Maculopathy In Type Research Articles

Risk factors of focal maculopathy in patients with type 2 diabetes mellitus with hard exudates: A hospital-based case–control study

Abstract Background: Dyslipidemia and hard exudates of the retina have an intricate association. Increased lipid levels cause increased hard exudates. Many studies found dyslipidemia as an independent risk factor for the development of hard exudates in maculopathy. Objectives: The objective of this study was the association between dyslipidemia and the presence of hard exudates among focal maculopathy patients with and without hard exudates. Materials and Methods: This was a hospital-based case–control study. This study included 60 patients with focal maculopathy in type 2 diabetes mellitus (DM) with hard exudates. Sixty patients with Focal maculopathy in type 2 DM without hard exudates were taken as control. Results: Dyslipidemia was significantly seen (P < 0.05) in cases compared to participants. Total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and very LDL-C were significantly higher in cases compared to controls. High-density lipoprotein cholesterol (HDL-C) had the opposite outcome. HDL-C was significantly lower in cases compared to controls. Conclusion: Dyslipidemia was a strong risk factor for the formation of hard exudates in the macula. An increase in lipid levels increased the hard exudates concentration in the macula and retina.

To study the association of dyslipidemia with macular edema and hard exudates in diabetic maculopathy in an industrial hospital in Chhattisgarh

To study the affect of LDL cholestrol, HDL cholestrol and triglycerides with diabetic maculopathy in type 2 diabetic patients.An informed written consent was obtained in every case.A 5ml blood sample was withdrawn. All the patients detailed history, general physical examination and ocular examination including visual acuity, intraocular pressure by applanation tonometry, slit lamp examination and fundus examination by biomicroscopy were done. Optical coherence tomography and fundus photograph were also taken.Patients who were having diabetic retinopathy had higher values of LDL and total cholestrol as compared to those who were not having diabetic retinopathy.Patients who were having diabetic retinopathy changes had non-significant differences in the level of HDL and triglycerides as compared to those who were not having diabetic retinopathy changes.Patients with changes of diabetic retinopathy had significantly higher values of foveal thickness as compared to those without changes of diabetic retinopathy. Foveal thickness had correlation with total cholesterol levels.

Фактор некрозу пухлин-альфа і рецидиви діабетичної макулопатії після хірургічного лікування у хворих з цукровим діабетом 2-го типу

Фактор некрозу пухлин-альфа і рецидиви діабетичної макулопатії після хірургічного лікування у хворих з цукровим діабетом 2-го типу

Нові чинники ризику рецидивів діабетичної макулопатії після хірургічного лікування у хворих на цукровий діабет II типу

Нові чинники ризику рецидивів діабетичної макулопатії після хірургічного лікування у хворих на цукровий діабет II типу

Correlation of serum endothelin-1 with relapses of surgical treatment of diabetic maculopathy in type 2 diabetes mellitus

Introduction. In type 2 diabetes mellitus (T2DM), a cascade of pathological reactions unfolds in the vas­­cular endothelium, which, in turn, is included in the pathogenesis mechanisms and causes the develop­­ment of complications. The main marker of endothelial function is its hormone — endothelin-1 (ET1). The aim of the study was to establish the relation­ship between serum ET1 and relapses in the surgical treatment of diabetic maculopathy (DMP) using various options for vitreoretinal interventions in patients with TD2M. Material and methods. We observed 313 patients T2DM (313 eyes) with DMP and initial (group 1; n = 40), moderate or severe non-proliferative (NPDR; group 2; n = 92) and proliferative diabetic retinopathy (PDR; group 3; n = 181). The severity of retinopathy and DMP was determined in accordance with the recom­men­dations of the American Academy of Ophthalmology (2002). In this study, patients underwent four types of surgical interventions: 78 patients (78 eyes) underwent a three-port closed subtotal vitrectomy; 85 patients (85 eyes) — closed subtotal vitrectomy with peeling of the retina inner border membrane; 81 patients (81 eyes) — closed subtotal vitrectomy with peeling of the retina inner border membrane in combination with panretinal laser coagulation; 69 patients (69 eyes) — closed subtotal vitrectomy with peeling of the retina inner border membrane and panretinal laser coagu­lation in combination with cataract phacoemulsifica­­tion. In pa­­tients before surgery, serum ET1 levels were determined by enzyme-linked immunosorbent assay. The control group consisted of 95 people. For statistical processing of the obtained data, Statistica 10 software (StatSoft, Inc., USA) was used. Results and discussion. In patients with DMP serum ET1 level was many times higher: in group 1 it exceeded the control by 2.9 times, in group 2 — by 3.7 times and in group 3 — by 4.6 times (p < 0.001). The initial ET1 level did not differ with different methods of surgical intervention; there was also no statistical difference between the serum ET1 in each group with different treatment methods (p > 0.5). Serum ET1 level was higher in patients of group 1 with the presence of relapses, compared with patients of the same group who didn’t have relapses (by 1.4 times; p < 0.001). In patients of the remaining groups, there was no such difference (p > 0.2), thus, the level of ET1 was important for the formation of relapses only for patients with initial NPDD. Serum ET1 level was also higher in pa­­tients who had early persistent relapses (p < 0.001), which related to moderate and severe NDPR and PDR. Conclusion. The results showed a correlation bet­­ween the serum level of ET1 and the occurrence of early sustained relapses in the surgical treatment of DMP in patients with T2DM.

Diagnostic Accuracy of Digital Retinal Fundus Image Analysis in Detecting Diabetic Maculopathy in Type 2 Diabetes Mellitus

Background: Digital retinal imaging is the gold standard technique for diabetic retinopathy (DR) and diabetic macular oedema (DME) assessment during DR screening. Objectives: To evaluate the diagnostic accuracy of digital retinal fundus image (DRFI) analysis in detecting DME using three manual grading systems (MGS) and comparing it with optical coherence tomography (OCT) findings. Method: A total of 287 DRFI of 287 eyes were analysed. Non-stereoscopic 45° images were acquired using a Kowa VX-20 camera and were graded according to three MGS: Early Treatment Diabetic Retinopathy Study (ETDRS), International Clinical Diabetic Retinopathy (ICDR), and United Kingdom National Screening Committee (UKNSC). The two graders were masked to the patient’s clinical DR status. DME characteristics were analysed using OCTs. Results: A very good agreement in detecting DME was found with Cohen’s κ = 0.83 (ICDR vs. ETDRS), κ = 0.83 (ICDR vs. UKNSC), and κ = 0.82 (ETDRS vs. UKNSC). Sensitivity and specificity of DRFI analysis in DME assessment were 70.0 and 69.6% for UKNSC, 71.9 and 67.4% for ETDRS, and 70.9 and 65.2% for ICDR, respectively. Positive and negative predictive values were 91.7 and 32.7% for UKNSC, 91.4 and 33.3% for ETDRS, and 90.7 and 31.9% for ICDR, respectively. On OCT scans, micro-architectural damages of both inner and outer retinal layers and mean ganglion cell layer thickness showed a significant association with the presence of DME detected with DRFI analysis. Conclusions: Despite the low negative predictive value, the good specificity and sensitivity of DRFI in detecting DME make it a useful tool in a routine clinical setting, and its potential in diabetic eye screening is yet to be realized.

The Prevalence and Risk Factors of Diabetic Maculopathy in Type 2 Diabetes Mellitus: A Study From Central Nepal

INTRODUCTION: Diabetic maculopathy is a complication of type 2 diabetes mellitus. This study was done to assess the prevalence and risk factors of Diabetic maculopathy in type 2 diabetes mellitus in Nepalese patients presenting to our hospital. MATERIAL AND METHODS: A hospital-based, descriptive, cross-sectional study was conducted at the department of ophthalmology, Kathmandu Medical College Teaching Hospital (KMCTH), Sinamangal, Kathmandu, Nepal from August, 2012 to October, 2014. 200 patients with type 2 diabetes mellitus underwent a detailed interview and a comprehensive dilated ocular evaluation by an ophthalmologist. Diabetic maculopathy was defined according to the international classification and grading system. RESULTS: 200 patients suffering from type 2 diabetes mellitus included 90 men (45%) and 110 women (55%) of age ranging from 23 80 years (mean age = 56.23, median age = 57.5 and SD = 10.83). Diabetic maculopathy was detected in 22 patients (11%). The disease duration of 6 to 15 years had the highest prevalence of Diabetic maculopathy. Significant risk factors for diabetic maculopathy were higher levels of HbA1c (p = 0.005), higher values of blood pressure (p = 0.001), higher cholesterol levels (p = 0.000), higher LDL-cholesterol levels (p = 0.000), higher triglyceride levels (p = 0.000), higher creatinine values (p = 0.000), higher urea values (p = 0.000), higher FBS levels (p = 0.020), higher PPBS levels (p = 0.001) and lower hemoglobin values (p = 0.000). CONCLUSION: Significant risk factors for diabetic maculopathy were higher levels of HbA1c, higher values of blood pressure, higher cholesterol levels, higher LDL-cholesterol levels, higher triglyceride levels, higher creatinine values, higher urea values, higher FBS levels, higher PPBS levels and lower hemoglobin values. However, smoking, drinking alcohol, dietary habits, HDL and BMI contributed as insignificant risk factors.Journal of Universal College of Medical Sciences (2016) Vol.04 No.01 Issue 13, Page: 16-21

Diabetic Retinopathy: More Patients, Less Laser

We aim to correlate the incidence of diabetic retinopathy and maculopathy requiring laser treatment with the control of risk factors in the diabetic population of Tayside, Scotland, for the years 2001-2006. Retinal laser treatment, retinal screening, and diabetes care databases were linked for calendar years 2001-2006. Primary end points were the numbers of patients undergoing first or any laser treatment for diabetic retinopathy or maculopathy. Mean A1C and blood pressure and retinal screening rates were followed over the study period. Over 6 years, the number of patients with diabetes in Tayside increased from 9,694 to 15,207 (57% increase). The number of patients receiving laser treatment decreased from 222 to 138 and first laser treatments decreased from 100 (1.03% of diabetic population) to 56 (0.37%). The number of patients with type 2 diabetes treated for maculopathy decreased from 180 in 2001 to 103 in 2006 (43% reduction, P = 0.03). Mean A1C decreased for type 1 and type 2 diabetic populations (P < 0.01) and a reduction in blood pressure was observed in type 2 diabetic patients (P < 0.01). The number of patients attending annual digital photographic retinopathy screening increased from 3,012 to 11,932. Laser treatment for diabetic maculopathy in type 2 diabetic patients has decreased in Tayside over a six-year period, despite an increased prevalence of diabetes and increased screening effort. We propose that earlier identification of type 2 diabetes and improved risk factor control has reduced the incidence of maculopathy severe enough to require laser treatment.

Quantitative analysis of retinopathy in type 2 diabetes: identification of prognostic parameters for developing visual loss secondary to diabetic maculopathy

To describe whether quantitative assessment of early changes in the morphology of retinopathy lesions can predict development of vision-threatening diabetic maculopathy. We used a nested case-control study, and we studied 11 type 2 diabetes patients who had developed visual loss secondary to diabetic maculopathy. For each diabetes patient, we also studied three matched control patients who had been followed for a comparable period of time without developing visual loss. Fundus photographs describing the early development of retinopathy were digitized and subjected to a full manual quantitative grading on a computer monitor. Differences in the early development of retinal morphology were compared between the two groups. The outcome parameters were changes in the number and area of haemorrhages and exudates in different regions of the fundus, and the weighted distance of these lesions from the fovea and the optic disc. In patients who developed visual loss secondary to diabetic maculopathy there was significant early progression in the total area and number of haemorrhages and exudates. The haemorrhages had progressed in all retinal areas except the area around the optic disc and the temporal vascular arcades. The exudates had progressed temporally from the fovea and in the retinal periphery. The results suggest that a quantitative description of the regional development of early diabetic retinopathy may help in identifying patients who will later develop vision-threatening maculopathy.

The occurrence and causes of registered blindness in diabetes patients in Arhus County, Denmark.

To report the occurrence of registered blindness among diabetes patients in Arhus County, Denmark during 1993-2002. Data were obtained from a database of 7527 diabetes patients, which included all patients in the county who had been treated for or had experienced visual loss due to diabetic retinopathy since 1992. Of these, 1949 had type 1 diabetes and represented 90% of the type 1 diabetes patient population in the county, and 5459 had type 2 diabetes and represented 40% of the type 2 diabetes patient population in the county. The point prevalence of legal blindness was 0.6% for type 1 and 1.5% for type 2 diabetes patients at January 1st, 2003. In type 1 diabetes patients, the major cause of blindness was proliferative diabetic retinopathy (PDR) (66.2% of all blind eyes); in type 2 diabetes patients the major causes were age-related macular degeneration (21.9%), PDR (18.0%) and diabetic maculopathy (DMac) (18.5%). During 1993-2002 there was a significant decrease in the number of blind eyes secondary to PDR (p = 0.008) in type 1 diabetes patients, and a significant increase in the number of blind eyes secondary to DMac (p = 0.005) in type 2 diabetes patients. The major challenge in reducing diabetes-related blindness is related to the detection and treatment of an increased incidence of diabetic maculopathy in type 2 diabetes patients.

Effects of losartan on diabetic maculopathy in type 2 diabetic patients – reply

Effects of losartan on diabetic maculopathy in type 2 diabetic patients – reply

Effects of losartan on diabetic maculopathy in type 2 diabetic patients

Effects of losartan on diabetic maculopathy in type 2 diabetic patients

Maculopathy and visual acuity in newly diagnosed type 2 diabetic patients and non‐diabetic subjects: A 10‐year follow‐up study

The long-term evolution of diabetic maculopathy and visual acuity and their risk factors in patients with newly diagnosed Type 2 diabetes and in control subjects. A 10-year prospective study consisting of a representative group of 133 (70 men, 63 women) newly diagnosed Type 2 diabetic patients diagnosed at health centers between 1979 and 1981 and 144 (62 men, 82 women) non-diabetic control subjects recruited from the population register. The frequency of maculopathy was determined by grading of 45 degrees fundus photographs and fluorescein angiograms. The subjects were studied at baseline and after 5 and 10 years. The frequency of maculopathy in Type 2 diabetic patients was low at the time of diagnosis but increased sharply after 5 years of the disease and at the 10-year examination 21% of diabetic patients had signs of maculopathy. By the 10-year follow-up the visual acuity declined more markedly in the diabetic patients than in the control subjects. Poor glycaemic control was the most important predictive factor for the development of maculopathy as well as deterioration of visual acuity. In newly diagnosed patients with Type 2 diabetes one-fifth had developed maculopathy which deteriorated their visual acuity. Poor glycaemic control was the most important predictor of maculopathy.