Diabetes Mellitus Retinopathy Research Articles

IDF23-0410 Epidemiology of Diabetic Retinopathy in diabetes mellitus in North African countries, a systematic review

IDF23-0410 Epidemiology of Diabetic Retinopathy in diabetes mellitus in North African countries, a systematic review

Gastroparesis might not be uncommon in patients with diabetes mellitus in a real-world clinical setting: a cohort study

BackgroundThis study investigated the frequency of diabetic gastroparesis and associated risk factors in a real-world clinical setting.MethodsThis retrospective cross-sectional study included patients who underwent assessments of solid gastric emptying time (GET) by technetium-99 m scintigraphy between May 2019 and December 2020. We categorized patients into three groups according to gastric retention of technetium-99 m: rapid (< 65% at 1 h or < 20% at 2 h), normal (≤60% at 2 h and/or ≤ 10% at 4 h), and delayed (> 60% at 2 h and/or > 10% at 4 h).ResultsPatients with diabetes mellitus (DM) were more likely to show abnormal GET than those without DM (119 [70.8%] vs. 16 [44.4%]). The mean glycated A1c was 10.3% in DM patients. DM patients with normal GET were significantly younger (57.2 years, P = 0.044) than those with delayed (65.0 years) or rapid GET (60.2 years). Fasting glucose levels were the lowest in the normal GET group and the highest in the rapid GET group (delayed: 176.3 mg/dL, normal: 151.2 mg/dL, rapid: 181.0 mg/dL, P = 0.030). However, glycated A1c was not significantly different among the delayed, normal, and rapid GET groups in patients with DM. Patients with delayed and rapid GET showed a higher frequency of retinopathy (6.0 vs. 15.5%, P = 0.001) and peripheral neuropathy (11.3 vs. 24.4%, P = 0.001) than those with normal GET. In the multinomial logistic regression analysis, retinopathy demonstrated a positive association with delayed GET, while nephropathy showed a significant negative correlation.ConclusionDM gastroparesis in the clinical setting was not uncommon. Abnormal GET, including delayed and rapid GET, was associated with DM retinopathy or peripheral neuropathy.

The Relationship between Expression of Nuclear Factor I and the Progressive Occurrence of Diabetic Retinopathy.

The loss of nuclear factor I (NFI) function can lead to defects in Muller's glial differentiation, abnormalities of retinal morphology, and changes in retinal neurons numbers, which are highly involved in diabetic retinopathy (DR). In this study, we addressed the roles of NFIA and NFIB gene expression in the development of DR by using diabetes mellitus (DM) rat models. Retinal histologies were examined, and the expression of NFIA and NFIB at mRNA and protein levels was detected. The results showed that retinal edema and disordered cell arrangement frequently occurred in DR rats. The expressions of NFIA and NFIB in retinal tissue were significantly decreased in DM rats with DR complications. After further inhibiting the expression of NFIA gene in DM rats by using RNA-silencing, majority of DM rats occurred retinopathy and lens fibrosis, which indicated the relationship between decreased expression of NFI and occurrence of retinopathy in DM.

Cytomegalovirus Retinitis in Immunocompetent Patients with Diabetes Mellitus

Purpose: We report five cases of cytomegalovirus (CMV) retinitis in immunocompetent patients with diabetes mellitus (DM).Methods: This was a retrospective observational case series of five immunocompetent patients with CMV retinitis. All patients had DM and variable degrees of DM retinopathy. After discovery of the retinitis, we assessed the patients in terms of ophthalmologic history, systemic conditions, underlying disease, and the medications used for treatment, such as immunosuppressants. This was followed by blood and immunology tests. None of the five patients were immunocompromised. We confirmed the diagnosis of CMV retinitis by polymerase chain reaction (PCR) analysis; samples were collected by anterior chamber paracentesis. All patients were treated with intravitreal antiviral injection until negative results were obtained for the anterior chamber PCR.Results: All five immunocompetent patients who had developed CMV retinitis, had a history of diabetes of at least 15 years. The average duration of diabetes was 17.4 ± 2.4 (15-20) years, the average HbA1c was 7.3 ± 0.5% (6.8-8.0%), and the average duration and numbers of Intravitreal antiviral injections were 23.8 ± 8.5 months (14-36 months) and 14.8 ± 3.2 times (10-18 times), respectively.Conclusions: We report this case series because CMV retinitis can be complicated even in diabetic patients shown to be immunocompetent.

Distribution of diabetic retinopathy in diabetes mellitus patients and its association rules with other eye diseases

The study aims to explore the distribution characteristics and influencing factors of diabetic retinopathy (DR) in diabetes mellitus (DM) patients and association rules of eye diseases in these patients. Data were obtained from 1284 DM patients at Henan Provincial People’s Hospital. Association rules were employed to calculate the probability of the common occurrence of eye-related diseases in DM patients. A web visualization network diagram was used to display the association rules of the eye-related diseases in DM patients. DR prevalence in people aged < 40 years (≥ 58.5%) was higher than that in those aged 50–60 years (≤ 43.7%). Patients with DM in rural areas were more likely to have DR than those in urban areas (56.2% vs. 35.6%, P < 0.001). DR prevalence in Pingdingshan City (68.4%) was significantly higher than in other cities. The prevalence of DR in patients who had DM for ≥ 5 years was higher than in other groups (P < 0.001). About 33.07% of DM patients had both diabetic maculopathy and DR, and 36.02% had both diabetic maculopathy and cataracts. The number of strong rules in patients ≥ 60 years old was more than those in people under 60 in age, and those in rural areas had more strong rules than those in urban areas. DM patients with one or more eye diseases are at higher risks of other eye diseases than general DM patients. These association rules are affected by factors such as age, region, disease duration, and DR severity.

Functional Role of miR-155 in the Pathogenesis of Diabetes Mellitus and Its Complications.

Substantial evidence indicates that microRNA-155 (miR-155) plays a crucial role in the pathogenesis of diabetes mellitus (DM) and its complications. A number of clinical studies reported low serum levels of miR-155 in patients with type 2 diabetes (T2D). Preclinical studies revealed that miR-155 partakes in the phenotypic switch of cells within the islets of Langerhans under metabolic stress. Moreover, miR-155 was shown to regulate insulin sensitivity in liver, adipose tissue, and skeletal muscle. Dysregulation of miR-155 expression was also shown to predict the development of nephropathy, neuropathy, and retinopathy in DM. Here, we systematically describe the reports investigating the role of miR-155 in DM and its complications. We also discuss the recent results from in vivo and in vitro models of type 1 diabetes (T1D) and T2D, discussing the differences between clinical and preclinical studies and shedding light on the molecular pathways mediated by miR-155 in different tissues affected by DM.

Corneal endothelial changes in type 2 diabetes mellitus relative to diabetic retinopathy

BackgroundTo evaluate the morphological features of corneal endothelial cells and their relationship with the stage of retinopathy in diabetes mellitus (DM).MethodsPatients with type 2 DM and age‐matched controls were included in this prospective, cross‐sectional study. Patients with diabetic retinopathy (DR) were divided into no‐DR, non‐proliferative DR and proliferative DR based on the fundus findings. Endothelial measurements were obtained using specular microscopy (Topcon SP‐3000P, Japan). Endothelial cell density, average cell area, co‐efficient variation of cell area and percentage of hexagonal cells were evaluated. Central corneal thickness (CCT) was measured using an ultrasound pachymeter. Endothelial cell parameters and CCTs of DM and control groups were compared and subgroup analysis of the patients with DM was performed.ResultsOne hundred and twenty patients (mean age 59.5 ± 8.1-years) were in the DM group, 112 patients (mean age 57.3 ± 7.2-years) were in the control group. Both the endothelial cell density and the hexagonal cell rate were lower, while the CCT was higher in the DM group. There were no significant differences between these two groups in terms of average cell area and co‐efficient variation of cell area. Significant differences were detected between endothelial cell density values of subgroups, and endothelial cell density decreased as the stage of the DR increased. The average cell area, co‐efficient variation of cell area and CCT measurements were similar across subgroups. Hexagonality values were significantly different between subgroups, with the lowest ratio of hexagonal cells in the proliferative DR group.ConclusionAdditional precautions should be taken to reduce the risk of endothelial decompensation prior to intraocular surgery, especially in patients with proliferative DR.

Choroidal structural changes correlate with severity of diabetic retinopathy in diabetes mellitus

BackgroundThis study aims to investigate the choroidal thickness and choroidal vascular density parameters and their correlation with severity of diabetic retinopathy (DR) in diabetes mellitus (DM) patients.MethodsAn observational cross-sectional study was conducted of 104 eyes, which were divided into 4 groups: Healthy controls (n = 38), DM with no DR eyes (n = 22), panretinal photocoagulation-untreated non-proliferative DR eyes (PRP-untreated NPDR eyes) (n = 24), PRP-untreated proliferative DR eyes (PRP-untreated PDR eyes) (n = 20). Optical coherence tomography (OCT) was performed. The total choroidal area (TCA), stromal area (SA), the luminal areas (LA) and the ratio of the luminal to choroidal area (L/C ratio) were compared. The choroidal parameters were also compared between PRP untreated and PRP-treated DR eyes.ResultsThe L/C ratio values were 0.68 ± 0.06 in controls and 0.63 ± 0.04 in DM eyes (P < 0.001). But there were no statistically significant differences in retinal nerve fiber layer (RNFL) thickness, retinal thickness and subfoveal choroidal thickness (SCT) measurements between the two groups (P = 0.407, P = 0.654 and P = 0.849; respectively). The vessel density values were significantly different in DM with no DR eyes, PRP-untreated NPDR eyes and PRP-untreated PDR eyes (P < 0.001 for SCT, TCA and SA). The L/C ratio values in the three groups were significant different (P = 0.019). There was no significant difference in SCT, TCA, LA, SA and the L/C ratio between PRP-untreated and PRP-treated DR eyes.ConclusionEyes of patients with DM showed the L/C ratio decreased compared with normal controls. The SCT increased, but L/C ratio significantly decreased with severity of DR eyes compared with DM and normal eyes. Changes in the L/C ratio may predict DR development before they are otherwise evident clinically. Choroidal blood flow deficit can be an early pathologic change in DR.

The prevalence of dry eye and diabetic retinopathy in diabetes mellitus and comparing with duration and urea, creatinine level

The prevalence of dry eye and diabetic retinopathy in diabetes mellitus and comparing with duration and urea, creatinine level

The prevalence of retinopathy in diabetes mellitus and associated risk factors: a community-based cross sectional study in peri urban area

Background: Visual impairment i.e. diabetic retinopathy is the one of most common manifestation of diabetes mellitus. Globally it is becoming an increasing public health problem especially in the developing countries because of increase in number of diabetic patients.Methods: A cross sectional study was conducted in the vicinity of Urban Heath and Training Centre (UHTC), Peoples University, Bhopal over a period of 6 months through screening in camps held, which included a total of 840 participants (aged ≥25 years) by following simple random procedure and in those who had newly diagnosed or long standing diabetes were referred to ophthalmologist for further evaluation. Retinopathy was determined by ophthalmoscopy and fundus photography. Anthropometric measurements (BMI), glycosylated haemoglobin were also evaluated among the confirmed diabetic patients in the study.Results: An increased prevalence of diabetes (5.95%) and retinopathy (28%) (95% CI 11.2-32.0) was found. In all age groups prevalence of bilateral blindness, bilateral low vision, unilateral blindness and unilateral low vision were respectively 2%, 28%, 0%, 70%. Independent risk indicators for the occurrence of diabetes such as age, BMI, HbA1c, were found significant for the occurrence of retinopathy in the study population.Conclusions: Visual impairment due to diabetic retinopathy remains an important public health problem in people with diabetes so timely interventions are required to resolve this major issue.

Renal cortex echogenicity increases degree of retinopathy in diabetes mellitus

Background&lt;br /&gt;The number of people with diabetes mellitus (DM) is increasing due to population growth, aging, and increasing prevalence of obesity. Diabetic retinopathy and diabetic nephropathy are two main complications of DM. Some studies suggest a correlation between diabetic nephropathy and diabetic retinopathy. However, other studies found that renal cortex echogenicity is associated with chronicity of kidney disease and renal histopathology. The aim of this study was to determine whether there is a correlation between renal cortex echogenicity as determined by renal ultrasonography and degree of retinopathy as determined by funduscopy in subjects with DM.&lt;br /&gt;&lt;br /&gt;Methods&lt;br /&gt;A cross sectional study was conducted on 41 DM subjects from September to November 2014. Data obtained by anamnesis, physical examination, and examination of ureum, creatinine, urinalysis, glycated hemoglobin (HbA1c), renal and urinary tract ultrasonography and funduscopy, were collected from all subjects. Blood samples were taken from the median cubital vein for biochemical measurements using COBAS automated analyzers. Normality of data distribution was tested using the Shapiro-Wilk test. To determine the relationship between variables the Spearman correlation test was used. &lt;br /&gt;&lt;br /&gt;Results&lt;br /&gt;Using the Spearman correlation test, a strongly significant correlation was found between degree of renal cortex echogenicity and degree of retinopathy (r=0.773; p=0.0001). A significant relationship was also found for the degree of retinopathy with age (r=0.317; p=0.044), duration of diabetes mellitus (r=0.639; p=0.0001) and HbA1c (r=0.681; p=0.001).&lt;br /&gt;&lt;br /&gt;Conclusion&lt;br /&gt;This study found that renal cortex echogenicity increased the degree of diabetic retinopathy in diabetic subjects. Renal ultrasonography for patients with type 2 DM has a great role in diagnosing and grading diabetic retinopathy.

Genetic polymorphisms of glutathione-s-transferase M1 and T1 genes with risk of diabetic retinopathy in Iranian population.

To the best of our knowledge, this is the first report on the contributions of GST genetic variants to the risk of diabetic retinopathy in an Iranian population. Therefore, the objective of this study was to determine whether sequence variation in glutathione S-transferase gene (GSTM1 and GSTT1) is associated with development of diabetic retinopathy in type 2 diabetes mellitus (T2DM) Iranian patients. A total of 605 subjects were investigated in this case-control study; Study groups consisted of 201 patients with diabetic retinopathy (DR), 203 subjects with no clinically significant signs of DR and a group of 201 cases of healthy volunteers with no clinical evidence of diabetes mellitus or any other diseases. The GSTM1 and GSTT1 were genotyped by multiplex-polymerase chain reaction (multiplex-PCR) analysis in all 404 T2DM patients and 201 healthy individuals served as control. Increased odds ratio showed that GSTM1-null genotype had a moderately higher occurrence in T2DM patients (OR=1.43, 95% CI=1.01-2.04; P=0.03) than in healthy individuals. However, the frequency of GSTT1 genotype (OR=1.41; 95% CI=0.92-2.18; P=0.09) was not significantly different comparing both groups. Although, regression analysis in T2DM patients showed that GSTM1 and GSTT1 genotypes are not associated with T2DM retinopathy development. Our findings suggest that GSTM1 and GSTT1 genotypes might not be involved in the pathogenesis of type 2 diabetes mellitus retinopathy in the Southern Iranian population. However, further investigations are needed to confirm these results in other larger populations.

Change of Retinal Nerve Fiber Layer Thickness in Various Retinal Diseases Treated With Multiple Intravitreal Antivascular Endothelial Growth Factor

To investigate the effect of multiple intravitreal injection of anti-VEGF on the retinal nerve fiber layer (RNFL) in AMD, diabetes mellitus retinopathy (DMR), and retinal vein occlusion (RVO). In this retrospective controlled case series, we reviewed the AMD, DMR, and RVO patients who received more than three anti-VEGF injections (injection group: 148 eyes). Patients without treatment were included as a control group (noninjection group: 183 eyes). RNFL thickness was measured by SD-OCT. Also, correlation between RNFL change and associated factors, including intraocular pressure (IOP), injection times, and severity of retinal ischemia, were analyzed using multivariate logistic regression. RNFL thickness (μm) had not changed in AMD, but it decreased from 100.0 to 97.1, and from 101.1 to 98.0 in injection groups of DMR and RVO, respectively, as well as the noninjection group. However, decreased RNFL thickness of the injection groups was not significantly different from those of the noninjection groups. Severity of retinal ischemia was associated with decreased RNFL thickness (odds ratio: 4.667). However, number of injections and IOP-related variables had no association with RNFL change. Multiple intravitreal injections of anti-VEGF did not lead to significant change in RNFL thickness in wet AMD, DMR, and RVO patients. Furthermore, IOP fluctuations and number of injections did not appear to adversely affect RNFL thickness. Decreased RNFL thickness associated with severity of retinal ischemia in the DMR and RVO patients suggests that inner retinal ischemia itself could be a cause of RNFL loss rather than anti-VEGF effect.

Systemic and ocular transplantation of human umbilical cord mesenchymal stem cells into rats with diabetic retinopathy

Objective To observe the effects of human umbilical cord mesenchymal stem cells (hUCMSCs) on blood glucose levels and diabetic retinopathy in diabetes mellitus (DM) rats.Method A total of 45 healthy male Sprague-Dawley rats were randomly divided into normal control group (group A,10 rats) and DM group (33 rats).Diabetic model was established in DM group by tail vein injection of streptozotocin.The DM group was further randomly divided into 3 groups (11 rats in each group),including group B (no transplantation),group C (hUCMSC was injected through tail vein) and group D (hUCMSC was injected into the vitreous).Blood glucose,retina wholemont staining and expression of brain derived neurotrophic factor (BDNF) in the retina were measured at 2,4,6,8 weeks after hUCMSC injection.The blood glucose was significantly different between A-D groups before injection (t=-64.400,-60.601,-44.065,-43.872; P=0.000) BDNF expression was studied by real time fluorescence quantitative polymerase chain reaction (RT-PCR) and immunohistochemistry staining.Results The blood glucose was significantly different between A-D groups after hUCMSC injection (F=400.017,404.410,422.043,344.109; P=0.000),and between group C and group B/D (t=4.447,4.990; P＜0.01).Immuno-staining shown that BDNF was positive in ganglion cell layer (RGC) of group A,weak in group B while BDNF expression increased in group C/D.BDNF mRNA expression was significantly different between group B,C andDat 4,6 and 8 weeks after hUCMSC injection (F 29.372,188.492,421.537; P=0.000),and between group B and C/D (t=66.781,72.401,63.880,88.423,75.120,83.002; P＜0.01) by RT-PCR analysis.The BDNF mRNA expression was significantly different between C and D groups only at 8 weeks after hUCMSC injection (t =127.321,P =0.005).Conclusions Tail vein injection of hUCMSCs can significantly reduce the blood glucose levels of rats.Intravenous and intravitreal injection of hUCMSCs can increase the expression of BDNF. Key words: Diabetic retinopathy/therapy; Mesenchymal stem cell transplantation/methods; Brain-derived neurotrophic factor

The change of oxidative stress products in diabetes mellitus and diabetic retinopathy

Aim:Enhanced oxidative stress contributes to the pathogenesis of diabetic retinopathy. The aim of this study is to detect oxidative stress parameters in type 2 diabetes mellitus with or without retinopathy...

Monitorização ambulatorial da pressão arterial e diabete melito tipo 2

Hypertension is one of the main risk factors for the onset and progression of chronic complications in type 2 diabetes mellitus (DM). Ambulatory blood pressure (BP) monitoring (ABPM) provides a better correlation with target organ lesions than BP obtained in the office. Furthermore, it allows the evaluation of distinct BP parameters such as the 24-h, daytime and nighttime systolic and diastolic BP means, BP loads and the absence of nocturnal drop of BP, as well as the identification of white-coat and masked hypertension. DM patients have higher daytime and nighttime BP means than non-DM patients. In addition, one third of normotensive type 2 DM patients have masked hypertension, which is associated with an increase in albuminuria and in left ventricle wall thickness. On the other hand, the prevalence and effect of white-coat hypertension in type 2 DM patients have not yet been properly evaluated. The absence of nocturnal drop of BP does not add information to the 24 h, daytime or nighttime BP measurements, but the nighttime BP means seem to be relevant in DM retinopathy. In conclusion, BP determination by ABPM allows better patient risk stratification for the development of DM chronic complications and is an essential instrument for effective BP control in these patients.

Identification of CML-modified Proteins in Hemofiltrate of Diabetic Patients by Proteome Analysis

The posttranslational modification of extra- and intracellular proteins by non-enzymatic glycation results in the formation of advanced glycation end products (AGEs) in physiological systems and is associated with the loss of protein structure and function. Modification by N (epsilon)-carboxymethyl lysine (CML) correlates with the risk for retinopathy in diabetes mellitus and has been discussed as a marker for the prediction of mortality in hemodialysis patients. AGEing of proteins is particularly increased under hyperglycemia associated with different late complications of diabetes mellitus. Modification of proteins to form AGE residues is significantly more enhanced in patients suffering from chronic renal disease than in hyperglycemia and is associated with increased risk for cardiovascular complications and inflammation in patients with chronic renal insuffiency. In order to identify and define the protein "substrates" for non-enzymatic glycation we used a proteome approach combining two-dimensional gel electrophoresis and immunoblotting with Edman protein sequencing to identify specific CML-modified proteins in human hemofiltrate, which essentially resembles plasma with respect to protein composition. Albumin, Ig kappa chain, prostaglandin D2 synthase, lysozyme C, plasma retinol binding protein and beta-2-microglobulin were identified as the major CML-modified proteins. CML-modified fragments of these proteins were also found in hemofiltrate. All identified proteins have in common that they appeared in hemofiltrate predominantly in their CML-modified form(s). Further studies of the functional roles of proteins identified by this new experimental approach could lead to the development of diagnostic tools to follow the progression of diabetes and contribute to the understanding of the pathogenesis of AGE-related diseases.

Molecular imaging system for possible prediction of active retinopathy in patients with Diabetes mellitus

The deposition of advanced glycation end products is enhanced in Diabetes mellitus (DM) and has been linked to diabetic complications such as a microvascular disease. Glycated proteins have receptors on mononuclear blood cells (MBCs) and have been shown to generate reactive oxygen species altering gene expression and modifying cellular targets, such as endothelial cells. Retinal angiopathy is a frequently observed microvascular complication in DM-patients. Because of the central role of activated MBCs, we hypothesised a functional link between specific alterations in gene expression of MBCs, an increased activity of matrix proteases in serum, and the extent of retinal angiopathy in DM. An appearance and proliferation index of diabetic retinopathy was evaluated in 38 DM-patients using fluorescein angiography. Alterations of gene transcription levels in MBCs were investigated using hybridisation of individual mRNA-pools to Atlas Array with a concomitant quantification of specific cDNAs by "Real-Time"-PCR. The activity of matrix metalloproteinases MMP-2 and MMP-9 in individual serum samples was measured by zymography combined with densitometric imaging system. Hybridisation to Atlas Array of mRNA-pools isolated from MBCs revealed an enhanced expression of recoverin in DM-patients compared to the control group. "Real-Time"-PCR showed the highest recoverin levels in the DM-subgroup with a high proliferation index. MMP-2 activity was highly increased in 36% of all patients, and in 44, 44, and 19% of patients with proliferative retinopathy, advanced proliferative retinopathy, and no detectable proliferation respectively. In those 3 groups MMP-9 activity was highly increased in 56, 67, and 31% of patients respectively, and in 44% of all DM-patients. In contrast to patients with active proliferation, the simultaneous high activation of all three genes was not observed in patients without active proliferation. The ex vivo molecular imaging system developed in this work may be helpful for the prediction of active proliferative retinopathy in DM.

Methods for studying the binding of advanced glycated proteins to receptors for advanced glycation endproducts (AGE receptors).

Advanced glycation endproducts (AGEs) are stable end-stage adducts formed by the nonenzymatic reaction of saccharide derivatives with proteins, nucleotides, and phospholipids. They are formed in physiological systems by glycation reactions of glucose and physiological α-oxoaldehydes, particularly glyoxal, methylglyoxal, and 3-deoxyglucosone (3-DG) with amino and guanidino groups. The concentration of intracellular AGEs is kept at alow level by protein, nucleotide, and phospholipid turnover and repair but AGEs formed on extracellular proteins may accumulate with age. Clearance of extracellular AGEs is achieved by binding of AGE-modified proteins to specific cell surface receptors-AGE receptors. AGE-ligand binding to AGE receptors is associated with internalization of the AGE ligand-receptor complex and proteolytic processing of the AGE-modified proteins. AGE-modified proteins are also stimuli for cell activation. AGE ligand binding is associated with increased expression of extracellular matrix (ECM) proteins, vascular adhesion molecules, cytokines, and growth factors. Depending on the cell type and concurrent signaling, this is associated with chemotaxis, angiogenesis, oxidative stress, and cell proliferation or apoptosis. These processes are thought to contribute to disease mechanisms associated with the chronic clinical complications of diabetes mellitus-retinopathy, neuropathy and nephropathy, cataract, macrovascular disease, Alzheimer’s disease (AD), and renal insufficiency.

The predictive value of auditory brainstem responses for diabetic retinopathy

Objective: The purpose was to find out whether there is a relationship between the central nervous system involvement and retinopathy in diabetes mellitus. Study Design: In a multidisciplinary clinical study, diabetic patients with and without retinopathy were examined utilising auditory brainstem response (ABR) testing, and the results were interpreted from clinical and pathophysiological point of view. Patients and Methods: Thirty-three diabetic patients with retinopathy (study group) and 20 diabetic patients without retinopathy (control group) were included. Audiometry and ABR testing were made. The results of both groups were compared for ABR parameters. Results: Audimetric results of the study and control groups were similar. In the study group, ABR testing revealed prolonged absolute and interpeak latency of the waves. The difference was significant for I–III interval ( P<0.01). The amplitudes of the waves were similar in both groups and wave V amplitude was significantly diminished in the study group. Abnormal waveforms were recorded by 40 and 12.5% in the study and control groups, respectively. Conclusion: Retinopathy is accompanied with lower brainstem disintegration. Microangiopathy is the possible mechanism that is involved in the occurrence of retinopathy and brainstem neuropathy. ABR can help diagnose retinopathy. Better understanding the role of ABR in diagnosis and early detection of retinopathy in diabetic patients needs further study.