61,813 research outputs found

    Diabetic retinopathy and socioeconomic deprivation in Gloucestershire

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    Objectives To investigate socioeconomic variations in diabetes prevalence, uptake of screening for diabetic retinopathy, and prevalence of diabetic retinopathy. Methods The County of Gloucestershire formed the setting of the study. A cross-sectional study of people with diabetes was done on a countywide retinopathy-screening database. Diabetes prevalence with odds ratios, uptake of screening, prevalence of any retinopathy and prevalence of sight-threatening retinopathy at screening were compared for different area deprivation quintiles. Logistic regression was used to adjust for confounding. Results With each increasing quintile of deprivation, diabetes prevalence increased (odds ratio 0.84), the probability of having been screened for diabetic retinopathy decreased (odds ratio 1.11), and the prevalence of sight-threatening diabetic retinopathy among screened patients increased (odds ratio of 0.98), while the prevalence of non-sight-threatening diabetic retinopathy remained unchanged with each increasing quintile of deprivation. Conclusion Sight-threatening diabetic retinopathy was associated with socioeconomic deprivation, but non-sight-threatening diabetic retinopathy was not. Uptake of screening was inversely related to socioeconomic deprivation

    Laser treatment in diabetic retinopathy

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    Diabetic retinopathy is a leading cause of visual impairment and blindness in developed countries due to macular edema and proliferative diabetic retinopathy (PDR). For both complications laser treatment may offer proven therapy: the Diabetic Retinopathy Study demonstrated that panretinal scatter photocoagulation reduces the risk of severe visual loss by >= 50% in eyes with high-risk characteristics. Pan-retinal scatter coagulation may also be beneficial in other PDR and severe nonproliferative diabetic retinopathy (NPDR) under certain conditions. For clinically significant macular edema the Early Treatment of Diabetic Retinopathy Study could show that immediate focal laser photocoagulation reduces the risk of moderate visual loss by at least 50%. When and how to perform laser treatment is described in detail, offering a proven treatment for many problems associated with diabetic retinopathy based on a high evidence level. Copyright (c) 2007 S. Karger AG, Basel

    Assessing risk for diabetic retinopathy among diabetics in the kalmunai region

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    Diabetic Retinopathy and diabetics are highly associated two severe diseases in human. This study asses the risk of getting Diabetic Retinopathy among the Diabetic patients in the Kalmunai region. For this a hospital based cross sectional study was carried out. All the diabetic patients who were attending to the diabetic clinic of the Ashraff memorial hospital during the month of May and June 2014 were screened for Diabetic Retinopathy and their demographic details were recorded. The risk for Diabetic Retinopathy among the diabetic patient was estimated as 13.16 %. No difference in risk of getting Diabetic Retinopathy was observed among different age group, educated level and gender patients. Risk of getting Diabetic Retinopathy was increasing with the duration of suffering from diabetic. The relative risk of getting Diabetic Retinopathy for > 12 years of diabetic patient is 3.55 times greater compare to the other age groups

    Comparison of the Modified Early Treatment Diabetic Retinopathy Study and Mild Macular Grid Laser Photocoagulation Strategies for Diabetic Macular Edema

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    OBJECTIVE: To compare 2 laser photocoagulation techniques for treatment of diabetic macular edema: the modified Early Treatment Diabetic Retinopathy Study (ETDRS) direct/grid photocoagulation technique and a potentially milder (but potentially more extensive) mild macular grid (MMG) laser technique in which microaneurysms are not treated directly and small mild burns are placed throughout the macula, whether or not edema is present. METHODS: Two hundred sixty-three subjects (mean age, 59 years) with previously untreated diabetic macular edema were randomly assigned to receive laser photocoagulation by either the modified ETDRS (162 eyes) or MMG (161 eyes) technique. Visual acuity, fundus photographs, and optical coherence tomography measurements were obtained at baseline and at 3.5, 8, and 12 months. Treatment was repeated if diabetic macular edema persisted. MAIN OUTCOME MEASURE: Change in optical coherence tomography measurements at 12-month follow-up. RESULTS: Among eyes with a baseline central subfield thickness of 250 microm or greater, central subfield thickening decreased by an average of 88 microm in the modified ETDRS group and by 49 microm in the MMG group at 12-month follow-up (adjusted mean difference, 33 microm; 95% confidence interval, 5-61 microm; P = .02). Weighted inner zone thickening by optical coherence tomography decreased by 42 microm in the modified ETDRS group and by 28 microm in the MMG group (adjusted mean difference, 14 microm; 95% confidence interval, 1-27 microm; P = .04); maximum retinal thickening (maximum thickening of the central and 4 inner subfields) decreased by 66 and 39 microm, respectively (adjusted mean difference, 27 microm; 95% confidence interval, 6-47 microm; P = .01), and retinal volume decreased by 0.8 and 0.4 mm3, respectively (adjusted mean difference, 0.3 mm3; 95% confidence interval, 0.02-0.53 mm3; P = .03). At 12 months, the mean change in visual acuity was 0 letters in the modified ETDRS group and 2 letters worse in the MMG group (adjusted mean difference, 2 letters; 95% confidence interval, -0.5 to 5 letters; P = .10). CONCLUSIONS: At 12 months after treatment, the MMG technique was less effective at reducing optical coherence tomography-measured retinal thickening than the more extensively evaluated current modified ETDRS laser photocoagulation approach. However, the visual acuity outcome with both approaches is not substantially different. Given these findings, a larger long-term trial of the MMG technique is not justified. APPLICATION TO CLINICAL PRACTICE: Modified ETDRS focal photocoagulation should continue to be a standard approach for treating diabetic macular edema. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00071773

    Observational Study of the Development of Diabetic Macular Edema Following Panretinal (Scatter) Photocoagulation Given in 1 or 4 Sittings

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    Purpose—To compare the effects of single-sitting vs. four-sitting panretinal photocoagulation (PRP) on macular edema in subjects with severe non-proliferative or early proliferative diabetic retinopathy with relatively good visual acuity and no or mild center involved macular edema. Method—Subjects were treated with one sitting or 4 sittings of PRP in a non-randomized, prospective, multi-centered clinical trial. Main Outcome Measures—Central subfield thickness on optical coherence tomography (OCT). Results—Central subfield thickness was slightly greater in the 1 sitting group (n=84) than in the 4 sitting group (n=71) at the 3-day (P=0.01) and 4-week visits (P=0.003). At the 34-week primary outcome visit, the slight differences had reversed, with the thickness being slightly greater in the 4- sitting group than in the 1-sitting group (P=0.06). Visual acuity differences paralleled OCT differences. Conclusions—Our results suggest that clinically meaningful differences are unlikely in OCT thickness or visual acuity following application of PRP in 1 sitting compared with 4 sittings in subjects in this cohort. More definitive results would require a large randomized trial. Application to Clinical Practice—These results suggest PRP costs to some patients, in terms of travel and lost productivity, as well as to eye care providers, could be reduced

    A Novel Approach for the Detection & Classification of Diabetic Retinopathy

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    When sugar level(glucose) in the blood fails to regulate the insulin properly in human body ,diabetic is occurred. The effect of diabetic on eye causes diabetic retinopathy. Diabetic Retinopathy is one of a complicated diabetes which can cause blindness .It is a metabolic disordered. patients perceive no symptoms until the disease is at late stage. So early detection and proper treatment has to be ensured. To serve this purpose, various automated systems have been designed. There are two levels of diabetic retinopathy which are non proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).The presence of micro aneurysms in the eye is one of the early signs of diabetic retinopathy. The objectives of this paper are 1) classify different stages of non proliferative diabetic retinopathy (NPDR) as mild NPDR, Moderate NPDR, Severe NPDR. 2)classification of micro aneurysms and exudates. DOI: 10.17762/ijritcc2321-8169.15031

    PERBEDAAN TEAR FILM BREAK UP TIME PADA PASIEN RETINOPATI DIABETIKA NONPROLIFERATIF DIBANDINGKAN RETINOPATI DIABETIKA PROLIFERATIF

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    Background : There are so many diabetic retinopathy patients that has complainted of dry eye syndrome, where the result of the dry eye syndrome cause the symptons more aggravate. Because of that, the writer want to know and analyze the difference of tear film break up time(TBUT) from nonproliverative diabetic retinopathy(NPDR) with proliverative diabetic retinopathy(PDR) in Indonesia. Aim : To know the difference of tear break up time from nonproliverative diabetic retinopathy and proliverative diabetic retinopathy. Methods : This is a cross sectional observational analytic study which used primary data. Sample were 25 NPDR patient and 25 PDR patient. The TBUT was obtained from the calculation since the last eye blink until the first dry spot appears after administration of the fluoroscein. Results: Sample are 25 NPDR patients and 25 PDR patients. Fiftyeight percent of the sample is woman. The average age of the sample is 53,88 for NPDR and 55,84 for PDR. The average time of patient has DM is 10,04 for NPDR and 12,4 for PDR. From the 50 sample of diabetic retinopathy patient, 26 patients is marginal of dry eye syndrome and 24 patients normal. The mann-whitney test show a difference(p=0,049) beetweenTBUT of NPDR and PDR. Conclusion : There is a different of tear break up time from nonproliverative diabetic retinopathy and proliverative diabetic retinopathy Key Word : Tear break up time, Nonproliverative Diabetic Retinopathy, Proliverative Retinopathy

    A study on relationship between severity of diabetic retinopathy and subclinical hypothyroidism

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    Background: Subclinical hypothyroidism (SCH) is defined as an asymptomatic condition characterized by normal serum levels of free thyroxine and elevated serum concentration of thyrotropin (>4.0µIU/ml). Association between diabetic retinopathy and SCH is unclear. Aim was to study the relationship between severity of diabetic retinopathy and SCH in patients of diabetic retinopathy with type 2 diabetes mellitus.Methods: 120 patients of diabetic retinopathy with known type 2 diabetes mellitus were taken and categorized them according to severity of diabetic retinopathy as per ETDRS classification. Serum thyrotropin (TSH) and free thyroxine (FT4) concentration were measured in all 120 patients. Patients with normal TSH and FT4 values are euthyroid patients and those with normal FT4 but TSH value >4µIU/ml are considered as having subclinical hypothyroidism. Severity of diabetic retinopathy is compared between the euthyroid and subclinical hypothyroid group.Results: Out of the 120 patients included in the study, 72 (60%) were male and 48 (40%) were female. 97 patients (80.83%) were Euthyroid and 23 patients (19.17%) had subclinical hypothyroidism. It was observed that prevalence of more severe form of diabetic retinopathy (severe NPDR and PDR) was higher in SCH group as compared to euthyroid group. Severity of diabetic retinopathy was compared with serum TSH level and it was seen that severity of diabetic retinopathy significantly increases with increase in serum TSH value.Conclusions: Patients with SCH had more severe form of diabetic retinopathy as compared to patients with euthyroidism. Severity of diabetic retinopathy significantly increases with increase in serum TSH value

    Screening intervals for diabetic retinopathy and incidence of visual loss: a systematic review

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    Screening for diabetic retinopathy can help to prevent this complication, but evidence regarding frequency of screening is uncertain. This paper systematically reviews the published literature on the relationship between screening intervals for diabetic retinopathy and the incidence of visual loss. The PubMed and EMBASE databases were searched until December 2012. Twenty five studies fulfilled the inclusion criteria, as these assessed the incidence/prevalence of sight‐threatening diabetic retinopathy in relation to screening frequency. The included studies comprised 15 evaluations of real‐world screening programmes, three studies modelling the natural history of diabetic retinopathy and seven cost‐effectiveness studies. In evaluations of diabetic retinopathy screening programmes, the appropriate screening interval ranged from one to four years, in people with no retinopathy at baseline. Despite study heterogeneity, the overall tendency observed in these programmes was that 2‐year screening intervals among people with no diabetic retinopathy at diagnosis were not associated with high incidence of sight‐threatening diabetic retinopathy. The modelling studies (non‐economic and economic) assessed a range of screening intervals (1–5 years). The aggregated evidence from both the natural history and cost‐effectiveness models favors a screening interval >1 year, but ≤2 years. Such an interval would be appropriate, safe and cost‐effective for people with no diabetic retinopathy at diagnosis, while screening intervals ≤1 year would be preferable for people with pre‐existing diabetic retinopathy. A 2‐year screening interval for people with no sight threatening diabetic retinopathy at diagnosis may be safely adopted. For patients with pre‐existing diabetic retinopathy, a shorter interval ≤1 year is warranted.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/100323/1/dme12274.pd
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