Occurrence of diabetic maculopathy according to diabetes control and hypertension prevalence

WSTĘP. Retinopatia cukrzycowa jest obecnie najczęstszym powikłaniem typu mikroangiopatii u chorych na cukrzycę. Prawie nieodłączną cechą retinopatii jest uszkodzenie plamki w cukrzycy — stanowi ono główną przyczynę znacznego pogorszenia ostrości wzroku. Mimo że hiperglikemia jest najważniejszym czynnikiem patogennym w rozwoju angiopatii, w niektórych przypadkach na rozwój makulopatii mogą wpływać również czynniki układowe, a szczególnie nadciśnienie tętnicze. MATERIAŁ I METODY. Badania przeprowadzono u 101 chorych na cukrzycę. Makulopatię cukrzycową stwierdzono w 168 oczach. Stopień wyrównania cukrzycy oraz ocenę skuteczności leczenia określono na podstawie stężenia fruktozaminy. U chorych wykonywano badanie ostrości wzroku do dali i do bliży, oftalmoskopię oraz angiografię fluoresceinową siatkówki. WYNIKI. U chorych z nadciśnieniem tętniczym stwierdzono częstsze występowanie wszystkich form makulopatii, w tym: ogniskowej w 63,6%, rozlanej w 30,3% i niedokrwiennej w 6,1% oczu. Normalizacja ciśnienia tętniczego za pomocą środków farmakologicznych wpływała na procentowy rozkład różnych typów uszkodzenia plamki z jego przesunięciem w kierunku form łagodnych. W przypadku dostatecznego i niedostatecznego wyrównania cukrzycy autorzy częściej stwierdzali makulopatię rozlaną (68,5%) i makulopatię niedokrwienną (66,6%). Jeżeli cukrzyca była wyrównana w stopniu idealnym i dobrym, częściej występowały makulopatia ogniskowa (60%) i makulopatia rozlana (31,8%). WNIOSKI. Makulopatia cukrzycowa częściej występowała u chorych ze współistniejącym nadciśnieniem tętniczym, a u pacjentów z uregulowanym ciśnieniem miała łagodniejszy przebieg. Wykazano także korzystny wpływ wyrównania cukrzycy na przebieg makulopatii.INTRODUCTION. Diabetic retinopathy is nowadays most common microvascular complication in diabetic patients. Macular damage is inseparable feature of retinopathy and it is the main reason of visual acuity reduction. Hyperglycaemia is dominant pathogenic factor in angiopathy, however in some cases the systemic factors, especially hypertension, can have a harmful effect. MATERIAL AND METHODS. 101 diabetic patients were observed. Diabetic maculopathy was diagnosed in 168 eyes. Diabetes control level and results of treatment were estimated by means of fructosamine level. From all patients we obtained visual acuity, ophthalmoscopy and fluorescein angiography. Function of central retina was evaluated by means of visual acuity. Retina was investigated in direct ophthalmoscopy. Angiography was also used in macula assessment. RESULTS. Maculopathy was observed more often in hypertensive patients: 63,6% had focal, 30,3% had diffuse and 6,1% had ischaemic maculopathy. Pharmacological normalization of hypertension had a positive effect on the type of macular damage and had a correlation with milder types of maculopathy. In sufficient and insufficient diabetes control level more often diffuse (68,5%) and ischaemic (66,6%) maculopathy were found. In perfect and good diabetes control level more often types were: focus (60%) and diffuse (31,8%) maculopathy. CONCLUSIONS. Diabetic maculopathy occurred more often in hypertensive patients and had milder course in patients with normalized hypertension. We also proved a beneficial effect of diabetes control on types of maculopathy

The evaluation of the central retina after laser therapy in diabetic retinopathy

WSTĘP. Celem niniejszej pracy jest ocena wpływu laseroterapii na stan przedmiotowy siatkówki centralnej w retinopatii cukrzycowej. MATERIAŁ I METODY. Analizie poddano 200 oczu u 101 chorych na cukrzycę typu 1 i typu 2. W badanej grupie było 47 kobiet i 54 mężczyzn w wieku 23-72 lat. Na podstawie szczegółowego badania oftalmoskopowego i angiograficznego w 168 oczach stwierdzono objawy makulopatii. W 105 oczach (62,5%) wykazano ogniskowy obrzęk plamki, w 54 oczach (32,1%) - makulopatię rozlaną, a w 9 oczach (5,4%) - makulopatię niedokrwienną. Zgodnie z zaleceniami Diabetic Retinopathy Study (DRS) oraz Early Treatment Diabetic Retinopathy Study (ETDRS) pacjentów poddano laseroterapii laserem argonowym firmy Coherent 920. Efekty leczenia oceniano po okresie 1,2–4,4 roku od czasu wykonania fotokoagulacji. WYNIKI. Po zastosowanej laseroterapii poprawę zaobserwowano w 88,6% przypadków z makulopatią ogniskową i w 83,3% z makulopatią rozlaną. Stabilizację zmian stwierdzono w 8,6% przypadków z makulopatią ogniskową i w 11,1% przypadków z makulopatią rozlaną. Autorzy niniejszej pracy progresję makulopatii ogniskowej zaobserwowali w 2,8% przypadków, a makulopatii rozlanej - w 5,6%0. W oczach z makulopatią niedokrwienną uzyskali stabilizację procesu w 60%, a poprawę zaledwie w 20%. Liczba mikrowłośniaków zmniejszyła się w 81,8% przypadków, liczba wysięków twardych - w 77% przypadków. Wybroczyny śródsiatkówkowe uległy regresji zaledwie w 24,2% przypadków, a strefy braku perfuzji jedynie w 3,6% przypadków. WNIOSKI. Pozytywne wyniki laseroterapii, szczególnie w makulopatii ogniskowej i rozlanej, uzasadniają uznanie tej terapii jako metody z wyboru w leczeniu retinopatii cukrzycowej.INTRODUCTION. The purpose of this study is the evaluation of the photocoagulation impact on central retina in diabetic retinopathy. MATERIAL AND METHODS. 101 patients (200 eyes), age varied from 23 to 72 years, 47 women and 54 men with insulin-dependent and insulin non-dependent diabetes were analyzed. On the basis of detailed ophthalmology and angiography examination diabetic maculopathy were found in 168 eyes. The focal macular edema was stated in 105 eyes (62.5%), diffuse maculopathy in 54 eyes (32.1%) and ischemic maculopathy in 9 eyes (5.4%). Patients were treated with argon laser Coherent 920, in accordance with DRS and ETDRS recommendations. The effects of laser therapy were estimated in 1.2 to 4.4 years after photocoagulation. RESULTS. In 88,6% eyes with focal macular edema and in 83.3% eyes with diffuse maculopathy we noticed an improvement after the photocoagulation. Stabilization was found in 8.6% eyes with focal macular edema and in 11.1% eyes with diffuse maculopathy. Deterioration was found in 2.8% eyes with focal maculopathy and in 5.6% eyes with diffuse maculopathy. Ischemic maculopathy was stabilized in 60%, improved only in 20%. The amount of microvessels decreased in 81.8% eyes, the amount of hard exudates in 77%, intraretinal blood extravasations in 24.2% eyes and zones of lack of perfusion only in 3.6%. CONCLUSION. The positive results of photocoagulation, especially in focal and diffuse maculopathy, justify the application of laser treatment as a method of choice in diabetic retinopathy

Computational Approach to Dendritic Spine Taxonomy and Shape Transition Analysis

The common approach in morphological analysis of dendritic spines of mammalian neuronal cells is to categorize spines into subpopulations based on whether they are stubby, mushroom, thin, or filopodia shaped. The corresponding cellular models of synaptic plasticity, long-term potentiation, and long-term depression associate the synaptic strength with either spine enlargement or spine shrinkage. Although a variety of automatic spine segmentation and feature extraction methods were developed recently, no approaches allowing for an automatic and unbiased distinction between dendritic spine subpopulations and detailed computational models of spine behavior exist. We propose an automatic and statistically based method for the unsupervised construction of spine shape taxonomy based on arbitrary features. The taxonomy is then utilized in the newly introduced computational model of behavior, which relies on transitions between shapes. Models of different populations are compared using supplied bootstrap-based statistical tests. We compared two populations of spines at two time points. The first population was stimulated with long-term potentiation, and the other in the resting state was used as a control. The comparison of shape transition characteristics allowed us to identify the differences between population behaviors. Although some extreme changes were observed in the stimulated population, statistically significant differences were found only when whole models were compared. The source code of our software is freely available for non-commercial use1

Impaired synaptic incorporation of AMPA receptors in a mouse model of fragile X syndrome

Fragile X syndrome (FXS) is the most common monogenetic cause of inherited intellectual disability and autism in humans. One of the well-characterized molecular phenotypes of Fmr1 KO mice, a model of FXS, is increased translation of synaptic proteins. Although this upregulation stabilizes in adulthood, abnormalities during the critical period of plasticity have long-term effects on circuit formation and synaptic properties. Using high-resolution quantitative proteomics of synaptoneurosomes isolated from the adult, developed brains of Fmr1 KO mice, we show a differential abundance of proteins regulating the postsynaptic receptor activity of glutamatergic synapses. We investigated the AMPA receptor composition and shuttling in adult Fmr1 KO and WT mice using a variety of complementary experimental strategies such as surface protein crosslinking, immunostaining of surface receptors, and electrophysiology. We discovered that the activity-dependent synaptic delivery of AMPARs is impaired in adult Fmr1 KO mice. Furthermore, we show that Fmr1 KO synaptic AMPARs contain more GluA2 subunits that can be interpreted as a switch in the synaptic AMPAR subtype toward an increased number of Ca2+−impermeable receptors in adult Fmr1 KO synapses

Prophylactic Ketamine Treatment Promotes Resilience to Chronic Stress and Accelerates Recovery: Correlation with Changes in Synaptic Plasticity in the CA3 Subregion of the Hippocampus

Ketamine is an N-methyl-d-aspartate receptor antagonist that has gained wide attention as a potent antidepressant. It has also been recently reported to have prophylactic effects in animal models of depression and anxiety. Alterations of neuroplasticity in different brain regions; such as the hippocampus; prefrontal cortex; and amygdala; are a hallmark of stress-related disorders; and such changes may endure beyond the treatment of symptoms. The present study investigated whether a prophylactic injection of ketamine has effects on structural plasticity in the brain in mice that are subjected to chronic unpredictable stress followed by an 8-day recovery period. Ketamine administration (3 mg/kg body weight) 1 h before stress exposure increased the number of resilient animals immediately after the cessation of stress exposure and positively influenced the recovery of susceptible animals to hedonic deficits. At the end of the recovery period; ketamine-treated animals exhibited significant differences in dendritic spine density and dendritic spine morphology in brain regions associated with depression compared with saline-treated animals. These results confirm previous findings of the prophylactic effects of ketamine and provide further evidence of an association between the antidepressant-like effect of ketamine and alterations of structural plasticity in the brai