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Diabetic Retinopathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Diagnosis of proliferative diabetic retinopathy is by funduscopy. The level of the disease may be graded via color fundus photography. To determine extent of the disease, guide treatment, and monitor results of treatment, fluorescein angiography is indicated. Optical coherence tomography is used to assess the severity of macular edema and the response to treatment. Ultra-wide-field imaging is used to screen for and detect diabetic retinopathy, along with ultra-wide-field angiography. All patients with diabetes must have an annual dilated ophthalmologic examination, and pregnant diabetic women must be examined every trimester. An ophthalmologic referral is needed if there is blurred vision or other vision symptoms.
Swarm Intelligence and Evolutionary Algorithms for Diabetic Retinopathy Detection
Published in Sandeep Kumar, Anand Nayyar, Anand Paul, Swarm Intelligence and Evolutionary Algorithms in Healthcare and Drug Development, 2019
Sachin Bhandari, Radhakrishna Rambola, Rajani Kumari
DR is a micro-angiopathy that shows features of microvascular occlusion and leakage, and it is important to be familiar with the signs of occlusion and leakage in the retina to understand the pathogenesis and signs of DR. DR pathogenesis comprises capillaropathy, haematological changes, microvascular occlusion [1]. So, what happens to blood vessels in the presence of diabetes, high blood sugar causes several things to occur in the blood vessels, there capillaropathy where the blood vessels walls degenerate, haematological changes where deformity of blood cells occurs and thickening of the blood happens and finally microvascular occlusion, causes irregular blood flow and decreased oxygen. Classification of DR are given as follows: Non-proliferative DR(NPDR) (background DR)MaculopathyPre-proliferativeProliferative1. Non-proliferative Diabetic Retinopathy
Surgical treatment of macular holes
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Kamal Kishore, Gholam A Peyman
In 1991, Kelly and Wendel65 published the first report of successful closure of idiopathic macular holes in 30 of 52 eyes (58%) with pars plana vitrectomy, removal of adherent cortical vitreous, stripping of ERMs, air–fluid exchange, and tamponade with a nonexpansile concentration of sulfur hexafluoride gas. Vision improved by 2 or more lines in 22 of 30 (73.3%) eyes in which a macular hole was successfully closed. Several authors have since reported surgical results with closure of macular holes ranging from 58% to 100%, with improvement in vision by 3–5 lines in most patients with successful hole closure.66–;84 Surgical treatment is currently indicated for stage 2, 3, and 4 macular holes. Visual improvement depends on successful closure of the hole and the duration of symptoms. Eyes with symptoms for less than 6 months have better visual prognosis. Improved anatomic and functional success is generally associated with smaller hole size, shorter duration of symptoms, and better initial acuity.66,80,81,85,86 Visual improvement for up to 3 years after surgery has been noted after successful macular hole surgery.83,84 Patients with proliferative diabetic retinopathy may have a worse prognosis.87 Good anatomic, but poorer visual acuity, results have been obtained in patients with high myopia.88 Patients with prominent macular drusen appear to do well both anatomically and visually after macular hole surgery.89
Potential molecular mechanism of action of sodium-glucose co-transporter 2 inhibitors in the prevention and management of diabetic retinopathy
Published in Expert Review of Ophthalmology, 2022
Lia Meuthia Zaini, Arief S Kartasasmita, Tjahjono D Gondhowiardjo, Maimun Syukri, Ronny Lesmana
The management of DR is developing quite rapidly. The use of laser photocoagulation and intravitreal anti-vascular endothelial growth factor (VEGF) injection helps DR patients with or without diabetic macular edema (DME). However, complications can often result in vision loss in high-risk proliferative diabetic retinopathy (PDR). Therefore, effective control of blood glucose, blood pressure, and cholesterol levels is still needed, which can help reduce the risk of DR. In addition, other therapies are still needed that can also act as protection so that DR can be avoided and treatment can be more optimal. SGLT2 inhibitors, which are reported to have a cardiac-kidney protective effect, are also thought to have an impact on preventing DR (Figure 1). There are several works of literature covering the clinical trial results of some SGLT2 inhibitors and their effect on DR. The summary of the selected articles is shown in Table 1.
Quantile-specific heritability of serum growth factor concentrations
Published in Growth Factors, 2021
Diabetic retinopathy is an incapacitating microvascular complication where diabetes-induced damage to small blood vessels leak blood and other fluid causing retinal tissue to swell. A more advanced condition is proliferative diabetic retinopathy, where widespread vessel growth in the retina and vitreous occurs due to the retina being deprived of oxygen. VEGF is up-regulated in subjects with the minor(C) allele of VEGF rs2010963 or minor (T) allele of rs3025039 polymorphism in diabetic retinopathy and its microvascular complications. Choudhuri et al. (2015) reported that rs2010963 serum VEGF genotype differences were greatest in patients with proliferative diabetic retinopathy (P < 0.0001) and highest average VEGF concentrations, intermediate in T2DM without proliferative diabetic retinopathy and intermediate VEGF concentrations, and least in healthy controls that had the lowest average VEGF concentrations (Figure 4E). Results were similar for rs3025039 genotypes (Figure 4(F)).
Feasibility of neonatal haemoglobin A1C as a biomarker for retinopathy of prematurity
Published in Biomarkers, 2020
Tammy Z. Movsas, Arivalagan Muthusamy
Retinopathy of prematurity (ROP) is a well-known neurovascular disorder afflicting the preterm infant population. The non-proliferative phase of ROP, also known as Early Stage ROP, is characterized by deficient retinal angiogenesis (Hartnett and Penn 2013, Hartnett 2015). The proliferative phase of ROP, also known as Late Stage ROP, is characterized by pathologic angiogenesis called retinal neovascularization (Hartnett and Penn 2013, Hartnett 2015). Importantly, retinal neovascularization is also the hallmark of proliferative diabetic retinopathy. Indeed, several studies have identified hyperglycaemia as a risk factor for ROP; however, some studies have not found such an association (Garg et al.2003, Au et al.2015, Lee et al.2016, Mohamed et al.2013). Perhaps, discrepant findings between studies are due to varying methodologies for evaluating hyperglycaemic duration and the use of different inclusion/exclusion criteria for ROP groups and control groups. Therefore, as of yet, the relationship between glucose dysregulation and ROP is not well established.