Incidence Of Retinopathy In Patients Research Articles

Incidence of Retinopathy in Newly Diagnosed Patients with Type-II Diabetes Mellitus

Aim: To determine the incidence of retinopathy in patients newly diagnosed with type-II diabetes mellitus. Place and Duration: Alshifa Trust Eye Hospital, Rawalpindi and Ophthalmology Department, CMH, Lahore for six-months duration from January 2022 to June 2022. Methods: The study included 200 individuals with type 2 diabetes mellitus diagnosed within the previous two months and selected with non-probability consecutive sampling technique. Diabetes was diagnosed on the basis of two consecutive values of random blood glucose (RBS), fasting blood glucose (FBS) and glycosylated hemoglobin (HBA1c)> 200 mg / dL according to the following criteria defined by the World Organization (WHO) which was revised in 1999 and 2006. All patients underwent detailed examination of the retina for diabetic retinopathy evaluation using biomicroscopic slit lamp and +90 Diopter lens. SPSS-21.0 was used for the data analysis. For each variable, descriptive statistics were calculated. Results: 200 patients in total were enrolled in this study. The participants ranged in age from 31 to 60 years, with the majority were in the 4th decade (mean age: 51.50 ± 9.02). 30 individuals (15%) with newly diagnosed type 2 diabetes had diabetic retinopathy. From 30 patients of newly diagnosed type 2 diabetes mellitus; the background retinopathy was seen in 18 (60%) of patients, pre proliferative retinopathy was observed in 8 (26.7%) of patients and proliferative retinopathy was seen in 3 (13.3%). Patients with diabetic retinopathy had a HbA1C (%) of 9.8± 1.2, while those without the diabetic retinopathy had HbA1c of 7.1 ± 2.2. Conclusions: We found that the incidence of retinopathy in patients with newly diagnosed type 2 diabetes is 15%, which underlines the value of a comprehensive ophthalmological assessment of all diabetic patients at diagnosis. Keywords: Retinopathy, Type-II diabetes mellitus and incidence.

Effect of postprandial hyperglycemia at clinic visits on the incidence of retinopathy in patients with type2 diabetes: An analysis using real-world long-term follow-up data.

Aims/IntroductionThere is little evidence on the role of postprandial glycemia in the incidence of diabetic retinopathy (DR) in a real‐world setting. We aimed to assess the effect of postprandial hyperglycemia at clinic visits on the incidence of DR in patients with type 2 diabetes, and whether its effect differs depending on glycated hemoglobin (HbA1c) values and age.Materials and MethodsIntrapersonal mean blood glucose levels at 1–2 h post‐breakfast (1–2h‐PBBG), post‐lunch (1–2 h‐PLBG) and both (1–2h‐PBLBG) during 2 years from the first visit were used as baseline data. This retrospective cohort study enrolled 487, 323 and 406 patients who had 1–2h‐PBLBG, 1–2h‐PBBG and 1–2h‐PLBG measurements, respectively. These three groups were followed from 1999 up through 2017.ResultsDR occurred in 145, 92 and 126 patients in the 1–2h‐PBLBG, 1–2h‐PBBG and 1–2h‐PLBG groups, respectively. Multivariate Cox regression analysis showed that the mean 1–2h‐PBLBG, 1–2h‐PBBG and 1–2h‐PLBG levels were significant predictors of DR, independent of mean HbA1c. In patients with mean HbA1c <7.0% and those with a baseline age <60 years, the mean 1–2h‐PBLBG, 1–2h‐PBBG and 1–2h‐PLBG levels were significant predictors.ConclusionsPostprandial hyperglycemia at clinic visits might predict the incidence of DR, independent of HbA1c. The effect of postprandial hyperglycemia on DR is obvious in patients with well‐controlled HbA1c and in younger patients. Even with the lower HbA1c level, correcting postprandial hyperglycemia is important for preventing DR, especially in middle‐aged adults with type 2 diabetes.

Incidence of retinopathy in patients with chronic hepatitis C treated with dual and triple antiviral protocols

Purpose The aim of this study was to compare the incidence of ophthalmological complications in chronic hepatitis C virus patients treated with dual versus triple antiviral protocols. Study design A Prospective, observational, comparative study. Setting Ahmed Maher Teaching Hospital and revised in the Outpatient Clinic of Ophthalmology Department of Beni Suef University. Patients and methods One hundred and fifty chronic hepatitis C virus patients were treated by dual therapy of sofosbuvir and ribavirin for 6 months (group A), and 150 patients were treated by triple therapy of sofosbuvir, ribavirin, and interferon pegylated interferon (pegINF-α) for 3 months (group B). Full general and ophthalmological examinations were done at the baseline visit before receiving treatment and at 3 and 6 months after treatment. Any ophthalmological complications including deterioration in best corrected visual acuity, anterior segment inflammation, or retinal complications in the form of hemorrhages, soft exudates, or changes in cup/disk ratio were recorded. Results In 11% of the patients under triple therapy, retinal hemorrhages and soft exudates were detected by the second visit; however, they resolved by the third visit. Patients under dual therapy showed no ophthalmological complications throughout the 6-month follow-up period. No uveitis or changes in best corrected visual acuity and cup/disk ratio were detected. Conclusion Interferon-free protocols showed no retinal complications. However, the retinal complications related to the interferon-containing protocols resolved shortly within weeks. Thus, interferon-free protocols showed higher safety on the eye.

Interferon‐associated retinopathy during the treatment of chronic hepatitis C: a systematic review

The incidence of retinopathy in patients with chronic hepatitis C treated with interferon-based regimens has been variably reported in the literature. There is no consensus regarding ophthalmologic screening before and during treatment with interferon-based therapy. To assess the incidence of retinopathy in patients with chronic hepatitis C being treated with interferon-based regimens and estimate the rate of resolution. A systematic literature search was performed to locate all relevant publications. Pooled incidence of retinopathy was calculated in patients treated with interferon or pegylated interferon. We also estimated the rate of discontinuation of treatment and resolution after the treatment was stopped. A total of 21 studies fulfilled the inclusion criteria. The overall incidence of retinopathy using random effect model was 27.7% (95% confidence interval [CI] 20.9-34.5%). The pooled incidence of retinopathy in 10 studies that only used pegylated interferon was 20.9% (95% CI: 11.6-29.8). The incidence of retinopathy with pegylated interferon in diabetic and hypertensive patients (high-risk group) was 65.32% and 50.7%, respectively. This was significantly higher compared with the incidence of retinopathy (11.7%) in patients without these risk factors. Overall pooled estimate for the resolution of retinopathy was 87% (95% CI 75.7-98.4%). The rate of discontinuation of treatment was 6.3%. The incidence of retinopathy with pegylated interferon in patients without hypertension and diabetes is low, but the risk is higher in patients with diabetes and hypertension. Routine pretreatment fundoscopic screening may not be warranted in all patients and can be limited to the patients with these risk factors.

Increased prevalence of diabetic complications in Japanese patients with type 1 diabetes and nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) is associated with insulin resistance, metabolic syndrome and cardiovascular disease. The purpose of this study was to evaluate the phenotype of Japanese type 1 diabetes with NAFLD. The study population consisted of patients with type 1 diabetes with (n = 25) and without (n = 119) NAFLD who underwent an examination with hepatic ultrasonography. The duration of diabetes, HbA1c, body mass index, basal and bolus insulin doses, urinary albumin excretion, prevalence of carotid artery plaques, and incidence of retinopathy in patients with NAFLD were all significantly higher than in those without NAFLD. Dyslipidemia and hypertension also occurred more frequently in the NAFLD group. Logistic analysis showed that age (P < 0.05), gender (P < 0.05), duration of diabetes (P < 0.05), dyslipidemia (P < 0.05), and the presence of NAFLD (P < 0.05) were independent risk factors for the presence of carotid artery plaque. Multiple regression analysis showed that the rate of urinary albumin excretion was significantly associated with age (P < 0.01), systolic blood pressure (P < 0.05), and the presence of NAFLD (P < 0.01). Our results suggest that the presence of NAFLD in type 1 diabetes may be strongly associated with the progression of diabetic nephropathy and macroangiopathy.

Management of cystic fibrosis-related diabetes in children and adolescents

TheDepartment of Pediatrics, University of Minnesota Children’sHospital, Minneapolis, USACorresponding author:Dr. Stephen MP O’Riordan MRCPI, MDThe Developmental Endocrinology and Research GroupThe Department of Clinical and Molecular GeneticsThe Institute of Child Health, University College London30 Guliford StreetLondon WC1N 1EH.Tel: +44-020-7242-9789, ext. 0732;fax: +44-020-7404-6191;e-mail: s.oriordan@ich.ucl.ac.ukAcknowledgments:PeterHindmarsh,MehulDattani,HilaryHoeyand Nicola Bridges.Conflicts of interest: The authors have declared no conflictsof interest.Editors of the ISPAD Clinical Practice Consensus Guide-lines 2009 Compendium: Ragnar Hanas, Kim Donaghue,Georgeanna Klingensmith, and Peter Swift.This article is a chapter in the