scholarly journals Changes of the Foveal Avascular Zone and Macular Microvasculature within the Framework of OCT Angiography Examination in Young Patients with Type 1 Diabetes (Pilot Study)

2020 ◽  
Vol 76 (3) ◽  
pp. 111-117
Author(s):  
Lukáš Magera ◽  
Jan Krásný ◽  
Patrik Pluhovský ◽  
Lucie Holubová
Keyword(s):  
Young Patients ◽  
Capillary Density ◽  
University Hospital ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Control Group ◽  
Diabetic Patients ◽  
Avascular Zone ◽  
The Difference

Aim: Learn about the development and changes in foveal avascular zone (FAZ) and vascularity of retina in the surrounding zone, depending on the duration in young diabetic patients type 1 (T1DM). Methods: As part of regular one-year examinations of young T1DM patients at the Eye Clinic of the University Hospital Královské Vinohrady in Prague (Czech Republic, EU) from January to December 2019, OCT angiography using the device Spectralis (Heidelberg Engineering) was included. Forty patients aged 18 to 30 years were examined, median 21 years. T1DM was diagnosed in childhood and lasted for more than 10 years. At the same time, a control group of forty individuals of similar age, without metabolic and other general disease was examined, normal visual acuity and physiological fundoscopic finding were obligatory. The FAZ size was evaluated in both groups (using built-in function "Draw Region"), also its shape, density decrease and change in character of vascularity of the retina was assessed. Results: In the control group, the FAZ area ranged from 0.06 to 0.4 mm², with an average of 0.253 ± 0.092 mm² and a median of 0.27 mm². It was not affected by a fundamental change in its round shape and the surrounding capillary netting was regular and reasonably dense. In T1DM patients, the FAZ area was in a wider range, from 0.05 to 0.64 mm², an average of 0.300 ± 0.132 mm², and a median of 0.31 mm². The difference in FAZ across-the-board evaluation was statistically significant (p = 0, 009). Diabetic preretinopathy (DpR) was defined by the irregularity of the capillary density up to the manifestation of non-perfusion, in 61% of cases the size of the FAZ was changed. In diabetic retinopathy (DR) there was always an irregularity of the FAZ shape with its enlargement, manifestation of non-perfusion, capillary dilatation and rare microaneurysms. Conclusion: Changes in FAZ size corresponded to the stage of T1DM on the fundoscopic finding of the eye depending on its duration. The initial increased amount of foveal capillaries, which resulted in decreased FAZ area, was followed by a gradual decrease in capillaries and increased FAZ area, consistent with the manifestations of DpR. It was accompanied by a change in capillary density in macula to eventual non-perfusion. On the contrary, the increase in the FAZ area and its irregularity accompanied by non-perfusion of the capillary net and microaneurysms corresponded to the development of DR already.

scholarly journals Parafoveal OCT Angiography Features in Diabetic Patients without Clinical Diabetic Retinopathy: A Qualitative and Quantitative Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Mathilde M. Goudot ◽  
Anne Sikorav ◽  
Oudy Semoun ◽  
Alexandra Miere ◽  
Camille Jung ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Quantitative Analysis ◽  
Capillary Density ◽  
Oct Angiography ◽  
Foveal Avascular Zone ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
The Mean ◽  
Fundus Photographs ◽  
And Gender

Purpose. To evaluate the capacity of OCT angiography (OCTA) for detecting infraclinical lesions in parafoveal capillaries in diabetic patients without diabetic retinopathy (DR). Methods. This prospective observational cross-sectional case-control study analyzed the superficial and deep capillary plexuses (SCP and DCP) on macular OCTA scans (3 × 3 mm) centered on the fovea. We compared 22 diabetic patients (34 eyes included) without DR diagnosis on color fundus photographs, with 22 age- and gender-matched nondiabetic controls (40 eyes included). Qualitative analysis concerned morphological ischemic capillary alterations. Quantitative analysis measured foveal avascular zone (FAZ) size, parafoveal capillary density, and enlargement coefficient of FAZ between SCP and DCP. Results. Neither the qualitative nor quantitative parameters were significantly different between both groups. No microaneurysms or venous tortuosity was observed in any of the analyzed images. On the SCP, the mean FAZ area was 0.322 ± 0.125 mm2 in diabetic patients and 0.285 ± 0.150 mm2 in controls, P=0.31. On the DCP, the mean FAZ area was 0.444 ± 0.153 mm2 in cases and 0.398 ± 0.138 mm2 in controls, P=0.20. Conclusion. OCTA did not detect infraclinical qualitative or quantitative differences in parafoveal capillaries of diabetic patients without DR in comparison with nondiabetic controls.

scholarly journals Differences in dental caries experience between diabetic adolescents and healthy controls

2016 ◽  
Vol 6 (1) ◽  
pp. 46-51
Author(s):  
Rusmira Fazlić ◽  
Amina Huseinbegović ◽  
Sniježana Hasanbegović ◽  
Mediha Selimović Dragaš
Keyword(s):  
Metabolic Control ◽  
Caries Experience ◽  
Control Group ◽  
Diabetic Patients ◽  
Missing Teeth ◽  
Periodontal Health ◽  
Dental Attendance ◽  
Dmft Index ◽  
The Difference

Introduction: While the influence of type 1 diabetes mellitus (T1DM) on periodontal health is well established, results of previous studies regarding the association of this metabolic disease and caries experience are rather inconsistent. The aim of this study was to assess the differences between caries status of healthy and adolescents with T1DM, as well as to determine the differences in caries experience among diabetic patients in relation to their metabolic control.Methods: Assessment of caries status was performed using the DMFT index (decayed, missing, and filled teeth). The study group (Diabetic) included 60 patients diagnosed with T1DM, aged 12-18 years, from Sarajevo Canton. This group was divided into two sub-groups: a sub-group Diabetic-W consisted of 30 patients with well-controlled glycaemia, while a subgroup Diabetic-P comprised of 30 patients with poorer glycemic control. The control group consisted of 30 age-matched metabolically healthy individuals.Results: The T1DM adolescents had a significantly higher (p < 0.01) mean DMFT score than the healthy subjects, 11.49 and 6.19 respectively. Statistically, the diabetic group had also significantly higher values of the D and M components. Concerning the metabolic control, mean DMFT score in the Diabetic-W subgroup was lower (10.57) than in the Diabetic-P subgroup (12.39), however the difference was not statistically significant.Conclusions: The results demonstrate that the T1DM patients have a higher caries experience, regardless of the degree of metabolic control. The level of untreated dental decay and missing teeth components among the diabetic adolescents indicates irregular dental attendance.

scholarly journals Multimodal Imaging Assessment of Vascular and Neurodegenerative Retinal Alterations in Type 1 Diabetic Patients without Fundoscopic Signs of Diabetic Retinopathy

2019 ◽  
Vol 8 (9) ◽  
pp. 1409 ◽  
Author(s):  
Riccardo Sacconi ◽  
Marco Casaluci ◽  
Enrico Borrelli ◽  
Giacomo Mulinacci ◽  
Francesca Lamanna ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Multimodal Imaging ◽  
Foveal Avascular Zone ◽  
Control Group ◽  
Diabetic Patients ◽  
Ganglion Cell Complex ◽  
Fiber Layer ◽  
Imaging Evaluation ◽  
Significant Difference

The aim of this cross-sectional case-control study is to investigate the possible presence of vascular/neurodegenerative alterations in the retina of type 1 diabetes mellitus (T1DM) patients without diabetic retinopathy (DR). Thirty-four eyes of 34 consecutive T1DM without DR (mean age 21 ± 2 years) were included. Another cohort of 27 eyes (27 healthy control subjects matched with age and sex) was also recruited. All patients underwent multimodal imaging evaluation using structural optical coherence tomography (OCT), OCT-angiography (OCT-A), dynamic vessel analyzer (DVA) and microperimetry. No significant differences were disclosed comparing diabetics and controls for visual acuity, central macular thickness, and subfoveal choroidal thickness. On retinal nerve fiber layer and ganglion cell complex thickness, no significant differences were disclosed comparing each 3-mm-diameter macular and peripapillary subfield between two groups. Using OCT-A, deep capillary plexus perfusion density (PD) of diabetics was significantly lower compared to control group, whereas PD of other retinal/choriocapillaris plexuses and foveal avascular zone area did not show any significant difference. Using DVA, diabetic eyes revealed a significantly decreased vessel response to flicker light in comparison to controls. No differences were disclosed using microperimetry analysis. Taken together, these results suggest that vascular alterations could be the first detectable retinal change in the development of DR.

Autoimmune thyroid disease in patients with anti-GAD positive type 1 diabetes mellitus

Open Medicine ◽  
2009 ◽  
Vol 4 (4) ◽  
pp. 415-422
Author(s):  
Kamile Gul ◽  
Ihsan Ustun ◽  
Yusuf Aydin ◽  
Dilek Berker ◽  
Halil Erol ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Statistical Significance ◽  
Control Group ◽  
Acid Decarboxylase ◽  
Thyroid Peroxidase ◽  
The Difference ◽  
Type 1 Dm

AbstractThe aim of the study was to determine the frequency and titers of anti-thyroid peroxidase (Anti-TPO), anti-thyroglobulin (Anti-TG), and anti-glutamic acid decarboxylase (Anti-GAD) antibodies in Turkish patients with type 1 diabetes mellitus (DM), and to compare the frequency of anti-TPO and anti-TG titers in the presence or absence of anti-GAD. A total of 104 patients including 56 males and 48 females with type 1 DM and their age-, gender-, and body mass index-matched control group, including 31 males and 27 females, 58 cases in total with an age range of 15-50 years, were recruited into this study. In patients with type 1 DM, positive anti-GAD was detected in 30.8% (n=32). In patients with positive anti-GAD, rate of positive anti-TPO was 37.5%; however, in patients with negative anti-GAD, the rate of positive anti-TPO was 9.7% and the difference was statistically significant (p=0.001). In patients with positive anti-GAD, the rate of positive anti-TG was 18.8%. In patients with negative anti-GAD, the rate of positive anti-TG was 2.8%, and the difference between them was statistically significant (p=0.005). In patients with positive and negative anti-GAD, rates of both positive anti-TPO and anti-TG were 15.6% and 1.4%, respectively, with the difference showing statistical significance (p=0.004). Thyroid autoimmunity in type 1 DM patients with positive anti-GAD was apparently higher; therefore, these patients should be followed more frequently and carefully.

Corneal Sensitivity in Bacterial Keratitis Patients with or without Diabetes Mellitus

2021 ◽  
pp. 67-72
Author(s):  
O. V. Zavoloka
Keyword(s):  
Diabetes Mellitus ◽  
Anterior Segment ◽  
Control Group ◽  
Sensitivity Threshold ◽  
Diabetic Patients ◽  
Bacterial Keratitis ◽  
Corneal Sensitivity ◽  
Fellow Eye ◽  
Nondiabetic Control

The aim. To identify the features of corneal sensitivity of the sick and the fellow eye in bacterial keratitis patients with or without diabetes mellitus. Materials and methods. The analysis was performed on the basis of survey data of 62 type 1 diabetes patients with bacterial keratitis and 43 nondiabetic control patients with bacterial keratitis. The examination was performed at the first visit. In addition to standard ophthalmic examination, the patients underwent fluorescein test, OCT of the anterior segment of the eye, non-contact corneal aesthesiometry. Results and discussion. The average corneal sensitivity threshold in diabetic patients with bacterial keratitis at the first visit at all air flow temperatures exceeded the corresponding indicators in nondiabetic patients of the control group: by 33.5% at an air temperature of 5 °C, by 30.6% at 15 °C, by 28.8% at 20 °C, by 27% at 30 °C, and by 26.1% at 40 °C (p<0.05). The average corneal sensitivity threshold at a temperature of 20 °C in the fellow eye in diabetic patients with bacterial keratitis exceeded that in nondiabetic patients with bacterial keratitis of the control group by 32.9 % (p<0.05). Conclusions. Corneal sensitivity of the sick and fellow eye in patients with bacterial keratitis depends on the presence of diabetes mellitus. The average threshold of corneal sensitivity of the sick and fellow eye in diabetic patients with bacterial keratitis at the first visit exceeds the corresponding values in nondiabetic patients with bacterial keratitis. Keywords: diabetes mellitus, bacterial keratitis, corneal sensitivity.

scholarly journals Glaucomatous Macular Vasculature: A Quantitative Analysis

2020 ◽  
Vol 9 (3) ◽  
pp. 185-197
Author(s):  
Pedro Arede ◽  
Joanna Przezdziecka-Dolyk ◽  
Fabian Debowy ◽  
Jacek Olszewski ◽  
Carla Fernandes ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Structural Changes ◽  
Open Angle Glaucoma ◽  
Major Axis ◽  
Foveal Avascular Zone ◽  
Control Group ◽  
Equivalent Diameter ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Avascular Zone

Background: The aim of this study was to evaluate the characteristics of the macular vessel density (VD) and the foveal avascular zone (FAZ) in glaucoma quantitatively using the optical coherence tomography angiography (OCT-A). Methods: Twenty-five eyes of 13 patients with primary open angle glaucoma (POAG) and 12 eyes of 6 healthy participants were enrolled retrospectively. Functional visual field (VF) and structural Spectral-Domain optical coherence tomography (SD-OCT) Retinal Nerve Fiber Layer Thickness (RNFLT) were assessed in all participants. OCT-A was performed on a fovea centered, 15x10 degrees, macular region. OCT-A scans were processed with MATLAB software and automatically graded to define FAZ parameters. The parafoveal VD in the superficial and deep retinal vascular plexus (SVP and DVP) was analyzed by quadrant and circular segmented zones. Results: Foveal Avascular Zone -Major Axis Length (p=0.02), Area (p=0.04), Equivalent Diameter (p=0.04) and Perimeter (p=0.04) were significantly larger in glaucoma than the control group. Regarding SVP and DVP, the average macular total VD were lower in glaucoma patients compared to the control group (p<0.01; p<0.01). Additionally, the inner circular region (p=0.04; p<0.01 respectively for SVP and DVP) and all quadrants except for North had a lower VD in glaucoma group compared to the control group. Assessment of the total VD successfully predicted RNFLT (p<0.001) and was significantly associated with the probability of glaucoma (p=0.009). Conclusion: OCT-A parameters, namely the FAZ morphology and the macular VD, were associated with glaucomatous functional and structural changes. The macular VD showed a considerable diagnostic value. It may be a modern biomarker, representing microvascular network disruption of the macular perfusion in glaucoma.

scholarly journals Volume rendered 3D OCTA assessment of macular ischemia in patients with type 1 diabetes and without diabetic retinopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Enrico Borrelli ◽  
Domenico Grosso ◽  
Mariacristina Parravano ◽  
Eliana Costanzo ◽  
Maria Brambati ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Healthy Subjects ◽  
Diabetic Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Vascular Volume ◽  
Patients With Diabetes ◽  
Perfusion Density

AbstractThe aim of this study was to measure macular perfusion in patients with type 1 diabetes and no signs of diabetic retinopathy (DR) using volume rendered three-dimensional (3D) optical coherence tomography angiography (OCTA). We collected data from 35 patients with diabetes and no DR who had OCTA obtained. An additional control group of 35 eyes from 35 healthy subjects was included for comparison. OCTA volume data were processed with a previously presented algorithm in order to obtain the 3D vascular volume and 3D perfusion density. In order to weigh the contribution of different plexuses’ impairment to volume rendered vascular perfusion, OCTA en face images were binarized in order to obtain two-dimensional (2D) perfusion density metrics. Mean ± SD age was 27.2 ± 10.2 years [range 19–64 years] in the diabetic group and 31.0 ± 11.4 years [range 19–61 years] in the control group (p = 0.145). The 3D vascular volume was 0.27 ± 0.05 mm3 in the diabetic group and 0.29 ± 0.04 mm3 in the control group (p = 0.020). The 3D perfusion density was 9.3 ± 1.6% and 10.3 ± 1.6% in diabetic patients and controls, respectively (p = 0.005). Using a 2D visualization, the perfusion density was lower in diabetic patients, but only at the deep vascular complex (DVC) level (38.9 ± 3.7% in diabetes and 41.0 ± 3.1% in controls, p = 0.001), while no differences were detected at the superficial capillary plexus (SCP) level (34.4 ± 3.1% and 34.3 ± 3.8% in the diabetic and healthy subjects, respectively, p = 0.899). In conclusion, eyes without signs of DR of patients with diabetes have a reduced volume rendered macular perfusion compared to control healthy eyes.

scholarly journals Elevated anticardiolipin titer as a stroke factor in young patients in kirkuk city

2019 ◽  
Vol 10 (3) ◽  
pp. 1932-1935
Author(s):  
Raad Hassan Najim ◽  
Bilal Jamal kamal
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Valvular Heart Disease ◽  
Young Patients ◽  
Control Group ◽  
P Value ◽  
Diabetic Patients ◽  
Hemorrhagic Disease ◽  
Coronary Arterial Disease

Background: Stroke is a common cause of morbidity and mortality worldwide, and it is the third leading cause of medical death in developed countries. Stroke can be classified into ischemic disease (80%) and hemorrhagic disease (20). Subject and methods: A case-control study done in the period extending from November 2013 to April 2014 in neuro medicine department in Azadi teaching hospital in Kirkuk city in Iraq. This study involving 2 study groups, each one of them, including 50 patients. The first group (cases) included 50 patients diagnosed as having an ischemic stroke by neurologist their ages were less than 45 years .in  another group (control), 50 patients involved admitted to the same hospital with no history of prior ischemic stroke. Results: Fifty patients with stroke of ischemic orgin and 50 controls included in the study. Table 1 summarize demographic and clinical characteristics of patients and control groups, control was older than ischemic stroke patient with no significant correlation (P-value=0.33). Gender distribution showing a significant correlation in regarding female sex in both groups (P-value=0.001). Ischemic stroke according to our findings is more prevalent in those patients with Hypertension with 66% of patients in comparison to 42% of control patients with P-value of 0.0001, diabetic patients with double percentage (72%) to those in control group (36%) with P-value of 0.0001,coronary arterial disease ,valvular heart disease and rhythm disease such as atrial fibrillation seen to be more popular  in those patients with ischemic stroke with no significant value in regarding to patients having coronary and valvular heart disease (P-value=0.11,0.21) and strongly associated with those patient presented with atrial fibrillation (P-value=0.0001). Conclusion: Elevated anticardiolipin antibodies are seen to be as an independent risk factor for ischemic stroke.

scholarly journals Cardiac Affection in Type 1 Diabetic Patients in Relation to Omentin

2015 ◽  
Vol 3 (4) ◽  
pp. 699-704 ◽  
Author(s):  
Soha M. Abd El Dayem ◽  
Ahmed A. Battah ◽  
Amal El Shehaby
Keyword(s):  
Type 1 Diabetes ◽  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Stepwise Multiple Regression ◽  
Cardiac Autonomic Neuropathy ◽  
Control Group ◽  
Diabetic Patients ◽  
Stepwise Multiple Regression Analysis

AIM: To evaluate cardiac affection in type 1 diabetes in relation to Omentin.PATIENTS AND METHODS: Sixty two diabetics and 30 volunteer of the same age and sex were included as a control group. Blood sample was taken for assessment of omentin and oxidized low density lipoprotein (OxLDL), glycosylated hemoglobin (HbA1) and lipid profile. Urine sample was taken for assessment of albumin/ creatinine ratio. 24 hour holter was also done. T-test, simple correlation followed by stepwise multiple regression analysis was used for analysis of data.RESULTS: Parameters of 24 hour holter were significantly lower in diabetics. Omentin was significantly lower, while OxLDL were significantly higher than controls. RMSSD, ST deviation and OxLDL were the parameters related to omentin by stepwise multiple regression analysis in diabetics.CONCLUSION: Diabetic patients had a cardiac autonomic neuropathy. A significant reduction of omentin and elevation OxLDL imply that they influence glucose metabolism in type 1 diabetes. Omentin had a significant relation to 24 hr holter which may reflect its role in cardiac affection. Omentin and OxLDL had a role in renal affection.

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