scholarly journals Serum microRNA Levels in Diabetes Mellitus

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 284
Author(s):  
Rodolfo Mastropasqua ◽  
Rossella D’Aloisio ◽  
Erica Costantini ◽  
Annamaria Porreca ◽  
Giada Ferro ◽  
...  
Keyword(s):  
Optical Coherence Tomography Angiography ◽  
Diabetic Patients ◽  
Swept Source ◽  
Expression Levels ◽  
Serum Microrna ◽  
Serum Mirnas ◽  
Patients With Diabetes ◽  
Ophthalmologic Examination ◽  
Circulating Rna ◽  
Circulating Levels

The aim of our study is to evaluate the serum circulating levels of some miRNA, such as hsa-let-7b-5p, hsa-let-7a-5p, hsa-miR-320b, hsa-miR-23a-3p, hsa-miR-27a-3p, hsa-miR-15a-5p, and hsa-miR-495-3, in diabetic patients without diabetic retinopathy (DR), diabetic patients with DR, and, healthy subjects in order to find reliable and reproducible biomarkers for DR. A total of 45 subjects underwent serum sampling for miRNAs evaluation and a complete ophthalmologic examination, including microperimetry and widefield swept source optical coherence tomography angiography (OCTA). Total circulating RNA was isolated from patients using the miRNeasy Serum/Plasma Kit. Serum miRNA expression levels were significantly different in the three groups. In detail, circulating hsa-miR-15a-5p levels were significantly reduced in both diabetic patients without DR and diabetic patients with DR (p = 0.027). Serum hsa-miR-495-3p was lower in diabetic patients with DR and diabetic patients without DR (p = 0.049). Hsa-miR-23a-3p serum expression levels were significantly lower in diabetic patients with DR and diabetic patients without DR (p = 0.013). Significant associations of miRNAs with anatomical/perfusion parameters and functional parameters were observed in the diabetic groups. We find evidence of damage in progression biomarkers in DR that are evidently early in patients with diabetes without DR. Serum miRNAs levels are considered to have strong potential as a novel biomarker for the early detection of DR in subjects suffering from diabetes and could represent noninvasive target therapies to block the progression of the disease at the early stages.

scholarly journals Ultra-wide field swept-source optical coherence tomography angiography in patients with diabetes without clinically detectable retinopathy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingyuan Yang ◽  
Bilei Zhang ◽  
Erqian Wang ◽  
Song Xia ◽  
Youxin Chen
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Coherence Tomography Angiography ◽  
Central Area ◽  
Diabetic Patients ◽  
Imaging Method ◽  
Wide Field ◽  
Optical Coherence ◽  
Swept Source ◽  
Retinal Microvasculature ◽  
Central Fixation

Abstract Background To investigate alterations in retinal microvasculature in eyes with preclinical diabetic retinopathy (DR) using ultra-wide field swept-source optical coherence tomography angiography (UWF SS OCTA). Methods Prospective cross-sectional study. Fifty-five eyes of 30 diabetic patients without clinical retinal signs were included. All subjects underwent OCTA examination with a 12 × 12 mm2 field of view of 5 visual fixations (1 central fixation and 4 peripheral fixations) to compose a UWF OCTA image. In the UWF images, the central area corresponded to the original central image obtained using central fixation, and the peripheral area was the remaining area. Lesions, including nonperfusion areas (NPAs), microvascular dilation and tortuosity, and neovascularization (NV), were recorded in different areas. Diabetes history was also recorded. Results Peripheral areas presented significantly more microvascular dilation and tortuosity than central areas (P = 0.024) and more NPAs than central areas, with borderline significance (P = 0.085). The number of lesion types was associated with HbA1c levels in the peripheral and overall areas (all P values < 0.001). Conclusions UWF SS OCTA is a promising imaging method for detecting vascular alterations in diabetic eyes without clinical signs to reveal retinal microvascular alterations. These alterations were correlated with systemic conditions.

scholarly journals Macular vessel density in diabetes and diabetic retinopathy with swept-source optical coherence tomography angiography

2020 ◽  
Author(s):  
Naiqiang Xie ◽  
Yan Tan ◽  
Sen Liu ◽  
Yining Xie ◽  
Shaoshuai Shuai ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Linear Regression ◽  
Large Scale ◽  
Optical Coherence Tomography Angiography ◽  
Vessel Density ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Swept Source ◽  
History Of

AbstractPurposePrevious studies on the association between macular vessel density (VD) and diabetic retinopathy had conflicting conclusions. This study assessed the alterations of macular VD, as well as other factors, in diabetic patients using swept-source optical coherence tomography angiography (SS-OCTA) in a large-scale sample from Chinese communities.MethodsPatients with type 2 diabetes without history of ocular treatment were recruited from 2017 to 2018. The average and quadrant parafoveal vessel density (PVD) were obtained with a commercial SS-OCTA device (Triton, Topcan, Japan). Univariate and multivariate linear regression was used to analyse the correlation of PVD with diabetic retinopathy (DR), diabetic macular edema (DME), HbA1c, and other factors.ResultsA total of 919 patients were included in the final statistical analysis. After adjusting for other confounding factors, the DR patients had significantly lower average PVD (β= −1.062, 95% CI = −1.424 to −0.699, P < 0.001) in comparison with those without DR. In addition, the patients with mild DR or vision-threatening diabetic retinopathy (VTDR) also had significantly lower PVD (P < 0.001 for mild DR, and P = 0.008 for VTDR) compared with those without DR. Age and HbA1c were also significantly related to PVD measurements, as shown by multivariable linear regression. Participants with DME had a significantly lower average PVD and temporal PVD than those without DME (P < 0.05).ConclusionsReduced PVD was independently associated with more severe DR, older age, higher HbA1c level, and the presence of DME. These findings provide manifest evidence to suggest that macular vessel alterations play a role in the pathogenesis of DR.

Comparison of widefield swept-source optical coherence tomography angiography with ultra-widefield colour fundus photography and fluorescein angiography for detection of lesions in diabetic retinopathy

2020 ◽  
pp. bjophthalmol-2020-316245 ◽  
Author(s):  
Ying Cui ◽  
Ying Zhu ◽  
Jay C Wang ◽  
Yifan Lu ◽  
Rebecca Zeng ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Fluorescein Angiography ◽  
Optical Coherence Tomography Angiography ◽  
Imaging System ◽  
Fundus Photography ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Swept Source ◽  
Detection Rates

AimsTo compare widefield swept-source optical coherence tomography angiography (WF SS-OCTA) with ultra-widefield colour fundus photography (UWF CFP) and fluorescein angiography (UWF FA) for detecting diabetic retinopathy (DR) lesions.MethodsThis prospective, observational study was conducted at Massachusetts Eye and Ear from December 2018 to October 2019. Proliferative DR, non-proliferative DR and diabetic patients with no DR were included. All patients were imaged with a WF SS-OCTA using a Montage 15×15 mm scan. UWF CFP and UWF FA were taken by a 200°, single capture retinal imaging system. Images were independently evaluated for the presence or absence of DR lesions including microaneurysms (MAs), intraretinal microvascular abnormalities (IRMAs), neovascularisation elsewhere (NVE), neovascularisation of the optic disc (NVD) and non-perfusion areas (NPAs). All statistical analyses were performed using SPSS V.25.0.ResultsOne hundred and fifty-two eyes of 101 participants were included in the study. When compared with UWF CFP, WF SS-OCTA was found to be superior in detecting IRMAs (p<0.001) and NVE/NVD (p=0.007). The detection rates of MAs, IRMAs, NVE/NVD and NPAs in WF SS-OCTA were comparable with UWF FA images (p>0.05). Furthermore, when we compared WF SS-OCTA plus UWF CFP with UWF FA, the detection rates of MAs, IRMAs, NVE/NVD and NPAs were identical (p>0.005). Agreement (κ=0.916) between OCTA and FA in classifying DR was excellent.ConclusionWF SS-OCTA is useful for identification of DR lesions. WF SS-OCTA plus UWF CFP may offer a less invasive alternative to FA for DR diagnosis.

scholarly journals Swept-source OCTA quantification of capillary closure predicts ETDRS severity staging of NPDR

2020 ◽  
pp. bjophthalmol-2020-317890
Author(s):  
Torcato Santos ◽  
Lewis H Warren ◽  
Ana Rita Santos ◽  
Inês Pereira Marques ◽  
Sophie Kubach ◽  
...  
Keyword(s):  
Gold Standard ◽  
Healthy Subjects ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Circulation ◽  
Swept Source ◽  
Retinal Capillary ◽  
Patients With Diabetes ◽  
Capillary Circulation ◽  
Swept Source Octa

PurposeTo test whether a single or composite set of parameters evaluated with optical coherence tomography angiography (OCTA), representing retinal capillary closure, can predict non-proliferative diabetic retinopathy (NPDR) staging according to the gold standard ETDRS grading scheme.Methods105 patients with diabetes, either without retinopathy or with different degrees of retinopathy (NPDR up to ETDRS grade 53), were prospectively evaluated using swept-source OCTA (SS-OCTA, PlexElite, Carl Zeiss Meditec) with 15×9 mm and 3×3 mm angiography protocols. Seven-field photographs of the fundus were obtained for ETDRS staging. Eyes from age-matched healthy subjects were also imaged as control.ResultsIn eyes of patients with type 2 diabetes without retinopathy or ETDRS levels 20 and 35, retinal capillary closure was in the macular area, with predominant alterations in the parafoveal retinal circulation (inner ring). Retinal capillary closure in ETDRS stages 43–53 becomes predominant in the retinal midperiphery with vessel density average values of 25.2±7.9 (p=0.001) in ETDRS 43 and 23.5±3.4 (p=0.001) in ETDRS 47–53, when evaluating extended areas of 15×9 protocol. Combination of acquisition protocols 3×3 mm and 15×9 mm, using SS-OCTA, allows discrimination between eyes with mild NPDR (ETDRS 10, 20, 35) and eyes with moderate-to-severe NPDR (ETDRS grades 43–53).ConclusionsRetinal capillary closure, quantified by SS-OCTA, can identify NPDR severity progression. It is located mainly in the perifoveal retinal capillary circulation in the initial stages of NPDR, whereas the retinal midperiphery is predominantly affected in moderate-to-severe NPDR.

scholarly journals Retinal Capillary Nonperfusion on OCT-Angiography and Its Relationship to Kidney Function in Patients with Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Elysse S. Tom ◽  
Steven S. Saraf ◽  
FuPeng Wang ◽  
Qinqin Zhang ◽  
Gautam Vangipuram ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Kidney Disease ◽  
Kidney Function ◽  
Optical Coherence Tomography Angiography ◽  
Creatinine Ratio ◽  
Swept Source ◽  
Urine Albumin ◽  
Retinal Capillary ◽  
Patients With Diabetes

Background. Diabetic retinopathy and kidney disease share underlying mechanisms of microvascular damage and are often comorbid in people with diabetes. We evaluated whether there is a relationship between retinal capillary perfusion as measured by swept-source optical coherence tomography angiography and estimated glomerular filtration rate (eGFR) and albuminuria in patients with diabetes and chronic kidney disease (CKD). Method. A cross-sectional pilot study was conducted at the University of Washington among a subset of participants with diabetes and CKD participating in a larger cohort study. Participants were excluded if they were known to have kidney disease from conditions other than diabetes. Ten participants (11 eyes) were included. Retinal nonperfusion (RNP) and vessel density (VD) were measured by swept-source optical coherence tomography angiography in 30° and 60° field of view (FOV) regions centered at the fovea. Correlations of RNP and VD with eGFR and albuminuria were analyzed. Results. Participants had a mean age of 72 years, hemoglobin A1c of 8.1%, eGFR of 45 mL/min/1.73 m2, and urine albumin-to-creatinine ratio of 162 mg/g. Mean (SD) RNP was 6.6% (4.2%) and 16.9% (7.7%) in 30° and 60° FOV regions, respectively. eGFR was negatively correlated to RNP in both the 30° and 60° FOV regions (R = −0.69, p = 0.004 , and R = −0.46, p = 0.057 , respectively), and correlations were stronger among a subset of 7 participants with evidence of diabetic retinopathy on exam and fundus photos. The estimated GFR was not significantly correlated with vessel density. Urine albumin-to-creatinine ratio was not significantly correlated with RNP or VD. Conclusions. Our proof-of-concept study showed that lower eGFR was significantly correlated with retinal nonperfusion in participants with diabetes and CKD. Advanced retinal imaging may enhance the noninvasive evaluation of kidney function in diabetes.

Swept-source optical coherence tomography angiography vitreo-retinal segmentation in proliferative diabetic retinopathy

2020 ◽  
pp. 112067212094402
Author(s):  
Alessandro Papayannis ◽  
Emmanouil Tsamis ◽  
Francesco Stringa ◽  
Pierluigi Iacono ◽  
Maurizio Battaglia Parodi ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Response To Therapy ◽  
Secondary Outcome ◽  
Peripheral Retina ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Swept Source

Purpose: To identify a new cortical vitreous segmentation protocol for non invasive standardised investigation of Neovascularisation (NV) with detection of regression of NV activity in Proliferative Diabetic Retinopathy (PDR). Design: Retrospective study. Participants: One hundred and eighty-six eyes of 93 consecutive diabetic patients (mean age: 52.6 ± 11.0 years) imaged using Topcon Triton® Swept-Source Optical Coherence Tomography Angiography (SS-OCTA) from June 2015 to January 2017. Methods: Scans were performed through the macula, optic disc and areas of possible NV in mid-peripheral retina using 6 × 6 mm and/or 9 × 9 mm raster-patterns in three segmentation protocols: Vitreo-Retinal (VRS), Outer-Vitreous (OVS) and Core-Vitreous Segmentation (CVS). Any suspicion of PDR was confirmed in all patients by Heidelberg® Widefield-Fundus-Fluorescein-Angiography (WF-FFA) and/or Optos® Ultra-WF-FFA (UWF-FFA). Inter-observer reproducibility of NV diagnosis and agreement between SS-OCTA and UWF-FFA were assessed. Primary outcome was the identification of an effective and reproducible segmentation protocol. Secondary outcome was the identification of NV regression after treatment. Results: Sensitivity-specificity reached, respectively, the value of 100 to 100 in detecting NVD, and 96.6 to 100 in detecting NVE in compared areas. SS-OCTA was able to confirm absence of blood flow within the residual NV plexus when using VRS protocol in 30 eyes in which regression of NV with absence of leakage was documented on FFA. Conclusion: Three segmentation protocols (VRS, OVS and CVS) with different but complementary characteristics, allowed a reproducible and standardised investigation of NVD and NVE. The proposed new SS-OCTA cortical vitreous segmentation protocols may be of value when identifying and assessing NV-activity (VRS, OVS and CVS) or NV-regression (VRS) in PDR and therefore, response to therapy.

scholarly journals Quantitative analysis of retinal vessel density and thickness changes in diabetes mellitus evaluated using optical coherence tomography angiography: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xinyue Li ◽  
Yu Yu ◽  
Xueting Liu ◽  
Yan Shi ◽  
Xin Jin ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Retinal Vessel ◽  
Cross Sectional Study ◽  
Vessel Density ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patients With Diabetes ◽  
Retinal Vessel Density

Abstract Background Diabetic retinopathy is the most common microvascular complication of diabetes; however, early changes in retinal microvessels are difficult to detect clinically, and a patient’s vision may have begun to deteriorate by the time a problem is identified. Optical coherence tomography angiography (OCTA) is an innovative tool for observing capillaries in vivo. The aim of this study was to analyze retinal vessel density and thickness changes in patients with diabetes. Methods This was a retrospective, observational cross-sectional study. Between August 2018 and February 2019, we collected OCTA data from healthy participants and diabetics from the First Affiliated Hospital of Harbin Medical University. Analyzed their retinal vessel density and thickness changes. Results A total of 97 diabetic patients with diabetes at different severity stages of diabetic retinopathy and 85 controls were involved in the experiment. Diabetic patients exhibited significantly lower retinal VD (particularly in the deep vascular complexes), thickening of the neurosensory retina, and thinning of the retinal pigment epithelium compared with controls. In the control group, nondiabetic retinopathy group and mild diabetic retinopathy group, superficial VD was significantly correlated with retinal thickness (r = 0.3886, P < 0.0001; r = 0.3276, P = 0.0019; r = 0.4614, P = 0.0024, respectively). Conclusions Patients with diabetes exhibit ischemia of the retinal capillaries and morphologic changes in vivo prior to vision loss. Therefore, OCTA may be useful as a quantitative method for the early detection of diabetic retinopathy.

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

Management of the Asymptomatic Diabetic Patient with Evidence of Ischaemia

2010 ◽  
Vol 6 (1) ◽  
pp. 62
Author(s):  
Dimitrios Bliagos ◽  
Ajay J Kirtane ◽  
Jeffrey W Moses ◽  
◽  
◽  
...  
Keyword(s):  
Coronary Artery ◽  
Medical Therapy ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Diabetic Patients ◽  
Ageing Population ◽  
Patients With Diabetes ◽  
Risk Patients ◽  
Asymptomatic Diabetic Patient ◽  
Artery Disease

In the US, a total of 23.6 million people have diabetes, representing 7.8% of the population, and the prevalence of diabetes is on the rise due to an increasingly sedentary lifestyle, increasing obesity and an ageing population. Coronary artery disease is the leading cause of death in patients with diabetes, despite a reduction in cardiovascular events over the last 50 years, due in part to better medical therapy. Asymptomatic diabetic patients with evidence of ischaemia on stress testing have higher cardiac mortality; increasing amounts of ischaemia are associated with higher mortality rates. Revascularisation of high-risk patients, or those with significant ischaemia, has the potential to improve outcomes in this patient population. The choice of which revascularisation strategy to choose – either percutaneous coronary intervention (PCI) or coronary artery bypass grafting – should be carefully individualised, and must always be implemented against the background of optimal medical therapy.

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