scholarly journals Discordance in Retinal and Choroidal Vascular Densities in Patients with Type 2 Diabetes Mellitus on Optical Coherence Tomography Angiography

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ho Ra ◽  
Nam Yeo Kang ◽  
Jiyun Song ◽  
Junhyuck Lee ◽  
Inkee Kim ◽  
...  

Purpose. In the present study, the retinal and choroidal vascular densities (VDs) in type 2 diabetes mellitus (DM) patients were analyzed using optical coherence tomography angiography (OCTA). Methods. The study included 282 eyes of 152 patients with type 2 DM (114 without retinopathy, 79 nonproliferative diabetic retinopathy (NPDR), 48 severe NPDR, and 41 proliferative diabetic retinopathy (PDR) eyes). The superficial and deep retinal vessel, choriocapillaris, and choroidal VDs were measured using a binarization method on OCTA images. VDs were compared based on retinopathy severity. Correlations among densities were analyzed. Results. Retinal and choriocapillaris VDs were lower in PDR than in NPDR (all P < 0.05 ). Correlation analysis showed significant positive correlations among densities of superficial and deep retinal vessels and choriocapillaris (all P < 0.001 ). Choroidal VD showed a negative correlation with superficial and deep retinal vessels and choriocapillaris (all P < 0.001 ). Retinal and choriocapillaris VDs showed a negative correlation with diabetic retinopathy (DR) grade (all P < 0.001 ); however, the choroidal VD showed a weak positive correlation ( P = 0.030 ). Conclusion. Choroidal VD increased as retinal and choriocapillaris VDs decreased, indicating that the outer layer of the choroid is less affected by DR severity and VD of larger choroidal vessels may even be increased as a compensatory mechanism for decreased retinal and choriocapillaris VDs in type 2 DM patients.

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052096398
Author(s):  
Lin Hou ◽  
Yingzhou Shi ◽  
Sichao Wang ◽  
Qing Chen ◽  
Qiu Li ◽  
...  

Objectives To analyze the associations of serum uric acid (SUA) level with diabetic microvascular complications, including diabetic retinopathy (DR) and diabetic nephropathy (DN), in patients with type 2 diabetes mellitus (DM). Methods Three hundred eighty-nine inpatients with type 2 DM were included in this retrospective analysis. Nonmydriatic fundus cameras were used to identify DR. Urinary albumin creatinine ratio was used to identify DN. Patients were divided into four groups according to SUA quartiles. Results The prevalences of DR and albuminuria increased with increasing SUA level. Multivariate logistic regression analysis showed that, following adjustment for other risk factors, higher levels of SUA (Q3 and Q4) were associated with greater risk for DR, compared with the lower level (Q1) (odds ratio [OR]: 3.056, 95% confidence interval [CI]: 1.506–6.198; OR: 3.417, 95% CI: 1.635–7.139, respectively). Moreover, higher levels of SUA (Q2, Q3, and Q4) were associated with greater risk for albuminuria (OR: 2.418, 95% CI: 1.059–5.522; OR: 7.233, 95% CI: 3.145–16.635; and OR: 8.911, 95% CI: 3.755–21.147, respectively). Conclusions SUA level was independently associated with DR and albuminuria in patients with type 2 DM. Elevated SUA level might be predictive for the occurrence of DR and DN.


Author(s):  
Satish Nayak ◽  
Karthik Rao ◽  
Navin Patil ◽  
Jayaprakash B ◽  
Amita Priya D ◽  
...  

  Objectives: In India, 69.1 million are diabetics as of 2015 compared to 18 million in 1995. Pan India prevalence study in diabetics carried out at 194 centers by All India Ophthalmological Society reported the prevalence of diabetic retinopathy (DR) among diabetics as 21.8%. DR is of two types, non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR). The severity of NPDR depends on microaneurysms, hemorrhages, cotton wool spots, and beading of veins and can progress to PDR. Inherit characteristic of PDR is neovascularization. The aim of this observational prevalence study is to study the prevalence of diabetic retinopathy in Type 2 diabetic patients attending diabetic clinic and to study the distribution of diabetic retinopathy with respect to age, sex, and duration of disease in a tertiary care hospital in southern India.Methods: This is a retrospective observational study. Age above 20 years and patients diagnosed with Type 2 diabetes mellitus (DM) and examined by the ophthalmologist were included and others excluded. Data documented were analyzed using statistical software SPSS version 16.Results: About 52.07% of patients with Type 2 DM for more than 10 years had diabetic retinopathy and 13.07 % of patients with Type 2 DM for more than 5 years have diabetic retinopathy.Conclusion: India being the diabetic capital of the world and DR being the most common cause for visual impairment and blindness and it becomes empirical to assess the factors for its rising prevalence, which will significantly contribute in reducing the progression of DR.


2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Elena Garcia-Martin ◽  
Marta Cipres ◽  
Isabel Melchor ◽  
Laura Gil-Arribas ◽  
Elisa Vilades ◽  
...  

Purpose. To evaluate neurodegeneration in patients with type 2 diabetes mellitus (DM2) without diabetic retinopathy and to assess the possible role of systemic vascular complications in retinal changes. Methods. Sixty eyes of 60 patients with DM2 and without any signs of diabetic retinopathy and 60 eyes of 60 healthy controls underwent retinal evaluation using Spectralis optical coherence tomography. Macular ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) were evaluated. Peripapillary RNFL thickness was assessed using Glaucoma and Axonal Analytics applications. Comparison between patients with the presence/absence of systemic vascular complications and different disease duration was made. Results. Macular GCL was reduced in patients compared to controls (p<0.001). Differences in the macular RNFL thickness were only observed in the outer inferior sector (p=0.033). A reduction in the peripapillary RNFL (average, inferior, and inferotemporal thickness, p<0.05 for all three) was observed in patients using both applications. Patients with chronic systemic vascular complications presented a reduction in the temporal RNFL (p=0.019) compared to patients without complications. The superotemporal RNFL thickness was thinner in patients with longer disease duration. Conclusions. Patients with type 2 DM without diabetic retinopathy and good metabolic control present neurodegeneration affecting neurons in the macular area and axons in different sectors of the optic disc. Systemic vascular complications contributed to further axonal damage in these patients, suggesting a possible role of subclinical ischaemia to retinal neurodegeneration in type 2 DM.


2015 ◽  
Author(s):  
Sattar El-Deeb Abd El ◽  
Mohamed Halawa ◽  
Ahmed Saad ◽  
Inas Sabry ◽  
Maram Mahdy ◽  
...  

2018 ◽  
Vol 71 (1) ◽  
pp. 49-53
Author(s):  
N. Zherdiova ◽  
◽  
N. Medvedovska ◽  
B Mankovsky ◽  
◽  
...  

2021 ◽  
Vol 9 (1) ◽  
pp. e001443
Author(s):  
Jingjing Zuo ◽  
Yuan Lan ◽  
Honglin Hu ◽  
Xiangqing Hou ◽  
Jushuang Li ◽  
...  

IntroductionDespite advances in diabetic retinopathy (DR) medications, early identification is vitally important for DR administration and remains a major challenge. This study aims to develop a novel system of multidimensional network biomarkers (MDNBs) based on a widely targeted metabolomics approach to detect DR among patients with type 2 diabetes mellitus (T2DM) efficiently.Research design and methodsIn this propensity score matching-based case-control study, we used ultra-performance liquid chromatography-electrospray ionization-tandem mass spectrometry system for serum metabolites assessment of 69 pairs of patients with T2DM with DR (cases) and without DR (controls). Comprehensive analysis, including principal component analysis, orthogonal partial least squares discriminant analysis, generalized linear regression models and a 1000-times permutation test on metabolomics characteristics were conducted to detect candidate MDNBs depending on the discovery set. Receiver operating characteristic analysis was applied for the validation of capability and feasibility of MDNBs based on a separate validation set.ResultsWe detected 613 features (318 in positive and 295 in negative ESI modes) in which 63 metabolites were highly relevant to the presence of DR. A panel of MDNBs containing linoleic acid, nicotinuric acid, ornithine and phenylacetylglutamine was determined based on the discovery set. Depending on the separate validation set, the area under the curve (95% CI), sensitivity and specificity of this MDNBs system were 0.92 (0.84 to 1.0), 96% and 78%, respectively.ConclusionsThis study demonstrates that metabolomics-based MDNBs are associated with the presence of DR and capable of distinguishing DR from T2DM efficiently. Our data also provide new insights into the mechanisms of DR and the potential value for new treatment targets development. Additional studies are needed to confirm our findings.


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