scholarly journals Corrigendum to “The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials” by Yuqi Liu,Juan Li, Jinfang Ma, Nanwei Tong

2020 ◽  
Vol 2020 ◽  
pp. 1-1
Author(s):  
Yuqi Liu ◽  
Juan Li ◽  
Jinfang Ma ◽  
Nanwei Tong
Keyword(s):  
Clinical Trials ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Randomized Clinical Trials ◽  
Diabetic Patients ◽  
Intensive Glycemic Control ◽  
Using Data

scholarly journals The Threshold of the Severity of Diabetic Retinopathy below Which Intensive Glycemic Control Is Beneficial in Diabetic Patients: Estimation Using Data from Large Randomized Clinical Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yuqi Liu ◽  
Juan Li ◽  
Jinfang Ma ◽  
Nanwei Tong
Keyword(s):  
Clinical Trials ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Glucose Control ◽  
Randomized Clinical Trials ◽  
Control Group ◽  
Diabetic Patients ◽  
Large Sample Size ◽  
Intensive Glucose Control ◽  
Intensive Glycemic Control

Intensive glucose therapy can protect the retina of individuals with diabetes, but it is unknown if it provides the same protection to patients with different severity of diabetic retinopathy (DR). We finally included DR-related studies involving intensive glucose control with large sample size and long follow-up time, including five large and high-quality randomized clinical trials (RCTs): DCCT, UKPDS, ACCORD, AdRem, and VADT. With DCCT as a reference, we supposed a DR severity threshold that is verified by other RCTs then. We found that individuals who have DR lesions that are equivalent to or less severe than moderate NPDR achieve benefits for the retina by intensive glycemic control. However, these are realized only if the HbA1c in type 1 or type 2 diabetic patients is reduced at least by 0.8% versus the control group or it is reduced to <7% and >3 years of intensive glucose control is required. If the severity of DR lesions is worse than moderate NPDR, intensive glycemic control may not bring benefits.

scholarly journals Citicoline in Ophthalmological Neurodegenerative Disease: A Comprehensive Review

2021 ◽  
Vol 14 (3) ◽  
pp. 281
Author(s):  
Francesco Oddone ◽  
Luca Rossetti ◽  
Mariacristina Parravano ◽  
Diego Sbardella ◽  
Massimo Coletta ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Diabetic Retinopathy ◽  
Neurodegenerative Diseases ◽  
Brain Ischemia ◽  
Metabolic Pathways ◽  
Randomized Clinical Trials ◽  
Mitochondrial Dynamics ◽  
Ischemic Optic Neuropathy ◽  
Comprehensive Review ◽  
Dopaminergic Transmission

Cytidine 5’-diphosphocholine has been widely studied in systemic neurodegenerative diseases, like Alzheimer’s disease, Parkinson’s disease, and brain ischemia. The rationale for the use of citicoline in ophthalmological neurodegenerative diseases, including glaucoma, anterior ischemic optic neuropathy, and diabetic retinopathy, is founded on its multifactorial mechanism of action and the involvement in several metabolic pathways, including phospholipid homeostasis, mitochondrial dynamics, as well as cholinergic and dopaminergic transmission, all being involved in the complexity of the visual transmission. This narrative review is aimed at reporting both pre-clinical data regarding the involvement of citicoline in such metabolic pathways (including new insights about its role in the intracellular proteostasis through an interaction with the proteasome) and its effects on clinical psychophysical, electrophysiological, and morphological outcomes following its use in ophthalmological neurodegenerative diseases (including the results of the most recent prospective randomized clinical trials).

scholarly journals Diabetic retinopathy with or without clinically significant macular edema: The influencing factors

2016 ◽  
Vol 7 (2) ◽  
pp. 142-147
Author(s):  
Barsha Suwal ◽  
Jeevan Kumar Shrestha ◽  
Sagun Narayan Joshi ◽  
Ananda Kumar Sharma
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Macular Edema ◽  
Total Cholesterol ◽  
Cholesterol Level ◽  
Total Cholesterol Level ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Introduction: Diabetic retinopathy is the commonest micro vascular complication in patients with diabetes and remains a leading cause of blindness in people of working age group. Objective: to determine the prevalence of clinically significant macular edema (CSME) and the influence of systemic risk factors Materials and methods: It is a hospital based comparative study conducted in 220 eyes of 110 diabetic patients. DR was graded according to International Clinical Diabetic Retinopathy Severity Scale and CSME was defined according to Early Treatment Diabetic Retinopathy Study (ETDRS) system. The patients were grouped as 1) CSME group (DR and CSME in one or both eyes) and 2) Non- CSME group(CSME in none of the eyes but with any grade of DR).Level of glycosylated hemoglobin (HbA1C), serum total cholesterol, triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and urine for albumin were studied in both groups. Results: CSME was present in 36% of 110 patients. Poor glycemic control and high total cholesterol level showed positive association with CSME (p<0.05). LDL and TG levels were higher and HDL lower in CSME group. However, no statistical significance was found. Conclusion: The CSME is significantly associated with poorer glycemic control and elevated total cholesterol level.

scholarly journals Stringent glycemic control is still the key to evade diabetic retinopathy.

2020 ◽  
Vol 27 (05) ◽  
pp. 1011-1016
Author(s):  
Syed Munawar Alam ◽  
Sagheer Ahmed ◽  
Shazia Bano ◽  
Shahneela Perveen
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Proliferative Diabetic Retinopathy ◽  
Study Groups ◽  
Hplc Method ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Cross Sectional ◽  
Institutional Review

Objectives: The aim of this study was to evaluate the major determinants of diabetic retinopathy. Study Design: Cross sectional, case control study. Setting: Department of Biochemistry, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Centre, Karachi. Period: March 2015 to April 2016. Material & Methods: Ethical approval was taken from the Institutional Review Board of JPMC. A total of 208 people including type 2 diabetic patients and healthy control subjects; of male gender, aged between ≥30 years and ≤ 60 years were recruited and assigned to four study groups. Each group comprise of 52 individuals, depending on the ophthalmoscopy findings, i.e. healthy controls, diabetic without retinopathy (NDR), diabetic with non-proliferative diabetic retinopathy (NPDR) and diabetic with proliferative diabetic retinopathy (PDR). Fasting blood sugar was estimated using GOD-PAP method, while HbA1c was estimated by HPLC method. Data was analyzed on SPSS software version 16. Results: Diabetics with Diabetic Retinopathy had a poor glycemic control as compare to Diabetics without Diabetic Retinopathy (FBS; 109.12 ± 13.81 vs. 184.29 ± 40.07 vs. 188.6 ± 47.68 vs. 217.06 ± 62.33; p-value = 0.001) (HbA1c; 6.73 ± 0.56 vs. 8.40 ± 1.77 vs. 9.71 ± 1.85 vs. 14.91 ± 3.87; p-value = 0.001). For Diabetic Retinopathy the odds ratio of glycemic control i.e. FBS was observed as 1.019 & HbA1c was recorded as 1.561; which was statistically significant. Conclusion: Glycemic indicators; including FBS and HbA1c, are found to be the major determinants of Diabetic Retinopathy in our study.

scholarly journals Blinded Independent Central Review of Progression-Free Survival in Phase III Clinical Trials: Important Design Element or Unnecessary Expense?

2008 ◽  
Vol 26 (22) ◽  
pp. 3791-3796 ◽  
Author(s):  
Lori E. Dodd ◽  
Edward L. Korn ◽  
Boris Freidlin ◽  
C. Carl Jaffe ◽  
Lawrence V. Rubinstein ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Treatment Effectiveness ◽  
Progression Free Survival ◽  
Informative Censoring ◽  
Phase Iii ◽  
General Strategy ◽  
Design Element ◽  
Free Survival ◽  
Using Data

Progression-free survival is an important end point in advanced disease settings. Blinded independent central review (BICR) of progression in randomized clinical trials has been advocated to control bias that might result from errors in progression assessments. However, although BICR lessens some potential biases, it does not remove all biases from evaluations of treatment effectiveness. In fact, as typically conducted, BICRs may introduce bias because of informative censoring, which results from having to censor unconfirmed locally determined progressions. In this article, we discuss the rationale for BICR and different ways of implementing independent review. We discuss the limitations of these approaches and review published trials that report implementing BICR. We demonstrate the existence of informative censoring using data from a randomized phase II trial. We conclude that double-blinded trials with consistent application of measurement criteria are the best means of ensuring unbiased trial results. When such designs are not practical, BICR is not recommended as a general strategy for reducing bias. However, BICR may be useful as an auditing tool to assess the reliability of marginally positive results.

scholarly journals How should the ticagrelor be used? The point after the TWILIGHT and THEMIS-PCI studies

2020 ◽  
Vol 22 (Supplement_L) ◽  
pp. L72-L76
Author(s):  
Laura Gatto ◽  
Francesco Prati
Keyword(s):  
Clinical Trials ◽  
Heart Attack ◽  
Randomized Clinical Trials ◽  
Stable Coronary Artery Disease ◽  
Diabetic Patients ◽  
Increased Risk ◽  
The Face ◽  
Risk Patients ◽  
History Of ◽  
Artery Disease

Abstract The ticagrelor represents a cornerstone of antiplatelet therapy and its use has been supported, over the years, by several clinical trials that have enrolled thousands of patients; while the PLATO study initially demonstrated its effectiveness in the immediate treatment of acute coronary syndromes, the PEGASUS study documented the benefit of prolonging this treatment beyond 12 months from the heart attack. Over the past few months, two new randomized clinical trials have been published that have seen the use of ticagrelor in different clinical settings. The TWILIGHT study showed that in high-risk patients who completed 3 months of double antiplatelet drugs after coronary angioplasty, ticagrelor monotherapy is associated with a 44% reduction in the risk of clinically relevant bleeding in the absence of an increase in the ischaemic risk. The THEMIS study instead concluded that in the population of diabetics with stable coronary artery disease, but without a history of heart attack or stroke, a strategy that involves the addition of ticagrelor to the acetylsalicylic acid is not advisable as in the face of a benefit in the prevention of events ischaemic an increased risk of bleeding has been observed. Only in the subgroup of diabetic patients with a history of previous angioplasty would a more powerful antithrombotic therapy seem to be advantageous.

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