Optic Nerve Changes in Diabetic Retinopathy

Optic Nerve ◽  
2019 ◽  
Author(s):  
Andi Arus Victor
Keyword(s):  
Diabetic Retinopathy ◽  
Optic Nerve

Association of systemic cardio-vasculature status with retinal vascular endothelium in diabetes

2020 ◽  
Vol 1 (1) ◽  
pp. 52-57
Author(s):  
Galina Dimitrova ◽  
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Arterial Stiffness ◽  
Vascular Endothelium ◽  
Lamina Cribrosa ◽  
Central Retinal Artery ◽  
Diabetic Patients ◽  
Retinal Artery ◽  
Central Retinal Vein

The relationship between diabetic retinopathy and macro-vascular complications in diabetes suggests a pathogenic association between these conditions. Vascular endothelium has been identified as a main site of blood vessel injury in diabetes. Diabetic retinopathy is associated with systemic arterial stiffness and altered vascular endothelium function and structure. Retinal vasculature endothelium at the macula, arterio-venous crossings, and in the optic nerve at the lamina cribrosa region is reported to differ from the endothelium in the rest of the retinal blood vessels. The central retinal artery and vein are in close proximity in the optic nerve where they share a common adventitia; thus, increased arterial wall stiffness and thickness may affect blood flow in the neighboring central retinal vein in this region. Moreover, increased arterial stiffness in small arterial beds is associated with retinal venular widening; it suggests the possibility of central retinal artery compressing the central retinal vein at the lamina cribrosa, thereby compromising venular outflow in the retina of diabetic patients. Altered blood flow in the central retinal vein in the postlaminar region has been detected in patients who experience progression of diabetic retinopathy. Increased hydrostatic pressure in the central retinal vein may play a major role in the pathogenesis of diabetic retinopathy. The aim of this review article is to emphasize this pathogenetic mechanism that has often been overlooked.

Bilateral diabetic papillopathy developed after starting insulin treatment. Potential toxic effect of insulin? A case report

2020 ◽  
pp. 112067212098438
Author(s):  
Marco Mafrici ◽  
Laura Toscani ◽  
Umberto Lorenzi
Keyword(s):  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Insulin Therapy ◽  
Rare Case ◽  
Insulin Treatment ◽  
Brain Magnetic Resonance Imaging ◽  
Diabetic Patients ◽  
Ischemic Optic Neuropathy ◽  
History Of ◽  
Hypoglycemic Therapy

Background: Diabetic papillopathy is a complication of diabetes. It presents with edema, uni or bilateral and vascular alteration of the anterior optic nerve. Often this complication is observed in patients with severe diabetic retinopathy, but is rarely observed in isolated form. Some authors believe that diabetic papillitis is a particular form of non-arteritic anterior ischemic optic neuropathy (NAION). But there is important evidence that confers an inflammatory component to diabetic papillopathy. We report in this work a rare case of isolated acute bilateral diabetic papillopathy developed in a diabetic patient after adding the insulin to the oral hypoglycemic therapy. Case presentation: Male patient, 49-years-old, diabetic type 2, with altered glycemia at follow up, with clinical history of HbA1c 8% to 12% in the last 2 years, on oral hypoglycemic therapy for 10 years. He never had a history of diabetic retinopathy. At the last check-up, this patient presented bilateral papillopathy, without reduction of visual acuity bilaterally. The patient reports he added 10 days before the insulin therapy to the oral hypoglycemic therapy, under medical supervision. Hematochemical and serological tests were requested, which excluded the presence of inflammatory and infectious diseases. The brain magnetic resonance imaging (MRI) with gadolinium excluded the hypothesis of optic neuritis or intracranial hypertension. Cardio-circulatory tests were normal. Fluorescein angiographic examinations and optical coherence tomography (oct) confirmed the bilateral edema and the thickening of optic nerve without other retinal damage. Therefore he was diagnosed with bilateral diabetic papillopathy. Then, diabetologists added pump insulin treatment to the oral hypoglycemic therapy. After 2 months, his blood sugar levels and HbA1C improved and papillopathy regressed. Conclusion: We have reported a rare case of bilateral acute diabetic papillopathy associated with the addition of insulin to the oral hypoglycemic therapy. A randomized control study with diabetic patients, would be useful to verify the possible injuries of the optic nerves during the delicate transition to insulin therapy.

scholarly journals Assessment of the development of primary open-angle glaucoma and diabetic retinopathy using digital medicine

2020 ◽  
Vol 224 ◽  
pp. 03022
Author(s):  
I V Vorobyeva
Keyword(s):  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Primary Open Angle Glaucoma ◽  
Low Vision ◽  
Open Angle Glaucoma ◽  
Digital Data ◽  
Open Angle ◽  
Neuroretinal Rim ◽  
Digital Medicine

The leading place in the structure of blindness and low vision is occupied by two diseases: primary open-angle glaucoma and diabetic retinopathy. The combination of two diseases in one eye gives an even more severe prognosis for vision. Modern diagnostic equipment helps in accurate and early diagnosis of the disease by analyzing digital data of the optic nerve head and macular area of the retina according to the results of an optical coherence tomograph. A mathematical model for predicting the development of diabetic retinopathy and primary open-angle glaucoma according to the proposed mathematical criteria has been developed. The criteria represent the ratio of the integral area of the neuroretinal rim to the integral volume of the neuroretinal rim; the retinal thickness criterion and criterion of the primary open-angle glaucoma and diabetic retinopathy are calculated. A computer program has been developed. The algorithm of the program, which includes windows for entering digital data of the macular zone and parameters of the optic nerve head, is presented. The result of the program is the statement of the risk of developing combined pathology of the fundus in a particular patient.

scholarly journals Vascular density of optic nerve head in diabetic retinopathy using optical coherence tomography angiography

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Fariba Ghassemi ◽  
Sahar Berijani ◽  
Ramak Roohipoor ◽  
Masoumeh Mohebbi ◽  
Ameneh Babeli ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Optical Coherence Tomography Angiography ◽  
Blood Perfusion ◽  
Cross Sectional Study ◽  
Vascular Density ◽  
Optical Coherence ◽  
Cross Sectional

Abstract Purpose To measure optic nerve head (ONH) blood perfusion using optical coherence tomography angiography (OCTA) at various stages of diabetic retinopathy (DR). Methods One hundred seventy six eyes of 94 patients included in this retrospective single-centre cross-sectional study. The subjects were studied in normal, no diabetic retinopathy (NDR), non-proliferative diabetic retinopathy (NPDR) and proliferative retinopathy (PDR) groups. The eyes were subjected to AngioDisc ONH imaging using OCTA for papillary (Disc) and peripapillary (RPC) vascular density (VD) evaluation. Results The mean age of the participants was 56.08 ± 8.87 years and 34 (36.2 percent) were male. With increased DR severity, a statistically significant decrease in peripapillary VD was found. The study showed that only VD of the whole RPC (W-RPC) could be a valid biomarker in the staging assessment. VD of RPC, in all subsections, was considerably different from normal cases in the PDR group. Visual acuity was correlated with whole image ONH VD. The duration of DM, FBS, hyperlipidemia and DME had no effect on the ONH perfusion. Conclusions The study showed that only the W-RPC VD could be a reasonable marker in the staging assessment. VDs assessed by OCTA can be useful for assessing and tracking early ONH changes in DR patients.

Look beyond the retinopathy: The incidental finding of a brain tumour

2020 ◽  
pp. 1357633X2095512
Author(s):  
Caroline Vloka ◽  
Evan Waxman
Keyword(s):  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Incidental Findings ◽  
Incidental Finding ◽  
Diabetic Retinopathy Screening ◽  
Added Benefit ◽  
Fundus Photographs ◽  
Large Vestibular Schwannoma ◽  
Retinopathy Screening

We report the case of a 33-year-old woman who was found to have optic-nerve head swelling on fundus photographs obtained for telemedicine diabetic retinopathy screening. The patient was found to have a large vestibular schwannoma on brain imaging. This case shows the added benefit of implementing timely changes in management in response to significant incidental findings on tele-ophthalmology diabetic retinopathy screening, which can lead to potentially life- and vision-saving interventions.

scholarly journals Quantification of Microvascular Density of the Optic Nerve Head in Diabetic Retinopathy Using Optical Coherence Tomographic Angiography

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Jianfeng Huang ◽  
Bodi Zheng ◽  
Yingyi Lu ◽  
Xiaoya Gu ◽  
Hong Dai ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Optic Nerve Head ◽  
Roc Curve ◽  
Mixed Model ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Binary Logistic Regression Model ◽  
Fiber Layer ◽  
Tomographic Angiography

Aims. To quantify the capillary density of the optic nerve head in healthy control eyes and different stages of diabetic retinopathy (DR) eyes and identify the parameters to detect eyes with or without DR using optical coherence tomographic angiography (OCTA). Methods. In this cross-sectional study, 211 eyes of 121 participants with type 2 diabetes with different stages of DR or without DR and 73 eyes of 38 healthy age-matched controls were imaged by OCTA. Radial peripapillary capillary (RPC) plexus density and retinal nerve fiber layer (RNFL) thickness were examined. The mixed model binary logistic regression model was used to identify the parameters to detect eyes with or without DR. The area under the receiver operating characteristic (ROC) curve was calculated. Results. RPC density decreased significantly in diabetic patients without DR compared with the healthy controls, and it was negatively correlated with the severity of DR (P<0.01). RPC density was a significant parameter to distinguish diabetic eyes with or without DR (P<0.01). The area under the ROC curve was 0.743. Conclusions. Quantification of RPC density by OCTA provides evidence of microvascular changes in the optic nerve in diabetic patients. RPC density can serve as a possible biomarker in detecting eyes with DR. Larger cohort studies need to support this statement.

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