Eyes Of Diabetic Patients Research Articles

Enhancing Retina Images by Lowpass Filtering Using Binomial Filter.

This study presents a method to enhance the contrast and luminosity of fundus images with boundary reflection. In this work, 100 retina images taken from online databases are utilized to test the performance of the proposed method. First, the red, green and blue channels are read and stored in separate arrays. Then, the area of the eye also called the region of interest (ROI) is located by thresholding. Next, the ratios of R to G and B to G at every pixel in the ROI are calculated and stored along with copies of the R, G and B channels. Then, the RGB channels are subjected to average filtering using a 3 × 3 mask to smoothen the RGB values of pixels, especially along the border of the ROI. In the background brightness estimation stage, the ROI of the three channels is filtered by binomial filters (BFs). This step creates a background brightness (BB) surface of the eye region by levelling the foreground objects like blood vessels, fundi, optic discs and blood spots, thus allowing the estimation of the background illumination. In the next stage, using the BB, the luminosity of the ROI is equalized so that all pixels will have the same background brightness. This is followed by a contrast adjustment of the ROI using CLAHE. Afterward, details of the adjusted green channel are enhanced using information from the adjusted red and blue channels. In the color correction stage, the intensities of pixels in the red and blue channels are adjusted according to their original ratios to the green channel before the three channels are reunited. The resulting color image resembles the original one in color distribution and tone but shows marked improvement in luminosity and contrast. The effectiveness of the approach is tested on the test images and enhancement is noticeable visually and quantitatively in greyscale and color. On average, this method manages to increase the contrast and luminosity of the images. The proposed method was implemented using MATLAB R2021b on an AMD 5900HS processor and the average execution time was less than 10 s. The performance of the filter is compared to those of two other filters and it shows better results. This technique can be a useful tool for ophthalmologists who perform diagnoses on the eyes of diabetic patients.

Impact of diabetes on visual acuity and its association with blood glucose levels in diabetic patients attending Murtala Muhammad Specialist Hospital, Kano, Nigeria

Diabetic retinopathy is a known complication of Diabetes, underscoring the need for regular eye examinations and glycemic control. The aim of the study was to assess visual acuity (VA), and Fasting blood glucose (FBG) among diabetic patients at Murtala Muhammad Specialist Hospital Kano. It was a cross-sectional observational study consisting of 60 participants; 30 Diabetic patients & 30 non-diabetic patients (controls), aged 30-60 years. Data was collected using questionnaire and FBG measured using glucometer. Data was analyzed using SPSS version 25, considering a p-value of <0.05 as statistically significant. Majority of the participants were aged 51-60, with most diabetics having the disease for 1-10 years. Diabetic patients exhibited severe visual impairment (VI) in both eyes, followed by moderate VI, contrasting with controls who mostly had normal VA. Significant differences were noted between controls and diabetics in terms of duration of diabetes (DOD), VA, and FBG, but not age. While no significant gender differences were found in age, VA, or DOD within diabetic and control groups. Female diabetics had slightly higher FBG levels than males. Also, a significant relationship was observed between DOD and VI in the right eye of diabetic patients. In conclusion, this study reveals that diabetic patients had a higher frequency and more severe VI compared to controls, with significantly elevated FBG. No significant differences in age, DOD, VA, or FBG levels between genders in both groups. However, the severity of VI increased with DOD in the right eye. This emphasizes the importance of regular eye examinations and improved glycemic control to minimize the risk of VI in diabetics.

Biochemical Changes in Anterior Chamber of the Eye in Diabetic Patients-A Review.

This article aims to provide a comprehensive review of the biochemical changes observed in the anterior chamber of the eye in diabetic patients. The increased levels of inflammatory markers, alterations in antioxidant defense mechanisms, and elevated levels of advanced glycation end products (AGEs) in the aqueous humor (AH) are explored. Additionally, the impact of these biochemical changes on diabetic retinopathy progression, increased intraocular pressure, and cataract formation is discussed. Furthermore, the diagnostic and therapeutic implications of these findings are presented. This study explores potential biomarkers for detecting diabetic eye disease at an early stage and monitoring its progression. An investigation of the targeting of inflammatory and angiogenic pathways as a potential treatment approach and the role of antioxidant agents in managing these biochemical changes is performed.

Association of Inflammatory Markers and Diabetic Retinopathy

Abstract Introduction: Diabetic retinopathy is a micro-angiopathy, the pathogenesis of which is manifold. Chronic inflammation releasing various mediators has been proposed to cause micro-angiopathy in long-term diabetics. These markers can be easily measured in serum and may serve as a risk factor for progression as well as allow newer modalities of management aimed at this pathology. Aims and Methodology: The aim of the study was to determine the association between different inflammatory markers and diabetic retinopathy. A total of 100 eyes in diabetic patients, 20 each with no retinopathy, mild NPDR, moderate NPDR, severe NPDR, and PDR were included. The serum levels of C-reactive protein (CRP) and absolute neutrophil count were recorded and compared across each of these groups. Results: The mean ANC among these groups, respectively, was 5525, 5162, 5374, 5239, and 5313 (per microlitre), and neither were these raised significantly nor was the difference between groups statistically significant. Mean CRP levels were within normal limits in all groups (2.56, 2.87, 4.06, 5.15, 6.97 mg/dl), although there was a steady increase with each grade of retinopathy, and this was found statistically significant. Conclusion: There was no association between absolute neutrophil count and diabetic retinopathy. Serum CRP levels may guide progression of retinopathy and can be monitored to help management protocols.

Pattern of Ocular B-Mode Sonographic Findings in Diabetic Ophthalmopathy in Zaria, Nigeria

Objectives: This study was aimed at using B-Mode ultrasonography to evaluate the various changes in the eyes of diabetic patients. Methods: The study was conducted with DC 6 Mindray ultrasound machine within a period of six months at the Radiology Department of ABUTH, Zaria. 200 established diabetic patients with ocular complications aged 15 to 70 years were recruited for the study as case group and 200 established diabetic patients without ocular complication as control group. Results: A total of 800 eyes of 400 patients were involved in this study; 200 diabetic patients with ocular complications as case group and equal number of diabetic patients without ocular complications as a control group. The age range of the patients was 15-70 years (54.16 ± 12.0). 164 were males and 236 were females. Out of the 200 cases studied, vitreous haemorrhage was the commonest finding 195(97.5%), followed by cataract 54(27%), Posterior vitreous detachment 28(14%), Retinal detachment 7(3.5%), optic nerve drusen 6(3%), Vitreous liquefaction 5(2.5%), Epiretinal fibrosis 3(1.5%), Asteroid hyalosis 3(1.5%), and intraocular infection 1(0.5%). In the control group however, 27 (13.5%) had vitreous haemorrhage while the remaining 173 (86.5%) showed normal sonographic findings. Sonographic Findings in the case group were significantly higher than those in the control (p?0.05). Conclusion: The utility of ultrasonography in the detection of ocular complications in diabetic patients is reechoed in this study, and diabetic patients should benefit from this safe radiological evaluation as that will aid early detection of the aforementioned complications.

Case Control Study to Evaluate Tear Film Function and Ocular Surface Disorder in Diabetic Patients

BACKGROUND
 Diabetic retinopathy and early development of cataracts are well-known ocular complications of long-standing diabetes. In recent years various researchers have reported ocular surface disorders, particularly dry eyes in diabetic patients which if left untreated may result in a variety of corneal complications. These ocular surface disorders can be clinically diagnosed by performing a detailed slit lamp examination, Schirmer's test and tear film break-up time. Our study intended at assessing tear film and ocular surface disorders in diabetic patients and study tear film function in them and compare it with non-diabetic patients.
 METHODS
 A comparative cross-sectional study was done on 100 diabetic and 100 non-diabetic patients > 30 years of age visiting OPD of health centre of tertiary care hospital of Central India. Clinical data and detailed clinical history were obtained from all subjects through direct patient interviews and reviewing of their medical records followed by a comprehensive ocular examination that included best-corrected vision, slit lamp examination, and Tear Film break up time (TBUT) & Schirmer test.
 RESULTS
 In our study, mean TBUT was found to be significantly reduced in diabetics (15.94 ± 3.8) as compared to non-diabetics (20.13 ± 6.6). No significant difference was found in the Schirmer test reading between diabetics (17.13 ± 3.20) and non-diabetics (19.20 ± 6.23). Diabetic male patients had significantly decreased mean TBUT & mean Schirmer test readings as compared to diabetic females. Mean Schirmer reading & Mean TBUT were lowest in a patients having > 20 years of DM and highest in patients having < 5 years of DM. No positive correlation was found between HbA1c (Glyosylated Haemoglobin) and diabetic retinopathy with TBUT/ Schirmer test readings.
 CONCLUSIONS
 Our study showed that the tear film stability was found to be affected in diabetic patients, as compared to non-diabetic subjects as evident by the lower level of TBUT in diabetic patients. Significantly reduced TBUT with no significant difference in Schirmer test reading in diabetic as compared to non-diabetic subjects might be due to a decrease in basal secretion with normal overall tear secretion. The absence of subjective symptoms of dryness in spite of decreased TBUT in the diabetic group might be due to a decrease in corneal sensitivity caused by diabetic peripheral neuropathy in diabetic patients. There was an increase in the prevalence of DES with an increasing duration of DM. Rheumatoid arthritis was found to be a risk factor for DES. Diabetic males were found to be at risk for developing dry eye syndrome. Hence it can be concluded from our study that every diabetic patient should undergo a comprehensive eye examination which should include various tests for dry eye assessing multiple tear parameters.

A study of incidence of dry eye after manual small incision cataract surgery and phacoemulsification

To compare incidence of dry eye between phacoemulsification and manual small incision cataract surgery. This observational study included two groups. Group A consisted of 30 patients who had undergone manual small incision cataract surgery and Group B consisted of 30 patients who had undergone phacoemulsification. A detailed history was taken from all paricipants before they underwent a complete systemic and ocular examination which included best corrected visual acuity, slit lamp examination, intraocular pressure, and dilated fundus examination. Tests for dry eyes likes Schirmer’s test 1, tear film break up time (TBUT), tear meniscus height (TMH) was done postoperatively at 1 week, 3 weeks and 1 month postoperative. One test positive out of three was considered as a dry eye.The values of various tear film tests schirmer’s test, tear film break up time and tear meniscus height showed no significant difference between both groups (Chi square test P Value = 0.605,0.832, 1). There was no significant difference in incidence of dry eye in manual small incision cataract surgery and phacoemulsification (Chi square test p value = 0.317). On comparing the data with respect to age and sex, no significant difference in incidence of dry eye was seen between both groups or between male and female. There is high incidence of dry eye 33.33⸓ seen in diabetic patients. (Chi square test P Value = 0.0371).There is no significant difference in incidence of dry eye between manual small incision cataract surgery and phacoemulsification. We also found out high incidence of dry eye in diabetic patients.

Choroidal changes and associations with visual acuity in diabetic patients

BackgroundThe variable visual function observed in diabetic retinopathy (DR) patients is not fully explained by the classic staging system. Our purpose was to evaluate choroidal changes, in standardized sectors, in DR patients and to find associations between choroidal measurements and visual function.MethodsCross-sectional study that included the right eye of diabetic patients (n = 265) without active edema, ischemia or neovascularization and age-matched controls (n = 73). Optical coherence tomography (OCT) imaging was performed with enhanced depth imaging protocol. Choroidal vascularity index (CVI) was calculated in a 5 mm scan centered in the fovea.ResultsCVI decreased with age (p < 0.001) but was not influenced by axial length. A multivariate analysis adjusting for age confirmed a significant difference in CVI between DR eyes that had previous treatments (intravitreal injections and/or photocoagulation) compared to control eyes (p = 0.013) and to DR eyes that never required treatment (p = 0.002). There was no significant difference between non-DR diabetic patients and normal controls. Considering the group of DR patients that had previous treatments, in eyes without optic media opacification, BCVA correlated with CVI (r = − 0.362, p < 0.001), whereas full retina thickness and individual retinal layer thickness did not (p > 0.066).ConclusionsA reduction in CVI was observed in patients with a more advanced stage of DR. In treated DR patients with stable disease, choroidal biomarkers correlated with best-corrected visual acuity whereas retinal biomarkers did not.Trial registration: N/A

Comparison of corneal changes after phacoemulsification in diabetic and nondiabetic eyes

Background and aim Endothelium of the cornea is susceptible to surgical trauma during phacoemulsification from ultrasound energy. Several studies have reported various results of corneal changes after phacoemulsification in diabetic and healthy patients. The aim was to evaluate and compare changes in precorneal tear film, anterior and posterior corneal surfaces, endothelial cell changes, and central corneal thickness (CCT) between diabetic and healthy patients before and after uneventful phacoemulsification. Patients and methods A total of 40 eyes of 40 patients who were scheduled for cataract surgery were divided into group 1 (20 eyes in nondiabetic patients) and group 2 (20 eyes in diabetic patients). Ophthalmological examinations, including uncorrected and best-corrected visual acuity (BCVA), slit lamp to examine anterior and posterior corneal surfaces, tear film breakup time test (TBUT), anterior chamber depth by IOL Master (Topcon ALADDIN HW2.0), and specular microscopy (Topcon SP-1P, made In Japan), were done preoperatively and at 1 week, 1 month, and 3 months postoperatively. Results Significant differences were found between preoperative and postoperative periods in both groups regarding BCVA, TBUT, CCT, endothelial cell density (ECD), coefficient of variation, and hexagonal cells, except that changes became insignificant with respect to CCT at 3 months in nondiabetic and at 1 week and 3 months in diabetic and in CD at 1 month in healthy patients. Conclusion There were significant changes in BCVA, TBUT, CCT, and ECD after phacoemulsification in the diabetic and healthy groups. There was a significant delay in the recovery of CCT 1 month after phacoemulsification in the diabetic compared with healthy individuals.

Evaluation of Corneal Endothelium after Myopic Laser-Assisted In Situ Keratomileusis (LASIK) with Accelerated Cross-Linking (CXL) in Diabetic Patients

Purpose: To study the effect of LASIK with accelerated CXL on corneal endothelium in myopic diabetic patients. Methods: A prospective comparative interventional case series study on 120 eyes of 60 myopic patients treated with LASIK with accelerated CXL. They were divided into two groups; group A included 60 eyes of diabetic patients, group B included 60 eyes of non-diabetic patients. Corneal endothelium was evaluated by specular microscope preoperatively and after 3 and 6 months postoperatively. Results: The endothelial cells density (ECD) showed statistically significant changes after 3 and 6 months postoperatively (p-value &lt;0.001) in group A while group B showed statistically significant changes after 3 months without significant change after 6 months (p-value= 0.103), both groups had improved to near preoperative levels, with no significant differences between them at the end of 6 months follow-up (p-value = 0.219). Regarding pleomorphism, there was a significant change in group A during 6 months follow-up (p-value &lt;0.001) with no significant change in group B (p-value= 0.884), and in comparing both groups, there was a significant change at the end of 6 months follow-up (p-value &lt;0.001). Regarding polymegathism, there was a significant change in group A during 6 months follow-up (p-value &lt;0.001) with no significant change in group B after 3 (p-value= 0.178) and 6 (p-value= 0.866) months follow-up, and in comparing both groups, there was a significant change at the end of 6 months follow-up (p-value &lt;0.001). Conclusion: LASIK with accelerated CXL is safe on corneal endothelium in diabetic myopic patients but needs to follow up for a long period.

Comparison of choroidal thickness in eyes of diabetic patients with eyes of healthy individuals using optical coherence tomography in a tertiary care hospital.

ABSTRACTObjectives:To compare the choroidal thickness in eyes of diabetic patients with eyes of age matched controls using optical coherence tomography in a tertiary care hospital.Methods:This Cross sectional study was conducted at the Department of Ophthalmology, Jinnah Postgraduate Medical Centre Karachi, for six months from13thJanuary 2020 to13thJuly 2020. The study group comprised of 44 patients with 88 eyes. Patients who fulfill the inclusion criteria that is age ranging from 35 to 80years, either gender, known case of diabetes mellitus and having any type of diabetic retinopathy (HbA1c >7), non-diabetic healthy individuals (HbA1c < 7) and those giving informed consent were included in the study. However, patients having active ocular infections, history of myocardial infarction, stroke, uveitis, any ocular surgery, lasers, intravitreal injections, poor fundus view and not giving consent were excluded. A pre-designed proforma was filled. A baseline ocular examination was performed and choroidal thickness was assessed from retinal pigment epithelium to choroid sclera junction in diabetic and healthy participants of the study group using high resolution Swept source OCT (DRI-OCT-2 Triton; Topcon).Results:The average age of the patients was 39.41±15.95 years. According to our study mean central subfoveal choroidal thickness in diabetic eyes was 268.5 ± 66.22 (95% CI 240 – 297) and in non-diabetic healthy participants it was 339.3 ± 71.49 (95% CI 308 – 369) with a p-value of 0.001. However, average choroidal thickness was 261.8 ± 61.93 (95% CI 235 – 288) and 336.0 ± 74.35 (95% CI 304 – 367) in diabetic and non-diabetic healthy population with a p-value of 0.001. Choroidal thickness comparison between gender in diabetic and non-diabetic population also showed similar trend.Conclusion:In this study, mean central choroidal thickness as well as average choroidal thickness was significantly reduced in eyes having diabetic retinopathy as compared to participants with non-diabetic healthy eyes. These findings indicate that changes in choroid may be a probable route in the pathogenesis of diabetic retinopathy.

Effect of insulin treatment on pulsatility ratio and resistance index of the retinal artery in patients with type 2 diabetes.

This study aimed to evaluate whether long-term insulin treatment is associated with abnormalities in retinal circulation in type 2 diabetic patients. We evaluated 19 eyes of nondiabetic individuals and 68 eyes of type 2 diabetic patients. The eyes of diabetic patients were classified into two groups according to the presence or absence of long-term insulin therapy. We used a Doppler optical coherence tomography flowmeter to measure diameter, velocity, and blood flow in the major temporal retinal artery. The pulsatility ratio (PR) and resistance index (RI), indices of vascular rigidity, were calculated from the blood velocity profile. PR and RI were significantly elevated in type 2 diabetic patients compared with nondiabetic subjects (P < 0.05). In type 2 diabetes patients, PR and RI were significantly higher in patients receiving long-term insulin treatment than in those without (P < 0.01). There was a significant difference in velocity (P < 0.05), but not diameter and blood flow, between nondiabetic subjects and type 2 diabetes patients. No significant difference in diameter, velocity, or blood flow was observed between the groups with and without long-term insulin treatment. Long-term insulin treatment can affect PR and RI, which might be associated with vascular rigidity of the retinal artery in patients with type 2 diabetes.

Intraoperative Complications and Visual Outcomes of Cataract Surgery in Diabetes Mellitus: A Multicenter Database Study

To compare the visual outcome and the rate of intraoperative complications in eyes of diabetic and nondiabetic patients undergoing phacoemulsification over 15 years. Retrospective clinical cohort study. Data of 179,159 eyes that underwent phacoemulsification at 8 centers were classified based on the presence or absence of diabetes mellitus. Visual acuity (VA) was defined as the best value of uncorrected or corrected distance measure available. For the VA analysis, eyes with co-pathologies or combined surgical procedures were further excluded, leaving a subset of 90,729 eyes. Main outcome measures were logarithm of the minimum angle of resolution (logMAR) VA at 4-12weeks postoperatively, and rate of intraoperative complications. Cataract surgery in eyes of diabetic patients was associated with an improvement in mean VA of 0.48 logMAR (5 Snellen lines). Mean postoperative VA was slightly worse in diabetic compared to nondiabetic group (logMAR 0.23 vs 0.13; Snellen 20/30 vs 20/25; P < .0001) and the proportions of eyes achieving a visual gain of ≥3 Snellen lines (≥0.3 logMAR) was lower in the diabetic group (56.6% vs 63.5%; P < .0001). There was a linear relationship between diabetic retinopathy severity and worse postoperative visual acuity (β coefficient 0.098 to 0.288; P < .0001). We observed higher rates of posterior capsule rupture (2.3% vs 1.6%; P < .001) and dropped nuclear fragments (0.3% vs 0.2%; P < .001) in the diabetic group. Postoperative VA negatively correlated with diabetes and diabetic retinopathy severity. Eyes of diabetic subjects had higher risks of posterior capsule rupture.

Чутливість рогівки у хворих на бактеріальний кератит залежно від наявності цукрового діабету

The aim. To identify the features of corneal sensitivity of the sick and the fellow eye in bacterial keratitis patients with or without diabetes mellitus. Materials and methods. The analysis was performed on the basis of survey data of 62 type 1 diabetes patients with bacterial keratitis and 43 nondiabetic control patients with bacterial keratitis. The examination was performed at the first visit. In addition to standard ophthalmic examination, the patients underwent fluorescein test, OCT of the anterior segment of the eye, non-contact corneal aesthesiometry. Results and discussion. The average corneal sensitivity threshold in diabetic patients with bacterial keratitis at the first visit at all air flow temperatures exceeded the corresponding indicators in nondiabetic patients of the control group: by 33.5% at an air temperature of 5 °C, by 30.6% at 15 °C, by 28.8% at 20 °C, by 27% at 30 °C, and by 26.1% at 40 °C (p&lt;0.05). The average corneal sensitivity threshold at a temperature of 20 °C in the fellow eye in diabetic patients with bacterial keratitis exceeded that in nondiabetic patients with bacterial keratitis of the control group by 32.9 % (p&lt;0.05). Conclusions. Corneal sensitivity of the sick and fellow eye in patients with bacterial keratitis depends on the presence of diabetes mellitus. The average threshold of corneal sensitivity of the sick and fellow eye in diabetic patients with bacterial keratitis at the first visit exceeds the corresponding values in nondiabetic patients with bacterial keratitis. Keywords: diabetes mellitus, bacterial keratitis, corneal sensitivity.

Study of dry eye parameters in diabetics in a tertiary care hospital

Aim: This study aims to study the frequency and severity of dry eye in diabetic patients and their correlation with duration of diabetes. Materials and Methods: This cross-sectional prospective study was conducted on all patients with diabetes mellitus presenting to ophthalmology department of a tertiary care hospital between November 1, 2019, and December 31, 2019. The study population included diabetic patients who were above the age of 40 years. Detailed ocular history including diabetic history was recorded and comprehensive ocular clinical examination to assess the dry eye status was done. Schirmer's I test and Tear film Break-Up Time (TBUT) tests were performed and results were recorded. Results: In this study, 100 eyes of 50 diabetic patients were subjected to dry eye tests. Varying degree of dryness was seen in 34 patients (68%). Schirmer's test was abnormal (

Potential risk factors and treatment of IOP elevation after operation in retinal detachment eyes of diabetic patients

AIM: To observe the intraocular pressure (IOP) fluctuation at the early stage of pars plana vitrectomy (PPV) and silicon oil tamponade in high myopia with rhegmatogenous retinal detachment (RRD) eyes in diabetic patients and analyze the potential risk factors and effective treatment. METHODS: One hundred consecutive diabetic patients of RRD in highly myopic eyes were retrospectively reviewed. Patients were divided into two groups: the experimental group, those who used Tobramycin Dexamethasone Eye Drops (TDED), and control group. Pre- and postoperative IOPs, retinal nerve fiber thickness (RNFL) and optic nerve head parameters were recorded before and after IOP elevation, and in the contralateral eye before the operation. Graphpad 7.01 was used for data analysis. RESULTS: IOP elevation occurred in 42 eyes within 1wk after vitrectomy in all diabetic participants. Ocular hypertension (OHTN) was observed in 31 of 53 eyes in experimental group and 11 eyes of 47 eyes in control group at the early stage after operation. Significant differences were found between groups in 5d-1wk and 1mo after vitrectomy. In addition, IOP of 39 eyes had decreased by proper treatment and 3 eyes received glaucoma filtration surgery. Compared to the optic disc parameters before IOP elevation, the average and inferior RNFL thickness were thinner and rim area decreased as well as cup volume and vertical C/D radio increased after IOP elevation. The RNFL thickness of the opposite eyes in patients with IOP elevation was found thinner than the ones who never suffered ocular hypertension. CONCLUSION: Continual use of glucocorticoid after vitrectomy is a potential risk factor of IOP elevation in high myopia with diabetes, and doubtful open angle glaucoma should be focused on its sensibility to glucocorticoid and IOP elevation.

ASSESSMENT OF THE INCIDENCE AND PREVALENCE OF DRY EYES IN DIABETIC INDIVIDUALS AND IT’S EFFECT ON VISUAL ACUITY

Objective: To find out the incidence and prevalence of Dry Eyes in Diabetic patients and find out its effect on visual acuity.&#x0D; Methods: A prospective study was conducted in Saveetha Medical College and Hospital. Schirmer’s test was done for 100 diabetic patients taking part in the research. Those with dry eyes were tested for their visual acuity and were asked to fill a questionnaire based on associated ocular symptoms. The collected data were analysed using Microsoft Excel.&#x0D; Results: There is about an incidence of 82% of dry eyes in diabetic patients. It’s more prevalent among elderly women. There seems to be a significant effect of dry eys on visual acuity as 31% of those tested with dry eyes have a moderate visual impairment.&#x0D; Conclusion: People with diabetes are at a higher risk of developing dry eye. So diabetic patients should undergo regular ocular examination and must be screened for dry eyes. Early diagnosis and treatment of dry eyes is the best choice to prevent ocular complications in the future.

EVALUATION OF MACULAR EDEMA USING OPTICAL COHERENCE TOMOGRAPHY IN DIABETIC PATIENTS AFTER PHACOEMULSIFICATION

Recent studies on cataract surgery in diabetics tend to report a lower incidence of complications and better visual outcomes due to better preoperative management of retinopathy, evolutions in operative techniques, better glycemic and hypertensive control, and better surgical technique of phacoemulsification. Diabetic patients with little or no retinopathy enjoy good visual prognosis similar to that in individuals without diabetes. It is important to differentiate diabetic macular edema (DME) from Pseudophakic cystoid macular edema (PCME), especially because people with diabetes are more prone to develop PCME. The aim of this work was to diagnose macular changes pre- and post-cataract surgery and to identify changes in central foveal thickness (CFT) using spectral domain optical coherence tomography (SD-OCT) relative to age, sex, and presence of concomitant ophthalmic pathologies in diabetic patients. A prospective, comparative, non-randomised cross sectional study was done on 50 eyes, subdivided into two main groups; group A involves 25 eyes of diabetic patients (Diabetic group) and group B involves 25 eyes of non-diabetic patients (control group). Both groups will be examined once before surgery and after 1, 3, and 6 month post-operative after obtaining an informed consent from participants and approval of the study by Alexandria University Ethical Committee. Evaluation of cystoid macular edema (CME) and visual outcome after phacoemulsification in patients with diabetes and its relation with oxidative stress along with other ailing factors will be of great use academically and clinically in modern ophthalmology.

Comparative study of outcome of cataract surgery in diabetic and non-diabetic patients

To compare the visual outcome following cataract surgery in diabetics and non-diabetics.A comparative study of 58 eyes in the diabetic and 58 eyes in the non-diabetic group that underwent small incision cataract surgery with posterior chamber intraocular lens implantation. Age, sex, surgical technique, follow up, pre- and postoperative best corrected visual acuity (BCVA) and post-op complications were evaluated.Out of 116 patients, 58 were diabetic and 58 were non diabetics. Small incision cataract surgery with posterior chamber intraocular lens implantation was done in all patients. Follow up duration was 4 weeks. The mean preoperative best corrected visual acuity in the diabetic group was 1.60±0.81 and in non-diabetic group was 1.62±0.87. The mean post-operative best corrected visual acuity in log MAR units in the diabetic group was 0.39±0.32 and in the non-diabetic group was 0.32±0.27. The difference in pre and post op visual outcome was statistically significant (p=0.001). Post-operative visual acuity of 6/12 or better was achieved in 62.1% eyes in diabetic patients and 69% among non-diabetic patients. Post-operative complications included: posterior capsular opacification, corneal edema, anterior chamber reaction, striate keratopathy, pigment dispersion, cystoid macular edema and vitreous loss. The incidence was higher in the diabetic group.Small incision cataract surgery in diabetics without diabetic retinopathy yields similar visual outcomes as non-diabetics. There is a higher incidence of post-operative complications among diabetics, which can be managed conservatively. So extra care should be taken intra-operatively and during post-op follow up.

MON-704 Tear Glands and the Diabetic Patient: Is It a Biomarker?

Background: Tear glands in the eyelids, meibomian glands, play a role in tear film production and tear film stabilization. Diabetic patients often complain of dry eye and eye pain. Recently, there are new infrared (820nm) photography techniques to image meibomian glands easily in patients. Purpose: To study meibomian glands in diabetic patients with dry eye. Methods: A retrospective chart review (2017-2019) of Type 2 Diabetes Mellitus (T2DM) patients and non-diabetic patients with the diagnosis of “dry eye” in EHR (eClinicalworks, Westborough, MA) was performed. Infrared eyelid imaging (820 nm wavelength, Heidelberg Spectralis, Heidelberg, Germany) was taken. T2DM: Inclusion criteria: 1) HbA1c of > 5.7% who also had infrared eyelid imaging performed + 4 weeks of their HbA1c lab test results; 2) the percentage loss of meibomian glands for each eye, then averaged, for each patient. Control: Inclusion criteria: 1) non-diabetic patients; 2) HbA1c lab test results; 3) infrared eyelid imaging was performed; 4) percentage loss of meibomian glands was calculated for each eye, then averaged per patient. Exclusion criteria for both T2DM and Controls: younger than the age of 18 years old, older than 90 years old, no glaucoma topical medications, no eyelid surgery, no corneal surgery, no conjunctival surgery. Results: n=120 patients, Avg Age=69.6 years (sd=15.1, range 23-89 years). Diabetic patients: n=60 patients, Male=30, Female=30, Avg Age=65.1 years (sd=11.50, med=65.5, range 36-85 years). Controls: n=60 patients, Male=37, Female=23, Avg Age=54.1 years (sd=16.4, med=56.5, range 23-89 years). Meibomian gland loss: Diabetics=51.54%, Controls=11.29% (p<0.0001, t-test). Of the 60 DM patients: 35/37pts with HbA1c > 6.6% had greater loss of meibomian glands (>40%), compared to 12/23 DM patients with HbA1c < 6.5%, p=0.0001. Discussion: Loss of meibomian glands in diabetic patients have been recently investigated; however, its relationship to HbA1c as a possible biomarker has not been widely discussed in literature. In this small study, loss of meibomian glands occur more frequently with elevated HbA1c, perhaps due to microischemia of the eyelids, thereby resulting in loss of meibomian glands. Conclusion: Loss of meibomian glands may suggest a need for HbA1c testing and further monitoring of the patient’s diabetic condition. Infrared imaging of the eyelid may be useful in characterizing dry eye in diabetic patients.