scholarly journals Diabetic retinopathy: history, modern approaches to management, prospective views of prevention and treatment

2020 ◽  
Vol 23 (1) ◽  
pp. 95-105
Author(s):  
Tatiana Y. Demidova ◽  
Alexander A. Kozhevnikov
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Diabetic Macular Oedema ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Laser Coagulation ◽  
Ongoing Research ◽  
Obstructive Sleep ◽  
Prevention And Treatment ◽  
The Impact

Diabetic retinopathy (DR) is a serious complication of diabetes mellitus (DM). As DR progresses, it could be complicated with a significant decrease or complete loss of vision. It is the leading cause of blindness in the working-age population and, according to global estimates, occurs in one in every three patients with diabetes. DR has been studied for more than 160 years, and the implementation of retinal laser coagulation into clinical practice in the 20th century, and then vascular endothelial growth factor (VEGF) inhibitors in the 21th century, allowed us to influence vascular proliferation in DR and reduce the risk of vision loss from diabetic macular oedema (DME). However, these tools can only stop the progression of DR at the stages with risk of complications with vision loss, and prevention screenings and the impact on risk factors (hyperglycaemia, arterial hypertension, and dyslipidemia) remains as the main method of management of DR. Possible new risk factors (hypodynamy, obesity, body weight deficiency, and obstructive sleep apnoea syndrome) attract a lot of attention, and there is ongoing research for early markers of DR in the fundus, which could allow more active influence on the pathological process in its early stages. This review focuses on epidemiology, history of research, proven and possible risk factors, and current and promising approaches to the prevention and treatment of DR, including accurate, less traumatic laser techniques (PASCAL, NAVILAS, and D-MPL), and intravitreal antiangiogenic drugs in studies.

IDENTIFICATION AND ASSESSMENT OF RISK FACTORS ROLE IN MYOCARDIAL INFARCTION DEVELOPMENT

2019 ◽  
Vol 72 (5) ◽  
pp. 779-783
Author(s):  
Victor A. Ognev ◽  
Anna A. Podpriadova ◽  
Anna V. Lisova
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Cardiovascular System ◽  
Control Group ◽  
Biological Factors ◽  
Prevention And Treatment ◽  
High Level ◽  
Social Importance ◽  
The Impact

Introduction:The high level of morbidity and mortality from cardiovascular disease is largely due toinsufficient influence on the main risk factors that contribute to the development of myocardial infarction.Therefore, a detailed study and assessment of risk factors is among the most important problems of medical and social importance. The aim: To study and evaluate the impact of biological, social and hygienic, social and economic, psychological, natural and climatic risk factors on the development of myocardial infarction. Materials and methods: A sociological survey was conducted in 500 people aged 34 to 85. They were divided into two groups. The main group consisted of 310 patients with myocardial infarction. The control group consisted of 190 practically healthy people, identical by age, gender and other parameters, without diseases of the cardiovascular system. Results: It was defined that 30 factors have a significant impact on the development of myocardial infarction.Data analysis revealed that the leading risk factors for myocardial infarction were biological and socio-hygienic. The main biological factors were: hypertension and hypercholesterolemia. The man socio-hygienic factor was smoking. Conclusions: Identification of risk factors provides new opportunities for the development of more effective approaches for the prevention and treatment of myocardial infarction.

Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

2019 ◽  
Vol 70 (10) ◽  
pp. 3582-3586
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Obstructive Sleep Apnoea ◽  
Cardiovascular Events ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Obstructive Sleep

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it’s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (± 9.67) in all cases. It was higher in men (22.17% ± 9.24) compare to women (12.39% ± 6.92) and it was not significantly different by stages of OSAS severity (20.58% ±9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation. Keywords: obstructive sleep apnoea syndrome, cardiovascular events, risk factors, oxygen desaturation

scholarly journals Rho-Kinase Inhibitors for the Treatment of Refractory Diabetic Macular Oedema

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1683
Author(s):  
Milagros Mateos-Olivares ◽  
Luis García-Onrubia ◽  
Fco. Javier Valentín-Bravo ◽  
Rogelio González-Sarmiento ◽  
Maribel Lopez-Galvez ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Oedema ◽  
Standard Therapy ◽  
Vision Loss ◽  
Therapeutic Potential ◽  
Rho Kinase ◽  
Diabetic Macular Oedema ◽  
New Drugs ◽  
Anti Vegf

Diabetic macular oedema (DMO) is one of the leading causes of vision loss associated with diabetic retinopathy (DR). New insights in managing this condition have changed the paradigm in its treatment, with intravitreal injections of antivascular endothelial growth factor (anti-VEGF) having become the standard therapy for DMO worldwide. However, there is no single standard therapy for all patients DMO refractory to anti-VEGF treatment; thus, further investigation is still needed. The key obstacles in developing suitable therapeutics for refractory DMO lie in its complex pathophysiology; therefore, there is an opportunity for further improvements in the progress and applications of new drugs. Previous studies have indicated that Rho-associated kinase (Rho-kinase/ROCK) is an essential molecule in the pathogenesis of DMO. This is why the Rho/ROCK signalling pathway has been proposed as a possible target for new treatments. The present review focuses on the recent progress on the possible role of ROCK and its therapeutic potential in DMO. A systematic literature search was performed, covering the years 1991 to 2021, using the following keywords: “rho-Associated Kinas-es”, “Diabetic Retinopathy”, “Macular Edema”, “Ripasudil”, “Fasudil” and “Netarsudil”. Better insight into the pathological role of Rho-kinase/ROCK may lead to the development of new strategies for refractory DMO treatment and prevention.

Beyond vision loss: the independent impact of diabetic retinopathy on vision-related quality of life in a Chinese Singaporean population

2018 ◽  
Vol 103 (9) ◽  
pp. 1314-1319 ◽  
Author(s):  
Eva K Fenwick ◽  
Ryan E K Man ◽  
Alfred Tau Liang Gan ◽  
Neelam Kumari ◽  
Charlene Wong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Well Being ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Significant Difference ◽  
Related Quality ◽  
The Impact

Background/aimsTo assess the independent impact of diabetic retinopathy (DR) on three domains of vision-related quality of life (VRQoL) in a Chinese Singapore population.MethodsThe Singapore Chinese Eye Study (n=3353; 2009–2011) was a population-based, prospective, cross-sectional study conducted at the Singapore Eye Research Institute. The study population included 292 adults with diabetes, with and without DR. DR (better eye) was categorised as presence and absence of any DR; severity of DR (no vision-threatening DR (VTDR); severe non-proliferative DR (NPDR); PDR and/or clinically significant macular oedema and VTDR). Our main outcome was VRQoL which was measured using Rasch-calibrated scores from the ‘Reading’, ‘Mobility’ and ‘Emotional’ domains of the Impact of Vision Impairment questionnaire. The relationship between DR and VRQoL was assessed using multiple linear regression models.ResultsOf the 292 individuals (mean age 61.35 ± 9.66 years; 55.8% male), 201 (68.8%), 49 (16.8%), 20 (6.8%), 22 (7.5%) and 27 (9.2%) had no DR, minimal-mild NPDR, moderate-severe NPDR, PDR and VTDR, respectively. Any DR and VTDR were independently associated with 6% and 12% worse Reading scores and 7% and 18% poorer Emotional well-being, respectively, compared with those without DR. These associations persisted after separate adjustment for visual impairment and presenting visual acuity. No significant difference was found in the Mobility domain between persons with and without DR.ConclusionsWe documented that DR, particularly VTDR, was independently associated with restrictions in Reading and Emotional well-being. Understanding factors underlying the detrimental DR-VRQoL relationship may optimise rehabilitation outcomes for individuals with DR.

scholarly journals Poorer Quality of Life and Treatment Satisfaction is Associated with Diabetic Retinopathy in Patients with Type 1 Diabetes without Other Advanced Late Complications

2019 ◽  
Vol 8 (3) ◽  
pp. 377 ◽  
Author(s):  
Minerva Granado-Casas ◽  
Esmeralda Castelblanco ◽  
Anna Ramírez-Morros ◽  
Mariona Martín ◽  
Nuria Alcubierre ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Treatment Satisfaction ◽  
Vision Loss ◽  
Multivariable Analysis ◽  
Work Life ◽  
The Impact

Diabetic retinopathy (DR) may potentially cause vision loss and affect the patient’s quality of life (QoL) and treatment satisfaction (TS). Using specific tools, we aimed to assess the impact of DR and clinical factors on the QoL and TS in patients with type 1 diabetes. This was a cross-sectional, two-centre study. A sample of 102 patients with DR and 140 non-DR patients were compared. The Audit of Diabetes-Dependent Quality of Life (ADDQoL-19) and Diabetes Treatment Satisfaction Questionnaire (DTSQ-s) were administered. Data analysis included bivariate and multivariable analysis. Patients with DR showed a poorer perception of present QoL (p = 0.039), work life (p = 0.037), dependence (p = 0.010), and had a lower average weighted impact (AWI) score (p = 0.045). The multivariable analysis showed that DR was associated with a lower present QoL (p = 0.040), work life (p = 0.036) and dependence (p = 0.016). With regards to TS, DR was associated with a higher perceived frequency of hypoglycaemia (p = 0.019). In patients with type 1 diabetes, the presence of DR is associated with a poorer perception of their QoL. With regard to TS, these subjects also show a higher perceived frequency of hypoglycaemia.

scholarly journals Andalusian program for early detection of diabetic retinopathy: implementation and 15-year follow-up of a population-based screening program in Andalusia, Southern Spain

2020 ◽  
Vol 8 (1) ◽  
pp. e001622 ◽  
Author(s):  
Rafael Rodriguez-Acuña ◽  
Eduardo Mayoral ◽  
Manuel Aguilar-Diosdado ◽  
Reyes Rave ◽  
Beatriz Oyarzabal ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Early Detection ◽  
Vision Loss ◽  
Screening Program ◽  
Target Population ◽  
Population Based ◽  
Annual Incidence ◽  
Population Coverage ◽  
Visual Disability ◽  
The Impact

IntroductionDiabetic retinopathy (DR) is a preventable cause of vision loss and blindness worldwide. We aim at analyzing the impact of a population-based screening program of DR using retinal photography with remote reading in terms of population coverage, diagnosis of asymptomatic DR and impact on visual disability, in the region of Andalusia, Spain, in the period 2005–2019.Research design and methodsDescriptive study. Sociodemographic and clinical features included in the Andalusian program for early detection of diabetic retinopathy (APDR) were analyzed. Population coverage, annual incidence of DR, and DR severity gradation were analyzed. Estimated data on prevalence and incidence of legal blindness due to DR were included.Results407 762 patients with at least one successful DR examination during the study period were included. Most of the performed retinographies (784 584, 84.3%) were ‘non-pathological.’ Asymptomatic DR was detected in 52 748 (5.9%) retinographies, most of them (94.2%) being classified as ‘mild to moderate non-proliferative DR.’ DR was detected in 44 815 patients, while sight-threatening DR (STDR) in 6256 patients; cumulative incidence of DR was 11.0% and STDR was 1.5%, as DR and STDR was detected in 44 815 and 6256 patients, respectively. Annual incidence risk per patient recruitment year progressively decreased from 22.0% by January 2005 to 3.2% by June 2019.ConclusionsImplementation of a long-term population-based screening program for early detection of DR is technically feasible and clinically viable. Thus, after 15 years of existence, the program has enabled the screening of the vast majority of the target population allowing the optimization of healthcare resources and the identification of asymptomatic DR.

scholarly journals Cardiovascular risk factors in men and women with obstructive sleep apnoea syndrome

2010 ◽  
Vol 104 (7) ◽  
pp. 1063-1068 ◽  
Author(s):  
Jean-Pierre Laaban ◽  
Line Mounier ◽  
Olivier Roque d'Orbcastel ◽  
Dan Veale ◽  
Jacques Blacher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Men And Women ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

scholarly journals Identifying Genetic Risk Factors for Diabetic Macular Edema and the Response to Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Rajya L. Gurung ◽  
Liesel M. FitzGerald ◽  
Bennet J. McComish ◽  
Nitin Verma ◽  
Kathryn P. Burdon
Keyword(s):  
Risk Factors ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Genetic Risk ◽  
Vision Loss ◽  
Genetic Risk Factors ◽  
Response To Treatment ◽  
Diabetic Eye Disease ◽  
Genetic And Environmental Factors ◽  
The Impact

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM). DR is complex and the term encompasses several clinical subtypes of diabetic eye disease, including diabetic macular edema (DME), the most frequent cause of central vision loss in DR patients. Both genetic and environmental factors contribute to the pathophysiology of DR and its subtypes. While numerous studies have identified several susceptibility genes for DR, few have investigated the impact of genetics on DME susceptibility. This review will focus on the current literature surrounding genetic risk factors associated with DME. We will also highlight the small number of studies investigating the genetics of response to antivascular endothelial growth factor (anti-VEGF) injection, which is used to treat DME.

scholarly journals A comparison of the risk factors of diabetic retinopathy between type 2 diabetes mellitus patients with and without metabolic syndrome

2021 ◽  
Author(s):  
Chao-Hsien Lee ◽  
Peng-Lin Tseng ◽  
Wei-Ting Chang ◽  
Yi-Chien Chen ◽  
Tsai-Tung Chiu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Betel Quid ◽  
Betel Quid Chewing ◽  
The Impact

IntroductionThis study was aimed at analyzing, modeling, and comparing the risk factors of diabetic retinopathy (DR) among type 2 diabetes mellitus (DM) patients with and without metabolic syndrome (MS).Material and methodsA cross-sectional study from July 2017 to July 2019 was performed by tracing type 2 DM patients who received treatment at an out-patient clinic and a mydriatic examination by an ophthalmologist in a single institute in south Taiwan. A total of 802 patients without DR were recruited and divided into two groups based on whether they had MS for this study. We analyzed the impact of DR based on the potential and related factors of these two groups.ResultsThe sample consisted of 802 patients; 282 patients did not have MS, and 520 did. A comparison of the risk factors of DR among the patients with and without MS revealed that the level of glycated hemoglobin (HbA1c) was a co-risk factor of DR. However, female sex, betel quid chewing, family history of DM, and higher total cholesterol were found to be risk factors of DR among the patients who had MS. Betel quid chewing, especially, could exacerbate the disease condition of DM and elevate the risk of DR.ConclusionsOf those risk factors, betel quid chewing may be the main reason for DM deterioration and raised risk of DR. Hence, we recommend that the chewing of betel quid should be avoided to prevent DR.

Obstructive Sleep Apnoea and Vascular Disease in Patients with Type 2 Diabetes

2015 ◽  
Vol 11 (02) ◽  
pp. 110
Author(s):  
Abd A Tahrani ◽  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Vascular Disease ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Obstructive Sleep ◽  
The Impact

Obstructive sleep apnoea (OSA) is common and is associated with many vascular risk factors, such as hypertension, insulin resistance, albuminuria, dyslipidaemia, increased inflammation and endothelial dysfunction. Epidemiological studies have shown that OSA is associated with increased cardiovascular disease (CVD) and that continuous positive airway pressure (CPAP) might reduce CVD events in patients with OSA. In addition, OSA has also been shown to be associated with albuminuria, chronic kidney disease, a wide range of ocular diseases and peripheral neuropathy. Considering that CVD and microvascular complications are major contributors to the morbidity, mortality and the economic burden of diabetes and that OSA is common in patients with type 2 diabetes (T2D), it is important to understand the role of OSA in the development and/or progression of vascular disease in patients with T2D and to explore the impact of CPAP on diabetes-related vascular outcomes. The purpose of this article is to review the evidence for the relationship and impact of OSA on vascular disease and vascular risk factors particularly in patients with T2D.

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