication of diabetes and remains the leading cause of blindness among the working-age population. For decades, diabetic retinopathy was considered only a microvascular complication, but the retinal microvasculature is intimately associated with and governed by neurons and glia, which are affected even prior to clinically detectable vascular lesions. While progress has been made to improve the vascular alterations, there is still no treatment to counteract the early neuro-glial perturbations in diabetic retinopathy. Diabetes is a complex metabolic disorder, characterized by chronic hyperglycemia along with dyslipidemia, hypoinsulinemia and hypertension. Increasing evidence points to inflammation as one key player in diabetes-associated retinal perturbations, however, the exact underlying molecular mechanisms are not yet fully understood. Interlinked molecular pathways, such as oxidative stress, formation of advanced glycation end-products and increased expression of vascular endothelial growth factor have received a lot of attention as they all contribute to the inflammatory response. In the current review, we focus on the involvement of inflammation in the pathophysiology of diabetic retinopathy with special emphasis on the functional relationships between glial cells and neurons. Finally, we summarize recent advances using novel targets to inhibit inflammation in diabetic retinopathy. PMID:29565290

  19. New Therapeutic Approaches in Diabetic Retinopathy

    Science.gov (United States)

    Vaziri, Kamyar; Schwartz, Stephen G.; Relhan, Nidhi; Kishor, Krishna S.; Flynn Jr, Harry W.

    2015-01-01

    Diabetic retinopathy is a common microvascular complication of diabetes mellitus. It affects a substantial proportion of US adults over age 40. The condition is a leading cause of visual loss. Much attention has been given to expanding the role of current treatments along with investigating various novel therapies and drug delivery methods. In the treatment of diabetic macular edema (DME), intravitreal pharmacotherapies, especially anti-vascular endothelial growth factor (anti-VEGF) agents, have gained popularity. Currently, anti-VEGF agents are often used as first-line agents in center-involved DME, with recent data suggesting that among these agents, aflibercept leads to better visual outcomes in patients with worse baseline visual acuities. While photocoagulation remains the standard treatment for proliferative diabetic retinopathy (PDR), recent FDA approvals of ranibizumab and aflibercept in the management of diabetic retinopathy associated with DME may suggest a potential for pharmacologic treatments of PDR as well. Novel therapies, including small interfering RNAs, chemokines, kallikrein-kinin inhibitors, and various anti-angiogenic agents, are currently being evaluated for the management of diabetic retinopathy and DME. In addition to these strategies, novel drug delivery methods such as sustained-release implants and refillable reservoir implants are either under active evaluation or have recently gained FDA approval. This review provides an update on the novel developments in the treatment of diabetic retinopathy. PMID:26676668

  20. Role of Inflammation in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Anne Rübsam

    2018-03-01

    Full Text Available Diabetic retinopathy is a common complication of diabetes and remains the leading cause of blindness among the working-age population. For decades, diabetic retinopathy was considered only a microvascular complication, but the retinal microvasculature is intimately associated with and governed by neurons and glia, which are affected even prior to clinically detectable vascular lesions. While progress has been made to improve the vascular alterations, there is still no treatment to counteract the early neuro-glial perturbations in diabetic retinopathy. Diabetes is a complex metabolic disorder, characterized by chronic hyperglycemia along with dyslipidemia, hypoinsulinemia and hypertension. Increasing evidence points to inflammation as one key player in diabetes-associated retinal perturbations, however, the exact underlying molecular mechanisms are not yet fully understood. Interlinked molecular pathways, such as oxidative stress, formation of advanced glycation end-products and increased expression of vascular endothelial growth factor have received a lot of attention as they all contribute to the inflammatory response. In the current review, we focus on the involvement of inflammation in the pathophysiology of diabetic retinopathy with special emphasis on the functional relationships between glial cells and neurons. Finally, we summarize recent advances using novel targets to inhibit inflammation in diabetic retinopathy.

  1. 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.

  2. Hemorrhagic Retinopathy after Spondylosis Surgery and Seizure.

    Science.gov (United States)

    Kord Valeshabad, Ali; Francis, Andrew W; Setlur, Vikram; Chang, Peter; Mieler, William F; Shahidi, Mahnaz

    2015-08-01

    To report bilateral hemorrhagic retinopathy in an adult female subject after lumbar spinal surgery and seizure. A 38-year-old woman presented with bilateral blurry vision and spots in the visual field. The patient had lumbar spondylosis surgery that was complicated by a dural tear with persistent cerebrospinal fluid leak. Visual symptoms started immediately after witnessed seizure-like activity. At presentation, visual acuity was 20/100 and 20/25 in the right and left eye, respectively. Dilated fundus examination demonstrated bilateral hemorrhagic retinopathy with subhyaloid, intraretinal, and subretinal involvement. At 4-month follow-up, visual acuity improved to 20/60 and 20/20 in the right and left eye, respectively. Dilated fundus examination and fundus photography showed resolution of retinal hemorrhages in both eyes. The first case of bilateral hemorrhagic retinopathy after lumbar spondylosis surgery and witnessed seizure in an adult was reported. Ophthalmic examination may be warranted after episodes of seizure in adults.

  3. 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.

  4. The Danish Registry of Diabetic Retinopathy

    DEFF Research Database (Denmark)

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

    2016-01-01

    . 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 analysis from DiaBase’s latest annual report (2014-2015) indicates...

  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. The Danish Registry of Diabetic Retinopathy

    DEFF Research Database (Denmark)

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

    2016-01-01

    . 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 analysis from DiaBase's latest annual report (2014-2015) indicates...

  7. Microvascular retinopathy in subjects without diabetes

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...... 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...

  8. Multicolor Scanning Laser Imaging in Diabetic Retinopathy.

    Science.gov (United States)

    Ahmad, Mohammad S Z; Carrim, Zia Iqbal

    2017-11-01

    Diabetic retinopathy is a common cause of blindness in individuals younger than 60 years. Screening for retinopathy is undertaken using conventional color fundus photography and relies on the identification of hemorrhages, vascular abnormalities, exudates, and cotton-wool spots. These can sometimes be difficult to identify. Multicolor scanning laser imaging, a new imaging modality, may have a role in improving screening outcomes, as well as facilitating treatment decisions. Observational case series comprising two patients with known diabetes who were referred for further examination after color fundus photography revealed abnormal findings. Multicolor scanning laser imaging was undertaken. Features of retinal disease from each modality were compared. Multicolor scanning laser imaging provides superior visualization of retinal anatomy and pathology, thereby facilitating risk stratification and treatment decisions. Multicolor scanning laser imaging is a novel imaging technique offering the potential for improving the reliability of screening for diabetic retinopathy. Validation studies are warranted.

  9. Effective panphotocoagulation in a case of radiation retinopathy

    International Nuclear Information System (INIS)

    Mori, Tatsuhiko; Tochikubo, Tetsuo; Shinohara, Atsuko; Komoto, Michiji; Tabata, Toshifumi.

    1992-01-01

    This paper reports a case of radiation retinopathy caused by 60 Co and Ra radiation therapy following surgery for carcinoma of the maxillary sinus in a 42-year-old male. The retinopathy was found at onset of vitreous hemorrhage; the proliferative retinopathy was disclosed by fluorescein angiography (FAG). The retinopathy was treated a total of five times with both argon and krypton laser photocoagulation (PHC). As a result, both the subjective and objective symptoms improved. When radiation retinopathy is suspected, FAG must be conducted as soon as possible, to decide whether PHC is needed or not. (author)

  10. The TetO rat as a new translational model for type 2 diabetic retinopathy by inducible insulin receptor knockdown.

    Science.gov (United States)

    Reichhart, Nadine; Crespo-Garcia, Sergio; Haase, Nadine; Golic, Michaela; Skosyrski, Sergej; Rübsam, Anne; Herrspiegel, Christina; Kociok, Norbert; Alenina, Natalia; Bader, Michael; Dechend, Ralf; Strauss, Olaf; Joussen, Antonia M

    2017-01-01

    Although the renin-angiotensin system plays an important role in the progression of diabetic retinopathy, its influence therein has not been systematically evaluated. Here we test the suitability of a new translational model of diabetic retinopathy, the TetO rat, for addressing the role of angiotensin-II receptor 1 (AT1) blockade in experimental diabetic retinopathy. Diabetes was induced by tetracycline-inducible small hairpin RNA (shRNA) knockdown of the insulin receptor in rats, generating TetO rats. Systemic treatment consisted of an AT1 blocker (ARB) at the onset of diabetes, following which, 4-5 weeks later the retina was analysed in vivo and ex vivo. Retinal function was assessed by Ganzfeld electroretinography (ERG). Retinal vessels in TetO rats showed differences in vessel calibre, together with gliosis. The total number and the proportion of activated mononuclear phagocytes was increased. TetO rats presented with loss of retinal ganglion cells (RGC) and ERG indicated photoreceptor malfunction. Both the inner and outer blood-retina barriers were affected. The ARB treated group showed reduced gliosis and an overall amelioration of retinal function, alongside RGC recovery, whilst no statistically significant differences in vascular and inflammatory features were detected. The TetO rat represents a promising translational model for the early neurovascular changes associated with type 2 diabetic retinopathy. ARB treatment had an effect on the neuronal component of the retina but not on the vasculature.

  11. [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.

  12. 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...

  13. 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

  14. Retinopathy of Prematurity in Triplets

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Şekeroğlu

    2016-06-01

    Full Text Available Objectives: To investigate the incidence, severity and risk factors of retinopathy of prematurity (ROP in triplets. Materials and Methods: The medical records of consecutive premature triplets who had been screened for ROP in a single maternity hospital were analyzed and presence and severity of ROP; birth weight, gender, gestational age of the infant; route of delivery and the mode of conception were recorded. Results: A total of 54 triplets (40 males, 14 females who were screened for ROP between March 2010 and February 2013 were recruited for the study. All triplets were delivered by Caesarean section and 36 (66.7% were born following an assisted conception. During follow-up, seven (13% of the infants developed ROP of any stage and two (3.7% required laser photocoagulation. The mean gestational age of triplets with ROP was 27.6±1.5 (27-31 weeks whereas it was 32.0±1.5 (30-34 weeks in those without ROP (p=0.002. The mean birth weights of triplets with and without ROP were 1290.0±295.2 (970-1600 g and 1667.5±222.2 (1130-1960 g, respectively (p<0.001. The presence of ROP was not associated with gender (p=0.358 or mode of conception (p=0.674. Conclusion: ROP in triplets seems to be mainly related to low gestational age and low birth weight. Further prospective randomized studies are necessary to demonstrate risk factors of ROP in triplets and to determine if and how gemelarity plays a role in the development of ROP.

  15. Turbine airfoil with outer wall thickness indicators

    Science.gov (United States)

    Marra, John J; James, Allister W; Merrill, Gary B

    2013-08-06

    A turbine airfoil usable in a turbine engine and including a depth indicator for determining outer wall blade thickness. The airfoil may include an outer wall having a plurality of grooves in the outer surface of the outer wall. The grooves may have a depth that represents a desired outer surface and wall thickness of the outer wall. The material forming an outer surface of the outer wall may be removed to be flush with an innermost point in each groove, thereby reducing the wall thickness and increasing efficiency. The plurality of grooves may be positioned in a radially outer region of the airfoil proximate to the tip.

  16. Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the “flying saucer” sign

    Directory of Open Access Journals (Sweden)

    Eric Chen

    2010-10-01

    Full Text Available Eric Chen, David M Brown, Matthew S Benz, Richard H Fish, Tien P Wong, Rosa Y Kim, James C MajorRetina Consultants of Houston, The Methodist Hospital, Houston, Texas, USAPurpose: While the long-term incidence of hydroxychloroquine (HCQ retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT to assess the feasibility of identifying HCQ retinopathy at an early stage.Methods: Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers.Results: Five patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS junction with intact outer retina directly under the fovea, creating the “flying saucer” sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none.Conclusion: Outer retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.Keywords: drug toxicity, hydroxychloroquine, photoreceptors, screening test

  17. Spectral domain optical coherence tomography as an effective screening test for hydroxychloroquine retinopathy (the "flying saucer" sign).

    Science.gov (United States)

    Chen, Eric; Brown, David M; Benz, Matthew S; Fish, Richard H; Wong, Tien P; Kim, Rosa Y; Major, James C

    2010-10-21

    While the long-term incidence of hydroxychloroquine (HCQ) retinopathy is low, there remains no definitive clinical screening test to recognize HCQ toxicity before ophthalmoscopic fundus changes or visual symptoms. Patients receiving HCQ were evaluated with spectral domain optical coherence tomography (SD OCT) to assess the feasibility of identifying HCQ retinopathy at an early stage. Twenty-five patients referred for the evaluation of hydroxychloroquine toxicity underwent a comprehensive ocular examination, Humphrey visual field (HVF) perimetry, time domain OCT, and SD OCT. Some patients with screening abnormalities also underwent further diagnostic testing at the discretion of the treating providers. Five patients were found to have SD OCT findings corresponding to HCQ toxicity and retinal damage as seen by clinical exam and/or HVF perimetry. Two patients with advanced toxicity were found to have significant outer retina disruption in the macula on SD OCT. Three patients with early HCQ toxicity and HVF 10-2 perifoveal defects were found to have loss of the perifoveal photoreceptor inner segment/outer segment (IS/OS) junction with intact outer retina directly under the fovea, creating the "flying saucer" sign. While two of these three patients had early ophthalmoscopic fundus changes, one had none. Outer retinal abnormalities including perifoveal photoreceptor IS/OS junction disruption can be identified by SD OCT in early HCQ toxicity, sometimes even before ophthalmoscopic fundus changes are apparent. SD OCT may have a potential complementary role in screening for HCQ retinopathy due to its quick acquisition and because it is more objective than automated perimetry.

  18. Quality assurance for diabetic retinopathy telescreening.

    Science.gov (United States)

    Schneider, S; Aldington, S J; Kohner, E M; Luzio, S; Owens, D R; Schmidt, V; Schuell, H; Zahlmann, G

    2005-06-01

    TOSCA was an EU-Commission supported international research project designed to develop telescreening services in diabetic retinopathy and glaucoma. This paper describes the quality assurance methods developed for the diabetic retinopathy telescreening service within the TOSCA project. The study was performed in 1895 patients with diabetes between 2000 and 2002 at diabetic retinopathy screening sites in five European countries. Data were analysed centrally. Patients attending each clinic's diabetic retinopathy screening service received standardized retinal photography. The images and associated data were transferred electronically to a remote location for grading. Each photographer uploading images and each grader downloading images for assessment was controlled by a systematic quality management approach. The quality assurance measures defined were image quality, intragrader reliability. A cockpit chart was developed for the management and presentation of relevant results and quality measures. For the intragrader reliability tests, 10% of the images were processed for a second grading. An algorithm for calculating differences between repeated gradings was developed. The assessment of image quality for the different sites showed that only 0-0.7% were unassessable. One hundred per cent agreement for both gradings was achieved in 50-85% of graded cases, depending on site and grader, and an agreement better than 95% in 71-100% of cases. A telemedicine-supported quality assurance process is practical and advantageous. The cockpit charts have proven to be useful tools when monitoring the performance of a telescreening service. Grader feedback showed high satisfaction with the quality assurance process.

  19. Presumed Chloroquine Retinopathy in Ibadan | Ajayi | Nigerian ...

    African Journals Online (AJOL)

    Objective: To review patients with clinical features of chloroquine retinopathy seen during the study period with the view of identifying the trend and creating public awareness for behavioural change. Methods: A retrospective review of case notes of patients seen between 1996 and 2002. Results: 19 patients with features of ...

  20. Oxidative stress in diabetic patients with retinopathy

    African Journals Online (AJOL)

    one of the late complications of diabetes mellitus is diabetic retinopathy, which is a leading cause of acquired blindness. ... cataract. Chronic hyperglycemia and its associated ... microvascular disease. This may be ... as ulcers, neuropathy, and nephropathy which are ... 10 ml of venous blood was collected from the median.

  1. Pericentral retinopathy and racial differences in hydroxychloroquine toxicity.

    Science.gov (United States)

    Melles, Ronald B; Marmor, Michael F

    2015-01-01

    To describe patterns of hydroxychloroquine retinopathy distinct from the classic parafoveal (bull's eye) maculopathy. Retrospective case series. Patients from a large multi-provider group practice and a smaller university referral practice diagnosed with hydroxychloroquine retinopathy. Patients with widespread or "end-stage" retinopathy were excluded. Review of ophthalmic studies (fundus photography, spectral-domain optical coherence tomography, fundus autofluorescence, multifocal electroretinography, visual fields) and classification of retinopathy into 1 of 3 patterns: parafoveal (retinal changes 2°-6° from the fovea), pericentral (retinal changes ≥ 8° from the fovea), or mixed (retinal changes in both parafoveal and pericentral areas). Relative frequency of different patterns of hydroxychloroquine retinopathy and comparison of risk factors. Of 201 total patients (18% Asian) with hydroxychloroquine retinopathy, 153 (76%) had typical parafoveal changes, 24 (12%) also had a zone of pericentral damage, and 24 (12%) had pericentral retinopathy without any parafoveal damage. Pericentral retinopathy alone was seen in 50% of Asian patients but only in 2% of white patients. Patients with the pericentral pattern were taking hydroxychloroquine for a somewhat longer duration (19.5 vs. 15.0 years, P Hydroxychloroquine retinopathy does not always develop in a parafoveal (bull's eye) pattern, and a pericentral pattern of damage is especially prevalent among Asian patients. Screening practices may need to be adjusted to recognize pericentral and parafoveal hydroxychloroquine retinopathy. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  2. 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

  3. [Diabetic retinopathy: pathogenesis and therapeutic implications].

    Science.gov (United States)

    Pelikánová, Terezie

    Diabetic retinopathy (DR) develops in patients with both type 1 and type 2 diabetes and is the major cause of vision loss and blindness in the working population. The main risk factor of DR is hyperglycemia accompanied by enhanced mitochondrial production of reactive oxygen species and oxidative stress, formation of advanced glycation end products (AGE) and hexosamines, increase in polyol metabolism of glucose. The severity of vascular injury depends on the individual genetic background and is modified by other epigenetic, metabolic and haemodynamic factors, including hypertension, dyslipidemia and oxidative stress. In diabetes, damage to the retina occurs in the vasculature (endothelial cells and pericytes), neurons and glia, pigment epithelial cells and infiltrating immunocompetent cells: monocytes, granulocytes, lymfocytes. These activated cells change the production pattern of a number of mediators such as growth factors, proinflammatory cytokines, vasoactive molecules, coagulation factors and adhesion molecules resulting in increased blood flow, increased capillary permeability, proliferation of extracellular matrix and thickening of basal membranes, altered cell turnover (apoptosis, proliferation, hypertrophy), procoagulant and proaggregant pattern, and finally in angiogenesis and tissue remodelling. Brain, liver, adipose tissue, GUT, skeletal muscle and other tissues could be another source of mediators. Therapeutic approaches used for patients with or at risk for diabetic retinopathy include drug therapy to reduce modifiable risk factors, laser photocoagulation, intravitreous administration of anti-VEGF agents/steroids and intraocular surgery. Screening plays an important role in early detection and intervention to prevent the progression of diabetic retinopathy. Described insights into pathophysiological mechanisms responsible for DR, could help in the development of more targeted approach for prevention and treatment of diabetic retinopathy. anti

  4. The CMS Outer Hadron Calorimeter

    CERN Document Server

    Acharya, Bannaje Sripathi; Banerjee, Sunanda; Banerjee, Sudeshna; Bawa, Harinder Singh; Beri, Suman Bala; Bhandari, Virender; Bhatnagar, Vipin; Chendvankar, Sanjay; Deshpande, Pandurang Vishnu; Dugad, Shashikant; Ganguli, Som N; Guchait, Monoranjan; Gurtu, Atul; Kalmani, Suresh Devendrappa; Kaur, Manjit; Kohli, Jatinder Mohan; Krishnaswamy, Marthi Ramaswamy; Kumar, Arun; Maity, Manas; Majumder, Gobinda; Mazumdar, Kajari; Mondal, Naba Kumar; Nagaraj, P; Narasimham, Vemuri Syamala; Patil, Mandakini Ravindra; Reddy, L V; Satyanarayana, B; Sharma, Seema; Singh, B; Singh, Jas Bir; Sudhakar, Katta; Tonwar, Suresh C; Verma, Piyush

    2006-01-01

    The CMS hadron calorimeter is a sampling calorimeter with brass absorber and plastic scintillator tiles with wavelength shifting fibres for carrying the light to the readout device. The barrel hadron calorimeter is complemented with a outer calorimeter to ensure high energy shower containment in CMS and thus working as a tail catcher. Fabrication, testing and calibrations of the outer hadron calorimeter are carried out keeping in mind its importance in the energy measurement of jets in view of linearity and resolution. It will provide a net improvement in missing $\\et$ measurements at LHC energies. The outer hadron calorimeter has a very good signal to background ratio even for a minimum ionising particle and can hence be used in coincidence with the Resistive Plate Chambers of the CMS detector for the muon trigger.

  5. Origin of Outer Solar System

    Science.gov (United States)

    Holman, Matthew J.; Lindstrom, David (Technical Monitor)

    2005-01-01

    Our ongoing research program combines extensive deep and wide-field observations using a variety of observational platforms with numerical studies of the dynamics of small bodies in the outer solar system in order to advance the main scientific goals of the community studying the Kuiper belt and the outer solar system. These include: (1) determining the relative populations of the known classes of KBOs as well as other possible classes; ( 2 ) determining the size distributions or luminosity function of the individual populations or the Kuiper belt as a whole; (3) determining the inclinations distributions of these populations; (4) establishing the radial extent of the Kuiper belt; ( 5 ) measuring and relating the physical properties of different types of KBOs to those of other solar system bodies; and, (6) completing our systematic inventory of the satellites of the outer planets.

  6. Acute Solar Retinopathy Imaged With Adaptive Optics, Optical Coherence Tomography Angiography, and En Face Optical Coherence Tomography.

    Science.gov (United States)

    Wu, Chris Y; Jansen, Michael E; Andrade, Jorge; Chui, Toco Y P; Do, Anna T; Rosen, Richard B; Deobhakta, Avnish

    2018-01-01

    Solar retinopathy is a rare form of retinal injury that occurs after direct sungazing. To enhance understanding of the structural changes that occur in solar retinopathy by obtaining high-resolution in vivo en face images. Case report of a young adult woman who presented to the New York Eye and Ear Infirmary with symptoms of acute solar retinopathy after viewing the solar eclipse on August 21, 2017. Results of comprehensive ophthalmic examination and images obtained by fundus photography, microperimetry, spectral-domain optical coherence tomography (OCT), adaptive optics scanning light ophthalmoscopy, OCT angiography, and en face OCT. The patient was examined after viewing the solar eclipse. Visual acuity was 20/20 OD and 20/25 OS. The patient was left-eye dominant. Spectral-domain OCT images were consistent with mild and severe acute solar retinopathy in the right and left eye, respectively. Microperimetry was normal in the right eye but showed paracentral decreased retinal sensitivity in the left eye with a central absolute scotoma. Adaptive optics images of the right eye showed a small region of nonwaveguiding photoreceptors, while images of the left eye showed a large area of abnormal and nonwaveguiding photoreceptors. Optical coherence tomography angiography images were normal in both eyes. En face OCT images of the right eye showed a small circular hyperreflective area, with central hyporeflectivity in the outer retina of the right eye. The left eye showed a hyperreflective lesion that intensified in area from inner to middle retina and became mostly hyporeflective in the outer retina. The shape of the lesion on adaptive optics and en face OCT images of the left eye corresponded to the shape of the scotoma drawn by the patient on Amsler grid. Acute solar retinopathy can present with foveal cone photoreceptor mosaic disturbances on adaptive optics scanning light ophthalmoscopy imaging. Corresponding reflectivity changes can be seen on en face OCT, especially

  7. Retinopathy secondary to radiation therapy for squamous cell carcinoma

    International Nuclear Information System (INIS)

    Groomer, A.E.; Gutwein, D.E.

    1989-01-01

    This report discusses a case of radiotherapy-induced retinopathy following treatment of squamous cell carcinoma. Treatment of the carcinoma with external beam radiotherapy to the supraorbital region and base of the skull was followed by the onset of retinopathy. The sensory retina, as well as other central nervous system tissues, is highly resistant to radiation damage; however, the retinal vasculature is extremely sensitive to radiation damage, producing a retinopathy that is characteristic of other vascular occlusive diseases. Management is discussed

  8. Nuclear fuel grid outer strap

    International Nuclear Information System (INIS)

    Duncan, R.; Craver, J.E.

    1989-01-01

    This patent describes a nuclear reactor fuel assembly grid. It comprises a first outer grip strap segment end. The first end having a first tab arranged in substantially the same plane as the plane defined by the first end; a second outer grip strap end. The second end having a second slot arranged in substantially the same plane as the plane defined by the second end, with the tab being substantially disposed in the slot, defining a socket therebetween; and a fort tine interposed substantially perpendicularly in the socket

  9. 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.

  10. Physical activity and its correlation to diabetic retinopathy.

    Science.gov (United States)

    Praidou, Anna; Harris, Martin; Niakas, Dimitrios; Labiris, Georgios

    2017-02-01

    The lack of physical activity, along with obesity, smoking, hypertension and hyperglycaemia are considered as risk factors for the occurrence of diseases such as diabetes. Primary objective of the study was to investigate potential correlation between physical activity and diabetic retinopathy. Three hundred and twenty patients were included in the study: 240 patients with diabetes type 2 (80 patients with mild to moderate non-proliferative diabetic retinopathy, 80 patients with severe to very severe non-proliferative diabetic retinopathy and 80 ones with proliferative diabetic retinopathy) were compared with 80 non-diabetic patients (control group). Physical activity of patients was assessed by the international physical activity questionnaire (IPAQ, 2002). HbA1c and BMI were also measured in diabetic patients. Group comparisons were attempted for levels of physical activity and sedentary behavior. Total physical activity was decreased in patients with severe to very severe non-proliferative diabetic retinopathy and proliferative diabetic retinopathy as compared to patients with mild to moderate non-proliferative diabetic retinopathy and to the control group (pdiabetic retinopathy and physical activity has been demonstrated (pdiabetic retinopathy, independent of the effects of HbA1c and BMI. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Structural neurodegeneration correlates with early diabetic retinopathy

    DEFF Research Database (Denmark)

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

    2018-01-01

    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 Topcon TRC-NW6S, a single, certified grader determined the presence of DR according to the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Retinal neurodegeneration was evaluated by Topcon 3D OCT-2000 spectral domain optical coherence tomography (OCT) and by a RETI-scan multifocal...... electroretinography (mf-ERG) system in rings 1-6. RESULTS: Median age and duration of diabetes were 63.6 and 10 years, respectively, and 46% were men. Median HbA1c was 50 mmol/mol (6.7%), and ETDRS levels were 10 (41.7%, n = 43), 20 (35.0%, n = 36), and 35 (23.3%, n = 24). The duration of diabetes increased...

  12. Neurodegeneration and Neuroprotection in Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Abdullah S. Alhomida

    2013-01-01

    Full Text Available Diabetic retinopathy is widely considered to be a neurovascular disease. This is in contrast to its previous identity as solely a vascular disease. Early in the disease progression of diabetes, the major cells in the neuronal component of the retina consist of retinal ganglion cells and glial cells, both of which have been found to be compromised. A number of retinal function tests also indicated a functional deficit in diabetic retina, which further supports dysfunction of neuronal cells. As an endocrinological disorder, diabetes alters metabolism both systemically and locally in several body organs, including the retina. A growing body of evidences indicates increased levels of excitotoxic metabolites, including glutamate, branched chain amino acids and homocysteine in cases of diabetic retinopathy. Also present, early in the disease, are decreased levels of folic acid and vitamin-B12, which are potential metabolites capable of damaging neurons. These altered levels of metabolites are found to activate several metabolic pathways, leading to increases in oxidative stress and decreases in the level of neurotrophic factors. As a consequence, they may damage retinal neurons in diabetic patients. In this review, we have discussed those potential excitotoxic metabolites and their implications in neuronal damage. Possible therapeutic targets to protect neurons are also discussed. However, further research is needed to understand the exact molecular mechanism of neurodegeneration so that effective neuroprotection strategies can be developed. By protecting retinal neurons early in diabetic retinopathy cases, damage of retinal vessels can be protected, thereby helping to ameliorate the progression of diabetic retinopathy, a leading cause of blindness worldwide.

  13. 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.

  14. Update on the Treatment of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Jennifer L. Wilkinson-Berka

    2008-01-01

    Full Text Available Retinopathy is the most feared complication of diabetes, compromising quality of life in most sufferers. Almost all patients with type 1 diabetes will develop retinopathy over a 15- to 20-year period, and approximately 20–30% will advance to the blinding stage of the disease[1]. Greater than 60% of patients with type 2 diabetes will have retinopathy. This situation is highlighted by the frightening statistic that diabetic retinopathy (DR remains the most common cause of vision impairment in people of working age in Western society. With the global epidemic of type 2 diabetes, this predicament is set to worsen as over 360 million people are projected to suffer from diabetes and its complications by 2030. Vision loss from diabetes is due to a number of factors, including haemorrhage from new and poorly formed blood vessels, retinal detachment due to contraction of deposited fibrous tissue, and neovascular glaucoma resulting in an increase in intraocular pressure. Diabetic macular oedema is now the principal cause of vision loss in diabetes and involves leakage from a disrupted blood-retinal barrier. In terms of treatment, there is clear evidence that strict metabolic and blood pressure control can lower the risk of developing DR and reduce disease progression. Laser photocoagulation and vitrectomy are effective in preventing severe vision loss in DR, particularly in the most advanced stages of the disease. However, both procedures have limitations. This review examines evidence from preclinical and clinical studies that shows that targeting inhibition of the renin-angiotensin system, vascular endothelial growth factor, corticosteroids, protein kinase C, growth hormone, and advanced glycation end-products are potential treatments for DR.

  15. Getting Sloshed in Outer Space

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 12; Issue 12. Getting Sloshed in Outer Space - Liquid Behavior in Microgravity. N Ananthkrishnan. General Article Volume 12 Issue 12 December 2007 pp 40-45. Fulltext. Click here to view fulltext PDF. Permanent link:

  16. Outer space structure and development

    International Nuclear Information System (INIS)

    Zeldovich, J.; Novikov, I.

    1975-01-01

    A brief account is presented answering the question of what in fact the outer space we observe consists of. The principle of spatial homogeneity of the universe and the idea of non-stationary cosmology are discussed. The origin and the future development of the universe are explained using the two above mentioned and some other hypotheses. (J.K.)

  17. Outer space structure and development

    Energy Technology Data Exchange (ETDEWEB)

    Zeldovich, J; Novikov, I

    1975-10-01

    A brief account is presented answering the question of what in fact the outer space we observe consists of. The principle of spatial homogeneity of the universe and the idea of non-stationary cosmology are discussed. The origin and the future development of the universe are explained using the two above mentioned and some other hypotheses.

  18. Plasmas in the outer heliosphere

    Science.gov (United States)

    Belcher, J. W.; Richardson, J. D.; Lazarus, A. J.; Gazis, P. R.; Barnes, A.

    1995-01-01

    We review the observed properties of the solar wind in the outer heliosphere, including observations from Voyager and the Pioneers, as well as from inner heliospheric probes as appropriate. These observations are crucial to modeling of the heliosphere and its interactions with the interstellar medium, since the wind ram pressure and its temporal variations are important in understanding the distance to the termination shock and heliopause and how those boundaries might vary in time. We focus on results since Solar Wind 7. Among the issues we will discuss are: (1) the time scales for and statistical properties of variations in the ram pressure in the outer heliosphere, and how those variations might affect the morphology of the heliospheric/interstellar medium interface; (2) the question of possible solar wind slowing in the outer heliosphere due to the pick-up of interstellar ions; (3) the issue of whether there is bulk heating of the solar wind associated either with interstellar ion pick-up or with continued heating due to stream-stream interactions; (4) evidence for latitudinal variations in solar wind properties; and (5) the 1.3 year periodicities apparent in the outer heliosphere, and the close correspondence with similar variations seen with inner heliospheric probes.

  19. Outer Synchronization of Complex Networks by Impulse

    International Nuclear Information System (INIS)

    Sun Wen; Yan Zizong; Chen Shihua; Lü Jinhu

    2011-01-01

    This paper investigates outer synchronization of complex networks, especially, outer complete synchronization and outer anti-synchronization between the driving network and the response network. Employing the impulsive control method which is uncontinuous, simple, efficient, low-cost and easy to implement in practical applications, we obtain some sufficient conditions of outer complete synchronization and outer anti-synchronization between two complex networks. Numerical simulations demonstrate the effectiveness of the proposed impulsive control scheme. (general)

  20. Relevance of Retinal Thickness Changes in the OCT Inner and Outer Rings to Predict Progression to Clinical Macular Edema

    DEFF Research Database (Denmark)

    Vujosevic, Stela; Varano, Monica; Egan, Catherine

    2015-01-01

    PURPOSE: To characterize the relevance of macular thickness changes in the inner and outer rings in the progression of macular edema in eyes/patients with diabetes type 2. METHODS: A total of 374 type 2 diabetic patients with mild nonproliferative diabetic retinopathy (ETDRS levels 20-35) were...... included in a 12-month prospective observational study to identify retinopathy progression. Retinal thickness analyses were performed in 194 eyes/patients using Cirrus SD- OCT and 166 eyes/patients using Spectralis SD-OCT. The DRCR.net classification of subclinical and clinical macular edema was used....... A composite grading of macular edema is proposed in this study. RESULTS: A total of 317 eyes/patients completed the study. SD-OCT identified clinical macular edema in 24 eyes/patients (6.7%) and subclinical macular edema in 104 eyes/patients (28.9%) at baseline. Increased thickness of the central subfield...

  1. Turbine airfoil with a compliant outer wall

    Science.gov (United States)

    Campbell, Christian X [Oviedo, FL; Morrison, Jay A [Oviedo, FL

    2012-04-03

    A turbine airfoil usable in a turbine engine with a cooling system and a compliant dual wall configuration configured to enable thermal expansion between inner and outer layers while eliminating stress formation in the outer layer is disclosed. The compliant dual wall configuration may be formed a dual wall formed from inner and outer layers separated by a support structure. The outer layer may be a compliant layer configured such that the outer layer may thermally expand and thereby reduce the stress within the outer layer. The outer layer may be formed from a nonplanar surface configured to thermally expand. In another embodiment, the outer layer may be planar and include a plurality of slots enabling unrestricted thermal expansion in a direction aligned with the outer layer.

  2. 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.

  3. Outcomes of vitrectomy for advanced diabetic retinopathy at Groote ...

    African Journals Online (AJOL)

    Background. Present limitations in primary and secondary prevention of diabetic retinopathy mean that many patients with diabetes present with advanced retinal complications, often requiring surgery (vitrectomy). Objectives. To determine the outcomes of vitrectomy for advanced diabetic retinopathy and to examine ...

  4. Pattern of diabetic retinopathy in Kano, Nigeria | Lawan | Annals of ...

    African Journals Online (AJOL)

    Pattern of diabetic retinopathy in Kano, Nigeria. ... Background: The aim of the study is to determine the pattern of retinopathy seen in diabetic patients attending the outpatient clinic in Aminu Kano Teaching Hospital, Kano, ... A screening program needs to be developed to facilitate early detection and prompt treatment.

  5. Global prevalence and major risk factors of diabetic retinopathy

    NARCIS (Netherlands)

    J.W.Y. Yau (Joanne W.); S.L. Rogers (Sophie); Y. Kawasaki; E.L. Lamoureux (Ecosse); J.W. Kowalski (Jonathan); T. Bek (Toke); S.-J. Chen (Shih-Jen); J.M. Dekker (Jacqueline); A.E. Fletcher (Astrid E.); J. Grauslund (Jakob); R.C.G. Haffner; U. Hamman (Ute); M.K. Ikram (Kamran); T. Kayama (Takamasa); B.E.K. Klein (Barbara); B.E.K. Klein (Barbara); S. Krishnaiah (Sannapaneni); K. Mayurasakorn (Korapat); J.P. O'Hare (Joseph); T. Orchard; M. Porta; M. Rema (Mohan); M.S. Roy (Monique); T. Sharma (Tarun); S-M. Saw (Seang-Mei); H. Taylor (Hugh); J.M. Tielsch (James); D. Varma (Dhiraj); J.J. Wang (Jie Jin); N. Wang (Ningli); S. West (Sheila); L. Zu (Liang); M. Yasuda (Maya); X. Zhang (Xinzhi); P. Mitchell (Paul); T.Y. Wong (Tien Yin)

    2012-01-01

    textabstractOBJECTIVE - To examine the global prevalence and major risk factors for diabetic retinopathy (DR) and vision-threatening diabetic retinopathy (VTDR) among people with diabetes. RESEARCH DESIGN AND METHODS - A pooled analysis using individual participant data from population-based studies

  6. Characteristics of patients with diabetic retinopathy in Gaborone ...

    African Journals Online (AJOL)

    (GLLAMMs) to account for the non-independence of the eye diabetic retinopathy outcome at the patient level (Rabe-Hesketh et al., 2000). This model allowed for analysis of a polytomous ordinal response on a set of predictors and computed the odds ratios (OR) of having a more severe diabetic retinopathy grade compared ...

  7. Bevacizumab treatment for retinopathy of prematurity in South Africa

    African Journals Online (AJOL)

    Retinopathy of prematurity (ROP) is a growing problem in South. Africa (SA), as it is .... detected in the serum of both infants and adults after intraocular injection,[7] ... use of anti-VEGF agents to treat macular degeneration, diabetic retinopathy ...

  8. Lipoprotein(a Serum Levels in Diabetic Patients with Retinopathy

    Directory of Open Access Journals (Sweden)

    Giulia Malaguarnera

    2013-01-01

    Full Text Available Background. Atherogenic lipoproteins, such as total cholesterol, LDL cholesterol, oxidized low density lipoprotein, and triglycerides, are associated with progression of retinopathy. Aim. To evaluate the relationship between lipoprotein(a and retinopathy in patients with type 2 diabetes mellitus. Materials and Methods. We enrolled 145 diabetic consecutive patients (82 females, 63 males; mean age 66.8±12 years, mean duration of diabetes 9.4±6.8 years. Presence and severity of retinopathy were evaluated. Serum lipid profile, including Lp(a level, was assessed. Results. High Lp(a levels have been observed in 54 (78.3% subjects and normal levels in 13 (18.85% subjects as regards diabetic patients with retinopathy. Lp(a levels were high in 15 subjects (21.75% and normal in 63 subjects (91.35% as regards patients without retinopathy. Conclusions. Lp(a levels are increased in a significant percentage of patients with retinopathy compared to diabetic patients without retinopathy. The impact of Lp(a levels on diabetic retinopathy needs to be further investigated.

  9. Hypoxia-induced retinopathy model in adult zebrafish

    DEFF Research Database (Denmark)

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

    2010-01-01

    Hypoxia-induced vascular responses, including angiogenesis, vascular remodeling and vascular leakage, significantly contribute to the onset, development and progression of retinopathy. However, until recently there were no appropriate animal disease models recapitulating adult retinopathy available....... 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......-induced retinopathy model in adult zebrafish. This model provides a unique opportunity to study kinetically the development of retinopathy in adult animals using noninvasive protocols and to assess therapeutic efficacy of orally active antiangiogenic drugs....

  10. 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.

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

    Science.gov (United States)

    Amin, Javeria; Sharif, Muhammad; Yasmin, Mussarat

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  13. C-reactive protein and chitinase 3-like protein 1 as biomarkers of spatial redistribution of retinal blood vessels on digital retinal photography in patients with diabetic retinopathy.

    Science.gov (United States)

    Cekić, Sonja; Cvetković, Tatjana; Jovanović, Ivan; Jovanović, Predrag; Pesić, Milica; Stanković Babić, Gordana; Milenković, Svetislav; Risimić, Dijana

    2014-08-20

    The aim of the study was to investigate the correlation between the levels of C-reactive protein (CRP) and chitinase 3-like protein 1 (YKL-40) in blood samples with morpohometric parameters of retinal blood vessels in patients with diabetic retinopathy. Blood laboratory examination of 90 patients included the measurement of glycemia, HbA1C, total cholesterol, LDL-C, HDL-C, triglycerides and CRP. Levels of YKL-40 were detected and measured in serum by ELISA (Micro VueYKL-40 EIA Kit, Quidel Corporation, San Diego, USA). YKL-40 correlated positively with diameter and negatively with number of retinal blood vessels. The average number of the blood vessels per retinal zone was significantly higher in the group of patients with mild non-proliferative diabetic retinopathy than in the group with severe form in the optic disc and all five retinal zones. The average outer diameter of the evaluated retinal zones and optic disc vessels was significantly higher in the group with severe compared to the group with mild diabetic retinopathy. Morphological analysis of the retinal vessels on digital fundus photography and correlation with YKL-40 may be valuable for the follow-up of diabetic retinopathy.

  14. Mitochondrial dysfunction underlying outer retinal diseases

    DEFF Research Database (Denmark)

    Lefevere, Evy; Toft-Kehler, Anne Katrine; Vohra, Rupali

    2017-01-01

    Dysfunction of photoreceptors, retinal pigment epithelium (RPE) or both contribute to the initiation and progression of several outer retinal disorders. Disrupted Müller glia function might additionally subsidize to these diseases. Mitochondrial malfunctioning is importantly associated with outer...

  15. MULTIMODAL IMAGING OF MOSAIC RETINOPATHY IN CARRIERS OF HEREDITARY X-LINKED RECESSIVE DISEASES.

    Science.gov (United States)

    Wu, An-Lun; Wang, Jung-Pan; Tseng, Yun-Ju; Liu, Laura; Kang, Yu-Chuan; Chen, Kuan-Jen; Chao, An-Ning; Yeh, Lung-Kun; Chen, Tun-Lu; Hwang, Yih-Shiou; Wu, Wei-Chi; Lai, Chi-Chun; Wang, Nan-Kai

    2018-05-01

    To investigate the clinical features in carriers of X-linked retinitis pigmentosa, X-linked ocular albinism, and choroideremia (CHM) using multimodal imaging and to assess their diagnostic value in these three mosaic retinopathies. We prospectively examined 14 carriers of 3 X-linked recessive disorders (X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM). Details of abnormalities of retinal morphology were evaluated using fundus photography, fundus autofluorescence (FAF) imaging, and spectral domain optical coherence tomography. In six X-linked retinitis pigmentosa carriers, fundus appearance varied from unremarkable to the presence of tapetal-like reflex and pigmentary changes. On FAF imaging, all carriers exhibited a bright radial reflex against a dark background. By spectral domain optical coherence tomography, loss of the ellipsoid zone in the macula was observed in 3 carriers (50%). Regarding the retinal laminar architecture, 4 carriers (66.7%) showed thinning of the outer nuclear layer and a dentate appearance of the outer plexiform layer. All five X-linked ocular albinism carriers showed a characteristic mud-splatter patterned fundus, dark radial streaks against a bright background on FAF imaging, and a normal-appearing retinal structure by spectral domain optical coherence tomography imaging. Two of the 3 CHM carriers (66.7%) showed a diffuse moth-eaten appearance of the fundus, and all 3 showed irregular hyper-FAF and hypo-FAF spots throughout the affected area. In the CHM carriers, the structural changes observed by spectral domain optical coherence tomography imaging were variable. Our findings in an Asian cohort suggest that FAF imaging is a practical diagnostic test for differentiating X-linked retinitis pigmentosa, X-linked ocular albinism, and CHM carriers. Wide-field FAF is an easy and helpful adjunct to testing for the correct diagnosis and identification of lyonization in carriers of these three mosaic retinopathies.

  16. WORKSHOP: Inner space - outer space

    International Nuclear Information System (INIS)

    Anon.

    1984-01-01

    During the first week of May, the Fermilab theoretical astrophysics group hosted an international conference on science at the interface of particle physics and cosmology/astrophysics. The conference (Inner Space-Outer Space) was attended by a very diverse group of more than 200 physical scientists, including astronomers, astrophysicists, cosmologists, low-temperature physicists, and elementary particle theorists and experimentalists. The common interest which brought this diverse group to gether is the connection between physics on the smallest scale probed by man - the realm of elementary particle physics - and physics on the largest scale imaginable (the entire Universe) - the realm of cosmology

  17. WORKSHOP: Inner space - outer space

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1984-09-15

    During the first week of May, the Fermilab theoretical astrophysics group hosted an international conference on science at the interface of particle physics and cosmology/astrophysics. The conference (Inner Space-Outer Space) was attended by a very diverse group of more than 200 physical scientists, including astronomers, astrophysicists, cosmologists, low-temperature physicists, and elementary particle theorists and experimentalists. The common interest which brought this diverse group to gether is the connection between physics on the smallest scale probed by man - the realm of elementary particle physics - and physics on the largest scale imaginable (the entire Universe) - the realm of cosmology.

  18. Outer scale of atmospheric turbulence

    Science.gov (United States)

    Lukin, Vladimir P.

    2005-10-01

    In the early 70's, the scientists in Italy (A.Consortini, M.Bertolotti, L.Ronchi), USA (R.Buser, Ochs, S.Clifford) and USSR (V.Pokasov, V.Lukin) almost simultaneously discovered the phenomenon of deviation from the power law and the effect of saturation for the structure phase function. During a period of 35 years we have performed successively the investigations of the effect of low-frequency spectral range of atmospheric turbulence on the optical characteristics. The influence of the turbulence models as well as a outer scale of turbulence on the characteristics of telescopes and systems of laser beam formations has been determined too.

  19. Association between human breast milk and retinopathy of prematurity.

    Science.gov (United States)

    Fonseca, Luciana Teixeira; Senna, Denise C; Eckert, Gabriela Unchalo; Silveira, Rita de Cássia; Procianoy, Renato Soibelmann

    2018-04-01

    To evaluate the possible protective effect of breast milk against retinopathy of prematurity by comparing the amount of breast milk received by patients who developed retinopathy of prematurity and those who did not and to determine both the required minimum amount of breast milk and the time of life during which neonates need to receive breast milk for this effect to be significant. Cohort study of newborns with a birth weight of prematurity of any degree was 31% (100 of 323 patients) and that of severe retinopathy of prematurity was of 9% (29 of 323 patients). The median amounts of breast milk received daily by patients with and without retinopathy of prematurity were 4.9 mL/kg (interquartile range, 0.3-15.4) and 10.2 mL/kg (1.5-25.5), respectively. The amount of breast milk received in the first 6 weeks of life was inversely associated with the incidence of both retinopathy of prematurity of any degree and severe retinopathy of prematurity in the univariate analyses. However, the statistical significance was maintained only during the sixth week of life in a per-period multivariate analysis controlling for confounding factors. Small amounts of breast milk are inadequate to prevent retinopathy of prematurity in premature newborns at risk for the disease.

  20. The worldwide epidemic of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Yingfeng Zheng

    2012-01-01

    Full Text Available Diabetic retinopathy (DR, a major microvascular complication of diabetes, has a significant impact on the world′s health systems. Globally, the number of people with DR will grow from 126.6 million in 2010 to 191.0 million by 2030, and we estimate that the number with vision-threatening diabetic retinopathy (VTDR will increase from 37.3 million to 56.3 million, if prompt action is not taken. Despite growing evidence documenting the effectiveness of routine DR screening and early treatment, DR frequently leads to poor visual functioning and represents the leading cause of blindness in working-age populations. DR has been neglected in health-care research and planning in many low-income countries, where access to trained eye-care professionals and tertiary eye-care services may be inadequate. Demand for, as well as, supply of services may be a problem. Rates of compliance with diabetes medications and annual eye examinations may be low, the reasons for which are multifactorial. Innovative and comprehensive approaches are needed to reduce the risk of vision loss by prompt diagnosis and early treatment of VTDR.

  1. Purtscher's retinopathy followed by neovascular glaucoma

    Directory of Open Access Journals (Sweden)

    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

  2. Four cases of radiation retinopathy and optic neuropathy

    International Nuclear Information System (INIS)

    Konari, Kenji; Suzuki, Jun-ichi; Nakagawa, Takashi

    1996-01-01

    We observed retinopathy and optic neuropathy in 4 patients after radiation for malignancies in the paranasal sinus or the brain. The dosis ranged from 56 Gy for 14 days to 64 Gy for 32 days. The interval between the termination of radiation and onset of fundus lesions ranged from 1 to 36 months, average 16.6 months. The retinopathy appeared as retinal hemorrhage, soft exudates and vitreous hemorrhage. Neovascular glaucoma developed in one eye. The optic neuropathy appeared as pallor of optic disc, disc edema or optic papillitis. Histological studies of one eye with retinopathy showed thickening of retinal capillary walls and rubeosis iridis with angle closure. (author)

  3. Four cases of radiation retinopathy and optic neuropathy

    Energy Technology Data Exchange (ETDEWEB)

    Konari, Kenji; Suzuki, Jun-ichi; Nakagawa, Takashi [Sapporo Medical Coll. (Japan)

    1996-03-01

    We observed retinopathy and optic neuropathy in 4 patients after radiation for malignancies in the paranasal sinus or the brain. The dosis ranged from 56 Gy for 14 days to 64 Gy for 32 days. The interval between the termination of radiation and onset of fundus lesions ranged from 1 to 36 months, average 16.6 months. The retinopathy appeared as retinal hemorrhage, soft exudates and vitreous hemorrhage. Neovascular glaucoma developed in one eye. The optic neuropathy appeared as pallor of optic disc, disc edema or optic papillitis. Histological studies of one eye with retinopathy showed thickening of retinal capillary walls and rubeosis iridis with angle closure. (author).

  4. Radiation retinopathy following treatment of posterior nasal space carcinoma

    International Nuclear Information System (INIS)

    Thompson, G.M.; Migdal, C.S.; Whittle, R.J.M.

    1983-01-01

    Posterior nasal space carcinoma has a high mortality and most patents are treated with radiotherapy. Radiation retinopathy was encountered in 7 out of 10 survivors included in this study. Five of the affected patients lost vision as a result of the retinopathy. One patient required laser photocoagulation and responded well to this treatment. There was a variation in the severity of the retinopathy among the patients studied despite the fact that all patients received a similar dose of radiotherapy. We suspect that previously unrecognised factors in the planning of radiotherapy fields may explain this difference. (author)

  5. Spectral domain optical coherence tomography characteristics in diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Laxmi Gella

    2014-01-01

    Full Text Available Purpose: To report the appearance of diabetic retinopathy lesions using spectral domain optical coherence tomography (SD-OCT. Materials and Methods: A total of 287 eyes of 199 subjects were included. All the subjects underwent complete ophthalmic examination including SD-OCT. Results: The appearance of various lesions of diabetic retinopathy and the retinal layers involved were reported. In subjects with macular edema the prevalence of incomplete PVD was 55.6%. Conclusion: SD-OCT brings new insights into the morphological changes of the retina in diabetic retinopathy.

  6. Diabetic retinopathy in a remote Indigenous primary healthcare population: a Central Australian diabetic retinopathy screening study in the Telehealth Eye and Associated Medical Services Network project.

    Science.gov (United States)

    Brazionis, L; Jenkins, A; Keech, A; Ryan, C; Brown, A; Boffa, J; Bursell, S

    2018-05-01

    To determine diabetic retinopathy prevalence and severity among remote Indigenous Australians. A cross-sectional diabetic retinopathy screening study of Indigenous adults with Type 2 diabetes was conducted by locally trained non-ophthalmic retinal imagers in a remote Aboriginal community-controlled primary healthcare clinic in Central Australia and certified non-ophthalmic graders in a retinal grading centre in Melbourne, Australia. The main outcome measure was prevalence of any diabetic retinopathy and sight-threatening diabetic retinopathy. Among 301 participants (33% male), gradable image rates were 78.7% (n = 237) for diabetic retinopathy and 83.1% (n = 250) for diabetic macular oedema, and 77.7% (n = 234) were gradable for both diabetic retinopathy and diabetic macular oedema. For the gradable subset, the median (range) age was 48 (19-86) years and known diabetes duration 9.0 (0-24) years. The prevalence of diabetic retinopathy was 47% (n = 110) and for diabetic macular oedema it was 14.4% (n = 36). In the fully gradable imaging studies, sight-threatening diabetic retinopathy prevalence was 16.2% (n = 38): 14.1% (n = 33) for clinically significant macular oedema, 1.3% (n = 3) for proliferative diabetic retinopathy and 0.9% (n = 2) for both. Sight-threatening diabetic retinopathy had been treated in 78% of detected cases. A novel telemedicine diabetic retinopathy screening service detected a higher prevalence of 'any' diabetic retinopathy and sight-threatening diabetic retinopathy in a remote primary care setting than reported in earlier surveys among Indigenous and non-Indigenous populations. Whether the observed high prevalence of diabetic retinopathy was attributable to greater detection, increasing diabetic retinopathy prevalence, local factors, or a combination of these requires further investigation and, potentially, specific primary care guidelines for diabetic retinopathy management in remote Australia. Clinical Trials registration number: Australia and

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

    Science.gov (United States)

    McLeod, D Scott; Lutty, Gerard A

    2016-01-01

    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.

  8. C - reactive protein and chitinase 3-like protein 1 as biomarkers of spatial redistribution of retinal blood vessels on digital retinal photography in patients with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Sonja Predrag Cekic

    2014-08-01

    Full Text Available The aim of the study was to investegate the correlation between the levels of CRP and YKL-40 in blood samples with morphometric parameters of retinal blood vessels in patients with diabetic retinopathy.Blood laboratory examination of 90 patients included the measurement of glycemia, HbA1C, total cholesterol, LDL-C, HDL-C, triglycerides and CRP. Levels of YKL-40 were detected and measured in serum by ELISA (Micro VueYKL-40 EIA Kit, Quidel Corporation, San Diego, USA.Morphmetric analysis was performed with ImageJ software (http://rsbweb.nih.gov/ij/ for digital retinal photography. We measured the number, diameter of retinal blood vessels in five different parts concentric to the optic disc. Differences between the morphometric parameters and the blood test analysis results were evaluated using the Student’s t – test. One Way ANOVA was used to establish the significance of differences.CRP and YKL-40 levels were moderately higher in the group of patients with severe diabetic retinopathy. Levels of YKL-40 correlated positively with diameter and negatively with number of retinal blood vessels. The average number of the blood vessels per retinal zone was significantly higher in the group of patients with mild non-proliferative diabetic retinopathy than in the group with severe form in the optic disc and all five retinal zones. The average outer diameter of the evaluated retinal zones and optic disc vessels was significantly higher in the group with severe compared to the group with mild diabetic retinopathy.Morphological analysis of the retinal vessels on digital fundus photography and correlation with YKL-40 may be valuable for the follow-up of diabetic retinopathy.

  9. Predictors of Diabetic Retinopathy in Patients with Type 2 Diabetes ...

    African Journals Online (AJOL)

    type 2 diabetes and diabetic retinopathy (DR) and nephropathy represent one of the ... control, hypertension, dyslipidemia, age of the patient, duration of diabetes .... thus, the presence of one is believed to predict the development of the other.

  10. Argon laser in the treatment of diabetic retinopathy (Preliminary communication)

    International Nuclear Information System (INIS)

    Saprykin, P.I.; Simonova, K.K.; Belyaeva, M.I.

    1974-01-01

    The complications observed in the photocoagulation treatment of diabetic angiopathy and retinopathy include the following conditions: tractional retinal detachment, accelerated development of proliferating retinitis and massive hemmorrhaging into the vitreous body. (V.A.P.)

  11. Incidence, risk factors, and morphology in operating microscope light retinopathy

    International Nuclear Information System (INIS)

    Khwarg, S.G.; Linstone, F.A.; Daniels, S.A.; Isenberg, S.J.; Hanscom, T.A.; Geoghegan, M.; Straatsma, B.R.

    1987-01-01

    A review of 135 consecutive cataract operations identified ten cases (7.4%) of operating microscope light retinopathy. Ophthalmoscopically, these light retinopathy lesions appeared as a focal pigment epithelial change with varying degrees of pigment clumping in the center. Fluorescein angiography accentuated the lesion by demonstrating a sharply demarcated transmission defect, occasionally with multiple satellite lesions. The shape of the lesion matched the shape of the illuminating source of the particular operating microscope used during the surgery. The most significant risk factor associated with the production of these light retinopathy lesions was prolonged operating time. Mean total operating time for the ten patients with light retinopathy was 51 minutes longer than for those without (P less than .0001). Other significant associated factors were the presence of diabetes mellitus (P less than .03), younger age (P less than .05), and the use of hydrochlorothiazide (P less than .04)

  12. 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...

  13. Ultra-wide-field imaging in diabetic retinopathy.

    Science.gov (United States)

    Ghasemi Falavarjani, Khalil; Tsui, Irena; Sadda, Srinivas R

    2017-10-01

    Since 1991, 7-field images captured with 30-50 degree cameras in the Early Treatment Diabetic Retinopathy Study were the gold standard for fundus imaging to study diabetic retinopathy. Ultra-wide-field images cover significantly more area (up to 82%) of the fundus and with ocular steering can in many cases image 100% of the fundus ("panretinal"). Recent advances in image analysis of ultra-wide-field imaging allow for precise measurements of the peripheral retinal lesions. There is a growing consensus in the literature that ultra-wide-field imaging improves detection of peripheral lesions in diabetic retinopathy and leads to more accurate classification of the disease. There is discordance among studies, however, on the correlation between peripheral diabetic lesions and diabetic macular edema and optimal management strategies to treat diabetic retinopathy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. 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)

  15. Bilateral proliferative retinopathy in B-cell acute lymphoblastic leukemia

    Directory of Open Access Journals (Sweden)

    Devesh Kumawat

    2018-01-01

    Full Text Available A 4-year-old child with B-cell acute lymphoblastic leukemia presented with vitreous hemorrhage due to proliferative retinopathy in both eyes. Pars plana vitrectomy was performed in both eyes to clear nonresolving vitreous hemorrhage after systemic stabilization. Visual recovery was limited by the disc drag in the right eye and subfoveal exudation in the left eye. Etiopathogenesis and management of proliferative retinopathy in acute leukemias are discussed.

  16. Efficacy of Intravitreal Bevacizumab for Stage 3+ Retinopathy of Prematurity

    Science.gov (United States)

    Mintz-Hittner, Helen A.; Kennedy, Kathleen A.; Chuang, Alice Z.

    2011-01-01

    BACKGROUND Retinopathy of prematurity is a leading cause of childhood blindness worldwide. Peripheral retinal ablation with conventional (confluent) laser therapy is destructive, causes complications, and does not prevent all vision loss, especially in cases of retinopathy of prematurity affecting zone I of the eye. Case series in which patients were treated with vascular endothelial growth factor inhibitors suggest that these agents may be useful in treating retinopathy of prematurity. METHODS We conducted a prospective, controlled, randomized, stratified, multicenter trial to assess intravitreal bevacizumab monotherapy for zone I or zone II posterior stage 3+ (i.e., stage 3 with plus disease) retinopathy of prematurity. Infants were randomly assigned to receive intravitreal bevacizumab (0.625 mg in 0.025 ml of solution) or conventional laser therapy, bilaterally. The primary ocular outcome was recurrence of retinopathy of prematurity in one or both eyes requiring retreatment before 54 weeks’ postmenstrual age. RESULTS We enrolled 150 infants (total sample of 300 eyes); 143 infants survived to 54 weeks’ postmenstrual age, and the 7 infants who died were not included in the primary-outcome analyses. Retinopathy of prematurity recurred in 4 infants in the bevacizumab group (6 of 140 eyes [4%]) and 19 infants in the laser-therapy group (32 of 146 eyes [22%], P = 0.002). A significant treatment effect was found for zone I retinopathy of prematurity (P = 0.003) but not for zone II disease (P = 0.27). CONCLUSIONS Intravitreal bevacizumab monotherapy, as compared with conventional laser therapy, in infants with stage 3+ retinopathy of prematurity showed a significant benefit for zone I but not zone II disease. Development of peripheral retinal vessels continued after treatment with intravitreal bevacizumab, but conventional laser therapy led to permanent destruction of the peripheral retina. This trial was too small to assess safety. PMID:21323540

  17. Purtscher-like retinopathy in systemic lupus erythematosus.

    Science.gov (United States)

    Wu, Chan; Dai, Rongping; Dong, Fangtian; Wang, Qian

    2014-12-01

    To investigate clinical characteristics of Purtscher-like retinopathy and its clinical implications among patients with systemic lupus erythematosus (SLE). Observational case series. setting: Tertiary medical center. patient population: Patients with SLE who were diagnosed with Purtscher-like retinopathy between 2002 and 2013. observation procedures: Assessment and follow-up in the ophthalmology department. main outcome measure: Visual acuity and funduscopic examination at presentation and at 6 month follow-up, with analysis of the association between Purtscher-like retinopathy and other systemic involvement of SLE and overall disease activity. Among 5688 patients with SLE evaluated, 8 cases of Purtscher-like retinopathy were diagnosed. Typical fundus abnormalities included Purtscher flecken, cotton-wool spots, retinal hemorrhages, macular edema, optic disk swelling, and a pseudo-cherry red spot. Fluorescein angiography abnormalities included areas of capillary nonperfusion corresponding to the retinal whitening, late leakage, peripapillary staining, precapillary occlusion, and slower filling of vessels. The prevalence of central nervous system lupus was significantly higher among those with Purtscher-like retinopathy (6/8) than among 240 patients randomly sampled from those without Purtscher-like retinopathy. A very high SLE Disease Activity Index (≥20) was present in all 8 patients with Purtscher-like retinopathy. All patients received corticosteroids combined with immunosuppressants. For the majority of patients, optic atrophy developed during follow-up with persistent low visual acuity. As a rare and severe ophthalmic complication of SLE, Purtscher-like retinopathy was associated with central nervous system lupus and highly active disease. Visual acuity recovery was usually poor despite prompt treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Purtscher-like retinopathy: A rare complication of peribulbar anesthesia

    OpenAIRE

    Narendran, Siddharth; Saravanan, V R; Pereira, Merlyn

    2016-01-01

    Purtscher and Purtscher-like retinopathy is a distinctive retinal syndrome characterized by ischemic retinal whitening in a peripapillary pattern. We report a case of Purtscher-like retinopathy in a healthy 64-year-old man after a routine peribulbar anesthetic injection for cataract surgery. Although peribulbar anesthesia is considered to be a safer alternative to retrobulbar anesthesia, it has been associated with unusual but grave complications including central retinal artery occlusion.

  19. Purtscher-like retinopathy: A rare complication of peribulbar anesthesia

    Directory of Open Access Journals (Sweden)

    Siddharth Narendran

    2016-01-01

    Full Text Available Purtscher and Purtscher-like retinopathy is a distinctive retinal syndrome characterized by ischemic retinal whitening in a peripapillary pattern. We report a case of Purtscher-like retinopathy in a healthy 64-year-old man after a routine peribulbar anesthetic injection for cataract surgery. Although peribulbar anesthesia is considered to be a safer alternative to retrobulbar anesthesia, it has been associated with unusual but grave complications including central retinal artery occlusion.

  20. Purtscher-like retinopathy: A rare complication of peribulbar anesthesia.

    Science.gov (United States)

    Narendran, Siddharth; Saravanan, V R; Pereira, Merlyn

    2016-06-01

    Purtscher and Purtscher-like retinopathy is a distinctive retinal syndrome characterized by ischemic retinal whitening in a peripapillary pattern. We report a case of Purtscher-like retinopathy in a healthy 64-year-old man after a routine peribulbar anesthetic injection for cataract surgery. Although peribulbar anesthesia is considered to be a safer alternative to retrobulbar anesthesia, it has been associated with unusual but grave complications including central retinal artery occlusion.

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

    OpenAIRE

    Amin, Javeria; Sharif, Muhammad; Yasmin, Mussarat

    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,...

  2. Visual functions and disability in diabetic retinopathy patients

    OpenAIRE

    Shrestha, Gauri Shankar; Kaiti, Raju

    2013-01-01

    Purpose: This study was undertaken to find correlations between visual functions and visual disabilities in patients with diabetic retinopathy. Method: 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 a...

  3. 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.

  4. Canonical Wnt signaling in diabetic retinopathy.

    Science.gov (United States)

    Chen, Qian; Ma, Jian-Xing

    2017-10-01

    Diabetic retinopathy (DR) is a common eye complication of diabetes, and the pathogenic mechanism of DR is still under investigation. The canonical Wnt signaling pathway is an evolutionarily conserved pathway that plays fundamental roles in embryogenesis and adult tissue homeostasis. Wnt signaling regulates expression of multiple genes that control retinal development and eye organogenesis, and dysregulated Wnt signaling plays pathophysiological roles in many ocular diseases, including DR. This review highlights recent progress in studies of Wnt signaling in DR. We discuss Wnt signaling regulation in the retina and dysregulation of Wnt signaling associated with ocular diseases with an emphasis on DR. We also discuss the therapeutic potential of modulating Wnt signaling in DR. Continued studies in this field will advance our current understanding on DR and contribute to the development of new treatments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Diabetic Retinopathy: Vascular and Inflammatory Disease

    Science.gov (United States)

    Semeraro, F.; Cancarini, A.; dell'Omo, R.; Rezzola, S.; Romano, M. R.; Costagliola, C.

    2015-01-01

    Diabetic retinopathy (DR) is the leading cause of visual impairment in the working-age population of the Western world. The pathogenesis of DR is complex and several vascular, inflammatory, and neuronal mechanisms are involved. Inflammation mediates structural and molecular alterations associated with DR. However, the molecular mechanisms underlying the inflammatory pathways associated with DR are not completely characterized. Previous studies indicate that tissue hypoxia and dysregulation of immune responses associated with diabetes mellitus can induce increased expression of numerous vitreous mediators responsible for DR development. Thus, analysis of vitreous humor obtained from diabetic patients has made it possible to identify some of the mediators (cytokines, chemokines, and other factors) responsible for DR pathogenesis. Further studies are needed to better understand the relationship between inflammation and DR. Herein the main vitreous-related factors triggering the occurrence of retinal complication in diabetes are highlighted. PMID:26137497

  6. 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.

  7. Early diagnosis of diabetic retinopathy in primary care.

    Science.gov (United States)

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

    2015-01-01

    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. 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. 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. 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.

  8. Visual cycle modulation in neurovascular retinopathy.

    Science.gov (United States)

    Akula, James D; Hansen, Ronald M; Tzekov, Radouil; Favazza, Tara L; Vyhovsky, Tanya C; Benador, Ilan Y; Mocko, Julie A; McGee, David; Kubota, Ryo; Fulton, Anne B

    2010-08-01

    Rats with oxygen-induced retinopathy (OIR) model the pediatric retinal disease retinopathy of prematurity (ROP). Recent findings in OIR rats imply a causal role for the rods in the ROP disease process, although only experimental manipulation of rod function can establish this role conclusively. Accordingly, a visual cycle modulator (VCM) - with no known direct effect on retinal vasculature - was administered to "50/10 model" OIR Sprague-Dawley rats to test the hypotheses that it would 1) alter rod function and 2) consequently alter vascular outcome. Four litters of pups (N=46) were studied. For two weeks, beginning on postnatal day (P) 7, the first and fourth litters were administered 6 mg kg(-1) N-retinylacetamide (the VCM) intraperitoneally; the second and third litters received vehicle (DMSO) alone. Following a longitudinal design, retinal function was assessed by electroretinography (ERG) and the status of the retinal vessels was monitored using computerized fundus photograph analysis. Rod photoreceptor and post-receptor response amplitudes were significantly higher in VCM-treated than in vehicle-treated rats; deactivation of phototransduction was also significantly more rapid. Notably, the arterioles of VCM-treated rats showed significantly greater recovery from OIR. Presuming that the VCM did not directly affect the retinal vessels, a causal role for the neural retina - particularly the rod photoreceptors - in OIR was confirmed. There was no evidence of negative alteration of photoreceptor function consequent to VCM treatment. This finding implicates the rods as a possible therapeutic target in neurovascular diseases such as ROP. Copyright 2010 Elsevier Ltd. All rights reserved.

  9. Hydroxychloroquine Induced Retinopathy: A Case Series

    Directory of Open Access Journals (Sweden)

    Maryam Mobini

    2016-10-01

    Full Text Available Background and Purpose: Occular toxicity is one of the most important complications of Hydroxychloroquine. Not any type of treatment has so far been found and recommended for this disorder. The purpose of this study was to report some characteristics of patients with Hydroxychloroquine Induced Retinopathy.    Materials and Methods: From 107 patients with rheumatoid arthritis (RA and/or systemic lupus erythematosus (SLE during 2013-14 in Sari, Iran, who were selected by a simple sampling method and were referred to hospitals for ophthalmologic examinations, 21 patients were found with HCQ induced retinopathy. The Examination for HCQ-induced maculopathy was performed through fundoscopy, perimetry or optical coherence tomography (OCT, and the physicians had their own discretion based on the examination. Although the patients were examined by different ophthalmologists, all of them were evaluated by the same device (Zeiss cirrus HD OCT4000.USA for OCT, Zeiss Humphrey Field analyzer 2i. USA for visual field, and Topcon. TRC.50Dx. Japan for angiography. Based on the collected data, the characteristics of clinical and ophthalmologic changes were reported, and the data were analysed through Independent Sample t Test and χ2.    Results: 21 patients (19 females with a mean age of 49.86 (±15.6 were evaluated during 4.95 (±4.7 years of therapy. The mean of cumulative dose was calculated to be 313.18±269.8 grams. Based on the findings, hypertension was detected in 5 (23.8% of the patients. Conclusion: In the present study, it was found that HCQ induced retinal toxicity may occur even in recommended doses or for less than 5 years. Other risk factors such as hypertension in addition to the dose or duration of toxicity could also accelerate retinal toxicity.

  10. Outer grid strap protruding spring repair apparatus

    International Nuclear Information System (INIS)

    Widener, W.H.

    1987-01-01

    This patent describes a nuclear fuel assembly grid spring repair apparatus for repairing a spring formed on an outer strap of a fuel assembly grid and having a portion protruding outwardly beyond the strap, the apparatus comprising: (a) a support frame defining an opening and having means defining a guide channel extending along the opening in a first direction; (b) means mounted on the frame and being adjustable for attaching the frame to the outer strap of the support grid so that the frame opening is aligned with the outwardly protruding spring on the outer strap; (c) an outer slide having a passageway defined therethrough and being mounted in the guide channel for reciprocable movement along the frame opening in the first direction for aligning the passageway with the outwardly protruding portion of the spring on the outer strap. The outer slide also has means defining a guide way extending along the passageway in a second direction generally orthogonal to the first direction; (d) a spring reset mechanism being operable for resetting the protruding spring to a nonprotruding position relative to the outer strap when the mechanism is aligned with the protruding portion of the spring; and (e) an inner slide supporting the spring reset mechanism and being mounted to the guide way for reciprocable movement along the passageway of the outer slide in the second direction for aligning the spring reset mechanism with the protruding portion of the spring on the outer strap

  11. 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.

  12. 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

  13. 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....

  14. 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

  15. 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....

  16. Prevalence of blindness and diabetic retinopathy in northern Jordan.

    Science.gov (United States)

    Rabiu, Mansur M; Al Bdour, Muawyah D; Abu Ameerh, Mohammed A; Jadoon, Muhammed Z

    2015-01-01

    To estimate the prevalence of blindness, visual impairment, diabetes, and diabetic retinopathy in north Jordan (Irbid) using the rapid assessment of avoidable blindness and diabetic retinopathy methodology. A multistage cluster random sampling technique was used to select participants for this survey. A total of 108 clusters were selected using probability proportional to size method while subjects within the clusters were selected using compact segment method. Survey teams moved from house to house in selected segments examining residents 50 years and older until 35 participants were recruited. All eligible people underwent a standardized examination protocol, which included ophthalmic examination and random blood sugar test using digital glucometers (Accu-Chek) in their homes. Diabetic retinopathy among diabetic patients was assessed through dilated fundus examination. A total of 3638 out of the 3780 eligible participants were examined. Age- and sex-adjusted prevalence of blindness, severe visual impairment, and visual impairment with available correction were 1.33% (95% confidence interval [CI] 0.87-1.73), 1.82% (95% CI 1.35-2.25), and 9.49% (95% CI 8.26-10.74), respectively, all higher in women. Untreated cataract and diabetic retinopathy were the major causes of blindness, accounting for 46.7% and 33.2% of total blindness cases, respectively. Glaucoma was the third major cause, accounting for 8.9% of cases. The prevalence of diabetes mellitus was 28.6% (95% CI 26.9-30.3) among the study population and higher in women. The prevalence of any retinopathy among diabetic patients was 48.4%. Cataract and diabetic retinopathy are the 2 major causes of blindness and visual impairment in northern Jordan. For both conditions, women are primarily affected, suggesting possible limitations to access to services. A diabetic retinopathy screening program needs to proactively create sex-sensitive awareness and provide easily accessible screening services with prompt treatment.

  17. Quantitative assessment of early diabetic retinopathy using fractal analysis.

    Science.gov (United States)

    Cheung, Ning; Donaghue, Kim C; Liew, Gerald; Rogers, Sophie L; Wang, Jie Jin; Lim, Shueh-Wen; Jenkins, Alicia J; Hsu, Wynne; Li Lee, Mong; Wong, Tien Y

    2009-01-01

    Fractal analysis can quantify the geometric complexity of the retinal vascular branching pattern and may therefore offer a new method to quantify early diabetic microvascular damage. In this study, we examined the relationship between retinal fractal dimension and retinopathy in young individuals with type 1 diabetes. We conducted a cross-sectional study of 729 patients with type 1 diabetes (aged 12-20 years) who had seven-field stereoscopic retinal photographs taken of both eyes. From these photographs, retinopathy was graded according to the modified Airlie House classification, and fractal dimension was quantified using a computer-based program following a standardized protocol. In this study, 137 patients (18.8%) had diabetic retinopathy signs; of these, 105 had mild retinopathy. Median (interquartile range) retinal fractal dimension was 1.46214 (1.45023-1.47217). After adjustment for age, sex, diabetes duration, A1C, blood pressure, and total cholesterol, increasing retinal vascular fractal dimension was significantly associated with increasing odds of retinopathy (odds ratio 3.92 [95% CI 2.02-7.61] for fourth versus first quartile of fractal dimension). In multivariate analysis, each 0.01 increase in retinal vascular fractal dimension was associated with a nearly 40% increased odds of retinopathy (1.37 [1.21-1.56]). This association remained after additional adjustment for retinal vascular caliber. Greater retinal fractal dimension, representing increased geometric complexity of the retinal vasculature, is independently associated with early diabetic retinopathy signs in type 1 diabetes. Fractal analysis of fundus photographs may allow quantitative measurement of early diabetic microvascular damage.

  18. Social and emotional impact of diabetic retinopathy: a review.

    Science.gov (United States)

    Fenwick, Eva; Rees, Gwyn; Pesudovs, Konrad; Dirani, Mohamed; Kawasaki, Ryo; Wong, Tien Y; Lamoureux, Ecosse

    2012-01-01

    People with vision-threatening diabetic retinopathy are likely to experience enhanced social and emotional strain. Critically, those with both vision-threatening diabetic retinopathy and psychosocial problems may have significantly reduced levels of functioning compared with psychologically healthy counterparts. This can cause inadequate compliance, increased strain on family functioning, worse diabetes control, increased progression of diabetic retinopathy and, consequently, further psychosocial stress resulting in a number of concerning implications for disease management, clinical outcomes and healthcare costs. However, the emotional and social health consequences of diabetic retinopathy have not yet been systematically explored. This information is crucial as it allows for a targeted approach to treatment and prevention and avoidance of the potentially detrimental implications described above. Therefore, this paper reviews the current qualitative and quantitative evidence regarding the social and emotional impact of diabetic retinopathy and identifies directions for future research. Key search terms were applied to the electronic databases Pubmed, ISI Web of Science and Embase and the bibliographies of relevant papers were systematically reviewed for additional references. Overall, the evidence suggests that diabetic retinopathy and associated vision loss have several debilitating effects, including disruption of family functioning, relationships and roles; increased social isolation and dependence; and deterioration of work prospects resulting in increased financial strain. Adverse emotional responses include fear, anxiety, vulnerability, guilt, loss of confidence, anger, stress and self-perception issues. However, the research to date is largely qualitative in nature, with most quantitative studies being small, cross-sectional and somewhat outdated. Similarly, the outcome measures used in many studies to date are suboptimal in terms of content and validity

  19. Automated detection of fundus photographic red lesions in diabetic retinopathy.

    Science.gov (United States)

    Larsen, Michael; Godt, Jannik; Larsen, Nicolai; Lund-Andersen, Henrik; Sjølie, Anne Katrin; Agardh, Elisabet; Kalm, Helle; Grunkin, Michael; Owens, David R

    2003-02-01

    To compare a fundus image-analysis algorithm for automated detection of hemorrhages and microaneurysms with visual detection of retinopathy in patients with diabetes. Four hundred fundus photographs (35-mm color transparencies) were obtained in 200 eyes of 100 patients with diabetes who were randomly selected from the Welsh Community Diabetic Retinopathy Study. A gold standard reference was defined by classifying each patient as having or not having diabetic retinopathy based on overall visual grading of the digitized transparencies. A single-lesion visual grading was made independently, comprising meticulous outlining of all single lesions in all photographs and used to develop the automated red lesion detection system. A comparison of visual and automated single-lesion detection in replicating the overall visual grading was then performed. Automated red lesion detection demonstrated a specificity of 71.4% and a resulting sensitivity of 96.7% in detecting diabetic retinopathy when applied at a tentative threshold setting for use in diabetic retinopathy screening. The accuracy of 79% could be raised to 85% by adjustment of a single user-supplied parameter determining the balance between the screening priorities, for which a considerable range of options was demonstrated by the receiver-operating characteristic (area under the curve 90.3%). The agreement of automated lesion detection with overall visual grading (0.659) was comparable to the mean agreement of six ophthalmologists (0.648). Detection of diabetic retinopathy by automated detection of single fundus lesions can be achieved with a performance comparable to that of experienced ophthalmologists. The results warrant further investigation of automated fundus image analysis as a tool for diabetic retinopathy screening.

  20. Assessing Progress in Retinopathy Outcomes in Type 1 Diabetes

    Science.gov (United States)

    LeCaire, Tamara J.; Palta, Mari; Klein, Ronald; Klein, Barbara E.K.; Cruickshanks, Karen J.

    2013-01-01

    OBJECTIVE The Wisconsin Diabetes Registry Study (WDRS) cohort consisted of patients diagnosed with type 1 diabetes in the same geographic region as, but 8–34 years later than the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) cohort, providing a unique opportunity to assess changes in complications. We estimated the current prevalence and severity of diabetic retinopathy at 20 years of diabetes duration, compared these between eras, and evaluated the influence of diabetes management. RESEARCH DESIGN AND METHODS Twenty-year examinations, including fundus photographs, were completed on 305 WDRS subjects during 2007–2011. A subgroup of the WESDR cohort participated in one of four study visits during 1980–1996, at similar diabetes duration (n = 583). Adjusted ordinal logistic regression with three retinopathy severity categories was used to estimate odds ratios (ORs) of more severe retinopathy with diagnosis during an earlier era. RESULTS Mean hemoglobin A1c (HbA1c) was lower in WDRS than in WESDR (8.0% vs. 9.3% [P < 0.001], and 93.4% vs. 21.3% [P < 0.001]) used ≥3 daily insulin injections or an insulin pump. In WDRS, 18% had vision-threatening levels of retinopathy vs. 43% in WESDR. The adjusted OR of more severe retinopathy in the earlier era (OR 3.0 [95% CI 2.2–4.0]) was reduced by including 20-year HbA1c in the model (OR 2.2 [1.6–3.0]). CONCLUSIONS Retinopathy severity at a diabetes duration of 20 years is lower in the more recent era of type 1 diabetes. Updated projections should be used when informing newly diagnosed individuals of prognosis and for health care cost assessments. Current glycemic control explained a limited amount of the difference. PMID:23193204

  1. Changes in serum leptin level in patients with diabetic retinopathy

    International Nuclear Information System (INIS)

    Yu Jing; Cao Huiling

    2003-01-01

    Objective: To explore the regulation of changes in serum leptin level in patients with diabetic retinopathy. Methods: The 120 participating subjects were of four groups: healthy controls, diabetic patients without retinopathy, patients with NPDR and patients with PDR, each group consisted of 18 males and 12 females with comparable BMI. The levels of serum leptin, IVC, insulin and blood glucose of these patients were measured and the correlation between serum leptin level and other parameters was analysed. Results: The level of serum leptin in controls, diabetic patients without retinopathy, patients with NPDR and patients with PDR were 6.91 ± 1.87 μg/L, 7,83 ±2.11 μg/L, 9.56 ± 2.43 μg/L and 11.69 ± 2.57 μg/L respectively. The patients with PDR had higher serum leptin levels than patients with NPDR (t=2.15, p < 0.05), diabetic patients without retinopathy (t = 2.71, p < 0.01), and controls (t = 3.50, p < 0.001), the patients with NPDR had higher serum leptin levels than diabetic patients without retinopathy (t = 2.23, p < 0.05) and controls (t = 2.75, p < 0.01), while the difference in serum leptin was not significant between diabetic patients without retinopathy and controls. The serum level was positively correlated to BMI (r = 0.22, p < 0.05) and FINS (r = 0.28, p < 0.01). Conclusion: Serum leptin level is elevated in patients with diabetic retinopathy and is positively correlated to the severity of the disease

  2. Improved method of measurement for outer leak

    International Nuclear Information System (INIS)

    Xu Guang

    2012-01-01

    Pneumatic pipeline is installed for the airborne radioactivity measurement equipment, air tightness and outer leak rate are essential for the testing of the characteristics, both in the national criteria and ISO standards, an improved practical method is available for the measurement of the outer air leak rate based on the engineering experiences for the equipment acceptance and testing procedure. (authors)

  3. The anatomy of the rat eye with oxygen-induced retinopathy.

    Science.gov (United States)

    Akula, James D; Favazza, Tara L; Mocko, Julie A; Benador, Ilan Y; Asturias, Ana L; Kleinman, Michael S; Hansen, Ronald M; Fulton, Anne B

    2010-02-01

    Prior studies have documented the intertwined developmental courses of retinal blood vessel tortuosity (in fundus photographs) and retinal dysfunction (in electroretinographs) in Sprague-Dawley rat models of retinopathy of prematurity (ROP). Two such models, the "50/10 model" and the "75 model," are named after the oxygen regimens used to induce retinopathy and are characterized by distinct neurovascular courses that span a range of disease severity. In this study of 50/10 and 75 model rats, retinal flatmounts were used to study the full vasculature at postnatal day (P) 15, P19 and P30. In addition, the layers of the neural retina were measured in toluidine blue-stained cross sections. Finally, gross anatomic features of the eye, including axial length, retinal surface area, and the ratio of anterior to posterior axial-lengths were evaluated. Both clock hours of neovascularization (NV) and percent avascular retina (AR) peaked at P19 and resolved by P30. Through P19, NV was found in every 50/10 model rat, but in only 60% of 75 model rats. AR was positively related to NV. All inner layers of the retina (outer plexiform layer through ganglion cell layer) were attenuated in 50/10 model rats but, in the 75 model, no layer differed significantly from that in controls. The eyes in both ROP models were smaller than those of age-matched controls. The ratio of anterior to posterior axial-lengths ranged from 0.45 in controls through 0.37 in the 75 model to 0.32 in the 50/10 model. Thus, eye growth is altered in these rat models of ROP.

  4. Deep image mining for diabetic retinopathy screening.

    Science.gov (United States)

    Quellec, Gwenolé; Charrière, Katia; Boudi, Yassine; Cochener, Béatrice; Lamard, Mathieu

    2017-07-01

    Deep learning is quickly becoming the leading methodology for medical image analysis. Given a large medical archive, where each image is associated with a diagnosis, efficient pathology detectors or classifiers can be trained with virtually no expert knowledge about the target pathologies. However, deep learning algorithms, including the popular ConvNets, are black boxes: little is known about the local patterns analyzed by ConvNets to make a decision at the image level. A solution is proposed in this paper to create heatmaps showing which pixels in images play a role in the image-level predictions. In other words, a ConvNet trained for image-level classification can be used to detect lesions as well. A generalization of the backpropagation method is proposed in order to train ConvNets that produce high-quality heatmaps. The proposed solution is applied to diabetic retinopathy (DR) screening in a dataset of almost 90,000 fundus photographs from the 2015 Kaggle Diabetic Retinopathy competition and a private dataset of almost 110,000 photographs (e-ophtha). For the task of detecting referable DR, very good detection performance was achieved: A z =0.954 in Kaggle's dataset and A z =0.949 in e-ophtha. Performance was also evaluated at the image level and at the lesion level in the DiaretDB1 dataset, where four types of lesions are manually segmented: microaneurysms, hemorrhages, exudates and cotton-wool spots. For the task of detecting images containing these four lesion types, the proposed detector, which was trained to detect referable DR, outperforms recent algorithms trained to detect those lesions specifically, with pixel-level supervision. At the lesion level, the proposed detector outperforms heatmap generation algorithms for ConvNets. This detector is part of the Messidor® system for mobile eye pathology screening. Because it does not rely on expert knowledge or manual segmentation for detecting relevant patterns, the proposed solution is a promising image

  5. 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

    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

  6. Retinopathy in youth with type 2 diabetes participating in the TODAY clinical trial

    Science.gov (United States)

    The objective of this study was to determine the prevalence of retinopathy in 517 youth with type 2 diabetes of 2–8 years duration enrolled in the TODAY study. Retinal photographs were graded centrally for retinopathy using established standards. Retinopathy was identified in 13.7% of subjects. Prev...

  7. Ultrastructure of neurovascular changes in human diabetic retinopathy.

    Science.gov (United States)

    Fehér, János; Taurone, Samanta; Spoletini, Marialuisa; Biró, Zsolt; Varsányi, Balázs; Scuderi, Gianluca; Orlando, Maria Patrizia; Turchetta, Rosaria; Micera, Alessandra; Artico, Marco

    2018-01-01

    The previous concept regarding diabetic retinopathy assigned a primary role to hyperglycemia-induced microvascular alterations, while neuronal and glial abnormalities were considered to be secondary to either ischemia or exudation. The aim of this study was to reveal the potential role of neuronal and glial cells in initial and advanced alterations of the retinopathy in human type 2 diabetes. Electron microscopy and histochemical studies were performed on 38 surgically removed human eyes (28 obtained from diabetic patients and 10 from non-diabetic patients). Morphometric analysis of basement membrane material and lipids was performed. An accumulation of metabolic by-products was found in the capillary wall with aging: this aspect was significantly more pronounced in diabetics. Müller glial cells were found to contribute to alterations of the capillary wall and to occlusion, as well as to the development of proliferative retinopathy and cystoid degeneration of the retina. Our results showed morphological evidence regarding the role of neuronal and glial cells in the pathology of diabetic retinopathy, prior and in addition to microangiopathy. These morphological findings support a neurovascular pathogenesis at the origin of diabetic retinopathy, thus the current treatment approach should be completed by neuroprotective measures.

  8. 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%.

  9. Axial Myopia and its Influence on Diabetic Retinopathy

    International Nuclear Information System (INIS)

    Tayyab, H.; Haider, M. A.; Bukhari, S. A. H.

    2014-01-01

    Objective: To evaluate the correlation between axial myopia and diabetic retinopathy. Study Design: Cross-sectional study. Place and Duration of Study: Eye Department of Postgraduate Medical Institute, Lahore General Hospital, from August 2012 to February 2013. Methodology: A total of 258 participants suffering from type-2 diabetic retinopathy were included. Axial length was measured by two optometrists using contact type ultrasound biometer. Colored retinal photographs, red free retinal photographs and Fundus Fluorescein Angiography (FFA) were performed on all patients using standard fundus camera. All fundus photographs and angiograms were independently reviewed and graded by two qualified vitreoretinal fellows. Results: Out of 258 patients, 163 were males (63.2%) and 95 (36.8%) were females. Average age of patients was 56.30 +- 7.57 years. Average axial length of right and left eyes were 23.16 mm and 23.15 mm respectively. There was statistically significant negative correlation between axial length and severity of diabetic retinopathy in the right eye, (Spearman correlation = -0.511, p = 0.0001) as well as the left eye (Spearman correlation = -0.522, p = 0.0001). Conclusion: There is a protective influence of longer axial length of globe on the stage and severity of diabetic retinopathy. This study may help in modifying the screening protocol for diabetic retinopathy amongst patients of differing axial lengths. (author)

  10. Radiation retinopathy as an experimental model for ischemic proliferative retinopathy and rubeosis iridis

    International Nuclear Information System (INIS)

    Irvine, A.R.; Wood, I.S.

    1987-01-01

    We produced radiation retinopathy in capuchin monkeys and studied them with fluorescein angiography and light and electron microscopy. The animals were followed up from ten days to 3 1/2 years after radiation in order to determine whether this could provide an experimental model for other chronic ischemic-proliferative retinopathies, such as diabetes. The first change detected after radiation was the focal loss of capillary endothelial cells and pericytes. As the areas of acellular capillaries became confluent, cotton-wool spots became visible ophthalmoscopically. These increased in number and then faded away, leaving large areas of retinal capillary perfusion. Histologic studies showed occlusion first of the deeper, smaller retinal vessels and then gradually of the larger vessels. Intraretinal neovascularization as well as apparent recanalization then developed, but no new vessels extended through the internal limiting lamina into the vitreous. Rubeosis iridis with neovascular glaucoma developed 2 1/2 to 3 1/2 years postirradiation, and vitreous aspirate demonstrated a high level of angiogenic factor

  11. Incorporation of squalene into rod outer segments

    International Nuclear Information System (INIS)

    Keller, R.K.; Fliesler, S.J.

    1990-01-01

    We have reported previously that squalene is the major radiolabeled nonsaponifiable lipid product derived from [ 3 H]acetate in short term incubations of frog retinas. In the present study, we demonstrate that newly synthesized squalene is incorporated into rod outer segments under similar in vitro conditions. We show further that squalene is an endogenous constituent of frog rod outer segment membranes; its concentration is approximately 9.5 nmol/mumol of phospholipid or about 9% of the level of cholesterol. Pulse-chase experiments with radiolabeled precursors revealed no metabolism of outer segment squalene to sterols in up to 20 h of chase. Taken together with our previous absolute rate studies, these results suggest that most, if not all, of the squalene synthesized by the frog retina is transported to rod outer segments. Synthesis of protein is not required for squalene transport since puromycin had no effect on squalene incorporation into outer segments. Conversely, inhibition of isoprenoid synthesis with mevinolin had no effect on the incorporation of opsin into the outer segment. These latter results support the conclusion that the de novo synthesis and subsequent intracellular trafficking of opsin and isoprenoid lipids destined for the outer segment occur via independent mechanisms

  12. Retinitis pigmentosa, pigmentary retinopathies, and neurologic diseases.

    Science.gov (United States)

    Bhatti, M Tariq

    2006-09-01

    Retinitis pigmentosa (RP) refers to a group of inherited retinal diseases with phenotypic and genetic heterogeneity. The pathophysiologic basis of the progressive visual loss in patients with RP is not completely understood but is felt to be due to a primary retinal photoreceptor cell degenerative process mainly affecting the rods of the peripheral retina. In most cases RP is seen in isolation (nonsyndromic), but in some other cases it may be a part of a genetic, metabolic, or neurologic syndrome or disorder. Nyctalopia, or night blindness, is the most common symptom of RP. The classic fundus appearance of RP includes retinal pigment epithelial cell changes resulting in retinal hypo- or hyperpigmentation ("salt-and-pepper"), retinal granularity, and bone spicule formation. The retinal vessels are often narrowed or attenuated and there is a waxy pallor appearance of the optic nerve head. Electroretinography will demonstrate rod and cone photoreceptor cell dysfunction and is a helpful test in the diagnosis and monitoring of patients with RP. A detailed history with pedigree analysis, a complete ocular examination, and the appropriate paraclinical testing should be performed in patients complaining of visual difficulties at night or in dim light. This review discusses the clinical manifestations of RP as well as describing the various systemic diseases, with a special emphasis on neurologic diseases, associated with a pigmentary retinopathy.

  13. 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.

  14. Angiogenic Factors and Cytokines in Diabetic Retinopathy

    Science.gov (United States)

    Abcouwer, Steven F.

    2013-01-01

    Diabetic retinopathy (DR) is a sight-threatening complication of both type-1 and type-2 diabetes. The recent success of treatments inhibiting the function of vascular endothelial growth factor (VEGF) demonstrates that specific targeting of a growth factor responsible for vascular permeability and growth is an effective means of treating DR-associated vascular dysfunction, edema and angiogenesis. This has stimulated research of alternative therapeutic targets involved in the control of retinal vascular function. However, additional treatment options and preventative measures are still needed and these require a greater understanding of the pathological mechanisms leading to the disturbance of retinal tissue homeostasis in DR. Although severe DR can be treated as a vascular disease, abundant data suggests that inflammation is also occurring in the diabetic retina.Thus, anti-inflammatory therapies may also be useful for treatment and prevention of DR. Herein, the evidence for altered expression of angiogenic factors and cytokines in DR is reviewed and possible mechanisms by which the expression of VEGF and cytokines may be increased in the diabetic retina are examined. In addition, the potential role for microglial activation in diabetic retinal neuroinflammation is explored. PMID:24319628

  15. Retinopathy of prematurity: the need for prevention

    Science.gov (United States)

    Liegl, Raffael; Hellström, Ann; Smith, Lois EH

    2016-01-01

    More than 450,000 babies are born prematurely in the USA every year. The improved survival of even the most vulnerable low body weight preterm infants has, despite improving health outcomes, led to the resurgence in preterm complications including one of the major causes for blindness in children, retinopathy of prematurity (ROP). The current mainstay in ROP therapy is laser photocoagulation and the injection of vascular endothelial growth factor (VEGF) antibodies in the late stages of the disease after the onset of neovascularization. Both are proven options for ophthalmologists to treat the severe forms of late ROP. However, laser photocoagulation destroys major parts of the retina, and the injection of VEGF antibodies, although rather simple to administer, may cause a systemic suppression of normal vascularization, which has not been studied in sufficient depth. However, the use of neither VEGF antibody nor laser treatment prevents ROP, which should be the long-term goal. It should be possible to prevent ROP by more closely mimicking the intrauterine environment after preterm birth. Such preventive measures include preventing the toxic postbirth influences (eg, oxygen excess) as well as providing the missing intrauterine factors (eg, insulin growth factor 1) and are likely to also reduce other complications of premature birth as well as ROP. This review is meant to summarize the current knowledge on the prevention of ROP with a particular emphasize on the use of insulin growth factor 1 supplementation. PMID:28539804

  16. Retinopathy of prematurity: Past, present and future

    Science.gov (United States)

    Shah, Parag K; Prabhu, Vishma; Karandikar, Smita S; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

    2016-01-01

    Retinopathy of prematurity (ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940s and 1950s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP. PMID:26862500

  17. Retinal Imaging Techniques for Diabetic Retinopathy Screening

    Science.gov (United States)

    Goh, James Kang Hao; Cheung, Carol Y.; Sim, Shaun Sebastian; Tan, Pok Chien; Tan, Gavin Siew Wei; Wong, Tien Yin

    2016-01-01

    Due to the increasing prevalence of diabetes mellitus, demand for diabetic retinopathy (DR) screening platforms is steeply increasing. Early detection and treatment of DR are key public health interventions that can greatly reduce the likelihood of vision loss. Current DR screening programs typically employ retinal fundus photography, which relies on skilled readers for manual DR assessment. However, this is labor-intensive and suffers from inconsistency across sites. Hence, there has been a recent proliferation of automated retinal image analysis software that may potentially alleviate this burden cost-effectively. Furthermore, current screening programs based on 2-dimensional fundus photography do not effectively screen for diabetic macular edema (DME). Optical coherence tomography is becoming increasingly recognized as the reference standard for DME assessment and can potentially provide a cost-effective solution for improving DME detection in large-scale DR screening programs. Current screening techniques are also unable to image the peripheral retina and require pharmacological pupil dilation; ultra-widefield imaging and confocal scanning laser ophthalmoscopy, which address these drawbacks, possess great potential. In this review, we summarize the current DR screening methods using various retinal imaging techniques, and also outline future possibilities. Advances in retinal imaging techniques can potentially transform the management of patients with diabetes, providing savings in health care costs and resources. PMID:26830491

  18. Diabetic retinopathy is a neurodegenerative disorder.

    Science.gov (United States)

    Lynch, Stephanie K; Abràmoff, Michael D

    2017-10-01

    Since 1875, controversy has ensued over whether ocular diabetic complications are primarily vasculopathic or neuropathic in nature. Here, we discuss the historical context by which diabetic retinopathy (DR) came to be considered a primary vasculopathy, in contrast to more recent data suggesting the importance of diabetic retinal neurodegeneration (DRN) as the primary manifestation of ocular diabetic damage. Unsurprisingly, DRN parallels other diabetic complications related to neuropathy. In general, there are three possible relationships between microvascular DR and DRN: i) microvasculopathy causes neurodegeneration; ii) neurodegeneration causes microvasculopathy or iii) they are mutually independent. The authors' group has recently produced experimental data showing that DRN precedes even the earliest manifestations of DR microvasculopathy. In combination with earlier studies showing that focal implicit time delays predicted future development of DR microvasculopathy in the same location, relationships i) and iii) are unlikely. As such, ii) is the most likely relationship: DRN is a cause of DR. Granted, additional studies are needed to confirm this hypothesis and elucidate the mechanism of diabetes-induced neurodegeneration. We conclude this review by proposing experimental approaches to test the hypothesis that DRN causes DR. If confirmed, this new paradigm may lead to earlier detection of ocular diabetic damage and earlier treatment of early DR, thereby preventing visual loss in people with diabetes. Published by Elsevier Ltd.

  19. Diabetic Retinopathy in the Asia-Pacific.

    Science.gov (United States)

    Chua, Jacqueline; Lim, Claire Xin Ying; Wong, Tien Yin; Sabanayagam, Charumathi

    2018-01-01

    Diabetic retinopathy (DR), the most common complication of diabetes mellitus, is the leading cause of new cases of blindness in middle-aged and elderly in the Asia-Pacific. It has been estimated that 51% of all those with blindness due to DR globally (n = 424,400) and 56% of those with visual impairment due to DR (2.1 million) come from the Asia-Pacific. Prevalence of DR among those with diabetes ranged from 10% in India to 43% in Indonesia within the Asia-Pacific. Awareness of DR among persons with diabetes ranged from 28% to 84%. Most common modifiable risk factors for DR in the Asia-Pacific were hyperglycemia, blood pressure, dyslipidemia, and obesity. Implementation of systematic screening programs for DR and advancement in telemedicine screening methods have increased patient coverage and cost-effectiveness, though there are still numerous factors impeding screening uptake in the low-middle income regions of the Asia-Pacific. Management and treatment of DR in the Asia-Pacific is mainly limited to traditional laser retinopexy, but it is suboptimal despite new clinical approaches such as use of intravitreal anti.vascular endothelial growth factor and steroids due to limited resources. Further research and data are required to structure a more cost-effective public healthcare program and more awareness-building initiatives to increase the effectiveness of DR screening programs. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  20. 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....

  1. Risk factors for diabetic retinopathy in Kuwaiti type 2 diabetic patients

    International Nuclear Information System (INIS)

    Al-Adsani, Afaf M.S.

    2007-01-01

    To determine the risk factors associated with diabetic retinopathy in Kuwaiti subjects with type 2 diabetes. Kuwaiti subjects with type 2 diabetes (n=165) attending the Diabetic Clinic at Al-sabah Hospital, Kuwait between October 2000 and March 2005 were screened for diabetic retinopathy. Any diabetic retinopathy was found in 40% while 20.6% had sight threatening retinopathy. Mild NPDR was present in 21.2%, moderate to severe non-proliferative diabetic retinopathy (NPDR) in 7.9%, and proliferative diabetic retinopathy in 3.0%. Maculopathy was present in 10.3% and 7.9 % pf patients were photocoagulated. Compared to those without retinopathy, diabetic patients with any retinopathy were significantly older (51.7+-10.3 versus 47.2+-9.5 years; p<0.005), had longer duration of diabetes (13.1+-6.3 versus 4.7 +-5.4 years; p<0.0001), higher systolic blood pressure (142.9+-23.0 versus 130.3+-20.2; p<0.0001) and poor glycemic control (Hemoglobin A1c=10.1+-2.4 versus 8.9+-2.3; p<0.005). The prevalence of hypertension and nephropathy was significantly higher in patients with any retinopathy than those without retinopathy (70.8% versus 49.5%; p<0.01 and 64.4% versus 30.8%; p<0.0001) respectively. Longer duration of diabetes and presence of nephropathy was the most significant independent factors associated with any retinopathy and sight-threatening retinopathy. Treatment with sulphonylurea or insulin, and poor glycemic control were other significant independent factors associated with any retinopathy. Longer duration of diabetes, presence of nephropathy, glycemic control and mode of treatment were the most significant independent factors of diabetic retinopathy. However, population-based study is warranted to identify the risk factors, as well as the prevalence of diabetic retinopathy. (author)

  2. Small RNAs controlling outer membrane porins

    DEFF Research Database (Denmark)

    Valentin-Hansen, Poul; Johansen, Jesper; Rasmussen, Anders A

    2007-01-01

    are key regulators of environmental stress. Recent work has revealed an intimate interplay between small RNA regulation of outer membrane proteins and the stress-induced sigmaE-signalling system, which has an essential role in the maintenance of the integrity of the outer membrane.......Gene regulation by small non-coding RNAs has been recognized as an important post-transcriptional regulatory mechanism for several years. In Gram-negative bacteria such as Escherichia coli and Salmonella, these RNAs control stress response and translation of outer membrane proteins and therefore...

  3. PPAR Agonists: Potential as Therapeutics for Neovascular Retinopathies

    Directory of Open Access Journals (Sweden)

    Harrihar A. Pershadsingh

    2008-01-01

    Full Text Available The angiogenic, neovascular proliferative retinopathies, proliferative diabetic retinopathy (PDR, and age-dependent macular degeneration (AMD complicated by choroidal neovascularization (CNV, also termed exudative or “wet” AMD, are common causes of blindness. The antidiabetic thiazolidinediones (TZDs, rosiglitazone, and troglitazone are PPAR agonists with demonstrable antiproliferative, and anti-inflammatory effects, in vivo, were shown to ameliorate PDR and CNV in rodent models, implying the potential efficacy of TZDs for treating proliferative retinopathies in humans. Activation of the angiotensin II type 1 receptor (AT1-R propagates proinflammatory and proliferative pathogenic determinants underlying PDR and CNV. The antihypertensive dual AT1-R blocker (ARB, telmisartan, recently was shown to activate PPAR and improve glucose and lipid metabolism and to clinically improve PDR and CNV in rodent models. Therefore, the TZDs and telmisartan, clinically approved antidiabetic and antihypertensive drugs, respectively, may be efficacious for treating and attenuating PDR and CNV humans. Clinical trials are needed to test these possibilities.

  4. Radiation retinopathy after orbital irradiation for Graves' ophthalmopathy

    International Nuclear Information System (INIS)

    Kinyoun, J.L.; Kalina, R.E.; Brower, S.A.; Mills, R.P.; Johnson, R.H.

    1984-01-01

    Recent reports indicate that orbital irradiation for Graves' ophthalmopathy is sometimes beneficial, particularly for dysthyroid optic neuropathy, and is not associated with serious complications. We are aware, however, of four patients who were found to have radiation retinopathy after orbital irradiation for Grave's ophthalmopathy. All four patients have decreased central acuity, and three of the four are legally blind in one or both eyes. Computer reconstruction of the dosimetry, based on computed tomography and beam profiles, shows that errors in dosage calculations and radiotherapy technique probably account for the radiation retinopathy in three of the four patients. Radiotherapy for Graves' ophthalmopathy should be administered only by competent radiotherapists who are experienced in the treatment of this disease. Similar errors in dosage calculations and treatment techniques may account for other reports of radiation retinopathy after reportedly safe dosages

  5. Clinical Investigation of Radiation Retinopathy Fundus and Fluorescein Angiographic Features

    Institute of Scientific and Technical Information of China (English)

    LiMei; QiuGT

    1999-01-01

    Purpose:To investigate the fundus and fluorescein angiographic features in the patients with radiation retinopathy.Clinical Materials:Color fundus photography and/or fluorescein angiography from 13 patients with nasopharyngeal carcinomas received external beam radiation were retrospectively analyzed.Reslts:In this study,26 damaged eyes of 13 patients eveloped some degree of radiation retinopathy.The earliest and most common finding was macular microvascular changes (microaneurysms and/or telangiectasia),which was observed in 100%(26/26)of the eyes.Intraretinal hemorrhages,macular capillary nonperfusion,and macular edema were noted in 84%,50%,and 42% of the eyes,respectively.Conclusions:Radiation retinopathy is common after external beam radiation of nasopharyngeal carcinomas.The prominent changes include maular microvascular changes,intraretinal hemorrhages and macular capillary nonperfusion.

  6. Automated detection of exudates for diabetic retinopathy screening

    International Nuclear Information System (INIS)

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

    2007-01-01

    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

  7. 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.

  8. 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......%) of the 32 patients without preoperative diabetic retinopathy had a transient worsening at 6 months. No patients developed macular edema, but the whole cohort had a minor increase in center point foveal thickness that peaked 6 months postoperatively. The patients were required to have good glucose control...

  9. 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...... era, suggesting new studies of the present population with diabetes. Aim and methods: This cross-section study included 656 people with type 1 diabetes and 328 with type 2 diabetes. Crude prevalence rates of proliferative diabetic retinopathy, clinically significant macular oedema and several specific...... retinal lesions were assessed, together with their association to a simplified and internationally approved retinal grading. Results: The point prevalence of proliferative retinopathy was found to be 0.8% and 0.3% for type 1 and type 2 diabetes. Equivalent prevalence rates of clinically significant...

  10. 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.

    2007-12-01

    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.

  11. 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.

  12. Fruit intake and incident diabetic retinopathy with type 2 diabetes.

    Science.gov (United States)

    Tanaka, Shiro; Yoshimura, Yukio; Kawasaki, Ryo; Kamada, Chiemi; Tanaka, Sachiko; Horikawa, Chika; Ohashi, Yasuo; Araki, Atsushi; Ito, Hideki; Akanuma, Yasuo; Yamada, Nobuhiro; Yamashita, Hidetoshi; Sone, Hirohito

    2013-03-01

    Antioxidants and dietary fiber are postulated to have preventive effects on diabetic retinopathy, but evidence is lacking. We investigated this association in a cohort with type 2 diabetes 40-70 years of age with hemoglobin (Hb)A1C ≥6.5%, originally part of the Japan Diabetes Complications Study. After excluding people who did not respond to a dietary survey and patients with diabetic retinopathy or a major ocular disease at baseline, we analyzed 978 patients. Baseline dietary intake was assessed by a food frequency questionnaire based on food groups and 24-hour dietary records. Primary outcome was incident diabetic retinopathy determined using international severity scales. Mean fruit intake in quartiles ranged from 23 to 253 g/day, with increasing trends across quartiles of fruit intake for vitamin C, vitamin E, carotene, retinol equivalent, dietary fiber, potassium, and sodium. Mean energy intake ranged from 1644 to 1863 kcal/day, and fat intake was approximately 25%. HbA1C, body mass index, triglycerides, and systolic blood pressure were well controlled. During the 8-year follow-up, the numbers of incident cases of diabetic retinopathy from the first through the fourth quartiles of fruit intake were 83, 74, 69, and 59. Multivariate-adjusted hazard ratios for the second, third, and fourth quartiles of fruit intake compared with the first quartile were 0.66 (95% confidence interval = 0.46-0.92), 0.59 (0.41-0.85), and 0.48 (0.32-0.71) (test for trend, P diabetes duration, overweight, smoking, and hypertension. Risk for diabetic retinopathy declined with increased intake of fruits and vegetables, vitamin C, and carotene. Increased fruit intake in ranges commonly consumed was associated with reduced incident diabetic retinopathy among patients adhering to a low-fat energy-restricted diet.

  13. Diabetic Retinopathy Awareness among Diabetic Patients Attending COMS-TH.

    Science.gov (United States)

    Dahal, P; Adhikari, H

    Background Diabetic retinopathy (DR) is one of the leading causes of blindness in Nepal. Objective The main objective of the study is to know the awareness of diabetic retinopathy among new cases of diabetes mellitus (DM) attending the college of medical science- teaching hospital, Bharatpur, Nepal. Method All the diabetic cases referred for ophthalmic consultation and also referred outpatient department cases from other departments to ophthalmic outpatient department was carried out. Detailed demographics of the subjects and their awareness of potential ocular problems from diabetes mellitus were noted. Result Total one hundred and thirty-one patients were enrolled during the study period from 15 November 2016 to 15 May 2017. Brahmin 39.69% and 19.08% Mongolian were the most predominant ethnical group. The predominant group of patients were housewives (41.22%) then followed by service (19.85%), business (13.74%), agriculture (12.21%), others (12.98%). Among 36.64% of the literate patients, 19.85% had passed school level, 9.92% had passed intermediate level, 88.55% were aware of Diabetic retinopathy. Among them majority 88.55% were referred by physician. Family history were present in 35.68% and fundus evaluation was done for the first time in almost half of diabetic cases (64.12%) and diabetic retinopathy was found in 32.06% of total cases in right eye and 30.53% of total cases in left eye. Conclusion Along with the awareness, routine dilated fundoscopy is mandatory for slight threating stage of retinopathy and to reduce the burden of blindness from diabetic retinopathy in Nepal.

  14. The metabolic syndrome and severity of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Chen JJ

    2015-04-01

    Full Text Available John J Chen,1,2,* Lucas J Wendel,1,3,* Emily S Birkholz,1 John G Vallone,4 Anne L Coleman,5,6 Fei Yu,7 Vinit B Mahajan1,3,8 1Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA; 2Mayo Clinic, Rochester, MN, USA; 3Vitreoretinal Service, University of Iowa, Iowa City, IA, USA; 4Department of Pathology, University of Southern California, 5Department of Ophthalmology, 6Department of Epidemiology, School of Public Health, 7Department of Biostatistics, University of California, Los Angeles, CA, USA; 8Omics Laboratory, University of Iowa, Iowa City, IA, USA *These authors contributed equally to this work Background: While metabolic syndrome has been strongly implicated as a risk factor for macrovascular diseases, such as stroke and cardiovascular disease, its relationship with microvascular diseases, including diabetic retinopathy, has been less defined. The purpose of this pilot study was to investigate the association between metabolic syndrome and the presence and severity of diabetic retinopathy.Methods: A retrospective case–control chart review at the University of Iowa ophthalmology and primary care clinics included 100 patients with proliferative diabetic retinopathy (PDR, 100 patients with nonproliferative diabetic retinopathy (NPDR, 100 diabetic patients without diabetic retinopathy, and 100 nondiabetic patients who were randomly selected. Using the International Diabetes Foundation definition, the prevalence of metabolic syndrome and the number of components of metabolic syndrome were compared among these groups.Results: The prevalence of metabolic syndrome in patients with diabetes was 69.3%, which was significantly higher than that in patients without diabetes (27%; P<0.0001 (odds ratio [OR] =6.28; 95% confidence interval [CI]: 3.76–10.49; P=0.0004. However, there was no significant difference in the prevalence of metabolic syndrome between diabetics with and without diabetic retinopathy, with rates

  15. A case of radiation retinopathy treated with panretinal photocoagulation

    International Nuclear Information System (INIS)

    Ohde, Hisao; Ayaki, Masahiko; Fujimura, Hiromi; Yokoyama, Noriko

    1993-01-01

    A 29-year-old male developed radiation retinopathy one year and three months after 60 Gy of radiotherapy was delivered by a linear accelerator for a grade III astrocytoma. Fundus examination at the initial visit showed several dot and blot hemorrhages and cotton-wool patches. One month later, mascular edema developed due to increased capillary permeability in the left eye, while proliferative changes and preretinal hemorrhages were noted in the right eye. Since panretinal photocoagulation was effective in treating both eyes, it may be the treatment of choice for radiation retinopathy with extensive avascular areas. (author)

  16. A review on exudates detection methods for diabetic retinopathy.

    Science.gov (United States)

    Joshi, Shilpa; Karule, P T

    2018-01-01

    The presence of exudates on the retina is the most characteristic symptom of diabetic retinopathy. As exudates are among early clinical signs of DR, their detection would be an essential asset to the mass screening task and serve as an important step towards automatic grading and monitoring of the disease. Reliable identification and classification of exudates are of inherent interest in an automated diabetic retinopathy screening system. Here we review the numerous early studies that used for automatic exudates detection with the aim of providing decision support in addition to reducing the workload of an ophthalmologist. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  17. 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

    AIMS/HYPOTHESIS: This study aimed to evaluate the prevalence of retinopathy in long-surviving type 1 diabetic patients. It also investigated the 25 year incidence of proliferative retinopathy and associated risk factors in a Danish population-based cohort. METHODS: A population-based cohort of 727...... type 1 diabetic patients from Fyn County, Denmark, was identified in 1973. In 1981-1982, baseline retinopathy was graded and other risk factors were assessed in 573 patients. Twenty-five years later, 308 patients were still alive. Of these, 201 (65.3%) were re-examined at follow-up in 2007......-2008. RESULTS: The median age and duration of diabetes at follow-up were 58.8 and 43 years, respectively. At follow-up, the prevalence of diabetic retinopathy was 97.0%. Non-proliferative retinopathy was found in 45.8%, and 51.2% had proliferative retinopathy. The 25 year incidence of proliferative retinopathy...

  18. The role of retinopathy distribution and other lesion types for the definition of examination intervals during screening for diabetic retinopathy.

    Science.gov (United States)

    Ometto, Giovanni; Erlandsen, Mogens; Hunter, Andrew; Bek, Toke

    2017-06-01

    It has previously been shown that the intervals between screening examinations for diabetic retinopathy can be optimized by including individual risk factors for the development of the disease in the risk assessment. However, in some cases, the risk model calculating the screening interval may recommend a different interval than an experienced clinician. The purpose of this study was to evaluate the influence of factors unrelated to diabetic retinopathy and the distribution of lesions for discrepancies between decisions made by the clinician and the risk model. Therefore, fundus photographs from 90 screening examinations where the recommendations of the clinician and a risk model had been discrepant were evaluated. Forty features were defined to describe the type and location of the lesions, and classification and ranking techniques were used to assess whether the features could predict the discrepancy between the grader and the risk model. Suspicion of tumours, retinal degeneration and vascular diseases other than diabetic retinopathy could explain why the clinician recommended shorter examination intervals than the model. Additionally, the regional distribution of microaneurysms/dot haemorrhages was important for defining a photograph as belonging to the group where both the clinician and the risk model had recommended a short screening interval as opposed to the other decision alternatives. Features unrelated to diabetic retinopathy and the regional distribution of retinal lesions may affect the recommendation of the examination interval during screening for diabetic retinopathy. The development of automated computerized algorithms for extracting information about the type and location of retinal lesions could be expected to further optimize examination intervals during screening for diabetic retinopathy. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  19. Fibrous membranes in diabetic retinopathy and bevacizumab.

    Science.gov (United States)

    Pattwell, David M; Stappler, Theodor; Sheridan, Carl; Heimann, Heinrich; Gibran, Syed K; Wong, David; Hiscott, Paul

    2010-01-01

    The purpose of this study was to determine the histopathologic characteristics of bevacizumab-treated human proliferative diabetic retinopathy (PDR) membranes with particular regard to membrane vasculature as a step toward addressing the effects of the drug on PDR membranes. Intravitreous injection of bevacizumab, an antivascular endothelial growth factor monoclonal antibody, has recently been advocated as an adjunct in surgery for PDR. In this context, a clinically observed decrease in PDR epiretinal membrane vascularity (vascular regression) occurs from 24 hours to 48 hours after injection, but the exact mechanisms of drug action are unknown. A consecutive series of seven PDR membrane specimens that had been removed sequentially from seven bevacizumab-treated patients were studied retrospectively. The membrane specimens were examined using light microscopic methods, including immunohistochemistry. Five of the seven membranes were clinically avascular (one contained "ghost" vessels) and did not hemorrhage during excision. Of these 5 specimens, which included 1 removed 7 days after a total of 6 intravitreous injections of 1.25 mg bevacizumab, 4 contained histologically detectable capillaries (1 did not). These blood vessels were lined by endothelial cells as determined by immunohistochemistry for the endothelial markers CD31 and CD34. The two remaining membranes were clinically and histologically still vascularized despite bevacizumab treatment. All the specimens also contained smooth muscle actin-containing fibroblastic cells within the collagenous stroma. The findings do not support the concept that the clinical phenomenon of vascular regression in PDR membranes after bevacizumab injection in the vitreous is resulting from obliteration of the membrane blood vessels. Another mechanism appears to be involved in at least some patients, possibly a vasoconstrictive response. Such a mechanism might explain reversal of the effects of bevacizumab that has been reported

  20. 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%.

  1. Detection of Glaucoma and Its Association With Diabetic Retinopathy in a Diabetic Retinopathy Screening Program.

    Science.gov (United States)

    Gangwani, Rita A; McGhee, Sarah M; Lai, Jimmy S M; Chan, Christina K W; Wong, David

    2016-01-01

    To determine the type of glaucoma in subjects with diabetes mellitus detected during a diabetic retinopathy screening program and to determine any association between diabetic retinopathy (DR) and glaucoma. This is a population-based prospective cross-sectional study, in which subjects with diabetes mellitus underwent screening for DR in a primary care outpatient clinic. Digital fundus photographs were taken and graded for presence/absence and severity of DR. During this grading, those fundus photographs showing increased cup-to-disc ratio (CDR) (≥0.6) were identified and these patients were referred to the specialist ophthalmology clinic for detailed examination. The presence of glaucoma was established based on CDR and abnormal visual field (VF) defects according to Hodapp-Parrish-Anderson's criteria. An elevation of intraocular pressure was not required for the diagnosis of glaucoma. The patients said to have definite glaucoma were those with vertical CDR>/=0.6, glaucomatous defects on VF examination, or retinal nerve fiber thinning if VF was unreliable. Of the 2182 subjects who underwent screening, 81 subjects (3.7%) had increased CDR and 40 subjects (1.8%) had confirmed glaucoma. Normal-tension variant of primary open-angle glaucoma was the most prevalent type (1.2%) We did not find any evidence that DR is a risk factor for glaucoma [odds ratio for DR vs. no DR=1.22 (95% confidence interval, 0.59-2.51)]. The overall prevalence of glaucoma in this diabetic population, based on finding increased cupping of optic disc in a teleretinal screening program was 1.8% (95% confidence interval, 1.0-3.0).

  2. Oscillations of the Outer Boundary of the Outer Radiation Belt During Sawtooth Oscillations

    Directory of Open Access Journals (Sweden)

    Jae-Hun Kim

    2006-09-01

    Full Text Available We report three sawtooth oscillation events observed at geosynchronous orbit where we find quasi-periodic (every 2-3 hours sudden flux increases followed by slow flux decreases at the energy levels of ˜50-400 keV. For these three sawtooth events, we have examined variations of the outer boundary of the outer radiation belt. In order to determine L values of the outer boundary, we have used data of relativistic electron flux observed by the SAMPEX satellite. We find that the outer boundary of the outer radiation belt oscillates periodically being consistent with sawtooth oscillation phases. Specifically, the outer boundary of the outer radiation belt expands (namely, the boundary L value increases following the sawtooth particle flux enhancement of each tooth, and then contracts (namely, the boundary L value decreases while the sawtooth flux decreases gradually until the next flux enhancement. On the other hand, it is repeatedly seen that the asymmetry of the magnetic field intensity between dayside and nightside decreases (increases due to the dipolarization (the stretching on the nightside as the sawtooth flux increases (decreases. This implies that the periodic magnetic field variations during the sawtooth oscillations are likely responsible for the expansion-contraction oscillations of the outer boundary of the outer radiation belt.

  3. Early diagnosis of sub-clinical stage of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Xing-Hui Xu

    2014-12-01

    Full Text Available AIM: To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.METHODS: This was cross sectional study,multifocal retina electroretinogram(mf-ERG, contrast sensitivity(CSand central retinal artery color Doppler examination were recorded from 30 cases(30 eyesmatched control subjects, 35 cases(35 eyeswith type 2 diabetes mellitus(DMwithout diabetic retinopathy(NDRand 38 cases(38 eyeswith non-prolifera tive diabetic retinopathy(NPDR. One-way ANOVA and SNK-q test were used for data analysis.RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy(PPPP>0.05, The differences between normal group, NDR group and NPDR group were found statistically significant(PCONCLUSION: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

  4. Petaloid-pattern pigmentary retinopathy: a novel case report.

    Science.gov (United States)

    Padhi, Tapas Ranjan; Jalali, Subhadra; Panda, Krushna Gopal; Mukherjee, Sujoy; Mohan, Neha; Agroiya, Pushpalata; Das, Taraprasad

    2014-10-01

    We report the case of a 6-year-old girl with an unusual petaloid-pattern pigmentary retinopathy associated with nyctalopia and reduction of vision which had been invariably static over the past 5 years. We performed a comprehensive ophthalmic examination including fundoscopy, autofluorescent imaging, electroretinography and optical coherence tomography. There were diffuse retinal pigment epithelium (RPE) washout areas with blotches of pigment distributed in the pattern of a petal with marked chorioretinal atrophy and scar at the fovea. The arterial caliber was normal. Investigations ruled out intrauterine and neonatal infection. Systemically, she was healthy with normal intellect but with 3-month delayed milestones of development. She had used valproic acid for seizure disorder (without any organic central nervous system lesion) from 2-5 years of age. Electroretinography showed extinguished scotopic responses with slight reduction in cone responses. Optical coherence tomography showed a scar with attenuated RPE-choriocapillary complex at the macula. Her clinical profile did not fully match with any previously described pigmentary retinopathies except rod-cone dystrophy and choroidal dystrophy to a certain extent. The pigmentary retinopathy reported here is a combination of a petaloid pattern of pigmentary disturbance, stationary reduction of vision, nyctalopia, normal intellect and marginal delayed milestones. In the absence of such a description in the literature we named this disorder as petaloid-pattern pigmentary retinopathy.

  5. Diabetic Retinopathy in Nnewi, Nigeria | Nwosu | Nigerian Journal of ...

    African Journals Online (AJOL)

    The objective of this paper is to determine the incidence and pattern of diabetic retinopathy in a clinic population of diabetics in Nnewi. All consecutive new patients seen at the Diabetic Eye Clinic, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, between March 1997 and September 1998 were examined.

  6. Factors Associated With Progression Of Diabetic Retinopathy, A ...

    African Journals Online (AJOL)

    Background: Diabetic retinopathy (DR) is a progressive sight threatening diabetic complication. The prognosis seems to be related to largely modifiable risk factors. Objectives: The aim of the study was to identify factors that could be associated with progression of DR. among adult diabetic patients attending primary health ...

  7. Sight threatening retinopathy in a child with sickle cell &beta ...

    African Journals Online (AJOL)

    Sight threatening changes in the retina are a well-recognized complication of sickle cell disease (SCD). However they usually occur in older patients with Haemoglobin SC or Sβ+thal patterns. It is rarely found under the age of 20 years in patients who are Hb SS or Sβ<°thal. This is a report of sight threatening retinopathy in ...

  8. Retinopathy of prematurity in infants with birth weight above 1500 ...

    African Journals Online (AJOL)

    Objective: To identify the rate and prognosis of retinopathy of prematurity (ROP) among newborn infants of birthweight of above 1500 grams, and the possible risk factors associated with the disease. Design: A prospective cohort study. Setting: Neonatal unit at Maternity Hospital, Kuwait city, Kuwait. Methods: All low birth ...

  9. Bevacizumab treatment for retinopathy of prematurity in South Africa

    African Journals Online (AJOL)

    ROP in the developing world. Retinopathy of prematurity (ROP) is a growing problem in South. Africa (SA), as it is in many parts of the developing world. The so-called 'third epidemic' of ROP is caused by a combination of high preterm birth rates, relatively good infant survival and inadequate oxygen monitoring in neonatal ...

  10. Subretinal neovascularization from the retina in radiation retinopathy

    International Nuclear Information System (INIS)

    Boozalis, G.T.; Schachat, A.P.; Green, W.R.

    1987-01-01

    In a 66-year-old woman with radiation retinopathy, subretinal neovascularization was present, originating from telangiectatic retinal vessels in the macular area. The patient showed no clinical or histologic evidence of age-related macular degeneration or other conditions that may have contributed to the subretinal neovascularization

  11. Prevalence and risk factors associated with retinopathy in diabetic ...

    African Journals Online (AJOL)

    Diabetic retinopathy is the fifth leading cause of blindness worldwide accounting for nearly 5% of all blindness. However, most of the prevalence and incidence data is from developed countries, with very limited information from sub-Saharan Africa. The study sought to determine the prevalence of, and factors associated ...

  12. Oxidative stress in diabetic patients with retinopathy | Kundu ...

    African Journals Online (AJOL)

    Background: Diabetes mellitus (DM) is known to induce oxidative stress along with deranging various metabolisms; one of the late complications of diabetes mellitus is diabetic retinopathy, which is a leading cause of acquired blindness. Poor glycemic control and oxidative stress have been attributed to the development of ...

  13. Screening for retinopathy of prematurity in a provincial hospital in ...

    African Journals Online (AJOL)

    Background. Retinopathy of prematurity (ROP) is an emerging public health problem in many middle-income countries where improved neonatal survival rates coupled with inadequate health resources have created a new epidemic. There are limited available data on the magnitude of the problem, and screening in South ...

  14. Clinical features of diabetes retinopathy in elderly patients with type ...

    African Journals Online (AJOL)

    Objective: The objective was to estimate the prevalence and clinical characteristics of diabetes retinopathy (DR) in elderly individuals with type 2 diabetes mellitus in Northern Chinese. Materials and Methods: 595 eligible subjects (263 men, 332 women) assisted by the community health service center in Beijing, China ...

  15. Adenosine receptors and caffeine in retinopathy of prematurity.

    Science.gov (United States)

    Chen, Jiang-Fan; Zhang, Shuya; Zhou, Rong; Lin, Zhenlang; Cai, Xiaohong; Lin, Jing; Huo, Yuqing; Liu, Xiaoling

    2017-06-01

    Retinopathy of prematurity (ROP) is a major cause of childhood blindness in the world and is caused by oxygen-induced damage to the developing retinal vasculature, resulting in hyperoxia-induced vaso-obliteration and subsequent delayed retinal vascularization and hypoxia-induced pathological neovascularization driven by vascular endothelial growth factor (VEGF) signaling pathway in retina. Current anti-VEGF therapy has shown some effective in a clinical trial, but is associated with the unintended effects on delayed eye growth and retinal vasculature development of preterm infants. Notably, cellular responses to hypoxia are characterized by robust increases in extracellular adenosine production and the markedly induced adenosine receptors, which provide a novel target for preferential control of pathological angiogenesis without affecting normal vascular development. Here, we review the experimental evidence in support of adenosine receptor-based therapeutic strategy for ROP, including the aberrant adenosine signaling in oxygen-induced retinopathy and the role of three adenosine receptor subtypes (A 1 R, A 2A R, A 2B R) in development and treatment of ROP using oxygen-induced retinopathy models. The clinical and initial animal evidence that implicate the therapeutic effect of caffeine (a non-selective adenosine receptor antagonist) in treatment of ROP are highlighted. Lastly, we discussed the translational potential as well therapeutic advantage of adenosine receptor- and caffeine-based therapy for ROR and possibly other proliferative retinopathy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. Does Niprisanฎ Retard the Evolution of Sickle Cell Retinopathy?

    African Journals Online (AJOL)

    Objective: To investigate the efficacy of Niprisan®, an antisickling agent, in the management of sickle cell retinopathy. Methods: The study was designed as a phase IIb double-blind, placebo-controlled crossover trial. Eighty-eight patients aged between 5 and 36 years (mean 15.3 years) were randomized into 2 treatment ...

  17. Automated detection of diabetic retinopathy lesions on ultrawidefield pseudocolour images.

    Science.gov (United States)

    Wang, Kang; Jayadev, Chaitra; Nittala, Muneeswar G; Velaga, Swetha B; Ramachandra, Chaithanya A; Bhaskaranand, Malavika; Bhat, Sandeep; Solanki, Kaushal; Sadda, SriniVas R

    2018-03-01

    We examined the sensitivity and specificity of an automated algorithm for detecting referral-warranted diabetic retinopathy (DR) on Optos ultrawidefield (UWF) pseudocolour images. Patients with diabetes were recruited for UWF imaging. A total of 383 subjects (754 eyes) were enrolled. Nonproliferative DR graded to be moderate or higher on the 5-level International Clinical Diabetic Retinopathy (ICDR) severity scale was considered as grounds for referral. The software automatically detected DR lesions using the previously trained classifiers and classified each image in the test set as referral-warranted or not warranted. Sensitivity, specificity and the area under the receiver operating curve (AUROC) of the algorithm were computed. The automated algorithm achieved a 91.7%/90.3% sensitivity (95% CI 90.1-93.9/80.4-89.4) with a 50.0%/53.6% specificity (95% CI 31.7-72.8/36.5-71.4) for detecting referral-warranted retinopathy at the patient/eye levels, respectively; the AUROC was 0.873/0.851 (95% CI 0.819-0.922/0.804-0.894). Diabetic retinopathy (DR) lesions were detected from Optos pseudocolour UWF images using an automated algorithm. Images were classified as referral-warranted DR with a high degree of sensitivity and moderate specificity. Automated analysis of UWF images could be of value in DR screening programmes and could allow for more complete and accurate disease staging. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. Automatic Detection of Diabetic Retinopathy in Digital Fundus Photographs

    NARCIS (Netherlands)

    Niemeijer, M.

    2006-01-01

    Diabetic retinopathy is a common ocular complication of diabetes. It is the most frequent cause of blindness in the working population of the United States and the European Union. Early diagnosis, and treatment can prevent vision loss in the majority of cases. Yet only approximately 50% of people

  19. 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

  20. Postnatal corticosteroids and risk of retinopathy of prematurity.

    Science.gov (United States)

    Movsas, Tammy Z; Spitzer, Alan R; Gewolb, Ira H

    2016-08-01

    To investigate the association between postnatal steroids and retinopathy of prematurity (ROP) in neonates born with birth weights at the limit of viability (large study cohort of critically low birth weight infants ROP was more common in neonates exposed to postnatal steroids. Copyright © 2016 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  1. Predictors of Diabetic Retinopathy in Patients with Type 2 Diabetes ...

    African Journals Online (AJOL)

    and end‑stage renal disease respectively in adults of both ... Departments of Medicine, and 1Ophthalmology, Era's Lucknow Medical ... The collected data included age, gender, duration of diabetes and ..... also shown to be effective in preventing DR in individuals .... retinopathy and diabetic macular edema disease severity.

  2. Evaluation of the central macula in commotio retinae not associated with other types of traumatic retinopathy.

    Science.gov (United States)

    Park, Joo Youn; Nam, Woo Ho; Kim, Seung Hoon; Jang, Sun Young; Ohn, Young-Hoon; Park, Tae Kwann

    2011-08-01

    To report on the anatomical and functional changes to the macula in nine patients suffering from commotio retinae not accompanied by any other types of traumatic retinopathy. Nine injured eyes with commotio retinae were evaluated soon after ocular trauma with ophthalmic examination, including Spectral-domain optical coherence tomography (SD-OCT). In 12 eyes of 6 patients, Humphrey visual field (HVF) and multifocal electroretinogram (mfERG) were performed. Re-examinations were periodically performed for a mean of 26 days. Data from 9 injured eyes were collected and compared to data collected from the 9 non-affected eyes of the same patients. SD-OCT revealed no significant differences in the foveal thickness and total macular volume between traumatized and intact eyes in all 9 patients. Only 3 out of the 9 injured eyes showed abnormal findings in SD-OCT images such as discontinuity of the inner/outer segment (IS/OS) junction or abnormal hyper-reflectivity from the IS/OS and retinal pigment epithelium (RPE) lines in the macula. HVF and mfERG results did not show any functional deterioration in the injured eyes compared with intact eyes. During follow-up, the commotio retinae resolved in all 9 eyes. The changes to the outer retinal region detected in 3 patients by SD-OCT were also resolved. Acute retinal changes in commotio retinae, not associated with other retinal pathologies, were resolved without histological and functional sequelae. In a few cases of commotio retinae, SD-OCT revealed transient abnormalities mainly observed at the IS/OS and RPE complexes.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Retinopathy in an obesity WHO III cohort: prevalence and risk factors.

    Science.gov (United States)

    Mattern, Juri; Lammert, Alexander; Otto, Mirko; Hammes, Hans-Peter

    2017-11-01

    To assess retinopathy and its risk factors in an obesity WHO III cohort. In the Mannheim Obesity Study , 277 subjects with obesity WHO III aged 18-64 years were examined in a cross-sectional approach. Screening for retinopathy was performed using 3-field retinal photography. Endothelial function was assessed using arteriole-to-venule ratio and flicker light analysis. Subjects with and without retinopathy were analysed for anthropometry, metabolic, vascular and renal parameters. Retinopathy was found in 18 of the 277 subjects (6.5%). Prevalence of retinopathy was 16.7% in subjects with and 3.4% in subjects without diabetes mellitus. Between subjects with and without retinopathy there were significant differences in diabetes prevalence (61.1% vs 21.7%, pretinopathy (OR 8.3, p=0.049, 95% CI 1.01 to 67.49), whereas risk for retinopathy decreased by nearly 50% (OR 0.54, p=0.032, 95% CI 0.30 to 0.95) with each percentage increase in venous dilatation in response to flicker light. Retinopathy prevalence in our obesity WHO III cohort is low. Presence of diabetes mellitus is the most important risk factor for retinopathy. Preserved venular function indicates protection from retinopathy. NCT00770276, Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Levels of serum vascular endothelial growth factor in type 2 diabetics with retinopathy

    International Nuclear Information System (INIS)

    Parveen, N.; Rahman, S.; Khan, Q.

    2012-01-01

    Background: Ischemic retina in diabetic patients releases a number of chemical substances including vascular endothelial growth factor which leads to retinal vascular proliferation and blindness following rupture and bleeding of vessels. Strategies to control this action can considerably halt this process. Objectives: To determine the relationship of various stages of diabetic retinopathy with the levels vascular endothelial growth factor in the serum of type 2 diabetic patients. Study type, settings and duration: This cross sectional analytical study was done over one year (2010-2011) in three major public sector hospitals of Peshawar. Patients and Methods: Adult patients of either gender having type 2 diabetes mellitus with proliferative or non proliferative retinopathy and those without retinopathy were selected for the study. Retinopathy was diagnosed on fundoscopy. Non-diabetic patients without retinopathy were selected as controls. Serum levels of vascular endothelial growth factor were done in patients and controls using ELISA. Results: Serum vascular endothelial growth factor levels were significantly higher in all cases having retinopathy as compared to controls. These levels progressively increased with the grades of retinopathy. Levels were higher in females. Conclusions: Levels of vascular endothelial growth factor are raised in diabetic retinopathy and rising levels can alert the clinician in worsening of retinopathy so that preventive and therapeutic measures can be taken promptly. Policy message: Further larger scale studies are recommended on national level to pave way for the establishment of appropriate management paradigms for diabetic retinopathy through anti-VEGF treatment. (author)

  6. Role of frequency doubling technology perimetry in screening of diabetic retinopathy.

    Directory of Open Access Journals (Sweden)

    Parikh Rajul

    2006-01-01

    Full Text Available Purpose: To study the ability of frequency-doubling technology perimetry (FDT to detect sight-threatening diabetic retinopathy. Method: Fifty-eight eyes of fifty-eight patients with established diagnosis of diabetes mellitus with diabetic retinopathy, fifty-five eyes of fifty-five diabetic patients without retinopathy, and forty-one eyes of forty-one normals underwent FDT and dilated stereo-biomicroscopic fundus examination. The sensitivity and specificity of FDT in identification of "sight-threatening retinopathy" (severe and very severe nonproliferative diabetic retinopathy and proliferative diabetic retinopathy and clinically significant macular edema (CSME were determined. Results: For the detection of sight-threatening retinopathy, two abnormal adjacent points depressed to any level on the 20-1 screening program had a sensitivity of 90.5% and specificity of 97.6%. At (assuming a 10% prevalence of sight-threatening retinopathy in a diabetic clinic, two abnormal adjacent points anywhere in the field depressed to any level has a positive predictive value (PPV of 48% with a negative predictive value of 98.8%. Sensitivity and specificity for the detection of CSME was poor. Conclusions: The 20-1 screening program of the FDT is useful in the detection of sight-threatening diabetic retinopathy (PPV 48%. A normal 20-1 test rules out sight-threatening retinopathy. FDT was not useful in the detection of CSME.

  7. NADPH Oxidase, NOX1, Mediates Vascular Injury in Ischemic Retinopathy

    Science.gov (United States)

    Deliyanti, Devy; Rana, Indrajeetsinh; Miller, Antonia G.; Agrotis, Alex; Armani, Roksana; Szyndralewiez, Cédric; Wingler, Kirstin; Touyz, Rhian M.; Cooper, Mark E.; Jandeleit-Dahm, Karin A.; Schmidt, Harald H.H.W.

    2014-01-01

    Abstract Aims: Ischemic retinal diseases such as retinopathy of prematurity are major causes of blindness due to damage to the retinal microvasculature. Despite this clinical situation, retinopathy of prematurity is mechanistically poorly understood. Therefore, effective preventative therapies are not available. However, hypoxic-induced increases in reactive oxygen species (ROS) have been suggested to be involved with NADPH oxidases (NOX), the only known dedicated enzymatic source of ROS. Our major aim was to determine the contribution of NOX isoforms (1, 2, and 4) to a rodent model of retinopathy of prematurity. Results: Using a genetic approach, we determined that only mice with a deletion of NOX1, but not NOX2 or NOX4, were protected from retinal neovascularization and vaso-obliteration, adhesion of leukocytes, microglial accumulation, and the increased generation of proangiogenic and proinflammatory factors and ROS. We complemented these studies by showing that the specific NOX inhibitor, GKT137831, reduced vasculopathy and ROS levels in retina. The source of NOX isoforms was evaluated in retinal vascular cells and neuro-glial elements. Microglia, the immune cells of the retina, expressed NOX1, 2, and 4 and responded to hypoxia with increased ROS formation, which was reduced by GKT137831. Innovation: Our studies are the first to identify the NOX1 isoform as having an important role in the pathogenesis of retinopathy of prematurity. Conclusions: Our findings suggest that strategies targeting NOX1 have the potential to be effective treatments for a range of ischemic retinopathies. Antioxid. Redox Signal. 20, 2726–2740. PMID:24053718

  8. Does bariatric surgery prevent progression of diabetic retinopathy?

    Science.gov (United States)

    Chen, Y; Laybourne, J P; Sandinha, M T; de Alwis, N M W; Avery, P; Steel, D H

    2017-08-01

    PurposeTo assess the changes in diabetic retinopathy (DR) in type 2 diabetes (T2DM) patients post bariatric surgery and report on the risk factors that may be associated with it.Patients and methodsRetrospective observational study of T2DM patients who underwent bariatric surgery in a UK specialist bariatric unit between 2009 and 2015. Preoperative and postoperative weight, HbA1c, and annual DR screening results were collected from medical records. Patients with preoperative retinal screening and at least one postoperative retinal screening were eligible for analysis. Multivariate analysis was used to explore significant clinical predictors on postoperative worsening in DR.ResultsA total of 102 patients were eligible for analysis and were followed up for 4 years. Preoperatively, 68% of patients had no DR compared to 30% with background retinopathy, 1% pre-proliferative retinopathy, and 1% proliferative retinopathy. In the first postoperative visit, 19% of patients developed new DR compared to 70% stable and 11% improved. These proportions remained similar for each postoperative visit over time. Young age, male gender, high preoperative HbA1c, and presence of preoperative retinopathy were the significant predictors of worsening postoperatively.ConclusionBariatric surgery does not prevent progression of DR. Young male patients with pre-existing DR and poor preoperative glycaemic control are most at risk of progression. All diabetic patients should attend regular DR screening post bariatric surgery to allow early detection of potentially sight-threatening changes, particularly among those with identifiable risk factors. Future prospective studies with prolonged follow-up are required to clarify the duration of risk.

  9. Enface Thickness Mapping and Reflectance Imaging of Retinal Layers in Diabetic Retinopathy.

    Science.gov (United States)

    Francis, Andrew W; Wanek, Justin; Lim, Jennifer I; Shahidi, Mahnaz

    2015-01-01

    To present a method for image segmentation and generation of enface thickness maps and reflectance images of retinal layers in healthy and diabetic retinopathy (DR) subjects. High density spectral domain optical coherence tomography (SDOCT) images were acquired in 10 healthy and 4 DR subjects. Customized image analysis software identified 5 retinal cell layer interfaces and generated thickness maps and reflectance images of the total retina (TR), inner retina (IR), outer retina (OR), and the inner segment ellipsoid (ISe) band. Thickness maps in DR subjects were compared to those of healthy subjects by generating deviation maps which displayed retinal locations with thickness below, within, and above the normal 95% confidence interval. In healthy subjects, TR and IR thickness maps displayed the foveal depression and increased thickness in the parafoveal region. OR and ISe thickness maps showed increased thickness at the fovea, consistent with normal retinal anatomy. In DR subjects, thickening and thinning in localized regions were demonstrated on TR, IR, OR, and ISe thickness maps, corresponding to retinal edema and atrophy, respectively. TR and OR reflectance images showed reduced reflectivity in regions of increased thickness. Hard exudates appeared as hyper-reflective spots in IR reflectance images and casted shadows on the deeper OR and ISe reflectance images. The ISe reflectance image clearly showed the presence of focal laser scars. Enface thickness mapping and reflectance imaging of retinal layers is a potentially useful method for quantifying the spatial and axial extent of pathologies due to DR.

  10. Characterization of Retinal Vascular and Neural Damage in a Novel Model of Diabetic Retinopathy.

    Science.gov (United States)

    Weerasekera, Lakshini Y; Balmer, Lois A; Ram, Ramesh; Morahan, Grant

    2015-06-01

    Diabetic retinopathy (DR) is a major cause of blindness globally. Investigating the underlying mechanisms of DR would be aided by a suitable mouse model that developed key features seen in the human disease, and did so without carrying genetic modifications. This study was undertaken to produce such a model. Our panel of Collaborative Cross strains was screened for DR-like features after induction of diabetes by intravenous injection with alloxan or streptozotocin. Both flat-mounted whole-retina and histologic sections were studied for the presence of retinal lesions. Progression of DR was also studied by histologic examination of the retinal vascular and neural structure at various time points after diabetes onset. In addition, microarray investigations were conducted on retinas from control and diabetic mice. Features of DR such as degenerated pericytes, acellular capillaries, minor vascular proliferation, gliosis of Müller cells, and loss of ganglion cells were noted as early as day 7 in some mice. These lesions became more evident with time. After 21 days of diabetes, severe vascular proliferation, microaneurysms, preretinal damage, increased Müller cell gliosis, and damage to the outer retina were all obvious. Microarray studies found significant differential expression of multiple genes known to be involved in DR. The FOT_FB strain provides a useful model to investigate the pathogenesis of DR and to develop treatments for this vision-threatening disease.

  11. Retinopathy of prematurity: inflammation, choroidal degeneration, and novel promising therapeutic strategies.

    Science.gov (United States)

    Rivera, José Carlos; Holm, Mari; Austeng, Dordi; Morken, Tora Sund; Zhou, Tianwei Ellen; Beaudry-Richard, Alexandra; Sierra, Estefania Marin; Dammann, Olaf; Chemtob, Sylvain

    2017-08-22

    Retinopathy of prematurity (ROP) is an important cause of childhood blindness globally, and the incidence is rising. The disease is characterized by initial arrested retinal vascularization followed by neovascularization and ensuing retinal detachment causing permanent visual loss. Although neovascularization can be effectively treated via retinal laser ablation, it is unknown which children are at risk of entering this vision-threatening phase of the disease. Laser ablation may itself induce visual field deficits, and there is therefore a need to identify targets for novel and less destructive treatments of ROP. Inflammation is considered a key contributor to the pathogenesis of ROP. A large proportion of preterm infants with ROP will have residual visual loss linked to loss of photoreceptor (PR) and the integrity of the retinal pigment epithelium (RPE) in the macular region. Recent studies using animal models of ROP suggest that choroidal degeneration may be associated with a loss of integrity of the outer retina, a phenomenon so far largely undescribed in ROP pathogenesis. In this review, we highlight inflammatory and neuron-derived factors related to ROP progression, as well, potential targets for new treatment strategies. We also introduce choroidal degeneration as a significant cause of residual visual loss following ROP. We propose that ROP should no longer be considered an inner retinal vasculopathy only, but also a disease of choroidal degeneration affecting both retinal pigment epithelium and photoreceptor integrity.

  12. Bloodstream-To-Eye Infections Are Facilitated by Outer Blood-Retinal Barrier Dysfunction.

    Directory of Open Access Journals (Sweden)

    Phillip S Coburn

    Full Text Available The blood-retinal barrier (BRB functions to maintain the immune privilege of the eye, which is necessary for normal vision. The outer BRB is formed by tightly-associated retinal pigment epithelial (RPE cells which limit transport within the retinal environment, maintaining retinal function and viability. Retinal microvascular complications and RPE dysfunction resulting from diabetes and diabetic retinopathy cause permeability changes in the BRB that compromise barrier function. Diabetes is the major predisposing condition underlying endogenous bacterial endophthalmitis (EBE, a blinding intraocular infection resulting from bacterial invasion of the eye from the bloodstream. However, significant numbers of EBE cases occur in non-diabetics. In this work, we hypothesized that dysfunction of the outer BRB may be associated with EBE development. To disrupt the RPE component of the outer BRB in vivo, sodium iodate (NaIO3 was administered to C57BL/6J mice. NaIO3-treated and untreated mice were intravenously injected with 108 colony forming units (cfu of Staphylococcus aureus or Klebsiella pneumoniae. At 4 and 6 days postinfection, EBE was observed in NaIO3-treated mice after infection with K. pneumoniae and S. aureus, although the incidence was higher following S. aureus infection. Invasion of the eye was observed in control mice following S. aureus infection, but not in control mice following K. pneumoniae infection. Immunohistochemistry and FITC-dextran conjugate transmigration assays of human RPE barriers after infection with an exoprotein-deficient agr/sar mutant of S. aureus suggested that S. aureus exoproteins may be required for the loss of the tight junction protein, ZO-1, and for permeability of this in vitro barrier. Our results support the clinical findings that for both pathogens, complications which result in BRB permeability increase the likelihood of bacterial transmigration from the bloodstream into the eye. For S. aureus, however, BRB

  13. 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 L; 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...

  14. Outer planet probe cost estimates: First impressions

    Science.gov (United States)

    Niehoff, J.

    1974-01-01

    An examination was made of early estimates of outer planetary atmospheric probe cost by comparing the estimates with past planetary projects. Of particular interest is identification of project elements which are likely cost drivers for future probe missions. Data are divided into two parts: first, the description of a cost model developed by SAI for the Planetary Programs Office of NASA, and second, use of this model and its data base to evaluate estimates of probe costs. Several observations are offered in conclusion regarding the credibility of current estimates and specific areas of the outer planet probe concept most vulnerable to cost escalation.

  15. 27 CFR 9.207 - Outer Coastal Plain.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Outer Coastal Plain. 9.207... Outer Coastal Plain. (a) Name. The name of the viticultural area described in this section is “Outer Coastal Plain”. For purposes of part 4 of this chapter, “Outer Coastal Plain” is a term of viticultural...

  16. Relationship between serum 25-hydroxy vitamin D levels and retinopathy of prematurity.

    Science.gov (United States)

    Kabataş, Emrah Utku; Dinlen, Nurdan Fettah; Zenciroğlu, Ayşegül; Dilli, Dilek; Beken, Serdar; Okumuş, Nurullah

    2017-11-01

    Aim To evaluate the relationship between serum 25-hydroxy vitamin D, 25 (OH) D, levels and retinopathy of prematurity. Methods and Results Serum 25 (OH) D levels were measured in 97 very low birth weight infants, prior to vitamin D supplementation. The development of retinopathy of prematurity and its treatment requirement were evaluated. At follow-up, retinopathy of prematurity developed in 71 (73.2%) infants. Serum 25 (OH) D levels were significantly lower in infants with retinopathy of prematurity than ones without retinopathy of prematurity ( P prematurity development [OR: 1.14, 95% CI (1.02-1.27), P = 0.02]. Conclusion Lower 25 (OH) D levels in the first days of life may be related to retinopathy of prematurity development and treatment requirement in premature infants.

  17. Outer-2-independent domination in graphs

    Indian Academy of Sciences (India)

    independent dominating set of a graph is a set of vertices of such that every vertex of ()\\ has a neighbor in and the maximum vertex degree of the subgraph induced by ()\\ is at most one. The outer-2-independent domination ...

  18. Intershell correlations in photoionization of outer shells

    Energy Technology Data Exchange (ETDEWEB)

    Amusia, M.Ya. [The Racah Institute of Physics, The Hebrew University of Jerusalem, Jerusalem 91904 (Israel); A.F. Ioffe Physical-Technical Institute, St. Petersburg 194021 (Russian Federation); Chernysheva, L.V. [A.F. Ioffe Physical-Technical Institute, St. Petersburg 194021 (Russian Federation); Drukarev, E.G. [National Research Center “Kurchatov Institute”, Konstantinov Petersburg Nuclear Physics Institute, St. Petersburg 188300 (Russian Federation)

    2016-02-15

    We demonstrate that the cross sections for photoionization of the outer shells are noticeably modified at the photon energies close to the thresholds of ionization of the inner shells due to correlations with the latter. The correlations may lead to increase or to decrease of the cross sections just above the ionization thresholds.

  19. Outer-2-independent domination in graphs

    Indian Academy of Sciences (India)

    Outer-2-independent domination in graphs. MARCIN KRZYWKOWSKI1,2,∗, DOOST ALI MOJDEH3 and MARYEM RAOOFI4. 1Department of Pure and Applied Mathematics, University of Johannesburg,. Johannesburg, South Africa. 2Faculty of Electronics, Telecommunications and Informatics, Gdansk University.

  20. Intershell correlations in photoionization of outer shells

    International Nuclear Information System (INIS)

    Amusia, M.Ya.; Chernysheva, L.V.; Drukarev, E.G.

    2016-01-01

    We demonstrate that the cross sections for photoionization of the outer shells are noticeably modified at the photon energies close to the thresholds of ionization of the inner shells due to correlations with the latter. The correlations may lead to increase or to decrease of the cross sections just above the ionization thresholds.

  1. Correlation between glycemic excursion by CGMS and diabetic retinopathy among Type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Pu Li; Ji Ning; Zhu Wei

    2011-01-01

    Objective: To investigate correlation between glycemic excursion by CGMS and diabetic retinopathy among type 2 diabetes mellitus. Methods: Used continuous glucose monitoring system (CGMS) to monitoring glycemic excursion within a day of twenty four patients with type 2 diabetes mellitus, and inspect fundus photography, correlation was analyzed. Results: Glycemic excursion might reveal the risk for diabetic retinopathy better than HbA1c does. Conclusion: Diabetic retinopathy may correlate with glycemic excursion. (authors)

  2. Diabetic Retinopathy Is Associated With Elevated Serum Asymmetric and Symmetric Dimethylarginines

    OpenAIRE

    Abhary, Sotoodeh; Kasmeridis, Nicholas; Burdon, Kathryn P.; Kuot, Abraham; Whiting, Malcolm J.; Yew, Wai Ping; Petrovsky, Nikolai; Craig, Jamie E.

    2009-01-01

    OBJECTIVE Asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and l-arginine directly influence nitric oxide production. Our objective was to test whether serum ADMA, SDMA, or l-arginine levels correlate with diabetic retinopathy subtype or severity. RESEARCH DESIGN AND METHODS A total of 162 subjects with type 1 diabetes and 343 with type 2 diabetes, of whom 329 subjects had no diabetic retinopathy, 27 had nonproliferative diabetic retinopathy (NPDR), 101 had proliferative...

  3. Comparing carotid intima-media thickness in type 2 diabetes between patients with and without retinopathy

    Directory of Open Access Journals (Sweden)

    Naroi Nejad M

    2012-06-01

    Conclusion: Diabetic retinopathy seems to be associated with increased intima-media thickness of carotid arteries in T2DM. It may be a common denominator of pathogene-sis of microvascular complications and atherosclerosis in T2DM. Evaluations of carotid arteries are to be done by non-invasive methods such as color Doppler sonography for screening and preventing prospective cereberovascular accidents in patients with diabetic retinopathy, especially proliferative retinopathy, in routine ophthalmological examination of patients with T2DM.

  4. Retinopathy after low dose irradiation for an intracranial tumor of the frontal lobe

    International Nuclear Information System (INIS)

    Elsaas, T.; Thorud, E.; Jetne, V.; Conradi, I.S.

    1988-01-01

    A 32-year-old man underwent an operation for an oligodendroglioma of the left frontal lobe. Postoperatively he was irradiated to a target dose of 54 Gy. One year later hedeveloped bilateral retinopathy quite similar to diabetic retinopathy. There were no clinical or biochemical signs of diabetes or hematological disease. The calcultated maximum dose to the retina was 11 Gy. This is to our knowledge the lowest retinal dose of ionizing radiation reported to produce retinopathy. (author)

  5. ROCK-1 mediates diabetes-induced retinal pigment epithelial and endothelial cell blebbing: Contribution to diabetic retinopathy.

    Science.gov (United States)

    Rothschild, Pierre-Raphaël; Salah, Sawsen; Berdugo, Marianne; Gélizé, Emmanuelle; Delaunay, Kimberley; Naud, Marie-Christine; Klein, Christophe; Moulin, Alexandre; Savoldelli, Michèle; Bergin, Ciara; Jeanny, Jean-Claude; Jonet, Laurent; Arsenijevic, Yvan; Behar-Cohen, Francine; Crisanti, Patricia

    2017-08-18

    In diabetic retinopathy, the exact mechanisms leading to retinal capillary closure and to retinal barriers breakdown remain imperfectly understood. Rho-associated kinase (ROCK), an effector of the small GTPase Rho, involved in cytoskeleton dynamic regulation and cell polarity is activated by hyperglycemia. In one year-old Goto Kakizaki (GK) type 2 diabetic rats retina, ROCK-1 activation was assessed by its cellular distribution and by phosphorylation of its substrates, MYPT1 and MLC. In both GK rat and in human type 2 diabetic retinas, ROCK-1 is activated and associated with non-apoptotic membrane blebbing in retinal vessels and in retinal pigment epithelium (RPE) that respectively form the inner and the outer barriers. Activation of ROCK-1 induces focal vascular constrictions, endoluminal blebbing and subsequent retinal hypoxia. In RPE cells, actin cytoskeleton remodeling and membrane blebs in RPE cells contributes to outer barrier breakdown. Intraocular injection of fasudil, significantly reduces both retinal hypoxia and RPE barrier breakdown. Diabetes-induced cell blebbing may contribute to ischemic maculopathy and represent an intervention target.

  6. 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...... the primary trial end-points were not met, there was a clear trend to less severe retinopathy with RAS blockade. A smaller trial, RASS, reported reduced retinopathy progression in type 1 diabetes from RAS blockade with both the ARB losartan and the angiotensin converting enzyme (ACE) inhibitor enalapril...

  7. Retinopathy of prematurity - from recognition of risk factors to treatment recommendations.

    Science.gov (United States)

    Fagerholm, Reija; Vesti, Eija

    Retinopathy of prematurity is a proliferative retinal disorder diagnosed exclusively in prematurely born infants. In retinopathy of prematurity, growth of the retinal vasculature is disturbed, leading to hypoxia-induced pathological changes typical of retinopathy of prematurity, in the worst case resulting in retinal detachment. The most typical risk factors predisposing to the disease include hyperoxemia, low levels of insulin-like growth factor 1 (IGF-I), and low birth weight in relation to weeks of pregnancy. Laser therapy of peripheral retina is the currently established form of treatment. Screening is applied in order to recognize the pathological changes in retinopathy of prematurity early enough.

  8. Ischemic Retinopathy and Neovascular Proliferation Secondary to Severe Head Injury

    Directory of Open Access Journals (Sweden)

    Muge Coban-Karatas

    2014-01-01

    Full Text Available We report a case with severe head trauma and perforating globe injury in one eye and ischemic retinopathy and neovascular proliferation in the other eye. A 37-year-old male was brought to the emergency department after a motor vehicle accident with severe maxillofacial trauma. Ophthalmic examination revealed hematoma of the left eyelids as well as traumatic rupture and disorganization of the left globe. On the right eye, anterior segment and fundoscopic examination were normal. Primary globe repair was performed. At postoperative one-month visit, the right eye revealed no pathology of the optic disc and macula but severe neovascularization in the temporal peripheral retina. The patient was diagnosed as ischemic retinopathy and neovascular proliferation due to head trauma.

  9. 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.

  10. Adequacy of published screening criteria for retinopathy of prematurity.

    Science.gov (United States)

    Taranath, Deepa A; Oh, Dickson D-S; Keane, Miriam C; Fabel, Helen; Marshall, Peter

    2016-03-01

    Criteria for screening preterm infants for retinopathy of prematurity vary around the world. We aimed to analyse the efficacy of alternative screening criteria. We collected retrospective data at a tertiary level neonatal nursery. Our participants were 1007 babies, born between 1997 and 2011, at prematurity. We determined whether disease would be detected using an alternative Australian screening model (gestational age prematurity is our main outcome. Using several of the alternative criteria, two neonates with clinically significant retinopathy of prematurity, one of whom required laser treatment to preserve sight, would not have been screened, and their disease may have gone undetected. Use of prematurity may risk clinically significant cases being missed and others may screen babies unnecessarily. Alternative criteria should be considered and '<30 weeks gestational age and/or <1500 g birth weight' appears a viable option. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

  11. Purtscher-like retinopathy associated with cerebro- or cardiovascular surgery.

    Science.gov (United States)

    Oshida, Eiki; Machida, Shigeki; Nishimura, Tomoharu; Sakamoto, Masaki

    2017-12-01

    To report the findings in five patients of Purtscher-like retinopathy that developed after cerebro- or cardiovascular surgeries. Three women and two men with a mean age of 56.6 years were studied. They had had cerebro- or cardiovascular disease that was treated by major vascular surgery. Postoperatively, all of the patients developed multiple patches of retinal whitening in the area corresponding to the radial peripapillary capillaries in the posterior pole of the eye uni- or bilaterally. In two patients, the optic nerve head was involved which affected their vision severely. Hematological examinations showed hypercoagulable state after the surgeries. The retinal pathologies abated with time. These results indicate that major cardio- or cerebrovascular surgeries can cause Purtscher-like retinopathy. The hypercoagulable state and specific structures of the radial peripapillary capillaries may play a role in pathogenesis of this disease.

  12. Anticardiolipin antibodies in proliferative diabetic retinopathy: An additional risk factor

    International Nuclear Information System (INIS)

    Shahin, Maha; ElDiasty, Amany M; Mabed, Mohamed

    2009-01-01

    To report the prevalence of anticardiolipin antibodies in patients with proliferative diabetic retinopathy (PDR) having high-risk criteria (HRC). Diabetic patients having PDR with HRC and diabetics free of retinopathy were compared for the presence of anticardiolipin antibodies. Among the 34 patients, 6 (17.7%) of diabetics having PDR with HRC were positive for anticardiolipin antibodies. There was no significant association of aCL antibodies with sex or type of diabetes. Using Pearson's correlation test, no significant associations of aCL antibodies with duration of diabetes or age of patients were found. All patients who were positive for anticardiolipin antibodies had PDR with HRC. The difference was statistically significant. Presence of anticardiolipin antibodies may represent an additional risk factor for PDR. (author)

  13. Nondiabetic retinal pathology - prevalence in diabetic retinopathy screening.

    Science.gov (United States)

    Nielsen, Nathan; Jackson, Claire; Spurling, Geoffrey; Cranstoun, Peter

    2011-07-01

    To determine the prevalence of photographic signs of nondiabetic retinal pathology in Australian general practice patients with diabetes. Three hundred and seven patients with diabetes underwent retinal photography at two general practices, one of which was an indigenous health centre. The images were assessed for signs of pathology by an ophthalmologist. Signs of nondiabetic retinal pathology were detected in 31% of subjects with adequate photographs. Features suspicious of glaucoma were detected in 7.7% of subjects. Other abnormalities detected included signs of age related macular degeneration (1.9%), epiretinal membranes (2.4%), vascular pathology (9.6%), chorioretinal lesions (2.9%), and congenital disc anomalies (2.9%). Indigenous Australian patients were more likely to have signs of retinal pathology and glaucoma. Signs of nondiabetic retinal pathology were frequently encountered. In high risk groups, general practice based diabetic retinopathy screening may reduce the incidence of preventable visual impairment, beyond the benefits of detection of diabetic retinopathy alone.

  14. Blood Vessel Enhancement and Segmentation for Screening of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Ibaa Jamal

    2012-06-01

    Full Text Available Diabetic retinopathy is an eye disease caused by the increase of insulin in blood and it is one of the main cuases of blindness in idusterlized countries. It is a progressive disease and needs an early detection and treatment. Vascular pattern of human retina helps the ophthalmologists in automated screening and diagnosis of diabetic retinopathy. In this article, we present a method for vascular pattern ehnacement and segmentation. We present an automated system which uses wavelets to enhance the vascular pattern and then it applies a piecewise threshold probing and adaptive thresholding for vessel localization and segmentation respectively. The method is evaluated and tested using publicly available retinal databases and we further compare our method with already proposed techniques.

  15. A Decision Support Framework for Automated Screening of Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available The early signs of diabetic retinopathy (DR are depicted by microaneurysms among other signs. A prompt diagnosis when the disease is at the early stage can help prevent irreversible damages to the diabetic eye. In this paper, we propose a decision support system (DSS for automated screening of early signs of diabetic retinopathy. Classification schemes for deducing the presence or absence of DR are developed and tested. The detection rule is based on binary-hypothesis testing problem which simplifies the problem to yes/no decisions. An analysis of the performance of the Bayes optimality criteria applied to DR is also presented. The proposed DSS is evaluated on the real-world data. The results suggest that by biasing the classifier towards DR detection, it is possible to make the classifier achieve good sensitivity.

  16. Neodymium-YAG laser vitreolysis in sickle cell retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Hrisomalos, N.F.; Jampol, L.M.; Moriarty, B.J.; Serjeant, G.; Acheson, R.; Goldberg, M.F.

    1987-08-01

    Six patients with proliferative sickle cell retinopathy and vitreous bands were treated with the neodymium-YAG (Nd-YAG) laser to accomplish lysis of avascular traction bands or to clear the media in front of the macula. Transection of bands was possible in five of the six cases but in two of these the effect was only partial. Three cases were satisfactorily treated with the Nd-YAG laser application alone, two eventually required conventional vitreoretinal surgery, and one patient's condition stabilized despite failure of the treatment. Complications from the treatment occurred in three cases and included subretinal (choroidal) hemorrhage, preretinal hemorrhage, microperforation of a retinal vein, and focal areas of damage to the retinal pigment epithelium. Neodymium-YAG vitreolysis may be a useful modality in carefully selected patients with proliferative sickle cell retinopathy, but potentially sight-threatening complications may occur.

  17. Biomarkers in Diabetic Retinopathy and the Therapeutic Implications

    Directory of Open Access Journals (Sweden)

    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.

  18. 'Rush' type retinopathy of prematurity: report of three cases.

    OpenAIRE

    Nissenkorn, I; Kremer, I; Gilad, E; Cohen, S; Ben-Sira, I

    1987-01-01

    Three premature infants observed to develop severe stage III retinopathy of prematurity (ROP) at 3 to 5 weeks of age received immediate treatment by cryoablation and photocoagulation, with good results. The critical importance of the ophthalmic examination of premature babies from the age of 2 weeks, so as not to overlook such cases of 'rush' type ROP is stressed and the difficulty involved in treating such small neonates is discussed.

  19. The Severity of Retinopathy in the Extremely Premature Infants

    OpenAIRE

    Trivli, Alexandra; Polychronaki, Maria; Matalliotaki, Charoula; Papadimas, Michail; Patelarou, Athina E.; Dermitzaki, Niki; Matalliotakis, Michail

    2017-01-01

    Objective. We aimed to investigate the incidence and the severity of retinopathy of extremely premature infants and to evaluate the risk factors and outcome of the cases. Materials and Methods. Out of 200 premature births, we retrospectively reviewed 9 cases that developed ROP. We excluded cases where ROP developed in newborns > 30 weeks of gestational age and cases where medical notes were unavailable or incomplete. Topical drops of cyclopentolate 1% and phenylephrine 5% were instilled and f...

  20. Effect of pregnancy on diabetic nephropathy and retinopathy

    International Nuclear Information System (INIS)

    Irfan, S.; Arain, M.; Shahid, A.; Shaukat, A.

    2004-01-01

    Objective: To determine whether pregnancy worsens renal function in women with diabetic nephropathy and the effect of pregnancy on diabetic retinopathy. Subject and Methods: Thirty-five patients (aged 20-36 years) identified with diabetic nephropathy and moderate to severe renal dysfunction (creatinine Cr) - > 1.4 mg/dl) at pregnancy onset by retrospective chart review. Alterations in glomerular filtration rate (GFR) were estimated. An equal number of non-pregnant premenopausal type I diabetic women with similar degrees of renal dysfunction served as controls for non-pregnant rate of decline of renal function and potential contributing factors. Student's t-test and repeated measures analysis of variance were analyzed. Results: Mean serum Cr rose from 1.8 mg/dl pre pregnancy to 2.5 mg/dl in the third trimester. Renal function was stable in 27%, showed transient worsening in pregnancy in 27%, and demonstrated a permanent decline in 45%. Proteinuria increased in pregnancy in 79%. Exacerbation of hypertension or pre-eclampsia occurred in 73% and 71% of these showed acceleration of disease during the pregnancy. All the patients had diabetic retinopathy, though proliferative retinopathy was diagnosed and treated in only 54.5.% pre pregnancy. The retinopathy progressed, requiring laser therapy, in 45.4%. Macular edema was noted in 6 of the patients. Other diabetic complications included peripheral and autonomic neuropathy in 8 patients. Conclusion: Pregnancy induced progression is seen in the decline of renal functions. Patients with diabetic nephropathy were found to have a > 40% chance of accelerated progression of their disease as a result of pregnancy. Forty-five percent of the patients had permanent decline in GFR in association with pregnancy. (author)

  1. VISUAL OUTCOME FOLLOWING PANRETINAL PHOTOCOAGULATION IN PROLIFERATIVE DIABETIC RETINOPATHY

    Directory of Open Access Journals (Sweden)

    Nellaye Mani Sindhu

    2018-01-01

    Full Text Available BACKGROUND Diabetes mellitus can be called as a noninfectious pandemic and the incidence of diabetic retinopathy is also uncontrollable. This vision-threatening complication can be treated by early diagnosis and effective treatment like panretinal photocoagulation. The aim of the study is to evaluate the effect of panretinal photocoagulation on visual acuity, colour vision, contrast sensitivity and severity of visual field changes. MATERIALS AND METHODS Prospective study of visual outcome following panretinal photocoagulation in patients with proliferative diabetic retinopathy conducted in Retina Clinic, RIO, Trivandrum, during the time period one year from April 2008. Inclusion Criteria- Eyes with proliferative diabetic retinopathy, visual acuity better than or equal to 6/60, a follow up of at least 6 months after panretinal photocoagulation. Exclusion Criteria- Eyes with cataractous changes in the lens, eyes, which would be undergoing or have undergone focal photocoagulation eyes, which undergone barrage or sectoral retinal photocoagulation, patients with colour blindness, eyes with vitreous haemorrhage and macular preretinal haemorrhage, glaucomatous patients with peripheral field loss. RESULTS The mean age of the patients was 52 years. Male patients (30 outnumbered the female patients (23. Mean duration of diabetes was 14.42 years. Though, there is a statistically significant reduction in visual acuity in the first followup, which was improved and stabilised by 6 months. There is a statistically significant reduction in the contrast sensitivity, which was stabilised after 3 months. Only, 9.5% patients had peripheral constrictions of visual field and no significant change in the colour vision. CONCLUSION We recommend panretinal photocoagulation for all patients with proliferative diabetic retinopathy.

  2. Disease course of patients with unilateral pigmentary retinopathy.

    Science.gov (United States)

    Potsidis, Emorfily; Berson, Eliot L; Sandberg, Michael A

    2011-11-29

    To evaluate the change in ocular function by eye in patients with unilateral pigmentary retinopathy. Longitudinal regression was used to estimate mean exponential rates of change in Goldmann visual field area (V4e white test light) and in full-field electroretinogram (ERG) amplitudes to 0.5- and 30-Hz white flashes in 15 patients with unilateral pigmentary retinopathy. Snellen visual acuity was assessed case by case. Mean annual rates of change for the affected eyes were -4.9% for visual field area, -4.7% for ERG amplitude to 0.5-Hz flashes, and -4.6% for ERG amplitude to 30-Hz flashes. All three rates were faster than the corresponding age-related rates of change for the fellow normal eyes (P = 0.0006, P = 0.003, P = 0.03, respectively). An initial cone ERG implicit time to 30-Hz flashes in affected eyes ≥ 40 ms predicted a faster mean rate of decline of visual field area and of ERG amplitude to 0.5- and 30-Hz flashes (P 35 years of age than in patients presenting at a younger age (P = 0.0004). The affected eye in unilateral pigmentary retinopathy shows a progressive loss of peripheral retinal function that cannot be attributed to aging alone and that is faster in eyes with a more prolonged initial cone ERG implicit time. Patients presenting at >35 years of age are at greater risk for losing visual acuity.

  3. [Deficient prevention and late treatment of diabetic retinopathy in Mexico].

    Science.gov (United States)

    Cervantes-Castañeda, René A; Menchaca-Díaz, Rufino; Alfaro-Trujillo, Beatriz; Guerrero-Gutiérrez, Manuel; Chayet-Berdowsky, Arturo S

    2014-01-01

    Retinopathy is a frequent complication of diabetes, causing visual impairment in 10% and blindness in 2% of diabetic patients. The aim of this study is to describe the clinical profile of diabetic patients in an ophthalmologic unit in Tijuana, México. Retrospective study of a random sample of 500 clinical charts of patients with diabetes who attended the Retina Service of "Fundación CODET para la Prevención de la Ceguera IBP" Ophthalmologic Center between 2006 and 2010. The main complaint of 58% of patients was decreased visual acuity in first evaluation. Only 6.2% of patients were referred by a health professional. Forty-six percent of the patients had a history of diabetes of at least 15 years. Thirty percent had clinically significant visual impairment at first visit, which was associated with a long history of diabetes and previous eye surgery. Twenty-five percent of these patients who were treated at our clinic experienced visual deterioration due to advanced retinopathy. Patients with diabetic retinopathy are referred to ophthalmological service tardily, when visual loss is usually severe and irreversible.

  4. 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.

  5. 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).

  6. The Diabetic Retinopathy Screening Workflow: Potential for Smartphone Imaging.

    Science.gov (United States)

    Bolster, Nigel M; Giardini, Mario E; Bastawrous, Andrew

    2015-11-23

    Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging. Systematic screening of the diabetic population has been shown to greatly reduce the prevalence and incidence of blindness within the population. Many national screening programs have digital fundus photography as their basis. In the past 5 years several techniques and adapters have been developed that allow digital fundus photography to be performed using smartphones. We review recent progress in smartphone-based fundus imaging and discuss its potential for integration into national systematic diabetic retinopathy screening programs. Some systems have produced promising initial results with respect to their agreement with reference standards. However further multisite trialling of such systems' use within implementable screening workflows is required if an evidence base strong enough to affect policy change is to be established. If this were to occur national diabetic retinopathy screening would, for the first time, become possible in low- and middle-income settings where cost and availability of trained eye care personnel are currently key barriers to implementation. As diabetes prevalence and incidence is increasing sharply in these settings, the impact on global blindness could be profound. © 2015 Diabetes Technology Society.

  7. Retinal changes in diabetic patients without diabetic retinopathy.

    Science.gov (United States)

    Dumitrescu, Alina Gabriela; Istrate, Sinziana Luminita; Iancu, Raluca Claudia; Guta, Oana Maria; Ciuluvica, Radu; Voinea, Liliana

    2017-01-01

    The purpose of this study was to measure retinal vessel caliber and to examine early changes in macular thickness using optical coherence tomography (OCT). We evaluated to what extend vascular caliber and macular thickness differed between patients with type 2 diabetes mellitus without diabetic retinopathy compared with healthy individuals. 26 diabetic patients without diabetic retinopathy and 26 normal participants without any retinal and optic nerve diseases underwent ophthalmic examination, fundus photography, and OCT imaging. Temporal inferior retinal vessel diameters were measured using OCT. Also, we measured macular thickness in nine ETDRS subfields using Cirrus OCT. The mean age in the diabetic group was 61.5 years and in the control group, 55.5 years. Wider retinal arterioles and venules were found in patients with diabetes compared with healthy subjects (120 µm versus 96 µm, pdiabetes mellitus, central macular thickness was significantly thinner than that of control eyes (243.5 µm versus 269.9 µm, p value diabetes without diabetic retinopathy.

  8. TAMOXIFEN RETINOPATHY DURING TREATMENT OF AN INOPERABLE DESMOID TUMOR.

    Science.gov (United States)

    Furst, Meredith; Somogyi, Marie B; Wong, Robert W; Araujo, Dejka; Harper, Clio A

    2017-12-08

    To evaluate the clinical significance and rarity of tamoxifen retinopathy after a long-term tamoxifen treatment for an inoperable desmoid tumor. Case report. Tamoxifen retinopathy is a condition rarely observed in clinical practice. Although tamoxifen is typically a treatment for breast cancer patients, we present a 68-year-old woman taking tamoxifen for an inoperable desmoid tumor, an equally rare condition. She presented with bilaterally deteriorating vision over the course of a year. Fundoscopic examination revealed parafoveal deposits bilaterally. Spectral domain optical coherence tomography exhibited hyperreflective deposits in all layers of the retina. She had a cumulative treatment dose of 292 g of tamoxifen, and the medication was subsequently stopped. Her vision remained stable 3 months after the cessation of tamoxifen. The development of tamoxifen retinopathy in the treatment of a desmoid tumor makes this case a rare entity, and this is the first reported case of these two concomitant conditions to our knowledge. With the use of long-term tamoxifen as a primary treatment, we recommend screening at regular intervals by an ophthalmologist as an integral part of treatment.

  9. Performance of the LHCb Outer Tracker

    CERN Document Server

    Arink, R; Bachmann, S.; Bagaturia, Y.; Band, H.; Bauer, Th.; Berkien, A.; Farber, Ch.; Bien, A.; Blouw, J.; Ceelie, L.; Coco, V.; Deckenhoff, M.; Deng, Z.; Dettori, F.; van Eijk, D.; Ekelhof, R.; Gersabeck, E.; Grillo, L.; Hulsbergen, W.D.; Karbach, T.M.; Koopman, R.; Kozlinskiy, A.; Langenbruch, Ch.; Lavrentyev, V.; Linn, Ch.; Merk, M.; Merkel, J.; Meissner, M.; Michalowski, J.; Morawski, P.; Nawrot, A.; Nedos, M.; Pellegrino, A.; Polok, G.; van Petten, O.; Rovekamp, J.; Schimmel, F.; Schuylenburg, H.; Schwemmer, R.; Seyfert, P.; Serra, N.; Sluijk, T.; Spaan, B.; Spelt, J.; Storaci, B.; Szczekowski, M.; Swientek, S.; Tolk, S.; Tuning, N.; Uwer, U.; Wiedner, D.; Witek, M.; Zeng, M.; Zwart, A.

    2014-01-01

    The LHCb Outer Tracker is a gaseous detector covering an area of 5x6 m2 with 12 double layers of straw tubes. The detector with its services are described together with the commissioning and calibration procedures. Based on data of the first LHC running period from 2010 to 2012, the performance of the readout electronics and the single hit resolution and efficiency are presented. The efficiency to detect a hit in the central half of the straw is estimated to be 99.2%, and the position resolution is determined to be approximately 200 um. The Outer Tracker received a dose in the hottest region corresponding to 0.12 C/cm, and no signs of gain deterioration or other ageing effects are observed.

  10. The Outer Space as an Educational Motivation

    Science.gov (United States)

    Pérez-Pérez, Melquíades; Hernández-López, Montserrat

    2017-06-01

    STEAM is an educational approach to learning that uses Science, Technology, Engineering, the Arts and Mathematics as access points for guiding student inquiry, dialogue, and critical thinking. The end results are students who take thoughtful risks, engage in experiential learning, persist in problem-solving, embrace collaboration, and work through the creative process. The Outer Space is a window to the past and the future of our travel around the history of the Universe and can be used as a educational tool in primary and secondary education. This paper talks about the integration of the resources of European Space Agency, Space Awareness, Nuclio, Scientix and Schoolnet as motivation to integrate STEAM methodology in secondary education. Keywords: STEAM, outer space, motivation, methodology

  11. The Outer Banks of North Carolina

    Science.gov (United States)

    Dolan, Robert; Lins, Harry F.; Smith, Jodi Jones

    2016-12-27

    The Outer Banks of North Carolina are excellent examples of the nearly 300 barrier islands rimming the Atlantic and Gulf coasts of the United States. These low, sandy islands are among the most dynamic natural landscapes occupied by man. Beach sands move offshore, onshore, and along the shore in the direction of the prevailing longshore currents. In this way, sandy coasts continuously adjust to different tide, wave, and current conditions and to rising sea level that causes the islands to migrate landward.Despite such changes, barrier islands are of considerable environmental importance. The Outer Banks are home to diverse natural ecosystems that are adapted to the harsh coastal environment. Native species tend to be robust and many are specifically adapted to withstand salt spray, periodic saltwater flooding, and the islands’ well-drained sandy soil. The Outer Banks provide an important stopover for birds on the Atlantic flyway, and many species inhabit the islands year round. In addition, Outer Banks beaches provide an important nesting habitat for five endangered or threatened sea turtle species.European explorers discovered North Carolina’s barrier islands in the 16th century, although the islands were not permanently settled until the middle 17th century. By the early 19th century, shipbuilding and lumber industries were among the most successful, until forest resources were depleted. Commercial fishing eventually followed, and it expanded considerably after the Civil War. By the Great Depression, however, little industry existed on the Outer Banks. In response to the effects of a severe hurricane in 1933, the National Park Service and the Civilian Conservation Corps proposed a massive sand-fixation program to stabilize the moving sand and prevent storm waves from sweeping across the entire width of some sections of the islands. Between 1933 and 1940, this program constructed sand fencing on 185 kilometers (115 miles) of beach and planted grass seedlings

  12. Cryovolcanism in the outer solar system

    Science.gov (United States)

    Geissler, Paul E.

    2015-01-01

    Cryovolcanism is defined as the extrusion of liquids and vapors of materials that would be frozen solid at the planetary surface temperatures of the icy bodies of the outer solar system. Active cryovolcanism is now known to occur on Saturn's moon Enceladus and on Neptune's moon Triton and is suspected on Jupiter's moon Europa, while evidence for past cryovolcanic activity is widespread throughout the outer solar system. This chapter examines the mechanisms and manifestations of cryovolcanism, beginning with a review of the materials that make up these unusual ‘‘magmas’’ and the means by which they might erupt and concluding with a volcanologist's tour of the farthest reaches of the solar system.

  13. Protection of nuclear facilities against outer aggressions

    International Nuclear Information System (INIS)

    Aussourd, P.; Candes, P.; Le Quinio, R.

    1976-01-01

    The various types of outer aggressions envisaged in safety analysis for nuclear facilities are reviewed. These outer aggressions are classified as natural and non-natural phenomena, the latter depending on the human activities in the vicinity of nuclear sites. The principal natural phenomena able to constitute aggressions are atmospheric phenomena (strong winds, snow storms, hail, frosting mists), hydrologie phenomena such as tides, surges, flood, low waters, and geologic phenomena such as earthquakes. Artificial phenomena are concerned with aircraft crashes, projectiles, fire, possible ruptures of dams, and intentional human aggressions. The protection against intentional human aggressions is of two sorts: first, the possibility of access to the installations mostly sensitive to sabotage are to be prevented or reduced, secondly redundant circuits and functions must be separated for preventing their simultaneous destruction in the case when sabotage actors have reach the core of the facility [fr

  14. Outer crust of nonaccreting cold neutron stars

    International Nuclear Information System (INIS)

    Ruester, Stefan B.; Hempel, Matthias; Schaffner-Bielich, Juergen

    2006-01-01

    The properties of the outer crust of nonaccreting cold neutron stars are studied by using modern nuclear data and theoretical mass tables, updating in particular the classic work of Baym, Pethick, and Sutherland. Experimental data from the atomic mass table from Audi, Wapstra, and Thibault of 2003 are used and a thorough comparison of many modern theoretical nuclear models, both relativistic and nonrelativistic, is performed for the first time. In addition, the influences of pairing and deformation are investigated. State-of-the-art theoretical nuclear mass tables are compared to check their differences concerning the neutron drip line, magic neutron numbers, the equation of state, and the sequence of neutron-rich nuclei up to the drip line in the outer crust of nonaccreting cold neutron stars

  15. Boundary layers of the earth's outer magnetosphere

    Science.gov (United States)

    Eastman, T. E.; Frank, L. A.

    1984-01-01

    The magnetospheric boundary layer and the plasma-sheet boundary layer are the primary boundary layers of the earth's outer magnetosphere. Recent satellite observations indicate that they provide for more than 50 percent of the plasma and energy transport in the outer magnetosphere although they constitute less than 5 percent by volume. Relative to the energy density in the source regions, plasma in the magnetospheric boundary layer is predominantly deenergized whereas plasma in the plasma-sheet boundary layer has been accelerated. The reconnection hypothesis continues to provide a useful framework for comparing data sampled in the highly dynamic magnetospheric environment. Observations of 'flux transfer events' and other detailed features near the boundaries have been recently interpreted in terms of nonsteady-state reconnection. Alternative hypotheses are also being investigated. More work needs to be done, both in theory and observation, to determine whether reconnection actually occurs in the magnetosphere and, if so, whether it is important for overall magnetospheric dynamics.

  16. Boundary layers of the earth's outer magnetosphere

    International Nuclear Information System (INIS)

    Eastman, T.E.; Frank, L.A.

    1984-01-01

    The magnetospheric boundary layer and the plasma-sheet boundary layer are the primary boundary layers of the earth's outer magnetosphere. Recent satellite observations indicate that they provide for more than 50 percent of the plasma and energy transport in the outer magnetosphere although they constitute less than 5 percent by volume. Relative to the energy density in the source regions, plasma in the magnetospheric boundary layer is predominantly deenergized whereas plasma in the plasma-sheet boundary layer has been accelerated. The reconnection hypothesis continues to provide a useful framework for comparing data sampled in the highly dynamic magnetospheric environment. Observations of flux transfer events and other detailed features near the boundaries have been recently interpreted in terms of nonsteady-state reconnection. Alternative hypotheses are also being investigated. More work needs to be done, both in theory and observation, to determine whether reconnection actually occurs in the magnetosphere and, if so, whether it is important for overall magnetospheric dynamics. 30 references

  17. Prevalence of diabetic retinopathy in various ethnic groups: a worldwide perspective.

    Science.gov (United States)

    Sivaprasad, Sobha; Gupta, Bhaskar; Crosby-Nwaobi, Roxanne; Evans, Jennifer

    2012-01-01

    The alarming rise in diabetes prevalence is a global public health and economic problem. Diabetic retinopathy is the most common complication of diabetes and the leading cause of blindness among working-age populations in the Western world. Screening and prompt treatment of diabetic retinopathy are not top priorities in many regions of the world, because the impacts of other causes of preventable blindness remain an issue. Ethnicity is a complex, independent risk factor for diabetic retinopathy. Observations from white populations cannot be extrapolated fully to other ethnic groups. The prevalence of diabetic retinopathy, sight-threatening diabetic retinopathy, and clinically significant macular edema are higher in people of South Asian, African, Latin American, and indigenous tribal descent compared to the white population. Although all ethnic groups are susceptible to the established risk factors of diabetic retinopathy-such as length of exposure and severity of hyperglycemia, hypertension, and hyperlipidemia-ethnic-specific risk factors also may influence these rates. Such risk factors may include differential susceptibility to conventional risk factors, insulin resistance, differences in anthropometric measurements, truncal obesity, urbanization, variations in access to healthcare systems, genetic susceptibility, and epigenetics. The rates of nonproliferative diabetic retinopathy appear to be declining in the United States, supporting the observation that better medical management of diabetes and prompt treatment of sight-threatening diabetic retinopathy substantially improve the long-term diabetic retinopathy incidence; studies from other parts of the world are limited and do not mirror this finding, however. We examine the ethnicity and region-based prevalence of diabetic retinopathy around the world and highlight the need to reinforce ethnicity-based screening and treatment thresholds in diabetic retinopathy. Copyright © 2012 Elsevier Inc. All rights

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

    International Nuclear Information System (INIS)

    Kaushik, Megha; Pulido, Jose S.; Schild, Steven E.; Stafford, Scott

    2012-01-01

    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

  19. 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

  20. Epidemiology of diabetic retinopathy and maculopathy in Africa: a systematic review

    Science.gov (United States)

    Burgess, P I; MacCormick, I J C; Harding, S P; Bastawrous, A; Beare, N A V; Garner, P

    2013-01-01

    Abstract Aim To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus. Methods Using a predefined search strategy, we systematically searched MEDLINE, EMBASE, Science Citation index and Conference Proceedings Citation index, African Index Medicus and the grey literature database ‘OpenSIGLE’ for studies published between January 1990 and February 2011. Included studies reported prevalence or incidence of diabetic retinopathy or diabetic maculopathy of subjects with diabetes resident in African countries. Results Sixty-two studies from 21 countries were included: three population-based surveys; two cohort studies; five case–control studies; 32 diabetes clinic-based, nine eye clinic-based and 11 other hospital-based surveys. Included studies varied considerably in terms of patient selection, method of assessing the eye and retinopathy classification. In population-based studies, the reported prevalence range in patients with diabetes for diabetic retinopathy was 30.2 to 31.6%, proliferative diabetic retinopathy 0.9 to 1.3%, and any maculopathy 1.2 to 4.5%. In diabetes clinic-based surveys, the reported prevalence range for diabetic retinopathy was 7.0 to 62.4%, proliferative diabetic retinopathy 0 to 6.9%, and any maculopathy 1.2 to 31.1%. No obvious association between prevalence and income level of the country was detected. Conclusions Large, community-based cross-sectional and cohort studies are needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. Consensus is needed on the most appropriate methods of identification and classification of retinopathy for research and clinical practice. Estimates of prevalence of diabetic retinopathy, proliferative diabetic retinopathy and maculopathy are comparable with recent European and American studies. PMID:22817387

  1. Differential Rotation within the Earth's Outer Core

    Science.gov (United States)

    Hide, R.; Boggs, D. H.; Dickey, J. O.

    1998-01-01

    Non-steady differential rotation drive by bouyancy forces within the Earth's liquid outer core (OC) plays a key role not only in the generation of the main geomagnetic field by the magnetohydrodynamic (MHD) dynamo process but also in the excitation of irregular fluctuations in the angular speed of rotation of the overlying solid mantle, as evidenced by changes in the length of the day (LOD) on decadal and longer timescales (1-8).

  2. Fluxgate magnetometers for outer planets exploration

    Science.gov (United States)

    Acuna, M. H.

    1974-01-01

    The exploration of the interplanetary medium and the magnetospheres of the outer planets requires the implementation of magnetic field measuring instrumentation with wide dynamic range, high stability, and reliability. The fluxgate magnetometers developed for the Pioneer 11 and Mariner-Jupiter-Saturn missions are presented. These instruments cover the range of .01 nT to 2 million nT with optimum performance characteristics and low power consumption.

  3. Outer Limits of Biotechnologies: A Jewish Perspective

    Directory of Open Access Journals (Sweden)

    John D. Loike

    2018-01-01

    Full Text Available A great deal of biomedical research focuses on new biotechnologies such as gene editing, stem cell biology, and reproductive medicine, which have created a scientific revolution. While the potential medical benefits of this research may be far-reaching, ethical issues related to non-medical applications of these technologies are demanding. We analyze, from a Jewish legal perspective, some of the ethical conundrums that society faces in pushing the outer limits in researching these new biotechnologies.

  4. Effect of disease stage on progression of hydroxychloroquine retinopathy.

    Science.gov (United States)

    Marmor, Michael F; Hu, Julia

    2014-09-01

    Hydroxychloroquine sulfate retinopathy can progress after the drug is stopped. It is not clear how this relates to the stage of retinopathy or whether early screening with modern imaging technology can prevent progression and visual loss. To determine the relationship between progression of retinopathy and the severity of disease using objective data from optical coherence tomography and assess the value of early screening for the toxic effects of hydroxychloroquine. Clinical findings in patients with hydroxychloroquine retinopathy were monitored with repeated anatomical and functional examinations for 13 to 40 months after the drug was stopped in a referral practice in a university medical center. Eleven patients participated, with the severity of toxic effects categorized as early (patchy parafoveal damage shown on field or objective testing), moderate (a 50%-100% parafoveal ring of optical coherence tomography thinning but intact retinal pigment epithelium), and severe (visible bull's-eye damage). Visual acuity, white 10-2 visual field pattern density plots, fundus autofluorescence, spectral-density optical coherence tomography cross sections, thickness (from cube diagrams), and ellipsoid zone length. Visual acuity and visual fields showed no consistent change. Fundus autofluorescence showed little or no change except in severe cases in which the bull's-eye damage expanded progressively. Optical coherence tomography cross sections showed little visible change in early and moderate cases but progressive foveal thinning (approximately 7 μm/y) and loss of ellipsoid zone (in the range of 100 μm/y) in severe cases, which was confirmed by quantitative measurements. The measurements also showed some foveal thinning (approximately 4 μm/y) and deepening of parafoveal loss in moderate cases, but the breadth of the ellipsoid zone remained constant in both early and moderate cases. A few cases showed a suggestion of ellipsoid zone improvement. Patients with

  5. Retinopatia hipertensiva: revisão Hypertensive retinopathy: review

    Directory of Open Access Journals (Sweden)

    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

  6. Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria.

    Science.gov (United States)

    Small, Dylan S; Taylor, Terrie E; Postels, Douglas G; Beare, Nicholas Av; Cheng, Jing; MacCormick, Ian Jc; Seydel, Karl B

    2017-06-07

    Cerebral malaria (CM) can be classified as retinopathy-positive or retinopathy-negative, based on the presence or absence of characteristic retinal features. While malaria parasites are considered central to the pathogenesis of retinopathy-positive CM, their contribution to retinopathy-negative CM is largely unknown. One theory is that malaria parasites are innocent bystanders in retinopathy-negative CM and the etiology of the coma is entirely non-malarial. Because hospitals in malaria-endemic areas often lack diagnostic facilities to identify non-malarial causes of coma, it has not been possible to evaluate the contribution of malaria infection to retinopathy-negative CM. To overcome this barrier, we studied a natural experiment involving genetically inherited traits, and find evidence that malaria parasitemia does contribute to the pathogenesis of retinopathy-negative CM. A lower bound for the fraction of retinopathy-negative CM that would be prevented if malaria parasitemia were to be eliminated is estimated to be 0.93 (95% confidence interval: 0.68, 1).

  7. Oral glucose for pain relief during examination for retinopathy of prematurity: a masked randomized clinical trial.

    Science.gov (United States)

    Costa, Marlene Coelho da; Eckert, Gabriela Unchalo; Fortes, Barbara Gastal Borges; Fortes Filho, João Borges; Silveira, Rita C; Procianoy, Renato S

    2013-01-01

    Ophthalmologic examination for retinopathy of prematurity is a painful procedure. Pharmacological and non-pharmacological interventions have been proposed to reduce pain during eye examinations. This study aims to evaluate the analgesic effect of 25% glucose using a validated pain scale during the first eye examination for retinopathy of prematurity in preterm infants with birth weight relief.

  8. Postnatal weight gain modifies severity and functional outcome of oxygen-induced proliferative retinopathy.

    Science.gov (United States)

    Stahl, Andreas; Chen, Jing; Sapieha, Przemyslaw; Seaward, Molly R; Krah, Nathan M; Dennison, Roberta J; Favazza, Tara; Bucher, Felicitas; Löfqvist, Chatarina; Ong, Huy; Hellström, Ann; Chemtob, Sylvain; Akula, James D; Smith, Lois E H

    2010-12-01

    In clinical studies, postnatal weight gain is strongly associated with retinopathy of prematurity (ROP). However, animal studies are needed to investigate the pathophysiological mechanisms of how postnatal weight gain affects the severity of ROP. In the present study, we identify nutritional supply as one potent parameter that affects the extent of retinopathy in mice with identical birth weights and the same genetic background. Wild-type pups with poor postnatal nutrition and poor weight gain (PWG) exhibit a remarkably prolonged phase of retinopathy compared to medium weight gain or extensive weight gain pups. A high (r(2) = 0.83) parabolic association between postnatal weight gain and oxygen-induced retinopathy severity is observed, as is a significantly prolonged phase of proliferative retinopathy in PWG pups (20 days) compared with extensive weight gain pups (6 days). The extended retinopathy is concomitant with prolonged overexpression of retinal vascular endothelial growth factor in PWG pups. Importantly, PWG pups show low serum levels of nonfasting glucose, insulin, and insulin-like growth factor-1 as well as high levels of ghrelin in the early postoxygen-induced retinopathy phase, a combination indicative of poor metabolic supply. These differences translate into visual deficits in adult PWG mice, as demonstrated by impaired bipolar and proximal neuronal function. Together, these results provide evidence for a pathophysiological correlation between poor postnatal nutritional supply, slow weight gain, prolonged retinal vascular endothelial growth factor overexpression, protracted retinopathy, and reduced final visual outcome.

  9. Phenotypic and genetic spectrum of Danish patients with ABCA4-related retinopathy

    DEFF Research Database (Denmark)

    Duno, Morten; Schwartz, Marianne; Larsen, Pernille L.

    2012-01-01

    Pathogenic variations in the ABCA4 gene were originally recognized as genetic background for the autosomal recessive disorders Stargardt disease and fundus flavimaculatus, but have expanded to embrace a diversity of retinal diseases, giving rise to the new diagnostic term, ABCA4-related retinopathy...... diagnosis must rely on a comprehensive genetic screening as the mutation spectrum of ABCA4-related retinopathies continues to expand....

  10. Retinal vessel caliber and myopic retinopathy: the blue mountains eye study.

    Science.gov (United States)

    Li, Haitao; Mitchell, Paul; Rochtchina, Elena; Burlutsky, George; Wong, Tien Y; Wang, Jie Jin

    2011-12-01

    To evaluate changes in the retinal vasculature in eyes with myopic retinopathy. Population-based, cross-sectional study. Emmetropic and myopic participants from the Blue Mountains Eye Study baseline survey were included in this study. Myopia was defined as a refractive error of less than -1.00 diopter. Myopic retinopathy was defined if either staphyloma, lacquer crack, Fuchs' spot or chorioretinal atrophy were present in myopic eyes. Retinal vascular caliber was measured from fundus photographs using standardized methods. The association of retinal vascular caliber with myopic retinopathy was assessed using generalized estimating equation models. A total of 2598 eyes of 1409 subjects were selected from 3654 baseline participants, with 2076 emmetropic eyes (normal controls), 486 myopic eyes without myopic retinopathy (myopic controls) and 36 myopic eyes with myopic retinopathy (cases). After adjusting for age, gender, height, body mass index and blood pressure, eyes with myopic retinopathy had significantly narrower mean arteriolar (166.6μm) and venular caliber (213.3μm), compared to normal (188.1μm and 226.9μm, respectively) or myopic control eyes (190.4μm and 227.0μm, respectively) (all P retinopathy and the two control groups remained significant after additional adjustment for refraction (all P retinopathy is associated with attenuation of retinal vessels.

  11. 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....

  12. A new risk-based screening criterion for treatment-demanding retinopathy of prematurity in Denmark

    DEFF Research Database (Denmark)

    Slidsborg, Carina; Forman, Julie Lyng; Rasmussen, Steen Christian

    2011-01-01

    The aim of this study was to uncover the most effective and safe criterion to implement for retinopathy of prematurity screening in Denmark.......The aim of this study was to uncover the most effective and safe criterion to implement for retinopathy of prematurity screening in Denmark....

  13. 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 diabetic retinopathy in relation to demographic variables and anthropometric characteristics of the participants is presented as means with their standard errors. The presence of periodontitis and presence of retinopathy categorized by body mass index (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 diabetic retinopathy was positively associated with the presence of 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.

  14. 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%....

  15. Frequency of diabetic retinopathy in hypertensive diabetic patients in a tertiary care hospital of Peshawar, Pakistan

    International Nuclear Information System (INIS)

    Rahman, S.; Khan, G.J.; Aamir, A.H.

    2011-01-01

    Background: Diabetic retinopathy is a common microvascular complication of both type 1 and type 2 diabetes mellitus. If left untreated, it can progress to serious visual disability. Coexistence of hypertension with diabetes has been described as another risk factor adding to the problem. We designed this study to assess the occurrence of diabetic retinopathy in hypertensive diabetic patients of this region and to compare it with normotensive diabetic patients. Methods: This cross-sectional study was carried out on 200 previously diagnosed diabetic patients. Apart from routine examination and investigations, retinopathy and blood pressure assessment of each patient was done using standard techniques. Hypertensive diabetic subjects (Group-I, n=107) were compared with non-hypertensive diabetics (Group-II, n=93) for the presence of retinopathy. Results: Retinopathy and hypertension were observed in 51% and 53.5% of the total diabetic patients respectively. Hypertensive diabetic patients had significantly higher percentage of retinopathy compared to non-hypertensive diabetic patients (58 vs 43%; p<0.05). Conclusion: Retinopathy and hypertension are highly prevalent in our diabetic patients. The proportion of retinopathy is significantly more in hypertensive as compared to normotensive diabetics. (author)

  16. 75 FR 1076 - Outer Continental Shelf Civil Penalties

    Science.gov (United States)

    2010-01-08

    ... initiate civil penalty proceedings; however, violations that cause injury, death, or environmental damage... DEPARTMENT OF THE INTERIOR Minerals Management Service Outer Continental Shelf Civil Penalties... daily civil penalty assessment. SUMMARY: The Outer Continental Shelf Lands Act requires the MMS to...

  17. Progressive Outer Retinal Necrosis Combined with Vitreous Hemorrhage in a Patient with Acquired Immunodeficiency Syndrome

    Science.gov (United States)

    You, Yong Sung; Lee, Sung Jin; Lee, Sung Ho; Park, Chang Hyun

    2007-01-01

    Purpose To describe an unusual case of rapidly progressive outer retinal necrosis (PORN) with vitreous hemorrhage in a 41-year-old woman with acquired immunodeficiency syndrome (AIDS), who had retinitis developed from what was probably varicellar-zoster virus combined with cytomegalovirus (CMV) and herpes simplex type 1,2, as proven by the polymerase chain reaction restriction fragment length polymorphism method (PCR-RFLP). Methods This study is a case report detailing clinical follow-up and an aqueous humor test by PCR-RFLP. Results The deep, white retinal lesions coalesced and progressively expanded in a circumferential manner, with sparing of the perivascular retina. However, retinal and vitreous hemorrhages, unusual findings for PORN, could be noted around the optic nerve. Varicellar-zoster virus (VZV), cytomegalovirus (CMV), and herpes simplex types 1,2 (HSV-1,2) were detected in the aqueous humor by PCR. Conclusions PORN has been described as a variant of necrotizing herpetic retinopathy, occurring particularly in patients with AIDS. Although the etiologic agent has been reported to be VZV, concurrent or combined etiologic agents can include HSV-1, HSV-2, and CMV in AIDS patients. Therefore, combined antiviral therapy with acyclovir and ganciclovir could be more reasonable as an initial therapy. PMID:17460434

  18. Zone 1 retinopathy of prematurity in a transitional economy: a cautionary note.

    Science.gov (United States)

    Carden, Susan M; Lan, Luu Ngoc; Huynh, Tess

    2006-06-01

    To describe three low risk infants in whom severe retinopathy of prematurity developed. A prospective, observational case series. setting: National Hospital of Pediatrics, Hanoi, Vietnam. study population: Premature infants in the neonatal ward. observation procedure: Eye examinations. Severe retinopathy of prematurity occurred in three infants. All had zone 1 disease and other unusually severe findings, such as neovascularization of the disk. These infants would not be at risk for the development of such severe retinopathy of prematurity in countries with a developed economy. Unusual characteristics of retinopathy of prematurity may be occurring in countries with transitional economies. Screening programs should be implemented and should take into consideration the possibility that retinopathy of prematurity may occur in infants who fall outside the screening guidelines that are used in the developed world.

  19. 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

    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...... was 6.3 µm (CI 95%: 1.0 to 11.6, p = 0.020) wider and CRVE was 7.9 µm (CI 95%: 0.7 to 15.2, p = 0.030) wider in those with retinopathy compared to those without retinopathy, after adjusting for age, gender, HbA1c, blood pressure, smoking, serum total and HDL cholesterol. In all participants, CRAE.......001), and decreased with higher HDL cholesterol (p gender was associated with wider CRVE (p = 0.029). CONCLUSIONS: Wider retinal vessel diameters were associated with the presence of retinopathy in participants with diabetes, but not in participants without diabetes...

  20. The effect of oral acetazolamide on cystoid macular edema in hydroxychloroquine retinopathy: a case report.

    Science.gov (United States)

    Hong, Eun Hee; Ahn, Seong Joon; Lim, Han Woong; Lee, Byung Ro

    2017-07-12

    Hydroxychloroquine (HCQ) retinopathy can accompany other retinal complications such as cystoid macular edema (CME), which leads to central visual loss. We report a case of CME with HCQ retinopathy that improved with the use of oral acetazolamide, and discussed the possible mechanisms of CME in HCQ retinopathy using multimodal imaging modalities. A 62-year-old patient with systemic lupus erythematosus (SLE) and HCQ retinopathy developed bilateral CME with visual decline. Fluorescein angiography (FA) showed fluorescein leakage in the macular and midperipheral area. After treatment with oral acetazolamide (250 mg/day) for one month, CME was completely resolved, best corrected visual acuity (BCVA) improved from 20/50 to 20/25, and FA examination showed decreased dye leakage in the macular and midperipheral areas. In cases of vision loss in HCQ retinopathy, it is important to consider not only progression of maculopathy, but also development of CME, which can be effectively treated with oral acetazolamide.

  1. [Buffering capacity of the vitreous body in aggressive posterior retinopathy of prematurity].

    Science.gov (United States)

    Amkhanitskaia, L I; Sidorenko, E I; Nikolaeva, G V; Kuznetsova, Iu D

    2014-01-01

    To investigate the role of vitreous body changes in the pathogenesis of aggressive posterior retinopathy of prematurity. The study included 60 children with stage 4-5 retinopathy of prematurity demonstrating either classical or aggressive posterior form of progression. In all cases vitreous samples for laboratory testing were taken during surgery. The study showed that aggressive posterior retinopathy of prematurity is associated with more significant metabolic changes in comparison with classical form of the disease. The degree of biochemical imbalance of the vitreous appeared directly related to the stage of the disease, which was determined by the type and extent of retinal detachment. Volcano-shaped retinal detachment with intensive exudation within the posterior eye segment is considered the most severe variant of aggressive posterior retinopathy of prematurity. Aggressive posterior retinopathy of prematurity is characterized by substantial disturbance of metabolism of the vitreous body, which contributes to exudation and proliferation, thus aggravating the course of the disease and worsening the prognosis.

  2. Nitric oxide and oxidative stress is associated with severity of diabetic retinopathy and retinal structural alterations.

    Science.gov (United States)

    Sharma, Shashi; Saxena, Sandeep; Srivastav, Khushboo; Shukla, Rajendra K; Mishra, Nibha; Meyer, Carsten H; Kruzliak, Peter; Khanna, Vinay K

    2015-07-01

    The aim of the study was to determine plasma nitric oxide (NO) and lipid peroxide (LPO) levels in diabetic retinopathy and its association with severity of disease. Prospective observational study. A total of 60 consecutive cases and 20 healthy controls were included. Severity of retinopathy was graded according to early treatment diabetic retinopathy study (ETDRS) classification. Photoreceptor inner segment ellipsoid band (ISel) disruption and retinal pigment epithelium (RPE) alteration were graded using spectral domain optical coherence tomography. Data were statistically analyzed. Plasma thiobarbituric acid reactive substances, NO assay and reduced glutathione (GSH) were measured using standard protocol. Increased severity of diabetic retinopathy was significantly associated with increase in plasma levels of LPO (P diabetic retinopathy. For the first time, it has been demonstrated that increased plasma LPO, NO and decreased GSH levels are associated with in vivo structural changes in inner segment ellipsoid and RPE. © 2015 Royal Australian and New Zealand College of Ophthalmologists.

  3. Digital tool for detecting diabetic retinopathy in retinography image using gabor transform

    Science.gov (United States)

    Morales, Y.; Nuñez, R.; Suarez, J.; Torres, C.

    2017-01-01

    Diabetic retinopathy is a chronic disease and is the leading cause of blindness in the population. The fundamental problem is that diabetic retinopathy is usually asymptomatic in its early stage and, in advanced stages, it becomes incurable, hence the importance of early detection. To detect diabetic retinopathy, the ophthalmologist examines the fundus by ophthalmoscopy, after sends the patient to get a Retinography. Sometimes, these retinography are not of good quality. This paper show the implementation of a digital tool that facilitates to ophthalmologist provide better patient diagnosis suffering from diabetic retinopathy, informing them that type of retinopathy has and to what degree of severity is find . This tool develops an algorithm in Matlab based on Gabor transform and in the application of digital filters to provide better and higher quality of retinography. The performance of algorithm has been compared with conventional methods obtaining resulting filtered images with better contrast and higher.

  4. Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    M.C. Boelter

    2006-08-01

    Full Text Available Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001. Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001, insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001 and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011 were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001 was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002 remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

  5. 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.

  6. Screening for retinopathy of prematurity and treatment outcome in a tertiary hospital in Hong Kong.

    Science.gov (United States)

    Iu, L Pl; Lai, C Hy; Fan, M Cy; Wong, I Yh; Lai, J Sm

    2017-02-01

    Studies on the prevalence and severity of retinopathy of prematurity in the local population are scarce. This study aimed to evaluate the prevalence, screening, and treatment outcome of retinopathy of prematurity in a tertiary hospital in Hong Kong. This cross-sectional study with internal comparison was conducted at Queen Mary Hospital, Hong Kong. The study evaluated 89 premature infants who were born at the hospital and were screened for retinopathy of prematurity, in accordance with the 2008 British Guidelines, between January 2013 and December 2013. The prevalences of retinopathy of prematurity and severe retinopathy requiring treatment were studied. The mean (± standard deviation) gestational age at birth was 30 +2 weeks ± 16.5 days (range, 24 +1 to 35 +5 weeks). The mean birth weight was 1285 g ± 328 g (range, 580 g to 2030 g). A total of 15 (16.9%) infants developed retinopathy of prematurity and three (3.4%) required treatment. In a subgroup analysis of extremely-low-birth-weight infants of prematurity and 17.6% required treatment. Multivariate logistic regression analysis suggested low birth weight and patent ductus arteriosus were significantly associated with development of retinopathy of prematurity (Pprematurity, all regressed successfully after one laser treatment. Retinopathy of prematurity is a significant problem among premature infants in Hong Kong, especially those with extremely low birth weight. Our screening service for retinopathy of prematurity was satisfactory and treatment results were good. Strict adherence to international screening guidelines and vigilance in infants at risk are key to successful management of retinopathy of prematurity.

  7. Role of advanced glycation end products (AGEs) and oxidative stress in diabetic retinopathy.

    Science.gov (United States)

    Yamagishi, Sho-ichi; Ueda, Seiji; Matsui, Takanori; Nakamura, Kazuo; Okuda, Seiya

    2008-01-01

    Diabetic retinopathy is a common and potentially devastating microvascular complication in diabetes and is a leading cause of acquired blindness among the people of occupational age. However, current therapeutic options for the treatment of sight-threatening proliferative diabetic retinopathy such as photocoagulation and vitrectomy are limited by considerable side effects and far from satisfactory. Therefore, to develop novel therapeutic strategies that specifically target diabetic retinopathy is actually desired for most of the patients with diabetes. Chronic hyperglycemia is a major initiator of diabetic retinopathy. However, recent clinical study has substantiated the concept of 'hyperglycemic memory' in the pathogenesis of diabetic retinopathy. Indeed, the Diabetes Control and Complications Trial-Epidemiology of Diabetes Interventions and Complications (DCCT-EDIC) Research, has revealed that the reduction in the risk of progressive retinopathy resulting from intensive therapy in patients with type 1 diabetes persisted for at least several years after the DCCT trial, despite increasing hyperglycemia. These findings suggest a long-term beneficial influence of early metabolic control on clinical outcomes in type 1 diabetic patients. Among various biochemical pathways implicated in the pathogenesis of diabetic retinopathy, the process of formation and accumulation of advanced glycation end products (AGEs) and their mode of action are most compatible with the theory 'hyperglycemic memory'. Further, there is a growing body of evidence that AGEs-RAGE (receptor for AGEs) interaction-mediated oxidative stress generation plays an important role in diabetic retinopathy. This article summarizes the role of AGEs and oxidative stress in the development and progression of diabetic retinopathy and the therapeutic interventions that could prevent this devastating disorder. We also discuss here the pathological crosstalk between the AGEs-RAGE and the renin-angiotensin system in

  8. Issues concerning outer space investments in international law ...

    African Journals Online (AJOL)

    Issues concerning outer space investments in international law. ... Recent improvements in technology have in essence increased the viability of outer space as the next frontier for international investment and development. In addition to ... Key words: Outer Space, Investments, International Law, International Space Station ...

  9. Dark matter in the outer solar system

    Science.gov (United States)

    Owen, T.; Cruikshank, D.; De Bergh, C.; Geballe, T.

    1994-01-01

    There are now a large number of small bodies in the outer solar system that are known to be covered with dark material. Attempts to identify that material have been thwarted by the absence of discrete absorption features in the reflection spectra of these planetesimals. An absorption at 2.2 micrometers that appeared to be present in several objects has not been confirmed by new observations. Three absorptions in the spectrum of the unusually red planetesimal 5145 Pholus are well-established, but their identity remains a mystery.

  10. Inner and Outer Life at Work

    DEFF Research Database (Denmark)

    Lundgaard Andersen, Linda

    2012-01-01

    involving people to people interactions offered by psychodynamic theories and methods take up a pivotal position. Psychoanalytic organisational and work life research explores how work, organisations and individuals are affected by psychic dynamics, the influence of the unconscious in the forms of human...... development and interaction situated in a societal context. Based on this substantial work I draw upon two influential psychoanalytical positions—the British Tavistock position and German psychoanalytic social psychology in order to situate and identify how to understand the inner and outer life at work...

  11. The urgency of outer territories anthropology

    Directory of Open Access Journals (Sweden)

    Miloš Milenković

    2016-02-01

    Full Text Available In the context of transforming a part of Serbian anthropology into social theoretic management of identity, I suggest both comparative historiographic and ethnographic learning from societies with similar post-colonial experience, with the aim to include the discipline into an urgent defense of Serbia and Belgrade from further ethno-profiteering interests of elites in/from outer territories, left over on the ruins of our ill judged, resource incompatible, exaggerated or immoral twentieth century adventures. Serbian anthropology, written by anthropologists to whom Serbia and Belgrade are "homeland" by origin or civilized choice, should play the key role in the defense of Serbian citizens from the interest of elites in/from the outer "homelands", particularly by revealing the processes for which it is, as a discipline, most expert at – the professionalization of ethnicity, interactive and hybrid nature of identity, instrumental nature of tradition and the identity politics in general. Having in mind the latest attempt, a particularly successful one, conducted by the end of the 20th and the beginning of the 21st century that the lives, health, well-being, dignity and future of persons born in and loyal to the interest of Serbia and Belgrade, in large scale, thoroughly and long term be sacrificed and dedicated to the interests of ethno-profiteering elites in/from outer territories, in this article I point to the possibility to, along with the comparative learning from the above mentioned post-colonial experiences, delicate experiences of urgent anthropology be applied as well as the rich tradition of collective research. This text analyzes the results of first such research, that represenst the initial, praiseworthy and a brave step in the wise striving to engage social sciences and humanities in a search of expert and not mythical/daily-political solutions of the key problem of the Serbian nation – that of how to settle the interests of the

  12. Asymmetric severity of diabetic retinopathy in Waardenburg syndrome.

    Science.gov (United States)

    Kashima, Tomoyuki; Akiyama, Hideo; Kishi, Shoji

    2011-01-01

    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 the authors' knowledge, this is the first case report of a patient with Waardenburg syndrome and diabetic retinopathy.

  13. Prothrombogenic thrombocytic phenotype in patients with nonproliferative diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    A.S. Gudz

    2018-03-01

    Full Text Available Background. Patients with type 2 diabetes mellitus (DM have increased reactivity of thrombocytes (Tc, the causes of which remain unclear. The hypothesis of the dependence of Tc receptors functional activity on the individual reactivity of the organism is tested. The purpose of the study was to establish whether the individual reactivity of Tc differs in patients with diabetic nonproliferative retinopathy (DNPR. Materials and methods. The study included 19 patients (19 eyes with type 2 DM, who, according to the results of the clinical and instrumental examination and according to the Early Treatment of Diabetic Retinopathy Study classification, had mild DNPR. Ophthalmological examination was performed before the beginning of treatment and included the collection of anamnesis, visual acuity study with optimal optical correction, tonometry, gonioscopy, biomicroscopy, ophthalmoscopy, optical coherence tomography (Stratus OCT apparatus. Thrombocytes were isolated by centrifugation from citrated peripheral blood of patients. To activate Tc, agonists were used: adenosine diphosphate (2.5 μM, adrenaline (2.5 μM, angiotensin II (1.0 μM, platelet activating factor (75.0 μM and collagen (1.0 mg/ml. The Tc aggregation was evaluated by a spectrophotometric method on the ChronoLog aggregometer (USA. Results. The revealed individual reactivity of Tc in patients with DNPR was manifested by the features of thrombogenesis induction. A hyperreactivity of Tc to three agonists was detected: adrenaline, collagen and angiotensin II, which was characteristic of prothrombogenic phenotype. Depending on the functional activity of the investigated receptors, two main clusters of Tc receptors were identified, which were equal by the activity of α2-adrenoreceptors and angiotensin type 1 receptors, but differed by the response of Tc to collagen. Conclusions. Determination of the prothrombogenic phenotype and clusters of functionally active Tc receptors opens the

  14. [Population-based study of diabetic retinopathy in Wolfsburg].

    Science.gov (United States)

    Hesse, L; Grüsser, M; Hoffstadt, K; Jörgens, V; Hartmann, P; Kroll, P

    2001-11-01

    Since November 1997 the complete documentation of an ophthalmological examination of diabetics has been annually subsidized by the Volkswagen Corporation Health Maintenance Organization (VW-HMO). The results of an annual ophthalmological examination were recorded in a standardised history sheet developed by the Initiative Group for Early Detection of Diabetic Eye Diseases. These data included visual acuity, intraocular pressure, lens status and a description of fundus abnormalities. Within 26 months ophthalmological examinations of 2,801 patients were completed which represented 4.5% of all VW-HMO insured patients. On average, patients suffered from diabetes for 9.6 years (SD +/- 8.3), artificial intraocular lenses were present in 357 eyes (6.4%) and 1,216 eyes (12.0%) were diagnosed with cataract or posterior capsule opacification impairing visual acuity. Out of 263 patients younger than 40 years old, 18.8% had a mild or moderate and 3.3% a severe non-proliferative diabetic retinopathy (NPDR). A proliferative diabetic retinopathy (PDR) was found in 2.2% of the younger patients. Of 2,228 patients aged 40 years and older, 11.9% had a mild or moderate and 2.6% a severe NPDR. In 0.9% of this group PDR was diagnosed. An annual ophthalmological screening based on a survey sheet of the Initiative Group was successfully introduced. For the first time a population-based evaluation on the prevalence of diabetic retinopathy was carried out for inhabitants of a German city. The prevalence of PDR was found to be lower than previously published in comparable studied.

  15. Revisiting the mouse model of oxygen-induced retinopathy

    Directory of Open Access Journals (Sweden)

    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

  16. Biochemical changes in diabetic retinopathy triggered by hyperglycaemia: A review

    Directory of Open Access Journals (Sweden)

    Solani D. Mathebula

    2018-04-01

    Full Text Available Background: Diabetes mellitus (DM is now a global health problem which will lead to increasing incidence of macrovascular and microvascular complications that contribute to morbidity, mortality and premature deaths. Diabetic retinopathy (DR is a serious complication of DM, and its prevalence is increasing worldwide. Diabetes mellitus is one of the fastest growing causes of visual impairment and blindness in the working-age population. Aim: The aim of this paper was to introduce the multiple interconnecting biochemical pathways that have been proposed and tested as key contributors in how the diabetic eye loses vision. Method: An extensive literature search was performed using the Medline database from 1970 to present. The search subjects included diabetes and eye, diabetic retinopathy and diabetic complications in the eye. The search was limited to the literature pertaining to humans and to English language. Preference was given to recent published papers. Results: Results were limited to human participants with publications in English. References of all included papers were also scrutinized to identify additional studies. Studies were selected for inclusion in the review if they met the following criteria: subjects with diabetes, pathophysiology of diabetic retinopathy. Conclusion: Although the biochemical pathways involved in DR have been researched, to date the exact mechanism involved in the onset and progression of the disease is uncertain, which makes therapeutic interventions challenging. The aim of this review is to discuss the possible biochemical pathways and clinical and anatomical changes that occur during the onset and progression of DR that link hyperglycaemia with retinal tissue damage. An understanding of the biochemical and molecular changes may lead to health care practitioners advising patients with DR on events that lead to possible complications of the diseases.

  17. Retinal micropseudocysts in diabetic retinopathy: prospective functional and anatomic evaluation.

    Science.gov (United States)

    Forte, Raimondo; Cennamo, Gilda; Finelli, Maria Luisa; Bonavolontà, Paola; Greco, Giovanni Maria; de Crecchio, Giuseppe

    2012-01-01

    To evaluate the prevalence, progression and functional predictive value of retinal micropseudocysts (MPCs) in diabetic patients. Prospective controlled observational study. From among all the type 2 diabetic patients evaluated during a period of 5 months between September 2009 and January 2010, we enrolled all patients with retinal MPCs at spectral-domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) not previously treated for diabetic retinopathy. Forty diabetic patients without MPCs served as the control group. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), macular sensitivity and stability of fixation at SD-SLO/OCT microperimetry were measured monthly for 12 months. 22/156 patients with type 2 diabetes (14.1%, 32 eyes) met the inclusion criteria. The 95% confidence interval for the prevalence estimate of MPCs was 12.3-16.6%. Mean BCVA, CRT and central retinal sensitivity at baseline were 77.53 ± 2.2 Early Treatment Diabetic Retinopathy Study letters, 242.31 ± 31.0 µm and 15.95 ± 0.61 dB, respectively. Fixation was stable in all cases. Compared to the control group, eyes with MPCs had similar BCVA but greater CRT (p = 0.01) and reduced macular sensitivity (p = 0.001) at baseline and at each follow-up visit. Over time, CRT remained stable in eyes with MPCs, whereas macular sensitivity progressively decreased. MPCs in diabetic retinopathy are associated, temporally or causally, with a progressive reduction of macular sensitivity despite a stable BCVA, CRT and fixation. Copyright © 2011 S. Karger AG, Basel.

  18. Validation of the Colorado Retinopathy of Prematurity Screening Model.

    Science.gov (United States)

    McCourt, Emily A; Ying, Gui-Shuang; Lynch, Anne M; Palestine, Alan G; Wagner, Brandie D; Wymore, Erica; Tomlinson, Lauren A; Binenbaum, Gil

    2018-04-01

    The Colorado Retinopathy of Prematurity (CO-ROP) model uses birth weight, gestational age, and weight gain at the first month of life (WG-28) to predict risk of severe retinopathy of prematurity (ROP). In previous validation studies, the model performed very well, predicting virtually all cases of severe ROP and potentially reducing the number of infants who need ROP examinations, warranting validation in a larger, more diverse population. To validate the performance of the CO-ROP model in a large multicenter cohort. This study is a secondary analysis of data from the Postnatal Growth and Retinopathy of Prematurity (G-ROP) Study, a retrospective multicenter cohort study conducted in 29 hospitals in the United States and Canada between January 2006 and June 2012 of 6351 premature infants who received ROP examinations. Sensitivity and specificity for severe (early treatment of ROP [ETROP] type 1 or 2) ROP, and reduction in infants receiving examinations. The CO-ROP model was applied to the infants in the G-ROP data set with all 3 data points (infants would have received examinations if they met all 3 criteria: birth weight, large validation cohort. The model requires all 3 criteria to be met to signal a need for examinations, but some infants with a birth weight or gestational age above the thresholds developed severe ROP. Most of these infants who were not detected by the CO-ROP model had obvious deviation in expected weight trajectories or nonphysiologic weight gain. These findings suggest that the CO-ROP model needs to be revised before considering implementation into clinical practice.

  19. 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

  20. The neurovascular relation in oxygen-induced retinopathy.

    Science.gov (United States)

    Akula, James D; Mocko, Julie A; Benador, Ilan Y; Hansen, Ronald M; Favazza, Tara L; Vyhovsky, Tanya C; Fulton, Anne B

    2008-01-01

    Longitudinal studies in rat models of retinopathy of prematurity (ROP) have demonstrated that abnormalities of retinal vasculature and function change hand-in-hand. In the developing retina, vascular and neural structures are under cooperative molecular control. In this study of rats with oxygen-induced retinopathy (OIR) models of ROP, mRNA expression of vascular endothelial growth factor (VEGF), semaphorin (Sema), and their neuropilin receptor (NRP) were examined during the course of retinopathy to evaluate their roles in the observed neurovascular congruency. Oxygen exposures designed to induce retinopathy were delivered to Sprague-Dawley rat pups (n=36) from postnatal day (P) 0 to P14 or from P7 to P14. Room-air-reared controls (n=18) were also studied. Sensitivities of the rod photoreceptors (S(rod)) and the postreceptor cells (Sm) were derived from electroretinographic (ERG) records. Arteriolar tortuosity, T(A), was derived from digital fundus images using Retinal Image multi-Scale Analysis (RISA) image analysis software. mRNA expression of VEGF(164), semaphorin IIIA (Sema3A), and neuropilin-1 (NRP-1) was evaluated by RT-PCR of retinal extracts. Tests were performed at P15-P16, P18-P19, and P25-P26. Relations among ERG, RISA, and PCR parameters were evaluated using linear regression on log transformed data. Sm was low and T(A) was high at young ages, then both resolved by P25-P26. VEGF(164) and Sema3A mRNA expression were also elevated early and decreased with age. Low Sm was significantly associated with high VEGF(164) and Sema3A expression. Low S(rod) was also significantly associated with high VEGF(164). S(rod) and Sm were both correlated with T(A). NRP-1 expression was little affected by OIR. The postreceptor retina appears to mediate the vascular abnormalities that characterize OIR. Because of the relationships revealed by these data, early treatment that targets the neural retina may mitigate the effects of ROP.

  1. Myopia in premature babies with and without retinopathy of prematurity.

    OpenAIRE

    Nissenkorn, I; Yassur, Y; Mashkowski, D; Sherf, I; Ben-Sira, I

    1983-01-01

    One hundred and fifty-five premature infants weighing 600-2000 g were followed up during 1974-80 for the presence of retinopathy of prematurity (ROP) and for the existence of myopia. 50% of the premature infants who had ROP were myopic, while only 16% myopic premature infants were found among those who did not have ROP. There was a positive correlation between the degree of myopia and the severity of cicatricial ROP. No difference existed in the frequency and degree of myopia between prematur...

  2. Neonatal Risk Factors for Treatment-Demanding Retinopathy of Prematurity

    DEFF Research Database (Denmark)

    Slidsborg, Carina; Jensen, Aksel; Forman, Julie Lyng

    2016-01-01

    PURPOSE: One goal of the study was to identify "new" statistically independent risk factors for treatment-demanding retinopathy of prematurity (ROP). Another goal was to evaluate whether any new risk factors could explain the increase in the incidence of treatment-demanding ROP over time in Denmark....... DESIGN: A retrospective, register-based cohort study. PARTICIPANTS: The study included premature infants (n = 6490) born in Denmark from 1997 to 2008. METHODS: The study sample and the 31 candidate risk factors were identified in 3 national registers. Data were linked through a unique civil registration...

  3. Automated Screening for Diabetic Retinopathy - A Systematic Review

    DEFF Research Database (Denmark)

    Nørgaard, Mads Fonager; Grauslund, Jakob

    2018-01-01

    PURPOSE: Worldwide ophthalmologists are challenged by the rapid rise in the prevalence of diabetes. Diabetic retinopathy (DR) is the most common complication in diabetes, and possible consequences range from mild visual impairment to blindness. Repetitive screening for DR is cost...... related to mild DR with a low risk of progression within 1 year. Several studies reported missed cases of diabetic macular edema. A meta-analysis was not conducted as studies were not suitable for direct comparison or statistical analysis. CONCLUSION: The study demonstrates that despite limited...

  4. [Macula structure and function in retinopathy of prematurity].

    Science.gov (United States)

    Kogoleva, L V; Katargina, L A; Rydnitskaia, Ia L

    2011-01-01

    Macula structure and function were studied in 64 patients with retinopathy of prematurity (RP) stage I-III aged 8-17 years old using optical coherence tomography (OCT) and electroretinography. Absence of foveolar depression associated with preservation of fovea layers and normal electroretinography indices were showed to be the evidence of differentiation damage and macula underdevelopment due to immaturity and to have no effect on visual acuity. Preserved or pathologic foveolar depression associated with abnormal OCT findings and central retina electrogenesis damage indicate dysfunction and morphological changes of macula due to not macula underdevelopment because of immaturity only but RP either that can lead to depression, visual function.

  5. Heating of the outer solar atmosphere

    International Nuclear Information System (INIS)

    Parker, E.N.

    1983-01-01

    The author discusses the idea that there must be a source of magnetic fields somewhere below the solar surface. He starts by considering present day ideas about the sun's internal structure. The sun has a radius of approximately 700,000 km, of which the outer 100,000 km or so is the convective zone, according to mixing-length models. The dynamo is believed to operate in the convective zone, across which there may be a 5-10% variation in the angular velocity. There are the stretched east-west fields similar to the ones in the earth's core. Associated with these are poloidal fields which contribute to a net dipole moment of the sun and are generated by a dynamo. The author shows that essentially no magnetic field configuration has an equilibrium; they dissipate quickly in spite of the high conductivity in fluid motions and heating. This is probably the major part of the heating of the sun's outer atmosphere. (Auth.)

  6. Cosmics in the LHCb Outer Tracker

    CERN Document Server

    Aaij, Roel

    2010-01-01

    The LHCb experiment at the Large Hadron Collider studies the decay of B mesons to test the description of CP violation in the Standard Model and to search for new physics. The decay $B_s \\to \\mu^+ \\mu^-$ has been identified as very promising in the search for new physics. An excellent invariant mass resolution is required to suppress backgrounds to this decay. This in turn requires a momentum resolution of dp/p = 0.4%. The Outer Tracker is part of the LHCb tracking system and has been commissioned with cosmic muons. The noise in the Outer Tracker is shown to be less than 0.05%. To use drift time information in the reconstruction of cosmic tracks, the event time must be known. Four methods to obtain the event time are studied and compared. It is shown that the event time can be obtained with a resolution better than 2.6 ns. Using drift time information, tracks are reconstructed with a resolution of 344 $\\mu$m. Knowledge of the event time enables the calibration of electronic time offsets and the r(t)– relati...

  7. Gamma rays from pulsar outer gaps

    International Nuclear Information System (INIS)

    Chiang, J.; Romani, R.W.; Cheng Ho

    1993-01-01

    We describe a gamma ray pulsar code which computes the high energy photon emissivities from vacuum gaps in the outer magnetosphere, after the model outlined by Cheng, Ho and Ruderman (1986) and Ho (1989). Pair-production due to photon-photon interactions and radiation processes including curvature, synchrotron and inverse Compton processes are computed with an iterative scheme which converges to self-consistent photon and particle distributions for a sampling of locations in the outer magnetosphere. We follow the photons from these distributions as they propagate through the pulsar magnetosphere toward a distant observer. We include the effects of relativistic aberration, time-of-flight delays and reabsorption by photon-photon pair-production to determine an intensity map of the high energy pulsar emission on the sky. Using data from radio and optical observations to constrain the geometry of the magnetosphere as well as the possible observer viewing angles, we derive light curves and phase dependent spectra which can be directly compared to data from the Compton Observatory. Observations for Crab, Vela and the recently identified gamma ray pulsars Geminga, PSR1706-44 aNd PSR 1509-58 will provide important tests of our model calculations, help us to improve our picture of the relevant physics at work in pulsar magnetospheres and allow us to comment on the implications for future pulsar discoveries

  8. Residual Stress Testing of Outer 3013 Containers

    International Nuclear Information System (INIS)

    Dunn, K.

    2004-01-01

    A Gas Tungsten Arc Welded (GTAW) outer 3013 container and a laser welded outer 3013 container have been tested for residual stresses according to the American Society for Testing Materials (ASTM) Standard G-36-94 [1]. This ASTM standard describes a procedure for conducting stress-corrosion cracking tests in boiling magnesium chloride (MgCl2) solution. Container sections in both the as-fabricated condition as well as the closure welded condition were evaluated. Significantly large residual stresses were observed in the bottom half of the as-fabricated container, a result of the base to can fabrication weld because through wall cracks were observed perpendicular to the weld. This observation indicates that regardless of the closure weld technique, sufficient residual stresses exist in the as-fabricated container to provide the stress necessary for stress corrosion cracking of the container, at the base fabrication weld. Additionally, sufficiently high residual stresses were observed in both the lid and the body of the GTAW as well as the laser closure welded containers. The stresses are oriented perpendicular to the closure weld in both the container lid and the container body. Although the boiling MgCl2 test is not a quantitative test, a comparison of the test results from the closure welds shows that there are noticeably more through wall cracks in the laser closure welded container than in the GTAW closure welded container

  9. Radioiodination of an outer membrane protein in intact Rickettsia prowazekii

    International Nuclear Information System (INIS)

    Smith, D.K.; Winkler, H.H.

    1980-01-01

    Intact Rickettsia prowazekii was radiolabeled with the glucose oxidase-lactoperoxidase method of iodination. Separation of the rickettsial extract into cytoplasmic, outer and inner membrane fractions demonstrated that the outer membrane was preferentially labeled. Analysis of the polypeptides of these fractions on high-resolution slab polyacrylamide gels showed that most of the 125 I was in polypeptide T49, an outer membrane constituent. Additional outer membrane polypeptides were iodinated in broken envelope preparations, demonstrating that T49 is uniquely accessible to the external environment and the asymmetric polypeptide organization of the outer membrane

  10. Endothelin-1 is associated with fibrosis in proliferative diabetic retinopathy membranes.

    Science.gov (United States)

    Chang, William; Lajko, Michelle; Fawzi, Amani A

    2018-01-01

    To characterize the relationship between endothelin-1 and fibrosis in epiretinal membranes in proliferative diabetic retinopathy and explore the role of endothelial-mesenchymal transition in these membranes. Membranes were obtained from eyes undergoing pars plana vitrectomy for complicated proliferative diabetic retinopathy or idiopathic epiretinal membrane. Through standard immunohistochemical techniques, we labeled membranes to explore the distribution of endothelin-1 and endothelin receptor B, comparing proliferative diabetic retinopathy and idiopathic epiretinal membranes. In addition, membranes were also labeled with markers for fibroblasts, endothelial, and glial cells and studied with confocal laser scanning microscopy. The intensity of endothelin-1 labeling was quantified using standard image analysis software. Fourteen membranes were included in the analysis, nine from eyes with proliferative diabetic retinopathy and five idiopathic membranes. Flatmount diabetic membranes showed co-localization of endothelin-1 with S100A4 and CD31. Immunohistochemistry and quantitative analysis of cross-sectional membranes showed significantly higher endothelin-1 labeling in proliferative diabetic retinopathy membranes compared to idiopathic membranes (pmembranes showed more elements staining positive for S100A4 compared to idiopathic membranes. Epiretinal membrane formation in proliferative diabetic retinopathy involves higher tissue levels of endothelin-1 and fibroblastic activity. Furthermore, endothelin-1, endothelial and fibroblastic staining appear to be correlated, suggestive of endothelial-to-mesenchymal transition in proliferative diabetic retinopathy.

  11. Grading and disease management in national screening for diabetic retinopathy in England and Wales.

    Science.gov (United States)

    Harding, S; Greenwood, R; Aldington, S; Gibson, J; Owens, D; Taylor, R; Kohner, E; Scanlon, P; Leese, G

    2003-12-01

    A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no 'questionable' lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.

  12. Maternal Iron Deficiency Anemia as a Risk Factor for the Development of Retinopathy of Prematurity.

    Science.gov (United States)

    Dai, Alper I; Demiryürek, Seniz; Aksoy, Sefika Nur; Perk, Peren; Saygili, Oguzhan; Güngör, Kivanc

    2015-08-01

    Retinopathy of prematurity is a proliferative vascular disease affecting premature newborns and occurs during vessel development and maturation. The aim of this study was to evaluate the maternal iron deficiency anemia as possible risk factors associated with the development of retinopathy of prematurity among premature or very low birth weight infants. In this study, mothers of 254 infants with retinopathy of prematurity were analyzed retrospectively, and their laboratory results of medical records during pregnancy were reviewed for possible iron deficiency anemia. In a cohort of 254 mothers of premature infants with retinopathy of prematurity, 187 (73.6%) had iron deficiency, while the remaining 67 (26.4%) mothers had no deficiency. Babies born to mothers with iron deficiency anemia with markedly decreased hemoglobin, hematocrit, mean corpuscular volume, serum iron, and ferritin levels were more likely to develop retinopathy of prematurity. Our results are the first to suggest that maternal iron deficiency is a risk factor for the development of retinopathy of prematurity. Our data suggest that maternal iron supplementation therapy during pregnancy might lower the risk of retinopathy of prematurity. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Retinopathy of Prematurity: Clinical Features, Classification, Natural History, Management and Outcome.

    Science.gov (United States)

    Shah, Parag K; Prabhu, Vishma; Ranjan, Ratnesh; Narendran, Venkatapathy; Kalpana, Narendran

    2016-11-07

    Retinopathy of prematurity is an avoidable cause of childhood blindness. Proper understanding of the classification and treatment methods is a must in tackling this disease. Literature search with PubMed was conducted covering the period 1940-2015 with regards to retinopathy of prematurity, retrolental fibroplasia, its natural history, classification and treatment. The clinical features, screening and staging of retinopathy of prematurity according to International classification of retinopathy of prematurity (ICROP) has been included with illustrations. The standard current treatment indications, modalities and outcomes from landmark randomized controlled trials on retinopathy of prematurity have been mentioned. This review would help pediatricians to update their current knowledge on classification and treatment of retinopathy of prematurity. Screening for retinopathy of prematurity, in India, should be performed in all preterm neonates who are born <34 weeks gestation and/or <1750 grams birthweight; as well as in babies 34-36 weeks gestation or 1750-2000 grams birthweight if they have risk factors for ROP. Screening should start by one month after birth.

  14. Machine Learning Approaches for Detecting Diabetic Retinopathy from Clinical and Public Health Records.

    Science.gov (United States)

    Ogunyemi, Omolola; Kermah, Dulcie

    2015-01-01

    Annual eye examinations are recommended for diabetic patients in order to detect diabetic retinopathy and other eye conditions that arise from diabetes. Medically underserved urban communities in the US have annual screening rates that are much lower than the national average and could benefit from informatics approaches to identify unscreened patients most at risk of developing retinopathy. Using clinical data from urban safety net clinics as well as public health data from the CDC's National Health and Nutrition Examination Survey, we examined different machine learning approaches for predicting retinopathy from clinical or public health data. All datasets utilized exhibited a class imbalance. Classifiers learned on the clinical data were modestly predictive of retinopathy with the best model having an AUC of 0.72, sensitivity of 69.2% and specificity of 55.9%. Classifiers learned on public health data were not predictive of retinopathy. Successful approaches to detecting latent retinopathy using machine learning could help safety net and other clinics identify unscreened patients who are most at risk of developing retinopathy and the use of ensemble classifiers on clinical data shows promise for this purpose.

  15. Study on the changes of three renal functional parameters in patients with diabetic retinopathy

    International Nuclear Information System (INIS)

    Zhang Rong; Li Sumei; Zhang Li; Ye Shandong; Jin Chunyan; Ren An; Chen Ruoping; Chen Chao

    2009-01-01

    Objective: To study the relationship between development of diabetic retinopathy (DR) and changes of urinary albumin (UAlb),urine albumin-creatinine ratio (ACR), glomerular filtration rate (GFR) in patients with type 2 diabetes. Methods: Blood urea nitrogen (BUN), serum creatinine (SCr), 24 hours UAlb, ACR, radionuclide renal dynamic imaging (for GFR determination) and bilatera1 retinal photography were examined in 124 patients with type 2 diabetes. Of them 51 were without diabetic retinopathy(group A), 50 were with simple retinopathy(group B) and 23 were complicated with proliferate retinopathy(group C). Results: The UAlb, ACR in the patients with complicated diabetic retinopathy were significantly higher than those in the other two groups, while the GFR was significantly lower (P<0.05). Correlationship studies revealed that UAlb, ACR and GFR were independent risk factors of diabetic retinopathy. Conclusion: The severity of type 2 diabetes retinopathy is closely linked with the increase of UAlb, ACR and the decrease of GFR. Radionuclide renal dynamic imaging is helpful for the diagnosis of early stage of diabetic nephropathy (DN). (authors)

  16. Association between diabetic retinopathy and subclinical atherosclerosis in China: Results from a community-based study.

    Science.gov (United States)

    Liu, Yu; Teng, Xiangyu; Zhang, Wei; Zhang, Ruifeng; Liu, Wei

    2015-09-01

    To evaluate the association of diabetic retinopathy with subclinical atherosclerosis in middle-aged and elderly Chinese with type 2 diabetes. A cross-sectional community-based study was performed among 1607 patients aged 40 years or older in Shanghai. Non-mydriatic digital fundus photography examination was used in diabetic retinopathy detection. Presence of elevated carotid intima-media thickness or carotid plaque was defined as subclinical atherosclerosis. The prevalence of diabetic retinopathy was 15.1% in total patients. Patients with diabetic retinopathy were more likely to have elevated carotid intima-media thickness, carotid plaque and subclinical atherosclerosis than those without diabetic retinopathy (37.9% vs 30.7%, 57.6% vs 49.6% and 64.6% vs 57.1%, respectively). The presence of diabetic retinopathy was significantly associated with increased odds of subclinical atherosclerosis (odds ratio = 1.93, 95% confidence interval = 1.03-3.60) after full adjustments. The presence of diabetic retinopathy was significantly associated with subclinical atherosclerosis in middle-aged and elderly patients with type 2 diabetics in China. © The Author(s) 2015.

  17. Frequency of diabetic retinopathy in patients after ten years of diagnosis of type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Shaikh, M.A.; Yakta, D.E.

    2010-01-01

    Background: Diabetic retinopathy is one of the most common and serious complications of type 2 diabetes mellitus and a leading cause of blindness not only in Pakistan but also worldwide. So we conducted this study to record the frequency of diabetic retinopathy in known diabetic patients ten years after diagnosis of type 2 diabetes mellitus. Methods: The study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan for a period of 1 year from January 2008 to January 2010. The study group comprised of 200 patients of type 2 diabetes mellitus attending the medical clinic. All patients who were diagnosed as type 2 diabetes mellitus since ten years duration were included in the study. Retinopathy was graded into background, pre proliferative and proliferative retinopathy. Type 2 diabetes was diagnosed using the WHO criteria. Statistical analysis was carried out using the SPSS-11. Results: Diabetic retinopathy was found in 25.5% of the total Type 2 patients after ten years of diagnosis, and of these 4% of patients had proliferative retinopathy. Conclusion: Type 2 diabetic patients should be screened as early as possible to prevent permanent visual loss by timely management of diabetic retinopathy because diabetes is one of most common preventable cause of blindness in the world. (author)

  18. Risk factors associated with diabetic retinopathy among type 2 diabetes patients at teaching hospital in Malaysia.

    Science.gov (United States)

    Abougalambou, Salwa Selim Ibrahim; Abougalambou, Ayman S

    2015-01-01

    Diabetic retinopathy (DR) is the leading cause of blindness in the United States and it is the leading cause of new cases of blindness in adults aged 20-74. It is estimated that about 20% of patients with type 2 DM have evidence of diabetic retinopathy at diagnosis with diabetes. To evaluate the prevalence of DR and to determine risk factors related to diabetic retinopathy among type 2 diabetes patients attending endocrinology clinics at Hospital Universiti Sains Malaysia (HUSM). The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at HUSM. Diagnosis of retinopathy is based on finding the diagnostic signs of retinopathy on eye exams by fundoscopy. Logistic regression analysis was used to assess the independent variables that affect the development of retinopathy. The prevalence of retinopathy was 39.3%. It has been noticed from this study findings, that the progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance. DR is highly prevalent among type 2 DM. The progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance. DR is a serious diabetic complication and public health strategies are required in order to reduce its risk factors and decrease its prevalence. Copyright © 2014 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  19. Diabetic retinopathy in sub-Saharan Africa: meeting the challenges of an emerging epidemic.

    Science.gov (United States)

    Burgess, Philip I; Msukwa, Gerald; Beare, Nicholas A V

    2013-07-02

    Sub-Saharan Africa faces an epidemic of diabetes. Diabetes causes significant morbidity including visual loss from diabetic retinopathy, which is largely preventable. In this resource-poor setting, health systems are poorly organized to deliver chronic care with multiple system involvement. The specific skills and resources needed to manage diabetic retinopathy are scarce. The costs of inaction for individuals, communities and countries are likely to be high. Screening for and treatment of diabetic retinopathy have been shown to be effective, and cost-effective, in resource-rich settings. In sub-Saharan Africa, clinical services for diabetes need to be expanded with the provision of effective, integrated care, including case-finding and management of diabetic retinopathy. This should be underpinned by a high quality evidence base accounting for differences in diabetes types, resources, patients and society in Africa. Research must address the epidemiology of diabetic retinopathy in Africa, strategies for disease detection and management with laser treatment, and include health economic analyses. Models of care tailored to the local geographic and social context are most likely to be cost effective, and should draw on experience and expertise from other continents. Research into diabetic retinopathy in Africa can drive the political agenda for service development and enable informed prioritization of available health funding at a national level. Effective interventions need to be implemented in the near future to avert a large burden of visual loss from diabetic retinopathy in the continent. An increase in visual loss from diabetic retinopathy is inevitable as the diabetes epidemic emerges in sub-Saharan Africa. This could be minimized by the provision of case-finding and laser treatment, but how to do this most effectively in the regional context is not known. Research into the epidemiology, case-finding and laser treatment of diabetic retinopathy in sub

  20. Agreement between photographic screening and hospital biomicroscopy grading of diabetic retinopathy and maculopathy.

    Science.gov (United States)

    Healy, Rachel; Sallam, Ahmed; Jones, Vanessa; Donachie, Paul H J; Scanlon, Peter H; Stratton, Irene M; Johnston, Robert L

    2014-01-01

    To examine the level of agreement and reasons for disagreement between grading of diabetic retinopathy and maculopathy using mydriatic digital photographs in a diabetic retinopathy screening service (DRSS) and hospital eye service (HES). English NHS Diabetic Eye Screening Programme grades for diabetic retinopathy prospectively recorded on a hospital electronic medical record were compared to the grades from the DRSS event that prompted referral. In cases of disagreement, images were reviewed. Data for 1,501 patients (3,002 eyes) referred between 2008 and 2011 were analyzed. The HES retinopathy grades were R0 (no retinopathy) in 341 eyes, R1 (background retinopathy) in 1,712 eyes, R2 (pre-proliferative retinopathy) in 821 eyes, and R3 (proliferative retinopathy) in 128 eyes. The DRSS grades were in agreement in 2,309 eyes (76.9%), recorded a lower grade in 227 eyes, and recorded a higher grade in 466 eyes. Agreement was substantial (κ = 0.65). The commonest cause for disagreement was overgrading of R1 as R2 by hospital clinicians. The HES maculopathy grades were M0 (no maculopathy) in 2,267 eyes and M1 (maculopathy) in 735 eyes. The DRSS were in agreement in 2,111 eyes (70.2%), recorded a lower grade in 106 eyes, and recorded a higher grade in 785 eyes. Agreement was fair (κ = 0.39). The commonest cause for disagreement was hospital clinicians missing fine exudates. This study establishes a benchmark standard for agreement between HES and DRSS grading. Review of DRSS and grading reports images for newly referred patients is likely to improve levels of agreement, particularly for diabetic retinopathy, and should be strongly encouraged.

  1. Frequency of diabetic retinopathy in karachi, pakistan: a hospital based study

    International Nuclear Information System (INIS)

    Alkhairy, S.; Rasheed, A.

    2015-01-01

    This study was conducted to determine the prevalence of diabetic retinopathy in diabetes patients presenting to the National Institute of Diabetes and Eye out patient department of Dow University Hospital (Ohja campus), Dow University of Health Sciences. Materials and Methods: This was a cross sectional study in which known diabetics were recruited between the period of 1st July 2011 till 31st July 2012.They were then referred to the Ophthalmology unit for eye examination. Subjective refraction was done with Snellens chart, anterior segment examination and fundus examined was done using a TopCon PS-61E Slit lamp BioMicroscope. All patients were dilated with eye drop tropicamide 1% instilled every ten minutes for thirty minutes and the fundus was examined with Volk 90D lens. Classification of diabetic retinopathy was done using the International clinical diabetic retinopathy disease severity scale study. The data was analyzed using Statistical package for social Science (SPSS version 20) and a p value of < 0.05 was taken as statistically significant. Results: There were a total number of 570 patients included in this study. Amongst them 325 were males and 245 were females. Out of these patients those that who were found to have diabetic retinopathy were 315 (55.3%).The age range was between 25 and 75 years and the mean age was 52.30 ± 9.333.Patients that were found to have mild non proliferative diabetic retinopathy were 231(40.5% ) while 33 (5.8%) had moderate non-proliferative diabetic retinopathy,11(1.9%) had severe non-proliferative diabetic retinopathy and 40 (7.0)% had proliferative diabetic retinopathy. Diabetic Maculopathy was seen in a total number of 72(12.6%) of patients. Conclusions: Diabetic retinopathy is highly prevalent in Karachi, Pakistan thus it is vital to detect as well as manage the disease early so as to prevent the onset of blindness in relation to it. (author)

  2. Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Jordan.

    Science.gov (United States)

    Bakkar, May M; Haddad, Mera F; Gammoh, Yazan S

    2017-01-01

    Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate awareness of diabetic retinopathy among a sample of type 2 diabetes mellitus patients in Jordan. The study period was from August to December 2015. The sample was selected randomly from patients with type 2 diabetes mellitus from the general population in three main cities of Jordan (Amman, Irbid, and Zarqa). A questionnaire was distributed to 237 participants with diabetes to assess their awareness and knowledge of diabetes and diabetic retinopathy. The questionnaire included questions to assess awareness about diabetic retinopathy, sources of knowledge about the disease, and patients' knowledge and compliance with available treatments and routine eye examinations. Patients were also questioned about the barriers that may interfere with early eye examination. A total of 237 participants (107 [45.1%] females and 130 [54.9%] males) with type 2 diabetes were interviewed. Mean age±SD for the study population was 54.51±10.28 years. Of the study population, 88.2% were aware that diabetes can affect the eyes and 81% reported that diabetic retinopathy can lead to blindness. Higher level of patients' awareness of diabetic retinopathy was related to higher level of formal education ( p diabetic retinopathy as reported by 47.3% patients was general practitioners. Patients' compliance with diabetes management was relatively high; however, their compliance with routine retinal assessment was poor, with only a total of 29.5% of participants having had an eye examination in the previous year. Awareness of the nature and consequences of diabetic retinopathy among patients with diabetes in Jordan is relatively high. However, patients' motivation to undergo retinal assessment was poor in the sample, thus hindering early diagnosis and management.

  3. 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

  4. Presence of chronic diabetic foot ulcers is associated with more frequent and more advanced retinopathy.

    Science.gov (United States)

    Sellman, A; Katzman, P; Andreasson, S; Löndahl, M

    2018-05-23

    To clarify the frequency and severity of diabetic retinopathy in a group of people with Type 2 diabetes and chronic diabetic foot ulcers, and to compare visual acuity, levels of retinopathy and clinical significant macular oedema with a matched control group of people with Type 2 diabetes without a history of chronic diabetic foot ulcers. Visual acuity and fundus imaging were evaluated in 90 white people with at least 3 months' duration of full-thickness diabetic foot ulcers below the ankle and the results compared with those in 180 white people with Type 2 diabetes without a history of chronic diabetic foot ulcers (control group). Controls were matched for age, sex and duration of diabetes. Despite similar age and diabetes duration, severe non-proliferative or proliferative diabetic retinopathy was present in 41% of the people in the diabetic foot ulcer group as compared to 15% in the control group (Pdiabetic foot ulcer group was without any diabetic retinopathy as compared to 34% among controls. Proliferative diabetic retinopathy was more common in the diabetic foot ulcer group (31% vs 8%; Pdiabetic retinopathy did not differ between groups. Clinically significant macular oedema was more frequently present, and the diabetic foot ulcer group exhibited significantly worse results in best and worst eye visual acuity testing. In this northern European setting almost all people with Type 2 diabetes and chronic diabetic foot ulcers had diabetic retinopathy. Almost one-third had proliferative diabetic retinopathy as compared to diabetic retinopathy was linked to worse visual acuity. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. 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.

  6. Endogenous erythropoietin protects neuroretinal function in ischemic retinopathy.

    Science.gov (United States)

    Mowat, Freya M; Gonzalez, Francisco; Luhmann, Ulrich F O; Lange, Clemens A; Duran, Yanai; Smith, Alexander J; Maxwell, Patrick H; Ali, Robin R; Bainbridge, James W B

    2012-04-01

    Because retinal ischemia is a common cause of vision loss, we sought to determine the effects of ischemia on neuroretinal function and survival in murine oxygen-induced retinopathy (OIR) and to define the role of endogenous erythropoietin (EPO) in this model. OIR is a reproducible model of ischemia-induced retinal neovascularization; it is used commonly to develop antiangiogenic strategies. We investigated the effects of ischemia in murine OIR on retinal function and neurodegeneration by electroretinography and detailed morphology. OIR was associated with significant neuroretinal dysfunction, with reduced photopic and scotopic ERG responses and reduced b-wave/a-wave ratios consistent with specific inner-retinal dysfunction. OIR resulted in significantly increased apoptosis and atrophy of the inner retina in areas of ischemia. EPO deficiency in heterozygous Epo-Tag transgenic mice was associated with more profound retinal dysfunction after OIR, indicated by a significantly greater suppression of ERG amplitudes, but had no measurable effect on the extent of retinal ischemia, preretinal neovascularization, or neuroretinal degeneration in OIR. Systemic administration of recombinant EPO protected EPO-deficient mice against this additional suppression, but EPO supplementation in wild-type animals with OIR did not rescue neuroretinal dysfunction or degeneration. Murine OIR offers a valuable model of ischemic neuroretinal dysfunction and degeneration in which to investigate adaptive tissue responses and evaluate novel therapeutic approaches. Endogenous EPO can protect neuroretinal function in ischemic retinopathy. Copyright © 2012 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

  7. Autoimmune retinopathy associated with systemic lupus erythematosus: A diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Wadakarn Wuthisiri

    2017-01-01

    Full Text Available Visual loss in systemic lupus erythematosus (SLE due to autoimmune retinopathy (AIR is rare and easily misdiagnosed as hydroxychloroquine retinopathy. We report the rare clinical presentation of severe visual loss in a patient with SLE due to nonparaneoplastic AIR as differentiated from hydroxychloroquine toxicity. A 70-year-old female diagnosed and treated for lupus for 17 years and had been taking hydroxychloroquine for 15 years. Over the past 2 years, she developed progressive peripheral visual loss oculus uterque which rapidly advanced in the latter 6 months. Hydroxychloroquine toxicity was initially suspected, but diagnostic testing revealed a retinal degeneration. Antiretinal autoantibody testing using Western blot analysis revealed autoantibodies against 44-kDa, 46-kDa (anti-enolase, and 68-kDa proteins. Visual acuity improved in the first 6 months of treatment with mycophenolate mofetil. Our case suggests that AIR should be considered in the differential diagnosis of rapid, severe visual loss in patients with hydroxychloroquine treatment.

  8. 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

  9. The relationship between diabetic retinopathy and cognitive impairment.

    Science.gov (United States)

    Crosby-Nwaobi, Roxanne R; Sivaprasad, Sobha; Amiel, Stephanie; Forbes, Angus

    2013-10-01

    Recent studies have shown an increased risk for cognitive impairment and dementia in patients with diabetes. An association between diabetic retinopathy (DR) and retinal microvasculature disease and cognitive impairment has been reported as potential evidence for a microvascular component to the cognitive impairment. It was hypothesized that severity of DR would be associated with cognitive impairment in individuals with type 2 diabetes. Three hundred eighty patients with type 2 diabetes were recruited from a population-based eye screening program and grouped by severity of DR as follows: no/mild DR (n=252) and proliferative diabetic retinopathy (PDR) (n=128). Each participant underwent psychosocial assessment; depression screening; ophthalmic and physical examination, including blood assays; and cognitive assessment with the Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini-Mental State Examination (MMSE), and the Mini-Cog. General linear modeling was used to examine severity of DR and cognitive impairment, adjusting for confounders. Severity of DR demonstrated an inverse relationship with cognitive impairment (fully adjusted R2=0.415, Pcognitive impairment scores on ACE-R (adjusted mean±SE 77.0±1.9) compared with the PDR group (82.5±2.2, Pcognitive impairment compared with 5% in the PDR group (n=6). Patients with minimal DR demonstrated more cognitive impairment than those with advanced DR. Therefore, the increased prevalence of cognitive impairment in diabetes may be associated with factors other than evident retinal microvascular disease.

  10. Mean trombosit volume in patients with retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    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

  11. Treatment of diabetic retinopathy: Recent advances and unresolved challenges

    Institute of Scientific and Technical Information of China (English)

    Michael W Stewart

    2016-01-01

    Diabetic retinopathy(DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor(VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement. Anti-VEGF injections improve visual acuity in patients with diabetic macular edema(DME) from 8-12 letters and improvements with corticosteroids are only slightly less. Unfortunately, a third of patients have an incomplete response to anti-VEGF therapy, but the best second-line therapy remains unknown. Current first-line therapy requires monthly visits and injections; longer acting therapies are needed to free up healthcare resources and improve patient compliance. VEGF suppression may be as effective as panretinal photocoagulation(PRP) for proliferative diabetic retinopathy, but more studies are needed before PRP is abandoned. For over 30 years laser was the mainstay for the treatment of DME, but recent studies question its role in the pharmacologic era. Aggressive treatment improves vision in most patients, but many still do not achieve reading and driving vision. New drugs are needed to add to gains achieved with available therapies.

  12. Treatment of diabetic retinopathy: Recent advances and unresolved challenges

    Institute of Scientific and Technical Information of China (English)

    Michael; W; Stewart[1

    2016-01-01

    Diabetic retinopathy (DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered.The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor (VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement. Anti-VEGF injections improve visual acuity in patients with diabetic macular edema (DME) from 8-12 letters and improvements with corticosteroids are only slightly less. Unfortunately, a third of patients have an incomplete response to anti-VEGF therapy, but the best second-line therapy remains unknown. Current first-line therapy requires monthly visits and injections; longer acting therapies are needed to free up healthcare resources and improve patient compliance. VEGF suppression may be as effective as panretinal photocoagulation (PRP) for proliferative diabetic retinopathy, but more studies are needed before PRP is abandoned. For over 30 years laser was the mainstay for the treatment of DME, but recent studies question its role in the pharmacologic era.Aggressive treatment improves vision in most patients,but many still do not achieve reading and driving vision.New drugs are needed to add to gains achieved with available therapies.

  13. 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.

    2007-01-01

    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.

  14. Genetic and Environmental Influences on Retinopathy of Prematurity

    Science.gov (United States)

    Ortega-Molina, J. M.; Anaya-Alaminos, R.; Uberos-Fernández, J.; Solans-Pérez de Larraya, A.; Chaves-Samaniego, M. J.; Salgado-Miranda, A.; Piñar-Molina, R.; Jerez-Calero, A.; García-Serrano, J. L.

    2015-01-01

    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. PMID:26089603

  15. The progress of prophylactic treatment in retinopathy of prematurity

    Science.gov (United States)

    Zhang, Hong-Bing; Wang, Xiao-Dong; Xu, Kun; Li, Xiao-Gang

    2018-01-01

    Retinopathy of prematurity (ROP) is a retinal vascular disorder frequently found in premature infants. Different therapeutic strategies have been developed to treat ROP. However, there are still many children with ROP suffering by severe limitations in vision or even blindness. Recently, ROP has been suggested to be caused by abnormal development of the retinal vasculature, but not simply resulted by retinal neovascularization which takes about 4 to 6wk after birth in premature infants. Thus, instead of focusing on how to reduce retinal neovascularization, understanding the pathological changes and mechanisms that occur prior to retinal neovascularization is meaningful, which may lead to identify novel target(s) for the development of novel strategy to promote the healthy growth of retinal blood vessels rather than passively waiting for the appearance of retinal neovascularization and removing it by force. In this review, we discussed recent studies about, 1) the pathogenesis prior to retinal neovascularization in oxygen-induced retinopathy (OIR; a ROP in animal model) and in premature infants with ROP; 2) the preclinical and clinical research on preventive treatment of early OIR and ROP. We will not only highlight the importance of the mechanisms and signalling pathways in regulating early stage of ROP but also will provide guidance for actively exploring novel mechanisms and discovering novel treatments for early phase OIR and ROP prior to retinal neovascularization in the future. PMID:29862189

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

    Directory of Open Access Journals (Sweden)

    Zheng Yingfeng

    2012-09-01

    Full Text Available Abstract Background 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. Methods 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. Results 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  Conclusions 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.

  17. Detection of hypertensive retinopathy using vessel measurements and textural features.

    Science.gov (United States)

    Agurto, Carla; Joshi, Vinayak; Nemeth, Sheila; Soliz, Peter; Barriga, Simon

    2014-01-01

    Features that indicate hypertensive retinopathy have been well described in the medical literature. This paper presents a new system to automatically classify subjects with hypertensive retinopathy (HR) using digital color fundus images. Our method consists of the following steps: 1) normalization and enhancement of the image; 2) determination of regions of interest based on automatic location of the optic disc; 3) segmentation of the retinal vasculature and measurement of vessel width and tortuosity; 4) extraction of color features; 5) classification of vessel segments as arteries or veins; 6) calculation of artery-vein ratios using the six widest (major) vessels for each category; 7) calculation of mean red intensity and saturation values for all arteries; 8) calculation of amplitude-modulation frequency-modulation (AM-FM) features for entire image; and 9) classification of features into HR and non-HR using linear regression. This approach was tested on 74 digital color fundus photographs taken with TOPCON and CANON retinal cameras using leave-one out cross validation. An area under the ROC curve (AUC) of 0.84 was achieved with sensitivity and specificity of 90% and 67%, respectively.

  18. 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.

  19. Automated detection of diabetic retinopathy in three European populations

    DEFF Research Database (Denmark)

    Hansen, M; Hansen, Morten B.; Tang, H L

    2016-01-01

    photocoagulation (PRP) in patients with proliferative diabetic retinopathy (PDR). Method: Forty eyes from 38 newly diagnosed patients with PDR were included and followed for 6 months. All patients received standard PRP treatment by a navigated laser (NAVILAS®; OD-OS GmbH, Berlin, Germany) at baseline...... to month 6 (group 1 p=0.71, group 2 p=0.62). Conclusion: In our cohort, retinal vascular fractal dimension does not seem to be a valid marker for prediction of activity in patients with proliferative diabetic retinopathy 6 months after panretinal photocoagulation....... of diabetes were 52±14 years and 21±11 years, respectively, and 75% were male. HbA1c was 68 ±16 mmol/mol, and the mean blood pressure was 183/84 mmHg. Groups 1 and 2 did not differ according to the mean number of laser spots (1581 vs. 1573, p=0.84) or the total laser energy delivered (13.67 joule vs. 13...

  20. Macular micropseudocysts in early stages of diabetic retinopathy.

    Science.gov (United States)

    Tremolada, Gemma; Pierro, Luisa; de Benedetto, Umberto; Margari, Sergio; Gagliardi, Marco; Maestranzi, Gisella; Calori, Giliola; Lorenzi, Mara; Lattanzio, Rosangela

    2011-01-01

    To identify by noninvasive means early retinal abnormalities that may predict diabetic macular edema. The authors analyzed retrospectively data from consecutive patients with Type 1 (n = 16) or Type 2 (n = 23) diabetes who presented for routine follow-up of early retinopathy, had no clinical signs or symptoms of diabetic macular edema, and were evaluated with spectral-domain optical coherence tomography. Age- and gender-matched nondiabetic subjects provided normative data. Spectral-domain optical coherence tomography revealed in the macular region of diabetic patients small hyporeflective areas (median diameter, 55 μm) contained within discrete retinal layers that we named micropseudocysts (MPCs). Micropseudocysts are associated with vascular leakage. The patients showing MPCs had more frequently systemic hypertension and increased central foveal thickness than those without MPCs. The association with increased central foveal thickness was only in the patients with Type 2 diabetes. Macular MPCs in patients with mild diabetic retinopathy appear to reflect leakage and can precede macular thickening. The association of MPCs with increased central foveal thickness in patients with Type 2 diabetes, but not in patients with Type 1 diabetes, points to a greater tendency to retinal fluid accumulation in patients with Type 2 diabetes. Studies in larger cohorts will determine the usefulness of MPCs in strategies to abort diabetic macular edema.

  1. 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.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

    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

  3. 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.

  4. Automated detection of neovascularization for proliferative diabetic retinopathy screening.

    Science.gov (United States)

    Roychowdhury, Sohini; Koozekanani, Dara D; Parhi, Keshab K

    2016-08-01

    Neovascularization is the primary manifestation of proliferative diabetic retinopathy (PDR) that can lead to acquired blindness. This paper presents a novel method that classifies neovascularizations in the 1-optic disc (OD) diameter region (NVD) and elsewhere (NVE) separately to achieve low false positive rates of neovascularization classification. First, the OD region and blood vessels are extracted. Next, the major blood vessel segments in the 1-OD diameter region are classified for NVD, and minor blood vessel segments elsewhere are classified for NVE. For NVD and NVE classifications, optimal region-based feature sets of 10 and 6 features, respectively, are used. The proposed method achieves classification sensitivity, specificity and accuracy for NVD and NVE of 74%, 98.2%, 87.6%, and 61%, 97.5%, 92.1%, respectively. Also, the proposed method achieves 86.4% sensitivity and 76% specificity for screening images with PDR from public and local data sets. Thus, the proposed NVD and NVE detection methods can play a key role in automated screening and prioritization of patients with diabetic retinopathy.

  5. 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.

  6. 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.

  7. Recurrent Neural Network for Computing Outer Inverse.

    Science.gov (United States)

    Živković, Ivan S; Stanimirović, Predrag S; Wei, Yimin

    2016-05-01

    Two linear recurrent neural networks for generating outer inverses with prescribed range and null space are defined. Each of the proposed recurrent neural networks is based on the matrix-valued differential equation, a generalization of dynamic equations proposed earlier for the nonsingular matrix inversion, the Moore-Penrose inversion, as well as the Drazin inversion, under the condition of zero initial state. The application of the first approach is conditioned by the properties of the spectrum of a certain matrix; the second approach eliminates this drawback, though at the cost of increasing the number of matrix operations. The cases corresponding to the most common generalized inverses are defined. The conditions that ensure stability of the proposed neural network are presented. Illustrative examples present the results of numerical simulations.

  8. Ageing of the LHCb outer tracker

    CERN Document Server

    Blom, M R; Tuning, N

    2009-01-01

    The modules of the LHCb outer tracker have shown to suffer severe gain loss under moderate irradiation. This process is called ageing. Ageing of the modules results from contamination of the gas system by glue, araldite AY 103-1, used in their construction. In this thesis the ageing process will be shown. The schemes known to reduce, reverse, or prevent ageing have been investigated to determine their effect on the detector performance. The addition of O2 to the gas mixture lowers the detector response by an acceptable amount and does not affect the gas transport properties significantly. The ageing rate is decreased after extensive flushing and HV training could eventually repair the irradiation damage. The risks of HV training have been assessed. Furthermore, several gaseous and aquatic additions have been tested for their capability to prevent, or moderate ageing, but none showed significant improvement.

  9. The fate of the outer plasmasphere

    International Nuclear Information System (INIS)

    Elphic, R.C.; Thomsen, M.F.; Borovsky, J.E.

    1997-01-01

    Both the solar wind and the ionosphere contribute to Earth close-quote s magnetospheric plasma environment. However, it is not widely appreciated that the plasmasphere is a large reservoir of ionospheric ions that can be tapped to populate the plasma sheet. We employ empirical models of high-latitude ionospheric convection and the geomagnetic field to describe the transport of outer plasmasphere flux tubes from the dayside, over the polar cap and into the magnetotail during the early phases of a geomagnetic storm. We calculate that this process can give rise to high densities of cold plasma in the magnetotail lobes and in the near-Earth plasma sheet during times of enhanced geomagnetic activity, and especially during storms. This model can help explain both polar cap ionization patches and the presence of cold flowing ions downtail.copyright 1997 American Geophysical Union

  10. Impulsive ion acceleration in earth's outer magnetosphere

    International Nuclear Information System (INIS)

    Baker, D.N.; Belian, R.D.

    1985-01-01

    Considerable observational evidence is found that ions are accelerated to high energies in the outer magnetosphere during geomagnetic disturbances. The acceleration often appears to be quite impulsive causing temporally brief (10's of seconds), very intense bursts of ions in the distant plasma sheet as well as in the near-tail region. These ion bursts extend in energy from 10's of keV to over 1 MeV and are closely associated with substorm expansive phase onsets. Although the very energetic ions are not of dominant importance for magnetotail plasma dynamics, they serve as an important tracer population. Their absolute intensity and brief temporal appearance bespeaks a strong and rapid acceleration process in the near-tail, very probably involving large induced electric fields substantially greater than those associated with cross-tail potential drops. Subsequent to their impulsive acceleration, these ions are injected into the outer trapping regions forming ion ''drift echo'' events, as well as streaming tailward away from their acceleration site in the near-earth plasma sheet. Most auroral ion acceleration processes occur (or are greatly enhanced) during the time that these global magnetospheric events are occurring in the magnetotail. A qualitative model relating energetic ion populations to near-tail magnetic reconnection at substorm onset followed by global redistribution is quite successful in explaining the primary observational features. Recent measurements of the elemental composition and charge-states have proven valuable for showing the source (solar wind or ionosphere) of the original plasma population from which the ions were accelerated

  11. THE PREVENTION OF BLINDNESS AND VISUAL IMPAIRMENT IN CHILDREN WITH RETINOPATHY OF PREMATURITY

    Directory of Open Access Journals (Sweden)

    V. V. Neroev

    2015-01-01

    Full Text Available The system of blindness prevention and visual impairment in children with retinopathy of prematurity is a multidisciplinary medical problem, and includes the prevention of the preterm birth, the correction of terms of caring for premature babies, early detection, monitoring, and treatment of retinopathy of prematurity, as well as the organization of the long clinical supervision. Patients with retinopathy of prematurity need a comprehensive approach to the prevention of the visual impairment in order to ensure high functional outcomes and improve their quality of life. 

  12. Semaglutide, reduction in HbA1c and the risk of diabetic retinopathy

    DEFF Research Database (Denmark)

    Vilsbøll, Tina; Bain, Stephen C; Leiter, Lawrence A

    2018-01-01

    AIMS: To evaluate diabetic retinopathy data from across the SUSTAIN clinical trial programme. MATERIALS AND METHODS: The SUSTAIN clinical trial programme evaluated the efficacy and safety of semaglutide, a glucagon-like peptide-1 analogue, for the treatment of type 2 diabetes (T2D). In SUSTAIN 6...... - a 2-year, preapproval cardiovascular outcomes trial - semaglutide was associated with a significant increase in the risk of diabetic retinopathy complications (DRC) versus placebo. Diabetic retinopathy (DR) data from across the SUSTAIN trials were evaluated and post hoc analyses of the SUSTAIN 6 data...

  13. Retinal vessel caliber as a potential marker of treatment outcome in patients with proliferative diabetic retinopathy

    DEFF Research Database (Denmark)

    Vergmann, Anna Stage; Torp, Thomas Lee; Lundberg, Kristian

    Title of abstract: Retinal vessel caliber as a potential marker of treatment outcome in patients with proliferative diabetic retinopathy Design of study: Three months prospective, interventional clinical study. Purpose: The retinal vascular tree can be measured non-invasively and summarized...... into the central retinal artery and vein equivalent (CRAE and CRVE). The purpose of this study was to evaluate retinal calibers as biomarkers for disease activity 3 months after panretinal photocoagulation (PRP) in patients with proliferative diabetic retinopathy (PDR). Methods: Fifty one eyes from 40 newly...... with proliferative diabetic retinopathy....

  14. Optical coherence tomography angiography discerns preclinical diabetic retinopathy in eyes of patients with type 2 diabetes without clinical diabetic retinopathy.

    Science.gov (United States)

    Cao, Dan; Yang, Dawei; Huang, Zhongning; Zeng, Yunkao; Wang, Jun; Hu, Yunyan; Zhang, Liang

    2018-05-01

    To investigate changes in retinal vascular plexuses and choriocapillaris in patients with type 2 diabetes mellitus (DM2) without diabetic retinopathy (DR) and healthy controls using optical coherence tomography angiography (OCTA). A total of 71 DM2 and 67 healthy control subjects were included. All subjects underwent OCTA examination (RTVue-XR Avanti; Optovue, Fremont, CA, USA). Average vessel density in superficial capillary plexus (SCP), deep capillary plexus (DCP) and choriocapillaris, parafoveal vessel density in SCP and DCP, FAZ area (mm 2 ) in SCP, microaneurysms and capillary nonperfusion were taken into analysis. Parafoveal vessel density in both SCP and DCP decreased in the eyes without clinical DR compared to normal controls (p Diabetic patients with no signs of DR also had a significant reduction in average vessel density of SCP, DCP and choriocapillaris (p diabetic eyes, and capillary nonperfusion was noted in 18 of 71 diabetic eyes. We demonstrated that OCTA can identify preclinical DR before the manifestation of clinically apparent retinopathy in diabetic eyes. DM2 patients without DR have SCP, DCP and choriocapillaris impairment. Our results suggested that OCTA might be a promising tool for regular screening of diabetic eyes for DR.

  15. 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 Mumbai 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.

  16. 670nm photobiomodulation as a novel protection against retinopathy of prematurity: evidence from oxygen induced retinopathy models.

    Directory of Open Access Journals (Sweden)

    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.

  17. 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)

    Broe, Rebecca; Rasmussen, Malin Lundberg; Peto, Tunde

    2013-01-01

    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...... 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...

  18. Will Outer Tropical Cyclone Size Change due to Anthropogenic Warming?

    Science.gov (United States)

    Schenkel, B. A.; Lin, N.; Chavas, D. R.; Vecchi, G. A.; Knutson, T. R.; Oppenheimer, M.

    2017-12-01

    Prior research has shown significant interbasin and intrabasin variability in outer tropical cyclone (TC) size. Moreover, outer TC size has even been shown to vary substantially over the lifetime of the majority of TCs. However, the factors responsible for both setting initial outer TC size and determining its evolution throughout the TC lifetime remain uncertain. Given these gaps in our physical understanding, there remains uncertainty in how outer TC size will change, if at all, due to anthropogenic warming. The present study seeks to quantify whether outer TC size will change significantly in response to anthropogenic warming using data from a high-resolution global climate model and a regional hurricane model. Similar to prior work, the outer TC size metric used in this study is the radius in which the azimuthal-mean surface azimuthal wind equals 8 m/s. The initial results from the high-resolution global climate model data suggest that the distribution of outer TC size shifts significantly towards larger values in each global TC basin during future climates, as revealed by 1) statistically significant increase of the median outer TC size by 5-10% (p<0.05) according to a 1,000-sample bootstrap resampling approach with replacement and 2) statistically significant differences between distributions of outer TC size from current and future climate simulations as shown using two-sample Kolmogorov Smirnov testing (p<<0.01). Additional analysis of the high-resolution global climate model data reveals that outer TC size does not uniformly increase within each basin in future climates, but rather shows substantial locational dependence. Future work will incorporate the regional mesoscale hurricane model data to help focus on identifying the source of the spatial variability in outer TC size increases within each basin during future climates and, more importantly, why outer TC size changes in response to anthropogenic warming.

  19. Rapid grading of fundus photographs for diabetic retinopathy using crowdsourcing.

    Science.gov (United States)

    Brady, Christopher J; Villanti, Andrea C; Pearson, Jennifer L; Kirchner, Thomas R; Gupta, Omesh P; Shah, Chirag P

    2014-10-30

    Screening for diabetic retinopathy is both effective and cost-effective, but rates of screening compliance remain suboptimal. As screening improves, new methods to deal with screening data may help reduce the human resource needs. Crowdsourcing has been used in many contexts to harness distributed human intelligence for the completion of small tasks including image categorization. Our goal was to develop and validate a novel method for fundus photograph grading. An interface for fundus photo classification was developed for the Amazon Mechanical Turk crowdsourcing platform. We posted 19 expert-graded images for grading by Turkers, with 10 repetitions per photo for an initial proof-of-concept (Phase I). Turkers were paid US $0.10 per image. In Phase II, one prototypical image from each of the four grading categories received 500 unique Turker interpretations. Fifty draws of 1-50 Turkers were then used to estimate the variance in accuracy derived from randomly drawn samples of increasing crowd size to determine the minimum number of Turkers needed to produce valid results. In Phase III, the interface was modified to attempt to improve Turker grading. Across 230 grading instances in the normal versus abnormal arm of Phase I, 187 images (81.3%) were correctly classified by Turkers. Average time to grade each image was 25 seconds, including time to review training images. With the addition of grading categories, time to grade each image increased and percentage of images graded correctly decreased. In Phase II, area under the curve (AUC) of the receiver-operator characteristic (ROC) indicated that sensitivity and specificity were maximized after 7 graders for ratings of normal versus abnormal (AUC=0.98) but was significantly reduced (AUC=0.63) when Turkers were asked to specify the level of severity. With improvements to the interface in Phase III, correctly classified images by the mean Turker grade in four-category grading increased to a maximum of 52.6% (10/19 images

  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. Prevalence of retinopathy of prematurity in Latin America

    Directory of Open Access Journals (Sweden)

    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. NLRP3 inflammasome activation is associated with proliferative diabetic retinopathy.

    Science.gov (United States)

    Loukovaara, Sirpa; Piippo, Niina; Kinnunen, Kati; Hytti, Maria; Kaarniranta, Kai; Kauppinen, Anu

    2017-12-01

    Innate immunity and dysregulation of inflammatory processes play a role in vascular diseases like atherosclerosis or diabetes. Nucleotide-binding domain and Leucine-rich repeat Receptor containing a Pyrin domain 3 (NLRP3) inflammasomes are pro-inflammatory signalling complexes that were found in 2002. In addition to pathogens and other extracellular threats, they can be activated by various endogenous danger signals. The purpose of this study was to find out whether NLRP3 activation occurs in patients with sight-threatening forms of diabetic retinopathy (DR). Inflammasome components NLRP3 and caspase-1, inflammasome-related pro-inflammatory cytokines IL-1β and IL-18, vascular endothelial growth factor (VEGF), acute-phase cytokines TNF-α and IL-6, as well as adaptive immunity-related cytokine interferon gamma (IFN-γ) were measured from the vitreous samples of 15 non-proliferative diabetic retinopathy (non-PDR) and 23 proliferative diabetic retinopathy (PDR) patients using the enzyme-linked immunosorbent assay (ELISA) method. The adaptor protein apoptosis-associated speck-like protein containing a CARD (ASC) was determined using the Western blot technique. Inflammasome components were present in the vitreous of DR patients. Along with VEGF, the levels of caspase-1 and IL-18 were significantly increased, especially in PDR eyes. Interestingly, clearly higher levels of NLRP3 were found in the PDR eyes with tractional retinal detachment (TRD) than from PDR eyes with fully attached retina. There were no significant differences in the amounts of IL-1β, TNF-α, IL-6, and IFN-γ that were detectable in the vitreous of both non-PDR and PDR patients. Our results suggest that NLRP3 inflammasome activation can be associated especially with the pathogenesis of PDR. The lack of differences in TNF-α, IL-6, and IFN-γ also alludes that acute inflammation or T-cell-mediated responses do not dominate in PDR pathogenesis. © 2017 Acta Ophthalmologica Scandinavica Foundation

  3. Proliferative diabetic retinopathy after vitrectomy early factors affect IOP

    Directory of Open Access Journals (Sweden)

    Shi-Bo Liu

    2013-05-01

    Full Text Available AIM:To explore possible causes of early postoperative elevated intraocular pressure caused by proliferative diabetic retinopathy(PDRvitrectomy. METHODS:Totally 72 cases(100 eyeswhich have performed vitrectomy for proliferative diabetic retinopathy were retrospectively analyzed to observe the incidence of postoperative ocular hypertension, and the relevant factors that caused postoperative high intraocular pressure were statistically analyzed. Early postoperative ocular hypertension diagnostic criteria: any time after 2 weeks of non-contact tonometer measured IOP> 25mmHg(1mmHg=0.133kPa. RESULTS:High intraocular pressure after vitrectomy occurred in 27 eyes(27%, the incidence of male and female were 27.27%, 26.79%, the difference was not statistically significant(P>0.05. Eyes filled with balanced liquid filling incidence rate of 30.95%, 6.25%, and the difference was statistically significant(P0.05. Incidences of intraoperative panretinal photocoagulation and additional retinal photocoagulation group were 41%, 20%, and the difference was statistically significant(P<0.05. Preoperative retinopathy of four, five, six groups of incidence were 9.52%, 23.81%, 40.56%, and the groups were statistically significant(P<0.05. Unconsolidated preoperative retinal detachment and retinal detachment incidence rate of 19%, 41%, and the difference was statistically significant(P<0.05. Surgery in the united lens resection with intraoperative unfederated lens the resection group's incidence rate of 34%, 15%, the difference was statistically significant(P<0.05. Logistic regression analysis showed that retinal detachment preoperative and intraoperative intraocular filling were independent risk factors that caused early postoperative ocular hypertension after vitrectomy. CONCLUSION:Post-operative ocular hypertension after PDR vitrectomy is related to preoperative retinal detachment, intraoperative lensectomy, intraoperative intraocular filling, and intraoperative

  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 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. Sildenafil and retinopathy of prematurity risk in very low birth weight infants

    NARCIS (Netherlands)

    S. Samiee-Zafarghandy; J.N. van den Anker (John); M. Laughon (Matthew); R.H. Clark; P.B. Smith; C.P. Hornik

    2016-01-01

    textabstractObjective: To examine the effect of sildenafil therapy on development of severe retinopathy of prematurity (ROP) requiring surgical intervention in premature infants. Study Design: We identified premature infants who were discharged from Pediatrix Medical Group neonatal intensive care

  6. 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.

  7. 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

    AIMS/HYPOTHESIS: We evaluated the effect of diabetic retinopathy on 25 year survival rate among a population-based cohort of type 1 diabetic patients from Fyn County, Denmark. METHODS: In 1973 all diabetic patients from Fyn County, Denmark with onset before the age of 30 years as of 1 July 1973...... were identified (n=727). In 1981, only 627 patients were still alive and resident in Denmark. Of these, 573 (91%) participated in a clinical baseline examination, in which diabetic retinopathy was graded and other markers of diabetes measured. Mortality rate was examined in a 25 year follow....../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....

  8. Development of a Deep Learning Algorithm for Automatic Diagnosis of Diabetic Retinopathy.

    Science.gov (United States)

    Raju, Manoj; Pagidimarri, Venkatesh; Barreto, Ryan; Kadam, Amrit; Kasivajjala, Vamsichandra; Aswath, Arun

    2017-01-01

    This paper mainly focuses on the deep learning application in classifying the stage of diabetic retinopathy and detecting the laterality of the eye using funduscopic images. Diabetic retinopathy is a chronic, progressive, sight-threatening disease of the retinal blood vessels. Ophthalmologists diagnose diabetic retinopathy through early funduscopic screening. Normally, there is a time delay in reporting and intervention, apart from the financial cost and risk of blindness associated with it. Using a convolutional neural network based approach for automatic diagnosis of diabetic retinopathy, we trained the prediction network on the publicly available Kaggle dataset. Approximately 35,000 images were used to train the network, which observed a sensitivity of 80.28% and a specificity of 92.29% on the validation dataset of ~53,000 images. Using 8,810 images, the network was trained for detecting the laterality of the eye and observed an accuracy of 93.28% on the validation set of 8,816 images.

  9. [Laser treatment for retinopathy of prematurity in neonatal intensive care units. Premature Eye Rescue Program].

    Science.gov (United States)

    Maka, Erika; Imre, László; Somogyvári, Zsolt; Németh, János

    2015-02-01

    Retinopathy of prematurity is a leading cause of childhood blindness around the world. The Department of Ophthalmology at the Semmelweis University and the Peter Cerny Neonatal Emergency and Ambulance Service started an innovative Premature Eye Rescue Program to reduce the non-essential transport of premature babies suffering from retinopathy of prematurity. During the first 5 years 186 eyes of 93 premature babies were treated at the bedside with stage 3 retinopathy of prematurity in the primary hospitals. In this first 5-years period the authors reduced the number of transports of premature babies for laser treatment; 93 children avoided the unnecessary transport, saving altogether a distance of 21,930 kilometers for children, as well as the ambulance service. The Premature Eye Rescue Program offers a good and effective alternative for treatment of retinopathy in the primary hospitals. The authors propose the national extension of this program.

  10. Giant Retinal Tear With Retinal Detachment in Regressed Aggressive Posterior Retinopathy of Prematurity Treated by Laser.

    Science.gov (United States)

    Chandra, Parijat; Tewari, Ruchir; Salunkhe, Nitesh; Kumawat, Devesh; Kumar, Vinod

    2017-06-29

    Rhegmatogenous retinal detachment after successfully regressed retinopathy of prematurity is a rare occurrence. Late onset rhegmatogenous retinal detachment has been reported infrequently. The authors report a case of aggressive posterior retinopathy of prematurity that underwent uneventful regression after laser photocoagulation and later developed an inoperable closed funnel retinal detachment due to a giant retinal tear. This case represents the earliest development of such complications in regressed aggressive posterior retinopathy of prematurity treated by laser. Development of a giant retinal tear has also not been previously reported after laser treatment. This case highlights that successful regression of severe retinopathy of prematurity does not safeguard against future complications and requires frequent long-term follow-up. [J Pediatr Ophthalmol Strabismus. 2017;54:e34-e36.]. Copyright 2017, SLACK Incorporated.

  11. Role of VEGF Inhibition in the Treatment of Retinopathy of Prematurity.

    Science.gov (United States)

    Eldweik, Luai; Mantagos, Iason S

    2016-01-01

    Retinopathy of prematurity (ROP) is a potentially blinding disease characterized by retinal neovascularization, which eventually can lead to tractional retinal detachment. Improvements have been made regarding the management of retinopathy of prematurity (ROP) since it was described in the Cryotherapy for Retinopathy of Prematurity study. A more appropriate time for therapeutic intervention was defined by the Early Treatment for Retinopathy of Prematurity (ETROP) trial. Advances in screening strategies with the use of digital imaging systems are now available. All of this and the use of laser photocoagulation and vitreoretinal surgery have contributed to significant increases in favorable outcomes and decreases in child blindness secondary to ROP. Recently the use of vascular endothelial growth factor (VEGF) inhibitors has been introduced to the armamentarium for the treatment of ROP. The purpose of this review article is to evaluate the role of VEGF inhibition in the treatment of ROP.

  12. 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

  13. 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...

  14. Radiation retinopathy caused by low dose irradiation and antithyroid drug-induced systemic vasculitis

    International Nuclear Information System (INIS)

    Sonoda, Koh-hei; Ishibashi, Tatsuro

    2005-01-01

    We report on a patient with Graves' disease with radiation retinopathy caused by low-dose irradiation and antithyroid drug-induced antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. A 38-year-old woman with Graves' disease presented with bilateral blurred vision, micro-aneurysms, telangiectasia, and macular edema. The patient was examined by ophthalmoscopy and fluorescein angiography, and radiation retinopathy was diagnosed. The patient had been treated with low-dose irradiation for her Graves' ophthalmopathy a few years earlier. She also had ANCA-positive vasculitis induced by the antithyroid drug (propylthiouracil, PTU) that had been prescribed for her at that time. Because of multiple avascular areas on both retinas, she was treated by intensive retinal photocoagulation to control progressive retinopathy. The radiation doses used to treat Graves' disease ophthalmopathy are low. Nevertheless, there is still a risk of radiation retinopathy developing in patients with PTU-induced ANCA-positive vasculitis. (author)

  15. The Prevalence of Diabetic Retinopathy Among Known Diabetic Population in Nepal.

    Science.gov (United States)

    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

  16. Open-angle glaucoma in patients with diabetic retinopathy at the Puerto Rico Medical Center.

    Science.gov (United States)

    Cruz-lñigo, Yousef; Izquierdo, Natalio J; García, Omar; Pérez, Raúl

    2012-01-01

    The association of open-angle glaucoma (OAG) with diabetes mellitus remains controversial. We report on the frequency of open-angle glaucoma in patients having diabetic retinopathy in a population of the Puerto Rico Medical Center. A cross-sectional study of 1,442 patients was done. Only the chart of patients 40 years-of-age and older, with a diagnosis of diabetic retinopathy and/or open-angle glaucoma were included. Descriptive analysis was done. Unadjusted and gender-adjusted logistic regression analyses were used to estimate risk of developing open-angle glaucoma in patients with diabetic retinopathy for each subsequent decade. 1,040 patients were diagnosed with diabetic retinopathy from July 1, 2004 to June 30, 2009. Also, 402 patients were diagnosed with open-angle glaucoma from July 1, 2007 to June 30, 2009. Of the 1,040 patients with diabetic retinopathy, 64 patients (6.15%) also had OAG. According to our gender-adjusted logistic regression analysis the estimated risk of developing open-angle glaucoma for patients 40 years-of-age with diabetic retinopathy increased for each subsequent decade until the seventh decade, odds ratio = 5.07 (95% confidence interval: 1.62-15.86). Thereafter, it decreased, odds ratio = 2.07 (95% confidence interval: 0.36-11.82). Our findings suggest that Puerto Rico patients between 40 to 79 years of age with diabetic retinopathy have an increased risk of developing open-angle glaucoma with each subsequent decade. Screening for open-angle glaucoma in patients with diabetic retinopathy is of utmost importance in the aging Puerto Rico population to prevent blindness.

  17. 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...

  18. Factors given by birth and oxygenotherapy in relation to development of retinopathy of prematurity

    OpenAIRE

    Olujić Maja; Oros Ana; Bregun-Doronjski Alekandra; Velisavljev-Filipović Gordana

    2012-01-01

    Introduction. Retinopathy of prematurity is a disease of the eye which affects the blood vessels of the retina and represents the most important cause of blindness and low vision in children worldwide. There are many risk factors given by birth and parameters of general health status that may influence this disease. The aim of this study was to investigate the significance of the factors given by birth and use of oxygen in relation to the development of premature retinopathy. Material a...

  19. Bilateral Ocular Decompression Retinopathy after Ahmed Valve Implantation for Uveitic Glaucoma

    Directory of Open Access Journals (Sweden)

    Javier Flores-Preciado

    2016-11-01

    Full Text Available Case Report: We report the case of a 29-year-old man who underwent Ahmed valve implantation in both eyes as treatment for uveitic glaucoma, subsequently presenting with bilateral ocular decompression retinopathy in the postoperative period. Discussion: Ocular decompression retinopathy is a rare complication of filtering surgery in patients with glaucoma; however, the course is benign in most cases, with spontaneous resolution of bleedings and improvement of visual acuity.

  20. Effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy

    OpenAIRE

    Lei Zhan; Si-Ying Xiong; Meng-Xin Gan; Li-Hui Wen

    2017-01-01

    AIM: To investigate the effects of vitrectomy combined with cataract surgery on the corneal endothelial cells in diabetic retinopathy. METHODS: A retrospective study was designed. 160 patients(160 eyes)with diabetic retinopathy from Jan 2015 to Feb 2017 were divided into two groups according to cataract. 74 patients(74 eyes)were operated on vitrectomy, and 86 patients(86 eyes)on vitrectomy combined with phacoemulsification cataract surgery and capsular bag implantation of foldable intraocular...

  1. Plasma E-selectin levels can play a role in the development of diabetic retinopathy.

    Science.gov (United States)

    Kasza, Márta; Meleg, J; Vardai, J; Nagy, B; Szalai, E; Damjanovich, J; Csutak, A; Ujhelyi, B; Nagy, V

    2017-01-01

    Diabetic retinopathy is one of the leading causes of blindness. There are several risk factors, such as the duration of diabetes or glycemic control of the patient; however, several biochemical factors also alter the process. Our aim was to investigate the role of soluble E-selectin in the formation of diabetic retinopathy. Fifty-seven patients (37 female and 20 male, aged 61.71 ± 12.31 years) and 14 healthy control subjects (ten female and four male, aged 63.06 ± 10.46 years) were enrolled in the study. We measured the soluble E-selectin level in the plasma of patients by ELISA. All patients underwent careful ophthalmological examination, including ophthalmoscopy and color fundus photography, while diabetic retinopathy grading was performed in line with the 2012 classification of the American Academy of Ophthalmology (AAO). The soluble E-selectin level was significantly higher in patients with diabetes compared to controls (32.95 ng/ml vs. 26.55 ng/ml, p = 0.03). Dividing patients into groups by the presence of retinopathy, the E-selectin level was also significantly higher in the retinopathy group (p diabetic patients by the severity of retinopathy (groups A, B, and C, by the guidelines of the AAO), however, we did not find any significant difference in soluble E-selectin levels, although it tended to be higher in group B. An elevated E-selectin level can play a role in the development of diabetic retinopathy, but it does not seem to alter disease severity. However, glycemic control and the reduction of cardiovascular risk factors may also alter the level of E-selectin that might play a role in the prevention of diabetic retinopathy.

  2. Statistics of the outer radiation belt

    International Nuclear Information System (INIS)

    Rodgers, D.J.; Johnstone, A.D.

    1996-01-01

    The highly variable electron flux levels in the outer radiation belt come about by competition between time-dependent source and loss mechanisms. In order to identify some of the different mechanisms involved, we examine the statistics of the variability of fluxes at geostationary orbit. Data from the SEM-2 analyzer on Meteosat-3 and from GOES-7 are used. Correlation analysis is used to find time-delays between changes in flux at different energies. We see that low energy flux is added to this region during sub-storms and that higher energy fluxes appear after 2 or 3 days. Whilst the timescale for this process is brief compared to a complete cycle of the open-quote Recirculation close-quote energization process, it is consistent with the timescale of its final step endash outward radial diffusion. By isolating periods when no new injection of plasma occurs, we make an assessment of flux loss rates in a quiet magnetosphere. copyright 1996 American Institute of Physics

  3. 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

    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......: 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...... 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...

  4. Crowdsourcing and Automated Retinal Image Analysis for Diabetic Retinopathy.

    Science.gov (United States)

    Mudie, Lucy I; Wang, Xueyang; Friedman, David S; Brady, Christopher J

    2017-09-23

    As the number of people with diabetic retinopathy (DR) in the USA is expected to increase threefold by 2050, the need to reduce health care costs associated with screening for this treatable disease is ever present. Crowdsourcing and automated retinal image analysis (ARIA) are two areas where new technology has been applied to reduce costs in screening for DR. This paper reviews the current literature surrounding these new technologies. Crowdsourcing has high sensitivity for normal vs abnormal images; however, when multiple categories for severity of DR are added, specificity is reduced. ARIAs have higher sensitivity and specificity, and some commercial ARIA programs are already in use. Deep learning enhanced ARIAs appear to offer even more improvement in ARIA grading accuracy. The utilization of crowdsourcing and ARIAs may be a key to reducing the time and cost burden of processing images from DR screening.

  5. Retinopathy of prematurity blindness worldwide: phenotypes in the third epidemic

    Directory of Open Access Journals (Sweden)

    Quinn GE

    2016-05-01

    Full Text Available Graham E Quinn Division of Ophthalmology, The Children’s Hospital of Philadelphia, Wood Center, Philadelphia, PA, USA Abstract: Blindness due to retinopathy of prematurity (ROP is an increasing problem worldwide as improved levels of neonatal care are provided in countries with developing neonatal intensive care units. The occurrence of ROP blindness varies dramatically with the socioeconomic development of a country. In regions with high levels of neonatal care and adequate resources, ROP blindness is largely restricted to premature infants with very low birth weight and low gestational age while in middle- and low-income countries with regional variation in technology and capacity, limited health resources may well limit the care of the premature newborn. Keywords: ROP, international, blindness

  6. 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.

  7. Automatic Tortuosity-Based Retinopathy of Prematurity Screening System

    Science.gov (United States)

    Sukkaew, Lassada; Uyyanonvara, Bunyarit; Makhanov, Stanislav S.; Barman, Sarah; Pangputhipong, Pannet

    Retinopathy of Prematurity (ROP) is an infant disease characterized by increased dilation and tortuosity of the retinal blood vessels. Automatic tortuosity evaluation from retinal digital images is very useful to facilitate an ophthalmologist in the ROP screening and to prevent childhood blindness. This paper proposes a method to automatically classify the image into tortuous and non-tortuous. The process imitates expert ophthalmologists' screening by searching for clearly tortuous vessel segments. First, a skeleton of the retinal blood vessels is extracted from the original infant retinal image using a series of morphological operators. Next, we propose to partition the blood vessels recursively using an adaptive linear interpolation scheme. Finally, the tortuosity is calculated based on the curvature of the resulting vessel segments. The retinal images are then classified into two classes using segments characterized by the highest tortuosity. For an optimal set of training parameters the prediction is as high as 100%.

  8. ADVANCES IN UNDERSTANDING AND MANAGEMENT OF RETINOPATHY OF PREMATURITY

    Science.gov (United States)

    Hartnett, Mary Elizabeth

    2016-01-01

    The understanding, diagnosis and treatment of retinopathy of prematurity (ROP) have changed in the last seventy years since the original description of retrolental fibroplasia associated with high oxygenation. It is now recognized that ROP differs in appearance world-wide and as ever smaller and younger premature infants survive. New methods are being evaluated to image the retina, diagnose severe ROP, and determine windows of time for treatment to save eyes and improve visual and neural outcomes. New treatments to promote physiologic retinal vascular development, vascular repair, and inhibit vasoproliferation by regulating proteins involved in vascular endothelial growth factor, insulin-like growth factor, or erythropoietin signaling. Reducing excessive oxidative/nitrosative stress and understanding progenitor cells and neurovascular and glial vascular interactions are being studied. PMID:28012875

  9. Retinopathy of prematurity and neurodevelopmental disabilities in premature infants.

    Science.gov (United States)

    Beligere, Nagamani; Perumalswamy, Vijayalaksmi; Tandon, Manish; Mittal, Amit; Floora, Jayasheele; Vijayakumar, B; Miller, Marilyn T

    2015-10-01

    Prematurity is a major global health issue leading to high mortality and morbidity among the survivors. Neurodevelopmental disability (NDD) and retinopathy of prematurity (ROP) are the most common complications of prematurity. In fact, ROP is the second leading cause of childhood blindness in the world. Although there is much information regarding the occurrence of ROP and of NDD in premature infants, there have been few studies on ROP and its association with NDD. The objectives of this article are to review the current literature on the subject and to publish our own findings concerning the association between ROP and NDD in premature infants. The review suggests that although NDDs are related to degree of prematurity, NDD could also be the result of visual impairments resulting from ROP. Our own study shows a close association between NDD and zonal involvement of ROP: higher NDD if zone 1 is involved and less if zone 3 is involved. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Aggressive Posterior Retinopathy of Prematurity in a Premature Male Infant

    Directory of Open Access Journals (Sweden)

    Jun Zhou

    2017-07-01

    Full Text Available A premature male infant was born at 30 weeks’ gestation with a birth weight of 1,700 g in a rural hospital. He was diagnosed with respiratory distress syndrome and received continuous positive airway pressure treatment for 26 days. At 26 days after birth, the patient was transferred to our hospital for further evaluation and management. A comprehensive eye examination revealed a stage 3 retinopathy of prematurity (ROP involving zone 2 in both eyes. The patient was recommended to a provincial-level eye hospital for emergency laser therapy. Five months after birth, the feedback from the eye hospital showed that the patient had a high risk of blindness in both eyes. Our case report shows that delaying first screening examination increases the possibility of developing aggressive posterior ROP in infants with ROP. Doctors in rural hospitals should be aware of this possibility and trained for early screening and treatment in high-risk infants.

  11. Endoplasmic Reticulum Stress-Related Factors Protect against Diabetic Retinopathy

    Directory of Open Access Journals (Sweden)

    Wei-Kun Hu

    2012-01-01

    Full Text Available The endoplasmic reticulum (ER is a principal mediator of signal transduction in the cell, and disruption of its normal function (a mechanism known as ER stress has been associated with the pathogenesis of several diseases. ER stress has been demonstrated to contribute to onset and progression of diabetic retinopathy (DR by induction of multiple inflammatory signaling pathways. Recent studies have begun to describe the gene expression profile of ER stress-related genes in DR; moreover, genes that play a protective role against DR have been identified. P58IPK was determined to be able to reduce retinal vascular leakage under high glucose conditions, thus protecting retinal cells. It has also been found by our lab that ER-associated protein degradation factors exhibit significantly different expression patterns in rat retinas under sustained high glucose conditions. Future research based upon these collective genomic findings will contribute to our overall understanding of DR pathogenesis as well as identify potential therapeutic targets.

  12. Application of optical coherence tomography angiography for diabetic retinopathy

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    Qing Liu

    2016-04-01

    Full Text Available Optical coherence tomography angiography(OCTAis a new emerging technology of the optical coherence tomography(OCTin recent years. It's a noninvasive and fast retinal vascular imaging technology with high resolution, and has been gradually applied to make diagnosis, gives treatment and follow-up for various types of retinal vascular diseases, such as diabetic retinopathy, choroid neovascularization, etc. OCTA has the unique advantages of layered observing the structure and shape of the chorioretinal vascular at different levels, and quantifying the blood flow index of designated scope and the flow area of lesions. However, OCTA requires high solid vision and good cooperation of patients, even has the limitations to observe the retinal scope and retinal vascular barrier function. With overcoming these limitations, it's helpful for us to improve the understanding of retinal vascular diseases, consummate the diagnosis and treatment and observation of retinal vascular diseases.

  13. Basement membrane abnormalities in human eyes with diabetic retinopathy

    DEFF Research Database (Denmark)

    Ljubimov, A V; Burgeson, R E; Butkowski, R J

    1996-01-01

    Vascular and parenchymal basement membranes (BMs) are thickened in diabetes, but alterations in individual BM components in diabetic eyes, especially in diabetic retinopathy (DR), are obscure. To identify abnormalities in the distribution of specific constituents, we analyzed cryostat sections...... of human eyes obtained at autopsy (seven normal, five diabetic without DR, and 13 diabetic with DR) by immunofluorescence with antibodies to 30 BM and extracellular matrix components. In non-DR eyes, no qualitative changes of ocular BM components were seen. In some DR corneas, epithelial BM was stained...... discontinuously for laminin-1, entactin/nidogen, and alpha3-alpha4 Type IV collagen, in contrast to non-DR corneas. Major BM alterations were found in DR retinas compared to normals and non-DR diabetics. The inner limiting membrane (retinal BM) of DR eyes had accumulations of fibronectin (including cellular...

  14. Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

    International Nuclear Information System (INIS)

    Krzywicki, S.; Slankiewicz, A.; Jablonska-Budaj, U.

    1980-01-01

    The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population. (author)

  15. Planning diabetic retinopathy services – lessons from Latin America

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    Pedro Gomez-Bastar

    2011-09-01

    Full Text Available The World Health Organization encourages the promotion and development of programmes for the prevention, detection, and management of diabetic retinopathy (DR. Such programmes must identify effective strategies and technology so that they can be adapted to the situation in each part of the world. Programmes must also be monitored and continuously improved.The guidelines discussed in this article were developed by experts brought together during workshops hosted by the VISION 2020 Latin America technical subcommittee on DR and technical support was provided by the Pan-American Asociation of Ophthalmology (PAAO. Although these guidelines have been developed for Latin America, we hope that the principles they contain will provide a good starting point for the planning of DR services in other low- and middle-income countries.

  16. Spontaneous retinopathy in HLA-A29 transgenic mice

    Science.gov (United States)

    Szpak, Yann; Vieville, Jean-Claude; Tabary, Thierry; Naud, Marie-Christine; Chopin, Martine; Edelson, Catherine; Cohen, Jacques H. M.; Dausset, Jean; de Kozak, Yvonne; Pla, Marika

    2001-01-01

    Humans who have inherited the class I major histocompatibility allele HLA-A29 have a markedly increased relative risk of developing the eye disease termed birdshot chorioretinopathy. This disease affecting adults is characterized by symmetrically scattered, small, cream-colored spots in the fundus associated with retinal vasculopathy and inflammatory signs causing damage to the ocular structures, leading regularly to visual loss. To investigate the role of HLA-A29 in this disease, we introduced the HLA-A29 gene into mice. Aging HLA-A29 transgenic mice spontaneously developed retinopathy, showing a striking resemblance to the HLA-A29-associated chorioretinopathy. These results strongly suggest that HLA-A29 is involved in the pathogenesis of this disease. Elucidation of the role of HLA-A29 should be assisted by this transgenic model. PMID:11226280

  17. Early diagnosis of retinopathy in juvenile diabetes by fluorescence angiography

    Energy Technology Data Exchange (ETDEWEB)

    Krzywicki, S; Slankiewicz, A; Jablonska-Budaj, U [Szpital-Pomnik Centrum Zdrowia Dziecka, Warsaw (Poland). Zespol Problemowy Okulistiky

    1980-09-01

    The authors defined the usefulness of the fluorescein angiography of the retina and choroid in the early stage diagnosis of diabetic retinopathy in children comparing its results to the traditional ophthalmoscopy. Examination involved 50 children from 4 to 18 (30 boys and 20 girls) on insulin treatment. The duration of the disease was 1 to 14 years (average 7.36 years). Ophthalmoscopy showed pathological changes in 24% of the children. The fluorescein angiography visualized more microaneurysms compared to ophthalmoscopy and showed them sometimes in the eyes where they had not been found in eye fundus studies. By means of angiography the early and advanced stages of vascular complications were found in 64% of patients. Comparing to ophthalmoscopy a 40% increase was noted. Fluorescein angiography can lead to the decrease in the number of patients with markedly impaired visual acuity and cases of blindness in the diabetic population.

  18. Telemedicine in diabetic retinopathy: Access to rural India

    Directory of Open Access Journals (Sweden)

    Taraprasad Das

    2016-01-01

    Full Text Available Diabetic retinopathy (DR is a growing concern in India. The first step in management of DR is timely screening. With 10% prevalence in rural India, 11 million people are likely to have DR by the year 2030. With limited resources and skilled manpower, it will not be possible to have routine eye examination to identify and treat these patients on a regular basis. Telemedicine is a possible answer in these situations where patients could be remotely screened and appropriately advised. With the advent of several technological advances such as low cost hand-held nonmydriatic camera, increased capabilities of the smartphones to take external eye and retinal photographs coupled with improving broadband connectivity; teleophthalmology in the management of DR could be a reality in the not too distant future.

  19. 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.

  20. Development of a screening tool for staging of diabetic retinopathy in fundus images

    Science.gov (United States)

    Dhara, Ashis Kumar; Mukhopadhyay, Sudipta; Bency, Mayur Joseph; Rangayyan, Rangaraj M.; Bansal, Reema; Gupta, Amod

    2015-03-01

    Diabetic retinopathy is a condition of the eye of diabetic patients where the retina is damaged because of long-term diabetes. The condition deteriorates towards irreversible blindness in extreme cases of diabetic retinopathy. Hence, early detection of diabetic retinopathy is important to prevent blindness. Regular screening of fundus images of diabetic patients could be helpful in preventing blindness caused by diabetic retinopathy. In this paper, we propose techniques for staging of diabetic retinopathy in fundus images using several shape and texture features computed from detected microaneurysms, exudates, and hemorrhages. The classification accuracy is reported in terms of the area (Az) under the receiver operating characteristic curve using 200 fundus images from the MESSIDOR database. The value of Az for classifying normal images versus mild, moderate, and severe nonproliferative diabetic retinopathy (NPDR) is 0:9106. The value of Az for classification of mild NPDR versus moderate and severe NPDR is 0:8372. The Az value for classification of moderate NPDR and severe NPDR is 0:9750.

  1. Frequency of different grades of retinopathy in type-2 diabetes mellitus patients at Military Hospital Rawalpindi

    International Nuclear Information System (INIS)

    Khan, A.U.; Yasmeen, R.; Habib, M.

    2012-01-01

    To analyse the various types of retinopathy in individuals with type 2 DM. Design: Descriptive study. Place and duration of study: Military Hospital Rawalpindi from January 2010 to July 2010 Methods: One hundred and fifty patients with type 2 DM were studied into for different types of retinopathy, based on history, clinical examination (ophthalmological) and laboratory investigations. Results: Out of 150 patients who fulfilled the criteria for study, 93(62%) were male and 57(38%) were female patients, frequency of retinopathy was 28.67%. The duration of diabetes ranged from 5 to 30 years. The frequency of retinopathy was higher in males as compared to females. The mean age of the patients was 51.10 +- 8.33 years with range 36-77 years. Proliferative retinopathy was seen more in those diabetic patients whose duration of disease was more than 10 years. They also showed poor glycaemic control in the form of raised blood glucose and HbA1C levels. Conclusion: About twenty eight percent of our diabetic patients are suffering from diabetic retinopathy. This can be controlled by early detection and effective treatment both in terms of strict glycemic control and laser photocoagulation, thus decreasing the morbidity and mortality due to this chronic disease. (author)

  2. The role of haemorrhage and exudate detection in automated grading of diabetic retinopathy.

    Science.gov (United States)

    Fleming, Alan D; Goatman, Keith A; Philip, Sam; Williams, Graeme J; Prescott, Gordon J; Scotland, Graham S; McNamee, Paul; Leese, Graham P; Wykes, William N; Sharp, Peter F; Olson, John A

    2010-06-01

    Automated grading has the potential to improve the efficiency of diabetic retinopathy screening services. While disease/no disease grading can be performed using only microaneurysm detection and image-quality assessment, automated recognition of other types of lesions may be advantageous. This study investigated whether inclusion of automated recognition of exudates and haemorrhages improves the detection of observable/referable diabetic retinopathy. Images from 1253 patients with observable/referable retinopathy and 6333 patients with non-referable retinopathy were obtained from three grading centres. All images were reference-graded, and automated disease/no disease assessments were made based on microaneurysm detection and combined microaneurysm, exudate and haemorrhage detection. Introduction of algorithms for exudates and haemorrhages resulted in a statistically significant increase in the sensitivity for detection of observable/referable retinopathy from 94.9% (95% CI 93.5 to 96.0) to 96.6% (95.4 to 97.4) without affecting manual grading workload. Automated detection of exudates and haemorrhages improved the detection of observable/referable retinopathy.

  3. Automatic non-proliferative diabetic retinopathy screening system based on color fundus image.

    Science.gov (United States)

    Xiao, Zhitao; Zhang, Xinpeng; Geng, Lei; Zhang, Fang; Wu, Jun; Tong, Jun; Ogunbona, Philip O; Shan, Chunyan

    2017-10-26

    Non-proliferative diabetic retinopathy is the early stage of diabetic retinopathy. Automatic detection of non-proliferative diabetic retinopathy is significant for clinical diagnosis, early screening and course progression of patients. This paper introduces the design and implementation of an automatic system for screening non-proliferative diabetic retinopathy based on color fundus images. Firstly, the fundus structures, including blood vessels, optic disc and macula, are extracted and located, respectively. In particular, a new optic disc localization method using parabolic fitting is proposed based on the physiological structure characteristics of optic disc and blood vessels. Then, early lesions, such as microaneurysms, hemorrhages and hard exudates, are detected based on their respective characteristics. An equivalent optical model simulating human eyes is designed based on the anatomical structure of retina. Main structures and early lesions are reconstructed in the 3D space for better visualization. Finally, the severity of each image is evaluated based on the international criteria of diabetic retinopathy. The system has been tested on public databases and images from hospitals. Experimental results demonstrate that the proposed system achieves high accuracy for main structures and early lesions detection. The results of severity classification for non-proliferative diabetic retinopathy are also accurate and suitable. Our system can assist ophthalmologists for clinical diagnosis, automatic screening and course progression of patients.

  4. Frizzled-4 Variations Associated with Retinopathy and Intrauterine Growth Retardation: A Potential Marker for Prematurity and Retinopathy.

    Science.gov (United States)

    Dailey, Wendy A; Gryc, Wojciech; Garg, Pooja G; Drenser, Kimberly A

    2015-09-01

    To present the association between mutations affecting the Wnt-signaling receptor protein (FZD4), inherited vitreoretinopathies, and retinopathy of prematurity (ROP). Retrospective analysis of prospective samples at a tertiary referral center. Patients referred to our practice for management of a variety of pediatric vitreoretinopathies were offered participation in an ophthalmic biobank (421 participants with vitreoretinopathies were included in this study). Full-term healthy infants (n = 98) were recruited to the study as controls. Patients with various vitreoretinopathies were prospectively enrolled in an ophthalmic biobank, approved by the Human Investigation Committee at William Beaumont Hospital. Retrospective genetic analysis of the FZD4 gene was performed (Sanger sequencing). Participants with a diagnosis of familial exudative vitreoretinopathy (FEVR), Norrie disease, Coats' disease, bilateral persistent fetal vasculature, and ROP were reviewed for the presence of a FZD4 variant. Data retrieval included status of retinopathy (including staging when possible), gestational age (GA), birth weight (BW) (when available), and family and birth histories. The association of FZD4 variants with the presence of vitreoretinopathy. The sequence variation p.[P33S(;)P168S] is the most prevalent FZD4 variant and is statistically significant for ROP and FEVR (P = 4.6E-04 and P = 2.4E-03, respectively) compared with full-term newborns (P = 1.7E-01). In addition, infants expressing the sequence variation tended to have significantly lower BWs for respective GA (P = 0.04). This suggests that the FZD4 p.[P33S(;)P168S] variant may be a risk factor for retinopathy and restricted intrauterine growth. Testing for FZD4 gene mutations is useful in patients with suspected FEVR and ROP. The relatively high prevalence of the p.[P33S(;)P168S] variant in ROP and intrauterine growth restriction suggests that it also may be a marker for increased risk of developing ROP and preterm birth

  5. Association between assisted reproductive technology and advanced retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    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

  6. 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;}

  7. 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.

  8. Patient preferences in the treatment of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    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

  9. 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.

  10. [Prognostic factors for laser treatment in retinopathy of prematurity].

    Science.gov (United States)

    Talu, Simona; Cormos, Diana; Zaharia, Gabriela; Stefanut, Claudia; Popa, Monica; Lucaci, Daiana Ioana

    2011-01-01

    The paper aims to determine the anatomical results of the eyes treated by laser photocoagulation for "threshold" retinopathy of prematurity (ROP) and to identify the potential risk factors for the unfavorable outcomes. A retrospective study including all the consecutive ROPs that were treated by laser photocoagulation between January the 1st 2006 and September the 1st 2009 has been conducted. The followed criteria has been the anatomical result after the laser treatment. The outcomes have been correlated with: the gestational ages, the birth weights, the moment of treatment (postnatal and post-conceptional ages), the sex of the premature infants, the stage and zone of ROR. RESULTS The total number of prematurely newborns that met the screening criteria for ROP in the above-mentioned period has been 474. Of these, 350 (74%) presented no ROP and the remaining 124 (26%) developed various stages of the disease. Within the ROP group, 54 patients required laser therapy (44% of the retinopathies, representing 11% of all the prematures). The anatomical outcome has been favorable in 84% of the treated eyes, the remaining 16% presenting the progression of ROP The results of the treatment depended on the type of ROP, being significantly better in the classic disease as in the agressive posterior disease (APD) (p < 0.05). The gender also influenced the outcome: the results were better in girls as compared with boys (p < 0.05). The precocity of the laser treatment (evaluated by the postnatal and postconceptional age) has positively influenced the ROP evolution (p < 0.05). Laser photocoagulation has proved its efficacy in the treatment of ROP on our cases. The factors that have negatively influenced the postlaser outcome were: the aggressive posterior disease, the delayed moment of the laser therapy and the male gender.

  11. Neuroimaging findings in children with retinopathy-confirmed cerebral malaria

    International Nuclear Information System (INIS)

    Potchen, Michael J.; Birbeck, Gretchen L.; DeMarco, J. Kevin; Kampondeni, Sam D.; Beare, Nicholas; Molyneux, Malcolm E.; Taylor, Terrie E.

    2010-01-01

    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.

  12. 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.

  13. Deregulation of ocular nucleotide homeostasis in patients with diabetic retinopathy.

    Science.gov (United States)

    Loukovaara, Sirpa; Sandholm, Jouko; Aalto, Kristiina; Liukkonen, Janne; Jalkanen, Sirpa; Yegutkin, Gennady G

    2017-02-01

    Clear signaling roles for ATP and adenosine have been established in all tissues, including the eye. The magnitude of signaling responses is governed by networks of enzymes; however, little is known about the regulatory mechanisms of purinergic signaling in the eye. By employing thin-layer chromatographic assays with 3 H-labeled substrates, this study aimed to evaluate the role of nucleotide homeostasis in the pathogenesis of vitreoretinal diseases in humans. We have identified soluble enzymes ecto-5'-nucleotidase/CD73, adenylate kinase-1, and nucleoside diphosphate kinase in the vitreous fluid that control active cycling between pro-inflammatory ATP and anti-inflammatory adenosine. Strikingly, patients with proliferative form of diabetic retinopathy (DR) had higher adenylate kinase activity and ATP concentration, when compared to non-proliferative DR eyes and non-diabetic controls operated for rhegmatogenous retinal detachment, macular hole, and pucker. The non-parametric correlation analysis revealed positive correlations between intravitreal adenylate kinase and concentrations of ATP, ADP, and other angiogenic (angiopoietins-1 and -2), profibrotic (transforming growth factor-β1), and proteolytic (matrix metalloproteinase-9) factors but not erythropoietin and VEGF. Immunohistochemical staining of postmortem human retina additionally revealed selective expression of ecto-5'-nucleotidase/CD73 on the rod-and-cone-containing photoreceptor cells. Collectively, these findings provide novel insights into the regulatory mechanisms that influence purinergic signaling in diseased eye and open up new possibilities in the development of enzyme-targeted therapeutic approaches for prevention and treatment of DR. Ecto-5'-nucleotidase/CD73 and adenylate kinase-1 circulate in human vitreous fluid. Adenylate kinase activity is high in diabetic eyes with proliferative retinopathy. Diabetic eyes display higher intravitreal ATP/ADP ratio than non-diabetic controls. Soluble adenylate

  14. 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.

  15. Visual functions and disability in diabetic retinopathy patients.

    Science.gov (United States)

    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.

  16. The role of serum apelin in retinopathy of prematurity

    Directory of Open Access Journals (Sweden)

    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

  17. Impairment of Colour Vision in Diabetes with No Retinopathy: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study (SNDREAMS- II, Report 3.

    Directory of Open Access Journals (Sweden)

    Laxmi Gella

    Full Text Available To assess impairment of colour vision in type 2 diabetics with no diabetic retinopathy and elucidate associated risk factors in a population-based cross-sectional study.This is part of Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular-genetics Study (SN-DREAMS II which was conducted between 2007-2010. FM 100 hue-test was performed in 253 subjects with no clinical evidence of diabetic retinopathy. All subjects underwent detailed ophthalmic evaluation including cataract grading using LOCS III and 45° 4-field stereoscopic fundus photography. Various ocular and systemic risk factors for impairment of colour vision (ICV were assessed in subjects with diabetes but no retinopathy. P value of < 0.05 was considered statistically significant.The mean age of the study sample was 57.08 ± 9.21 (range: 44-86 years. Gender adjusted prevalence of ICV among subjects with diabetes with no retinopathy was 39.5% (CI: 33.5-45.5. The mean total error score in the study sample was 197.77 ± 100 (range: 19-583. The risk factors for ICV in the study were women OR: 1.79 (1.00-3.18, increased resting heart rate OR: 1.04 (1.01-1.07 and increased intraocular pressure OR: 1.12 (1.00-1.24. Significant protective factor was serum high-density lipoprotein OR: 0.96 (0.93-0.99.Acquired ICV is an early indicator of neurodegenerative changes in the retina. ICV found in diabetic subjects without retinopathy may be of non-vascular etiology.

  18. [The German program for disease management guidelines: type 2 diabetes--diabetic retinopathy/maculopathy guideline 2006. Short review].

    Science.gov (United States)

    Ollenschläger, Günter; Kopp, Ina; Thole, Henning; Lelgemann, Monika

    2007-02-15

    In Germany, the first national consensus between six medical scientific associations on evidence-based recommendations for prevention and therapy of retinopathy/maculopathy in type 2 diabetes was reached in fall 2006. The recommendations' main sources are the NICE Retinopathy Guideline 2002, and existing German guidelines and reviews of recent scientific evidence. The article gives an overview on authors, sources, and key recommendations of the German National Disease Management Guideline Type 2 Diabetes-Retinopathy/Maculopathy 2006 (www.diabetes.versorgungsleitlinien.de).

  19. Vasoinhibins regulate the inner and outer blood-retinal barrier and limit retinal oxidative stress.

    Science.gov (United States)

    Arredondo Zamarripa, David; Díaz-Lezama, Nundehui; Meléndez García, Rodrigo; Chávez Balderas, Jesús; Adán, Norma; Ledesma-Colunga, Maria G; Arnold, Edith; Clapp, Carmen; Thebault, Stéphanie

    2014-01-01

    Vasoinhibins are prolactin fragments present in the retina, where they have been shown to prevent the hypervasopermeability associated with diabetes. Enhanced bradykinin (BK) production contributes to the increased transport through the blood-retina barrier (BRB) in diabetes. Here, we studied if vasoinhibins regulate BRB permeability by targeting the vascular endothelium and retinal pigment epithelium (RPE) components of this barrier. Intravitreal injection of BK in male rats increased BRB permeability. Vasoinhibins prevented this effect, as did the B2 receptor antagonist Hoe-140. BK induced a transient decrease in mouse retinal and brain capillary endothelial monolayer resistance that was blocked by vasoinhibins. Both vasoinhibins and the nitric oxide (NO) synthase inhibitor L-NAME, but not the antioxidant N-acetyl cysteine (NAC), blocked the transient decrease in bovine umbilical vein endothelial cell (BUVEC) monolayer resistance induced by BK; this block was reversed by the NO donor DETANONOate. Vasoinhibins also prevented the BK-induced actin cytoskeleton redistribution, as did L-NAME. BK transiently decreased human RPE (ARPE-19) cell monolayer resistance, and this effect was blocked by vasoinhibins, L-NAME, and NAC. DETANONOate reverted the blocking effect of vasoinhibins. Similar to BK, the radical initiator Luperox induced a reduction in ARPE-19 cell monolayer resistance, which was prevented by vasoinhibins. These effects on RPE resistance coincided with actin cytoskeleton redistribution. Intravitreal injection of vasoinhibins reduced the levels of reactive oxygen species (ROS) in retinas of streptozotocin-induced diabetic rats, particularly in the RPE and capillary-containing layers. Thus, vasoinhibins reduce BRB permeability by targeting both its main inner and outer components through NO- and ROS-dependent pathways, offering potential treatment strategies against diabetic retinopathies.

  20. Vasoinhibins regulate the inner and outer blood-retinal barrier and limit retinal oxidative stress

    Directory of Open Access Journals (Sweden)

    David eArredondo Zamarripa

    2014-10-01

    Full Text Available Vasoinhibins are prolactin fragments present in the retina, where they have been shown to prevent the hypervasopermeability associated with diabetes. Enhanced bradykinin (BK production contributes to the increased transport through the blood-retina barrier (BRB in diabetes. Here, we studied if vasoinhibins regulate BRB permeability by targeting the vascular endothelium and retinal pigment epithelium (RPE components of this barrier. Intravitreal injection of BK in male rats increased BRB permeability. Vasoinhibins prevented this effect, as did the B2 receptor antagonist Hoe-140. BK induced a transient decrease in mouse retinal and brain capillary endothelial monolayer resistance that was blocked by vasoinhibins. Both vasoinhibins and the nitric oxide (NO synthase inhibitor L-NAME, but not the antioxidant N-acetyl cysteine (NAC, blocked the transient decrease in bovine umbilical vein endothelial cell (BUVEC monolayer resistance induced by BK; this block was reversed by the NO donor DETANONOate. Vasoinhibins also prevented the BK-induced actin cytoskeleton redistribution, as did L-NAME. BK transiently decreased human RPE (ARPE-19 cell monolayer resistance, and this effect was blocked by vasoinhibins, L-NAME, and NAC. DETANONOate reverted the blocking effect of vasoinhibins. Similar to BK, the radical initiator Luperox induced a reduction in ARPE-19 cell monolayer resistance, which was prevented by vasoinhibins. These effects on RPE resistance coincided with actin cytoskeleton redistribution. Intravitreal injection of vasoinhibins reduced the levels of reactive oxygen species (ROS in retinas of streptozotocin-induced diabetic rats, particularly in the RPE and capillary-containing layers. Thus, vasoinhibins reduce BRB permeability by targeting both its main inner and outer components through NO- and ROS-dependent pathways, offering potential treatment strategies against diabetic retinopathies.

  1. 46 CFR 154.170 - Outer hull steel plating.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false Outer hull steel plating. 154.170 Section 154.170... STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES Design, Construction and Equipment Hull Structure § 154.170 Outer hull steel plating. (a) Except as required in paragraph (b) of this section, the...

  2. Outer space and nuclear deterrence: problems and prospects

    International Nuclear Information System (INIS)

    Gasparini Alves, P.

    1993-01-01

    The presentation deals with the role of outer-space applications and prospects for near future developments in nuclear deterrence. Outer space capabilities of United Sates, Russian Federation, Belarus, Kazakhstan, Ukraine, China, and United Kingdom as well as other states are analyzed. Conceptual problems of offensive and defensive doctrines are reviewed together with legal implications

  3. Long-Lived Glass Mirrors For Outer Space

    Science.gov (United States)

    Bouquet, Frank L.; Maag, Carl R.; Heggen, Philip M.

    1988-01-01

    Paper summarizes available knowledge about glass mirrors for use in outer space. Strengths and weaknesses of various types of first and second reflective surfaces identified. Second-surface glass mirrors used in outer space designed to different criteria more stringent for terrestrial mirrors. Protons, electrons, cosmic rays, meteorites, and orbiting space debris affect longevities of components. Contamination also factor in space.

  4. Newborns' Face Recognition: Role of Inner and Outer Facial Features

    Science.gov (United States)

    Turati, Chiara; Macchi Cassia, Viola; Simion, Francesca; Leo, Irene

    2006-01-01

    Existing data indicate that newborns are able to recognize individual faces, but little is known about what perceptual cues drive this ability. The current study showed that either the inner or outer features of the face can act as sufficient cues for newborns' face recognition (Experiment 1), but the outer part of the face enjoys an advantage…

  5. Proteomics of Aggregatibacter actinomycetemcomitans Outer Membrane Vesicles.

    Directory of Open Access Journals (Sweden)

    Thomas Kieselbach

    Full Text Available Aggregatibacter actinomycetemcomitans is an oral and systemic pathogen associated with aggressive forms of periodontitis and with endocarditis. Outer membrane vesicles (OMVs released by this species have been demonstrated to deliver effector proteins such as cytolethal distending toxin (CDT and leukotoxin (LtxA into human host cells and to act as triggers of innate immunity upon carriage of NOD1- and NOD2-active pathogen-associated molecular patterns (PAMPs. To improve our understanding of the pathogenicity-associated functions that A. actinomycetemcomitans exports via OMVs, we studied the proteome of density gradient-purified OMVs from a rough-colony type clinical isolate, strain 173 (serotype e using liquid chromatography-tandem mass spectrometry (LC-MS/MS. This analysis yielded the identification of 151 proteins, which were found in at least three out of four independent experiments. Data are available via ProteomeXchange with identifier PXD002509. Through this study, we not only confirmed the vesicle-associated release of LtxA, and the presence of proteins, which are known to act as immunoreactive antigens in the human host, but we also identified numerous additional putative virulence-related proteins in the A. actinomycetemcomitans OMV proteome. The known and putative functions of these proteins include immune evasion, drug targeting, and iron/nutrient acquisition. In summary, our findings are consistent with an OMV-associated proteome that exhibits several offensive and defensive functions, and they provide a comprehensive basis to further disclose roles of A. actinomycetemcomitans OMVs in periodontal and systemic disease.

  6. EPIDEMIOLOGICAL STUDY OF DIABETIC RETINOPATHY IN DIABETES MELLITUS PATIENTS IN TERTIARY CARE CENTRE

    Directory of Open Access Journals (Sweden)

    Bhaskar

    2016-02-01

    Full Text Available OBJECTIVE The study objective was to examine the effect of glycaemic control and variations on the incidence and progression of diabetic retinopathy (DR among the diabetes mellitus patients visiting Medicine and Ophthalmology OPD Sapthagiri Medical college, Bangalore. MATERIALS AND METHODS 10 patients with type 1 diabetes mellitus, and 70 persons with type 2 diabetes mellitus, visiting the Medicine OPD of Sapthagiri Medical College and referred to Ophthalmology department of the above to detect the Diabetic Retinopathy changes in a diabetes mellitus management programme conducted for 3 months in Bangalore, participated in the study. Patients who were followed up for 6 months the same above were also included in the study. Analyses were conducted to assess the relationship between the risk factors, incidence and progression of Diabetic Retinopathy among Diabetes Mellitus patients and management. MAIN OUTCOME MEASURES To determine the risk factors associated with it, stage of retinopathy diagnosed at presentation, management of it, and final visual outcome. The prevention is by strict glycaemic control, prompt use of anti-diabetic drugs and regular exercises. These included age and gender-adjusted prevalence of diabetes and diabetic retinopathy, 1 and correlation of prevalence with history-based risk factors. RESULTS The three months cumulative incidence of DR was 58 %in type I diabetes mellitus and 42 % among type II Diabetes mellitus. After controlling for known risk factors for DR,1 a high baseline haemoglobin A1c (HbA1c, ethnicity, age, type of diabetes mellitus, duration were associated with the incidence of referable DR in patients with type 1 and type 2 diabetes mellitus. The age- and gender-adjusted prevalence rate of diabetes in urban Bangalore 28.2% (95% confidence interval [CI], and the prevalence of diabetic retinopathy in general population was 3.5% (95% CI. The prevalence of diabetic retinopathy in the population with diabetes

  7. 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, Nish; Porta, Massimo; Klein, Ronald

    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 ...

  8. Regional differences in the prevalence of diabetic retinopathy: a multi center study in Brazil.

    Science.gov (United States)

    Drummond, Karla Rezende Guerra; Malerbi, Fernando Korn; Morales, Paulo Henrique; Mattos, Tessa Cerqueira Lemos; Pinheiro, André Araújo; Mallmann, Felipe; Perez, Ricardo Vessoni; Leal, Franz Schubert Lopes; de Melo, Laura Gomes Nunes; Gomes, Marília Brito

    2018-01-01

    Diabetic retinopathy has a significant impact in every healthcare system. Despite that fact, there are few accurate estimates in the prevalence of DR in Brazil's different geographic regions, particularly proliferative DR and diabetic macular edema. This study aims to determine the prevalence of diabetic retinopathy in Brazil's five continental regions and its determinant factors. This multi center, cross-sectional, observational study, conducted between August 2011 and December 2014, included patients with type 1 diabetes from the 5 Brazilian geographic regions (South, Southeast, North, Northeast and Midwest). During a clinical visit, a structured questionnaire was applied, blood sampling was collected and each patient underwent mydriatic binocular indirect ophthalmoscopy evaluation. Data was obtained from 1644 patients, aged 30.2 ± 12 years (56.1% female, 54.4% Caucasian), with a diabetes duration of 15.5 ± 9.3 years. The prevalence of diabetic retinopathy was 242 (36.1%) in the Southeast, 102 (42.9%) in the South, 183 (29.9%) in the North and Northeast and 54 (41.7%) in the Midwest. Multinomial regression showed no difference in the prevalence of non-proliferative diabetic retinopathy in each geographic region, although, prevalence of proliferative diabetic retinopathy (p = 0.022), and diabetic macular edema (p = 0.003) was higher in the Midwest. Stepwise analyses reviled duration of diabetes, level of HbA1c and hypertension as independent variables. The prevalence of non proliferative diabetic retinopathy in patients with type 1 diabetes was no different between each geographic region of Brazil. The Midwest presented higher prevalence of proliferative diabetic retinopathy and diabetic macular edema. Duration of DM and glycemic control is of central importance to all. Hypertension is another fundamental factor to every region, at special in the South and Southeast. Glycemic control and patients in social and economic vulnerability deserves

  9. 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.

  10. Following-up study on radiation-induced retinopathy in nasopharyngeal carcinoma

    International Nuclear Information System (INIS)

    Zhang Qingping; Zhou Weiwei; Xie Chengxi; Huang Guangwu; Ruan Lin

    2003-01-01

    Objective: To investigate the frequency of ocular complication and the quality of patient's life after radiation therapy in nasopharyngeal carcinoma (NPC). Methods: 254 NPC patients who initially received radiation were followed and analysed. Visual acuity, automational visual field, slit-lamp microscopic findings, pattern visual evoked potential (P-VEP) and fundal findings were determined before, during and after radiation therapy. The severity of retinal impairment was assessed according to the international criteria on late tissue effects. Results: The radiation dose was more than 70 Gy in 241 (94.9%)NPC patients, giving a radiation retinopathy incidence of 8.7% (22) patients after a mean of 46.8±14.4 months. After being diagnosed as radiation retinopathy, 16 patients received combined-modality therapy of the modern medicine and Chinese traditional medicine. The disease condition was controlled in 56%(9) patients but progressed into optic neuropathy in 7 patients, 3 of whom developed radiation encephalopathy in 14 to 20 months after onset of retinopathy. The morbidity of radiation retinopathy was not associated with the patient's age, but was related to the radiation dose. The retinopathy rate was as high as 13.6% in the 75-79 Gy group, which is significantly higher than 5.6% in the 70-74 Gy group (P<0.05). Conclusions: Radiation retinopathy in NPC patients is related to the radiation dose and individual difference in radiosensitivity. Optic nerve and brain damage are already present when clinical manifestations of radiation retinopathy occur. Therefore CT and MRI of the brain should be carried out. The importance of long-term follow-up should be stressed for early diagnosis and treatment of radiation sequelae for the sake of complete return of visual function and good quality of life

  11. [Outcomes of surgical management of retinopathy of prematurity--an overview].

    Science.gov (United States)

    Kuprjanowicz, Leszek; Kubasik-Kładna, Katarzyna; Modrzejewska, Monika

    2014-01-01

    According to the guidelines by the ETROP (Early Treatment for Retinopathy of Prematurity) study group, laser therapy is the gold standard in the treatment of retinopathy of prematurity. However, progression of the disease is seen in 12% of eyes despite the treatment. Since there is no causal treatment, new therapies of retinopathy of prematurity, are continually sought, such as anti-VEGF agents, beta-blockers, or insulin-like growth factor gene therapy. In cases with concomitant retinal detachment, surgery is performed. The standard therapy for retinopathy of prematurity stages 4-5 involves pars plicata vitrectomy and lensectomy (stage 5), ab externo surgery (scleral buckling) and lens-sparing vitrectomy (some cases of stage 4). Classic vitrectomy with lensectomy is reserved only for cases with advanced retinal tractions, retina-lens apposition or for cases of intraoperative lens damage during the lens-sparing vitrectomy. The ab externo surgery does not eliminate vitreous tractions, but it stabilises the neovascular membrane activity (transforming it into a scar). The indication for this type of operation is stage 4 retinopathy of prematurity with peripheral proliferations, except for the posterior--aggressive form of retinopathy of prematurity. Many papers have been published on combined therapy involving vitrectomy and conservative treatment. In conclusion, optimal timing of surgical intervention is difficult to determine in stages 4 and 5, because the anatomical and functional outcomes in stage 5 are unfavourable. Both, ab externo surgery and vitrectomy tend to produce poor macular vision in eyes with advanced retinopathy of prematurity, therefore surgical intervention at stage 4 just before the local macular retinal detachment provides better anatomical and functional outcomes.

  12. Screening in Primary Care for Diabetic Retinopathy, Maculopathy and Visual Loss in South Africa.

    Science.gov (United States)

    Webb, Elizabeth M; Rheeder, Paul; Roux, Polla

    2016-01-01

    The aim of the study was to determine the prevalence of diabetic retinopathy, maculopathy and visual loss in primary care patients and to identify associated risk factors. We conducted a cluster randomised trial at primary care clinics in the Tshwane district in South Africa. Grades of retinopathy and maculopathy (with fundus camera) and visual acuity (Snellen chart) were assessed and, using mobile screening and teleophthalmology, clinical and biochemical testing was conducted to obtain information about glycaemic control and microvascular complications. The prevalence rates for any retinopathy, preproliferative retinopathy and proliferative retinopathy were 24.9, 19.5 and 5.5%, respectively. The prevalence rates of diabetic maculopathy, observable maculopathy and referable maculopathy were 20.8, 11.8 and 9.0%, respectively. The presence of retinopathy was associated with high body mass index, systolic blood pressure, being on insulin treatment, high HbA1c and the presence of neuropathy. High systolic blood pressure, being on insulin treatment, high HbA1c level and high low-density lipoprotein cholesterol level as well as the presence of albuminuria were significant in predicting any diabetic maculopathy. Laser photocoagulation was given to 8.3% of patients from the mobile unit and 12% of patients were referred to the nearest hospital with an outpatient eye clinic for follow-up treatment of various other eye conditions. Using the WHO categories, the study found that 78.1% of diabetes patients had normal vision, 19.3% were visually impaired and 2.2% were severely impaired or blind. High prevalence rates for diabetic retinopathy, maculopathy and visual loss were found and associations were identified. © 2016 S. Karger AG, Basel.

  13. Screening for diabetic retinopathy in rural area using single-field, digital fundus images.

    Science.gov (United States)

    Ruamviboonsuk, Paisan; Wongcumchang, Nattapon; Surawongsin, Pattamaporn; Panyawatananukul, Ekchai; Tiensuwan, Montip

    2005-02-01

    To evaluate the practicability of using single-field, 2.3 million-pixel, digital fundus images for screening of diabetic retinopathy in rural areas. All diabetic patients who regularly attended the diabetic clinic at Kabcheang Community Hospital, located at 15 kilometers from the Thailand-Cambodia border, were appointed to the hospital for a 3-day diabetic retinopathy screening programme. The fundi of all patients were captured in single-field, 45 degrees, 2.3 million-pixel images using nonmydriatic digital fundus camera and then sent to a reading center in Bangkok. The fundi were also examined through dilated pupils by a retinal specialist at this hospital. The grading of diabetic retinopathy from two methods was compared for an exact agreement. The average duration of single digital fundus image capture was 2 minutes. The average file size of each image was 750 kilobytes. The average duration of single image transmission to a reading center in Bangkok via satellite was 3 minutes; via a conventional telephone line was 8 minutes. Of all 150 patients, 130 were assessed for an agreement between dilated fundus examination and digital fundus images in diagnosis of diabetic retinopathy. The exact agreement was 0.87, the weighted kappa statistics was 0.74. The sensitivity of digital fundus images in detecting diabetic retinopathy was 80%, the specificity was 96%. For diabetic macular edema the exact agreement was 0.97, the weighted kappa was 0.43, the sensitivity was 43%, and the specificity was 100%. The image capture of the nonmydriatic digital fundus camera is suitable for screening of diabetic retinopathy and single-field digital fundus images are potentially acceptable tools for the screening. The real-time image transmission via telephone lines to remote reading center, however, may not be practical for routine diabetic retinopathy screening in rural areas.

  14. Prevalence of diabetic retinopathy in screening-detected diabetes mellitus: results from the Gutenberg Health Study (GHS).

    Science.gov (United States)

    Ponto, Katharina A; Koenig, Jochem; Peto, Tunde; Lamparter, Julia; Raum, Philipp; Wild, Philipp S; Lackner, Karl J; Pfeiffer, Norbert; Mirshahi, Alireza

    2016-09-01

    Individuals with type 2 diabetes mellitus may experience an asymptomatic period of hyperglycaemia, and complications may already be present at the time of diagnosis. We aimed to determine the prevalence of diabetic retinopathy in patients with newly diagnosed (screening-detected) type 2 diabetes. The Gutenberg Health Study is a population-based study with 15,010 participants aged between 35 and 74 years. We determined the weighted prevalence of diabetic retinopathy by assessing fundus photographs. Screening-detected type 2 diabetes was defined as an HbA1c concentration of 6.5% (47.5 mmol/mol) or more, no medical diagnosis of diabetes and no intake of insulin or oral glucose-lowering agents. Of 14,948 participants, 1377 (9.2%) had diabetes mellitus. Of these, 347 (25.2%) had newly diagnosed type 2 diabetes detected by the screening. Overall, the weighted prevalence of screening-detected type 2 diabetes was 2.1%. Fundus photos were evaluable for 285 (82.1%) participants with newly diagnosed diabetes. The weighted prevalence of diabetic retinopathy in screening-detected type 2 diabetes was 13.0%; 12% of participants had a mild non-proliferative diabetic retinopathy and 0.6% had a moderate non-proliferative diabetic retinopathy. Diabetic retinopathy was proliferative in 0.3%. No cases of severe non-proliferative diabetic retinopathy or diabetic maculopathy were found. Thirty (14.9%) of 202 and six (7.2%) of 83 individuals with and without concomitant arterial hypertension, respectively, had diabetic retinopathy (OR 2.54, 95% CI 1.06, 7.14). Visual acuity did not differ between individuals with and without diabetic retinopathy . In this large European study, the prevalence of diabetic retinopathy in screening-detected type 2 diabetes was 13%. Only a very small proportion of participants with detected diabetic retinopathy needed treatment.

  15. Relation between fasting glucose and retinopathy for diagnosis of diabetes: three population-based cross-sectional studies.

    Science.gov (United States)

    Wong, Tien Y; Liew, Gerald; Tapp, Robyn J; Schmidt, Maria Inês; Wang, Jie Jin; Mitchell, Paul; Klein, Ronald; Klein, Barbara E K; Zimmet, Paul; Shaw, Jonathan

    2008-03-01

    The WHO and American Diabetes Association criteria for diagnosing diabetes mellitus assume the presence of a glycaemic threshold with high sensitivity for identifying retinopathy. However, this assumption is based on data from three previous studies that had important limitations in detecting retinopathy. We aimed to provide updated data for the relation between fasting plasma glucose (FPG) and retinopathy, and to assess the diagnostic accuracy of current FPG thresholds in identifying both prevalent and incident retinopathy. We examined the data from three cross-sectional adult populations: those in the Blue Mountains Eye Study (BMES, Australia, n=3162), the Australian Diabetes, Obesity and Lifestyle Study (AusDiab, Australia, n=2182), and the Multi-Ethnic Study of Atherosclerosis (MESA, USA, n=6079). Retinopathy was diagnosed from multiple retinal photographs of each eye, and graded according to the modified Airlie House Classification system. Plasma glucose concentrations were measured from fasting venous blood samples. The overall prevalence of retinopathy was 11.5% in BMES (95% CI 10.4-12.6%), 9.6% in AusDiab (8.4-10.9), and 15.8% in MESA (14.9-16.7). However, we found inconsistent evidence of a uniform glycaemic threshold for prevalent and incident retinopathy, with analyses suggesting a continuous relation. The widely used diabetes FPG cutoff of 7.0 mmol/L or higher had sensitivity less than 40% (range 14.8-39.1) for detecting retinopathy, with specificity between 80.8% and 95.8%. The area under receiver operating characteristic curves for FPG and retinopathy was low and ranged from 0.56 to 0.61. We saw no evidence of a clear and consistent glycaemic threshold for the presence or incidence of retinopathy across different populations. The current FPG cutoff of 7.0 mmol/L used to diagnose diabetes did not accurately identify people with and without retinopathy. These findings suggest that the criteria for diagnosing diabetes could need reassessment.

  16. ULTRAHIGH SPEED SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF RETINAL AND CHORIOCAPILLARIS ALTERATIONS IN DIABETIC PATIENTS WITH AND WITHOUT RETINOPATHY.

    Science.gov (United States)

    Choi, WooJhon; Waheed, Nadia K; Moult, Eric M; Adhi, Mehreen; Lee, ByungKun; De Carlo, Talisa; Jayaraman, Vijaysekhar; Baumal, Caroline R; Duker, Jay S; Fujimoto, James G

    2017-01-01

    To investigate the utility of ultrahigh speed, swept source optical coherence tomography angiography in visualizing retinal microvascular and choriocapillaris (CC) changes in diabetic patients. The study was prospective and cross-sectional. A 1,050 nm wavelength, 400 kHz A-scan rate swept source optical coherence tomography prototype was used to perform volumetric optical coherence tomography angiography of the retinal and CC vasculatures in diabetic patients and normal subjects. Sixty-three eyes from 32 normal subjects, 9 eyes from 7 patients with proliferative diabetic retinopathy, 29 eyes from 16 patients with nonproliferative diabetic retinopathy, and 51 eyes from 28 diabetic patients without retinopathy were imaged. Retinal and CC microvascular abnormalities were observed in all stages of diabetic retinopathy. In nonproliferative diabetic retinopathy and proliferative diabetic retinopathy, optical coherence tomography angiography visualized a variety of vascular abnormalities, including clustered capillaries, dilated capillary segments, tortuous capillaries, regions of capillary dropout, reduced capillary density, abnormal capillary loops, and foveal avascular zone enlargement. In proliferative diabetic retinopathy, retinal neovascularization above the inner limiting membrane was visualized. Regions of CC flow impairment in patients with proliferative diabetic retinopathy and nonproliferative diabetic retinopathy were also observed. In 18 of the 51 of eyes from diabetic patients without retinopathy, retinal mircrovascular abnormalities were observed and CC flow impairment was found in 24 of the 51 diabetic eyes without retinopathy. The ability of optical coherence tomography angiography to visualize retinal and CC microvascular abnormalities suggests it may be a useful tool for understanding pathogenesis, evaluating treatment response, and earlier detection of vascular abnormalities in patients with diabetes.

  17. Sex differences in risk factors for retinopathy in non-diabetic men and women: the Tromsø Eye Study.

    Science.gov (United States)

    Bertelsen, Geir; Peto, Tunde; Lindekleiv, Haakon; Schirmer, Henrik; Solbu, Marit D; Toft, Ingrid; Sjølie, Anne Katrin; Njølstad, Inger

    2014-06-01

      To determine the prevalence and risk factors for retinopathy in a nondiabetic population.   The study population included 5869 participants without diabetes aged 38-87 years from the Tromsø Eye Study, a substudy of the population-based Tromsø Study in Norway. Retinal images from both eyes were graded for retinopathy. We collected data on risk factors from self-report questionnaires, clinical examinations, laboratory measurements and case note reviews. The cross-sectional relationship between potential risk factors and retinopathy was assessed using logistic regression analysis.   The overall prevalence of retinopathy was 14.8%. Men had a higher prevalence of retinopathy compared with women (15.9% versus 14.0%, p=0.04). In men, retinopathy was associated with hypertension (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.24-2.04) and HbA1c (OR per %, 1.41; 95% CI, 1.01-1.96). In women, retinopathy was associated with age (OR per 10 years, 1.32; 95% CI, 1.14-1.52), log-transformed urinary albumin excretion (OR per log unit, 1.46; 95% CI, 1.14-1.87) and hypertension (OR, 1.36; 95% CI, 1.08-1.71). In women, retinopathy was associated with very low levels of urinary albumin excretion (urinary albumin/creatinine ratio >0.43 mg/mmol).   This study confirms results from previous studies on the strong association between blood pressure and retinopathy. A novel finding is the sex differences in risk factors for retinopathy, suggesting a sex difference in the pathogenesis leading to retinopathy. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  18. Prevention of an arms race in outer space

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    The space age may be the to have begun in 1957, when for the first time a man-made object was lofted into orbit round the Earth. Since that date, the new problems of outer space have been discussed in the United Nations, particularly in the General Assembly, in the Committee on the Peaceful Uses of Outer Space and its subsidiary bodies, and in the Conference on Disarmament. The discussions have contributed to the conclusion of a number of international agreements concerning both military and peaceful aspects of the use of outer space. This paper reports that according to the 1967 Treaty on Principles Governing the Activities of States in the Exploration and Use of Outer Space, including the Moon and Other Celestial Bodies, known as the outer space Treaty, outer space, including the moon and other celestial bodies, is not subject to national appropriation by claim of sovereignty, by means of use or occupation, or by any other means (article II), and the parties undertake not to place in orbit around the earth any objects carrying nuclear weapons or any other kinds of weapons of ass destruction, install such weapons on celestial bodies, or station such weapons in outer space in any other manner (article IV). Detailed norms for States' actions in this environment are included in the 1979 Agreement Governing the Activities of States on the Moon and other Celestial Bodies to ensure that the Moon and other celestial bodies within the solar system, other than Earth, are used exclusively for peaceful purposes

  19. Role of VEGF-A in endothelial phenotypic shift in human diabetic retinopathy and VEGF-A-induced retinopathy in monkeys

    NARCIS (Netherlands)

    Hofman, P.; Blaauwgeers, H. G.; Vrensen, G. F.; Schlingemann, R. O.

    2001-01-01

    The endothelium-specific antigen PAL-E, associated with transport vesicles in non-barrier endothelium, is almost absent from barrier capillaries in the normal brain and retina. We have recently demonstrated that only leaking retinal capillaries in diabetic retinopathy (DR) in humans

  20. Visual acuity at 10 years in Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study eyes: effect of retinal residua of retinopathy of prematurity.

    Science.gov (United States)

    Dobson, Velma; Quinn, Graham E; Summers, C Gail; Hardy, Robert J; Tung, Betty

    2006-02-01

    To describe recognition (letter) acuity at age 10 years in eyes with and without retinal residua of retinopathy of prematurity (ROP). Presence and severity of ROP residua were documented by a study ophthalmologist. Masked testers measured monocular recognition visual acuity (Early Treatment of Diabetic Retinopathy Study) when the children were 10 years old. Two hundred forty-seven of 255 surviving Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) randomized trial patients participated. A reference group of 102 of 104 Philadelphia-based CRYO-ROP study participants who did not develop ROP was also tested. More severe retinal residua were associated with worse visual acuity, regardless of whether retinal ablation was performed to treat the severe acute-phase ROP. However, within each ROP residua category, there was a wide range of visual acuity results. This is the first report of the relation between visual acuity (Early Treatment of Diabetic Retinopathy Study charts) and structural abnormalities related to ROP in a large group of eyes that developed threshold ROP in the perinatal period. Visual deficits are greater in eyes with more severe retinal residua than in eyes with mild or no residua. However, severity of ROP residua does not predict the visual acuity of an individual eye because within a single residua category, acuity may range from near normal to blind.