scholarly journals Black patients sustain vision loss while White and South Asian patients gain vision following delamination or segmentation surgery for tractional complications associated with proliferative diabetic retinopathy

Eye ◽  
2017 ◽  
Vol 31 (10) ◽  
pp. 1468-1474 ◽  
Author(s):  
R Mastropasqua ◽  
Y H-L Luo ◽  
Y S Cheah ◽  
C Egan ◽  
J J Lewis ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
South Asian ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Asian Patients ◽  
Black Patients

scholarly journals Visual Cortex Transcranial Direct Current Stimulation for Proliferative Diabetic Retinopathy Patients: A Double-Blinded Randomized Exploratory Trial

2021 ◽  
Vol 11 (2) ◽  
pp. 270
Author(s):  
Angelito Braulio F. de Venecia ◽  
Shane M. Fresnoza
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Cortex ◽  
Proliferative Diabetic Retinopathy ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Vision Loss ◽  
Sham Stimulation ◽  
Direct Current Stimulation ◽  
Residual Vision ◽  
Cathodal Tdcs

Proliferative diabetic retinopathy (PDR) is a severe complication of diabetes. PDR-related retinal hemorrhages often lead to severe vision loss. The main goals of management are to prevent visual impairment progression and improve residual vision. We explored the potential of transcranial direct current stimulation (tDCS) to enhance residual vision. tDCS applied to the primary visual cortex (V1) may improve visual input processing from PDR patients’ retinas. Eleven PDR patients received cathodal tDCS stimulation of V1 (1 mA for 10 min), and another eleven patients received sham stimulation (1 mA for 30 s). Visual acuity (logarithm of the minimum angle of resolution (LogMAR) scores) and number acuity (reaction times (RTs) and accuracy rates (ARs)) were measured before and immediately after stimulation. The LogMAR scores and the RTs of patients who received cathodal tDCS decreased significantly after stimulation. Cathodal tDCS has no significant effect on ARs. There were no significant changes in the LogMAR scores, RTs, and ARs of PDR patients who received sham stimulation. The results are compatible with our proposal that neuronal noise aggravates impaired visual function in PDR. The therapeutic effect indicates the potential of tDCS as a safe and effective vision rehabilitation tool for PDR patients.

scholarly journals Wide-field imaging in proliferative diabetic retinopathy

2019 ◽  
Vol 5 (S1) ◽  
Author(s):  
T. Y. Alvin Liu ◽  
J. Fernando Arevalo
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Current Data ◽  
Panretinal Photocoagulation ◽  
Main Body ◽  
Wide Field ◽  
Fundus Imaging ◽  
Field Imaging ◽  
Wide Field Imaging

Abstract Background Diabetic retinopathy (DR) is one of the leading causes of vision loss worldwide. For decades, 7-field 30-degree fundus imaging has been the gold standard for DR classification. The aim of this review article is to discuss how the advent of ultra-wide-field (UWF) fundus imaging has changed the management of proliferative diabetic retinopathy (PDR). Main body Current data suggests that UWF imaging, as compared to conventional Early Treatment Diabetic Retinopathy Study (ETDRS) fields, detects additional and more extensive PDR pathologies. DR lesions, captured by UWF imaging outside of ETDRS fields, likely carry prognostication value. Conclusion UWF imaging represents a major advancement in the detection and management of DR. It remains unclear whether, when and how patients, with PDR changes only peripheral to standard ETDRS fields, should be treated. A larger, prospective, randomized clinical trial is also needed to compare the efficacy of UWF image-guided targeted laser photocoagulation with that of conventional panretinal photocoagulation.

Outcomes of Surgically Managed Proliferative Diabetic Retinopathy

2018 ◽  
Vol 2 (6) ◽  
pp. 338-342
Author(s):  
Amir Hadayer ◽  
Brett H. Mueller ◽  
Janelle Fassbender Adeniran ◽  
Charles C. Barr
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Average Duration ◽  
Vitreous Hemorrhage ◽  
Retrospective Chart Review ◽  
University Of Louisville ◽  
Small Gauge ◽  
23 Gauge

Purpose: The purpose of this article is to conduct a retrospective chart review of the results of vitrectomy for diabetic vitreous hemorrhage (VH) and diabetic traction retinal detachment (TRD) using small-gauge instruments. Methods: We retrospectively reviewed medical records of all diabetic vitrectomies performed at the University of Louisville from 2012 to 2016 that had at least 6 months of follow-up. Patients included in this study underwent pars plana vitrectomy (PPV) for proliferative diabetic retinopathy complications. We analyzed the preoperative and 6- and 12-month postoperative visual acuities (VAs) in patients who had vitrectomy for their diabetic retinopathy. We also determined the proportion of patients who had best-corrected visual acuity (BCVA) of 20/40 or better and 20/80 or worse. In the patients who had BCVA of 20/80 or worse, we identified the reasons for the decreased VA. We also report intraocular pressure, demographic characteristics, operative techniques, and complications. Results: We identified 93 eyes that underwent diabetic vitrectomy; 81 eyes of 63 patients had at least 6 months’ follow-up. Of those 81 eyes, 40 eyes had VH only; the average duration of vision loss before surgery was 4.7 months. Forty-one eyes had TRDs with average duration of vision loss before surgery of 7 months. The presenting BCVA was 1.14 logMAR (20/300) in the VH-only group and 1.49 logMAR (20/600) in the TRD group ( P < .09). Six months after surgery, the BCVA was 0.59 logMAR (20/80) in the VH-only group but still 1.37 logMAR (20/500) in the TRD group ( P < .001). By 12 months after surgery (63 eyes), the BCVA was 0.60 logMAR (20/80) vs 1.09 logMAR (20/250), respectively ( P < .02). Technical success was achieved in 79 of 81 eyes. At 12 months after surgery, 22 eyes (55%) in the VH-only group and 19 eyes (46%) in the TRD group gained 15 letters or more (doubling the VA) compared with their presenting VA. In the VH-only group 7 eyes (18%) were 23-gauge (G) PPV, 22 (58%) were 25G PPV, and 9 (24%) were 27G PPV, while in the TRD group 15 (38%) were 20G PPV, 11 (27%) were 23G PPV, and 14 (35%) were 25G PPV. There was no difference in outcome with different gauges. Conclusions: While vitrectomy for complications of diabetic retinopathy was technically successful with small-gauge surgery, visual results were disappointing. Further work is needed to clarify the best timing of surgery to improve visual outcomes.

scholarly journals Survival Time of Visual Gains after Diabetic Vitrectomy and Its Relationship with Ischemic Heart Disease

2020 ◽  
Vol 17 (1) ◽  
pp. 310
Author(s):  
Abdah Khairiah Che Md Noor ◽  
Evelyn Li Min Tai ◽  
Yee Cheng Kueh ◽  
Ab Hamid Siti-Azrin ◽  
Zamri Noordin ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Survival Time ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Ischemic Heart ◽  
Vitrectomy Surgery

Vitrectomy surgery in proliferative diabetic retinopathy improves the vision-related quality of life. However, there is lack of data on the duration of maintenance of visual gains post vitrectomy. This study thus aimed to determine the survival time of visual gains and the prognostic factors of vision loss after vitrectomy surgery for complications of proliferative diabetic retinopathy. A retrospective cohort study was conducted in an ophthalmology clinic in Malaysia. We included 134 patients with type 2 diabetes mellitus on follow-up after vitrectomy for proliferative diabetic retinopathy. Visual acuity was measured using the log of minimum angle of resolution (LogMar). A gain of ≥0.3 LogMar sustained on two subsequent visits was considered evidence of visual improvement post vitrectomy. Subjects were considered to have vision loss when their post-operative visual acuity subsequently dropped by ≥0.3 LogMar. Kaplan–Meier analysis was used to determine the survival time of visual gains. Cox Proportional Hazard regression was used to determine the prognostic factors of vision loss. The median age of patients was 56.00 years (IQR ± 10.00). The median duration of diabetes mellitus was 14.00 years (IQR ± 10.00). Approximately 50% of patients with initial improvement post vitrectomy subsequently experienced vision loss. The survival time, i.e., the median time from surgery until the number of patients with vision loss formed half of the original cohort, was 14.63 months (95% CI: 9.95, 19.32). Ischemic heart disease was a significant prognostic factor of vision loss. Patients with underlying ischemic heart disease (adjusted HR: 1.97, 95% CI: 1.18, 3.33) had a higher risk of vision loss post vitrectomy, after adjusting for other factors. Approximately half the patients with initial visual gains post vitrectomy maintained their vision for at least one year. Ischemic heart disease was a poor prognostic factor for preservation of visual gains post vitrectomy.

scholarly journals EFFECT OF MRIDWEEKADI KASHAYA SEKA IN RETINAL HAEMORRHAGES ASSOCIATED WITH NON-PROLIFERATIVE DIABETIC RETINOPATHY – A CLINICAL STUDY

2021 ◽  
pp. 1-10
Author(s):  
Navaneetha K.P ◽  
Sunil Kumar S ◽  
Kusumam Joseph
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Contrast Sensitivity ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Control Sample ◽  
Modern Science ◽  
Rank Test ◽  
Fundus Photographs ◽  
Retinal Haemorrhages

Diabetic retinopathy (DR) is a leading cause of acquired vision loss in middle-aged and elderly people globally. In modern science, other than the meticulous control of diabetes there is no proven non-invasive management for the prevention or cure of Diabetic retinopathy. In this study, mild to moderate Non-proliferative diabetic retinopathy (NPDR) with retinal haemorrhages is considered as a Timira (symptomatically) and as Abhishyanda (considering etiopathogenesis) with Kapha-pitta predominance. Mridweekadi kashaya, predominantly Kapha Pitta samana, was selected for the study to be used as Seka. Method: The study design was Interventional- pre and post evaluation without control, sample size fixed as 30 eyes. Mridweekadi kashaya was used as Seka for 21 days, twice daily. Fundus photographs were taken prior to commencement of Seka, on the 22nd day and then on 30th and 60th day after completion of the procedure. Change in extent of retinal hemorrhages were assessed as visualized in Fundus photographs and direct ophthalmoscopy. Change in visual acuity was assessed by LogMar Visual acuity chart and change in contrast sensitivity by Pelli-Robson contrast sensitivity chart consecutively, prior to the treatment, on the 10th day, 22nd day and then on 30th and 60th day after completion of procedure. Statistical analysis was done using Wilcoxon signed rank test and Paired t test according to the variable. Result: Control in retinal haemorrhages associated with NPDR and improvement in visual acuity and contrast sensitivity. Conclusion: Mridweekadi kashaya seka is effective in controlling retinal haemorrhages associated with NPDR.

scholarly journals Effects of Ocufolin on retinal microvasculature in patients with mild non-proliferative diabetic retinopathy carrying polymorphisms of the MTHFR gene

2021 ◽  
Vol 9 (1) ◽  
pp. e002327
Author(s):  
Zhiping Liu ◽  
Hong Jiang ◽  
Justin H Townsend ◽  
Jianhua Wang
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Structural Changes ◽  
Methylenetetrahydrofolate Reductase ◽  
Vision Loss ◽  
Retinal Vessel ◽  
Mthfr Gene ◽  
Mthfr Polymorphisms ◽  
Retinal Microvasculature

IntroductionTo evaluate effects of Ocufolin on retinal microvasculature in mild non-proliferative diabetic retinopathy patients who carried methylenetetrahydrofolate reductase (MTHFR) polymorphisms (DR+MTHFRP).Research design and methodsThis is a prospective cohort study. Eight DR+MTHFRP (administrated Ocufolin for 6 months) and 15 normal controls (NCs) were recruited. MTHFR polymorphisms were subtyped as normal, C677T, or A1298C. Best-corrected visual acuity (BCVA) was evaluated. Retinal vessel density (VD) and microstructure were evaluated by optical coherence tomography angiography.ResultsBCVA and vascular indices of DR+MTHFRP at baseline were worse than those of NC and improved. Compared with baseline, DR+MTHFRP had significantly improved BCVA during follow-up period (p<0.05). VD of superficial vascular plexus was increased at 4 months (p=0.012), while VD of retinal vascular network did not change (p>0.05). Carriers of A1298C and C677T showed statistically significant increase in VD at all layers by 6 months, while carriers of C677T alone showed no significant change and carriers of A1298C alone showed decreased density from 4 months to 6 months. Microstructure did not change during the follow-up period.ConclusionA 6-month intake of Ocufolin is capable of reversing structural changes of microangiopathy in mild non-proliferative DR+MTHFRP. This suggests a novel way to address these impairments prior to catastrophic vision loss.

scholarly journals Hubungan tekanan intraocular dengan diabetes retinopati proliferatif

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Felix Martua ◽  
Laya Rares ◽  
Yamin Tongku
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Intraocular Pressure ◽  
Proliferative Diabetic Retinopathy ◽  
Vital Sign ◽  
Vision Loss ◽  
Severe Form ◽  
Common Complication ◽  
Dummy Variable ◽  
Period Data

Abstrak: Diabetes Mellitus (DM) adalah penyakit tidak menular yang diderita lebih dari 170 juta orang di seluruh dunia, salah satu komplikasi dari DM adalah diabetes retinopati dimana salah satu bentuknya adalah proliferatif (PDR). Jika PDR tidak ditangani dengan cepat maka akan menimbulkan penurunan tajam penglihatan dan disertai peningkatan tekanan intraokular (TIO). Penelitian ini dilakukan untuk menemukan hubungan antara PDR dengan peningkatan TIO. Penelitian dilakukan dengan metode analitik retrospektif, dengan menggunakan data rekam medik dari pasien yang berobat di Poliklinik Mata RSUP Prof. R.D. Kandou Manado periode Januari 2015-September 2016. Data yang diambil antara lain status tekanan intraocular dan tanda vital pasien sebelum menerima tindakan terapi. Dari 24 data rekam medik pasien yang memenuhi kriteria didapat 15 pasien jenis kelamin perempuan (62,5%) dan 9 pasien jenis kelamin laki-laki (37,5%). Rentang usia paling banyak terkena PDR adalah 55-64 tahun sebanyak 10 orang (41,7%). Hasil analisis menggunakan metode analisis regresi dengan variabel dummy terdapat tingkat hubungan sebesar 29,7% yang berarti PDR sedikit berpengaruh pada TIO, dengan p=0,03 yang menunjukkan hubungan yang kurang signifikan antara PDR dan TIO (p<0,05). Simpulan: didapat hubungan yang kurang signifikan antara PDR dan TIO.Kata kunci: diabetes retinopati proliferatif, tekanan intraokular Abstract: Diabetes Mellitus (DM) is an uninfectious disease that affect more than 170 million persons worldwide. Diabetic retinopathy is one of the most common complication on people with diabetes, and Proliferative Diabetic Retinopathy (PDR) is the most severe form of diabetic retinopathy. PDR will cause vision loss if not treated quickly and causing elevation of intraocular pressure (IOP). PDR and its association with elevation of IOP is the main focus of this study. This study was an analytic-retrospective, using the data from medical record of patients that visits Polyclinic of Opthalmology in Prof. R.D. Kandou Hospital from January 2015 until September 2016 period. Data used for this study is IOP, vision status, and vital sign, and the IOP was measured before patient taking any medication. From 24 samples were used for this study, 15 of them is females (62,5%), based on age span, most patients with PDR are between 55-64 y.o. by 10 people (41,7%). Analytic result using dummy variable shows PDR has little effect to IOP, by 29,7% and shows little signifancy (p=0,03; p<0,05). Conclusion: PDR has little significant correlation to IOP. Keywords: proliferative diabetic retinopathy, intraocular pressure

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