Journal articles: 'Diabetes on eye sight'

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Leese, G. P., D. M. Broadbent, S. P. Harding, and J. P. Vora. "Detection of Sight-threatening Diabetic Eye Disease." Diabetic Medicine 13, no. 10 (October 1996): 850–53. http://dx.doi.org/10.1002/(sici)1096-9136(199610)13:10<850::aid-dia167>3.0.co;2-e.

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AlSawahli, Heba, Caleb D. Mpyet, Gamal Ezzelarab, Ibrahim Hassanin, Mohammad Shalaby, Omar Safa, and Ahmed Almansour. "Population-based cross-sectional prevalence survey of diabetes and diabetic retinopathy in Sohag—Egypt, 2019." BMJ Open 11, no. 6 (June 2021): e047757. http://dx.doi.org/10.1136/bmjopen-2020-047757.

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ObjectivesTo determine the prevalence of diabetes mellitus (DM), prevalence of diabetic retinopathy (DR) and sight-threatening conditions among persons with DM aged 50 years and older in Sohag governorate in Upper Egypt.DesignPopulation-based, cross-sectional survey using the standardised Rapid Assessment of Avoidable Blindness with the addition of the Diabetic Retinopathy module methodology.SettingsSohag governorate in Egypt where 68 clusters were selected using probability proportional to population size. Households were selected using the compact segment technique.Participants4078 people aged 50 years and older in 68 clusters were enrolled, of which 4033 participants had their random blood sugar checked and 843 examined for features of DR.Primary and secondary outcomesThe prevalence of DM and DR; secondary outcome was the coverage with diabetic eye care.ResultsThe prevalence of DM was 20.9% (95% CI 19.3% to 22.5%). The prevalence in females (23.8%; 95% CI 21.4% to 26.3%) was significantly higher than in males (18.9%; 95% CI 17.1% to 20.7%) (p=0.0001). Only 38.8% of persons diagnosed with diabetes had good control of DM. The prevalence of DR in the sample was 17.9% (95% CI 14.7% to 21.1%). The prevalence in females was higher (18.9%; 95% CI 14.0% to 23.8%) than in males (17.1%; 95% CI 13.0% to 21.2%). Up to 85.3% of study participants have never had eye examination. Sight-threatening DR (R4 and/or M2) was detected in 5.2% (95% CI 3.4% to 7.0%) with only 2.3% having had laser treatment.ConclusionThe prevalence of uncontrolled DM in Sohag governorate in Egypt is higher than the national prevalence. There is a high prevalence of sight-threatening retinopathy and/or maculopathy with few people having access to diabetic eye care. A public health approach is needed for health promotion, early detection and management of DR.

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Collins, Sonya. "Nevada pharmacist prepares patient with diabetes for sight-saving eye surgery." Pharmacy Today 24, no. 11 (November 2018): 44. http://dx.doi.org/10.1016/j.ptdy.2018.10.025.

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Denniston, Alastair K., Aaron Y. Lee, Cecilia S. Lee, David P. Crabb, Clare Bailey, Peck-Lin Lip, Paul Taylor, et al. "United Kingdom Diabetic Retinopathy Electronic Medical Record (UK DR EMR) Users Group: report 4, real-world data on the impact of deprivation on the presentation of diabetic eye disease at hospital services." British Journal of Ophthalmology 103, no. 6 (September 29, 2018): 837–43. http://dx.doi.org/10.1136/bjophthalmol-2018-312568.

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AimTo assess the impact of deprivation on diabetic retinopathy presentation and related treatment interventions, as observed within the UK hospital eye service.MethodsThis is a multicentre, national diabetic retinopathy database study with anonymised data extraction across 22 centres from an electronic medical record system. The following were the inclusion criteria: all patients with diabetes and a recorded, structured diabetic retinopathy grade. The minimum data set included, for baseline, age and Index of Multiple Deprivation, based on residential postcode; and for all time points, visual acuity, ETDRS grading of retinopathy and maculopathy, and interventions (laser, intravitreal therapies and surgery). The main outcome measures were (1) visual acuity and binocular visual state, and (2) presence of sight-threatening complications and need for early treatment.Results79 775 patients met the inclusion criteria. Deprivation was associated with later presentation in patients with diabetic eye disease: the OR of being sight-impaired at entry into the hospital eye service (defined as 6/18 to better than 3/60 in the better seeing eye) was 1.29 (95% CI 1.20 to 1.39) for the most deprived decile vs 0.77 (95% CI 0.70 to 0.86) for the least deprived decile; the OR for being severely sight-impaired (3/60 or worse in the better seeing eye) was 1.17 (95% CI 0.90 to 1.55) for the most deprived decile vs 0.88 (95% CI 0.61 to 1.27) for the least deprived decile (reference=fifth decile in all cases). There is also variation in sight-threatening complications at presentation and treatment undertaken: the least deprived deciles had lower chance of having a tractional retinal detachment (OR=0.48 and 0.58 for deciles 9 and 10, 95% CI 0.24 to 0.90 and 0.29 to 1.09, respectively); in terms of accessing treatment, the rate of having a vitrectomy was lowest in the most deprived cohort (OR=0.34, 95% CI 0.19 to 0.58).ConclusionsThis large real-world study suggests that first presentation at a hospital eye clinic with visual loss or sight-threatening diabetic eye disease is associated with deprivation. These initial hospital visits represent the first opportunities to receive treatment and to formally engage with support services. Such patients are more likely to be sight-impaired or severely sight-impaired at presentation, and may need additional resources to engage with the hospital eye services over complex treatment schedules.

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Warwick, A. N., A. P. Brooks, C. Osmond, and R. Krishnan. "Prevalence of referable, sight-threatening retinopathy in type 1 diabetes and its relationship to diabetes duration and systemic risk factors." Eye 31, no. 2 (January 27, 2017): 333–41. http://dx.doi.org/10.1038/eye.2016.294.

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Sapkota, Raju, Zhiqing Chen, Dingchang Zheng, and Shahina Pardhan. "The profile of sight-threatening diabetic retinopathy in patients attending a specialist eye clinic in Hangzhou, China." BMJ Open Ophthalmology 4, no. 1 (April 2019): e000236. http://dx.doi.org/10.1136/bmjophth-2018-000236.

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Background/aimsTo examine the profile of diabetic retinopathy, awareness and self-help in patients attending a specialist eye clinic in Hangzhou, China.MethodsA total of 199 consecutive patients with diabetes (mean age = 57 years, SD = 11) attending eye clinic at the School of Medicine, Zhejiang University, Hangzhou were examined in a cross-sectional study. Clinical/demographic data were obtained from patients’ records. Fundus photographs obtained from each patient were graded using Early Treatment of Diabetic Retinopathy Study (ETDRS) criteria; severe non-proliferative, proliferative retinopathy and/or macular oedema (hard exudates/thickening around fovea) were classified as sight-threatening diabetic retinopathy (STDR). Optical coherence tomography was used to confirm the diagnosis of macular oedema. Data on knowledge/awareness about diabetes and self-help/lifestyle were collected using a structured questionnaire.ResultsSTDR was found in 80% patients of whom 18% had visual acuity of ≤counting fingers in at least one eye. Male gender, longer diabetic duration and use of insulin were significantly associated with STDR (p ≤ 0.05). Of the total, 41% patients reported that they were attending for the first time. Of all the first-time attendees, 67% had STDR. Also of all the first-time attendees, 14% were unclear whether diabetes affected their eyes. Fifty-one per cent of patients who thought their diabetes was well controlled had fasting blood sugar ≥6.5 mmol/L (p < 0.001). Of the total, 65% patients reported not doing ≥4 hours/week of physical exercise.ConclusionsThe majority of patients with diabetes presented to this eye clinic suffered with late-stage retinopathy. Our results advocate the need to improve diabetic diagnosis, management and awareness and to set up eye screening for diabetics in Hangzhou, China.

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Bailey, C. C., and J. M. Sparrow. "Co-morbidity in patients with sight-threatening diabetic retinopathy." Eye 15, no. 6 (November 2001): 719–22. http://dx.doi.org/10.1038/eye.2001.236.

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Granström, Therese, Henrietta Forsman, Anna-Lena Brorsson, Elisabet Granstam, and Janeth Leksell. "Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study." Nordic Journal of Nursing Research 38, no. 1 (May 18, 2017): 11–17. http://dx.doi.org/10.1177/2057158517709409.

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The diabetic complication macular oedema (DME) is a growing problem worldwide because of the increasing number of patients suffering from diabetes mellitus (DM). DME is treated with injections of anti-vascular endothelial growth factor (anti-VEGF) in the eye. This real-world study aimed to describe patients’ experiences before they received their first injection in the eye. Twenty-one men and women aged 49 to 86 years were interviewed. The interviews were analysed using qualitative content analysis. Two categories and an overall theme ‘to be at a crossroads and a crucial phase in life with an uncertain outcome’ were found. The participants expressed thoughts and concerns at different levels, practical concerns about the treatment procedure, and other existential thoughts regarding hope for improved visual acuity or fear of deterioration. Cooperation between eye clinics and diabetes clinics should be strengthened to clarify who is responsible for providing the information and support required by patients.

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Singh, Gurkirpal, Maanek Sehgal, Alka Mithal, Chris Alabiad, and Andrea Kossler. "Severe Thyroid Eye Disease in the US: A National Perspective." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A843. http://dx.doi.org/10.1210/jendso/bvab048.1720.

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Abstract Background: Thyroid eye disease (TED) is an unpredictable autoimmune inflammatory disease which can be sight-threatening, debilitating, and disfiguring. The majority of patients have mild, self-limited TED, 20-30% of patients experience moderate/severe disease, and 3-5% may develop sight-threatening disease, such as CON or exposure keratopathy. Surgical intervention is commonly necessary for patients with moderate/severe stable disease or sight-threatening disease, however, there is little data on the prevalence of TED requiring surgical interventions. Objective: To document the number of surgical procedures for thyroid eye disease in the US and evaluate the associated costs of these interventions. Methods: National Ambulatory Surgery Sample (NASS) is the largest ambulatory surgery database, representing approximately 14 million ambulatory surgeries performed annually in a hospital setting in the US. Data from 2,699 hospital-owned facilities located in 31 States and the District of Columbia, approximating a 63-percent stratified sample of U.S. hospital-owned facilities performing selected ambulatory surgeries are available for analyses. Data on clinical procedures and diagnoses, disposition of the patient, expected source of payment, and total charges, as well as geographic, hospital-owned facility, and patient characteristics are collected. For the purposes of this study, TED was identified by concomitantly occurring ICD 10 codes of thyroid disease and ICD-10 codes for eye manifestations of thyroid eye disease. CPT codes were used to identify eye surgeries performed in these patients. The coding algorithms were developed by consensus of three ophthalmic surgeons. Results: In 2018, a total of 1,991 patients with TED required eye surgery, with a national prevalence of 0.6 per 100,000 population. Mean age at surgery was 56.2 years (95% Confidence Interval (CI) 55.3-57.2). Women comprised 73% (1455 women and 536 men) of TED patients who underwent surgery. The average charges for each surgical encounter were $21,875 (95% CI $19,066-$24,684). Total charges for TED surgery in the US totaled over 43.5 million annually. While many patients had private insurance (49.7%), Medicare (31%) and Medicaid (13%) were also significant sources of reimbursement. Of all TED-related surgeries, 93% were conducted in teaching hospitals. Only 0.2% of surgeries were conducted in non-urban rural settings. Conclusion: In the US, severe TED requiring surgery, although uncommon, has significant economic impact. Further research is warranted to better understand the natural history of TED that may inform treatment pathways which may prevent complications needing surgery.

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Forster, A. S., A. Forbes, H. Dodhia, C. Connor, A. Du Chemin, S. Sivaprasad, S. Mann, and M. C. Gulliford. "OP90 Non-Attendance at Diabetes Eye Screening and Risk of Sight-Threatening Diabetic Retinopathy: Population-based Cohort Study." Journal of Epidemiology and Community Health 67, Suppl 1 (September 2013): A42.1—A42. http://dx.doi.org/10.1136/jech-2013-203126.90.

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Pulido, Jose E., Jose S. Pulido, Jay C. Erie, Jorge Arroyo, Kurt Bertram, Miao-Jen Lu, and Scott A. Shippy. "A Role for Excitatory Amino Acids in Diabetic Eye Disease." Experimental Diabetes Research 2007 (2007): 1–7. http://dx.doi.org/10.1155/2007/36150.

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Diabetic retinopathy is a leading cause of vision loss. The primary clinical hallmarks are vascular changes that appear to contribute to the loss of sight. In a number of neurodegenerative disorders there is an appreciation that increased levels of excitatory amino acids are excitotoxic. The primary amino acid responsible appears to be the neurotransmitter glutamate. This review examines the nature of glutamatergic signaling at the retina and the growing evidence from clinical and animal model studies that glutamate may be playing similar excitotoxic roles at the diabetic retina.

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Tramunt, Blandine, Philippe Imbert, Solange Grunenwald, Franck Boutault, and Philippe Caron. "Sight-threatening Graves’ orbitopathy: Twenty years’ experience of a multidisciplinary thyroid-eye outpatient clinic." Clinical Endocrinology 90, no. 1 (November 19, 2018): 208–13. http://dx.doi.org/10.1111/cen.13880.

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Scanlon, Peter H. "The contribution of the English NHS Diabetic Eye Screening Programme to reductions in diabetes-related blindness, comparisons within Europe, and future challenges." Acta Diabetologica 58, no. 4 (April 2021): 521–30. http://dx.doi.org/10.1007/s00592-021-01687-w.

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AbstractThe aim of the English NHS Diabetic Eye Screening Programme (DESP) is to reduce the risk of sight loss amongst people with diabetes by the prompt identification and effective treatment if necessary of sight-threatening diabetic retinopathy, at the appropriate stage during the disease process, with a long-term aim of preventing blindness in people with diabetes.For the year 2009–2010, diabetic retinopathy (DR) was no longer the leading cause of blindness in the working age group. There have been further reductions in DR certifications for WHO severe vision impairment and blindness from 1,334 (5.5% of all certifications) in 2009/2010 to 840 (3.5% of all certifications) in 2018/2019. NHS DESP is a major contributor to this further reduction, but one must also take into account improvements in glycaemic and blood pressure control, timely laser treatment and vitrectomy surgery, improved monitoring techniques for glycaemic control, and vascular endothelial growth factor inhibitor injections for control of diabetic macular oedema. The latter have had a particular impact since first introduced in the UK in 2013.Current plans for NHS DESP include extension of screening intervals in low-risk groups and the introduction of optical coherence tomography as a second line of screening for those with screen positive maculopathy with two dimensional markers. Future challenges include the introduction of automated analysis for grading and new camera technologies.

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James, M. "Cost effectiveness analysis of screening for sight threatening diabetic eye disease." BMJ 320, no. 7250 (June 17, 2000): 1627–31. http://dx.doi.org/10.1136/bmj.320.7250.1627.

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Hart, Patricia M., and Simon Harding. "Is it time for a national screening programme for sight-threatening diabetic retinopathy?" Eye 13, no. 2 (March 1999): 129–30. http://dx.doi.org/10.1038/eye.1999.37.

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Henriques, José, Sara Vaz-Pereira, João Nascimento, and Paulo Caldeira Rosa. "Doença Ocular Diabética." Acta Médica Portuguesa 28, no. 1 (February 27, 2015): 107. http://dx.doi.org/10.20344/amp.5361.

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Diabetes mellitus is a chronic metabolic disease characterized by sustained hyperglycemia leading to macro and microvascular complications. The eye is one of the main organs affected by this disease, being diabetic retinopathy the most well-known microvascular complication and the leading cause of blindness in the working age population. However, diabetic ocular disease is not only characterized by diabetic retinopathy. Other important ocular manifestations of diabetes mellitus include cataract, glaucoma, ischemic optic neuropathy, cranial nerve palsies and recurrent corneal erosion syndrome. Here, we emphasize diabetic retinopathy as the most important and characteristic complication of diabetes mellitus, but also review less well-known complications with the aim to alert and sensitize non-ophthalmologist clinicians that treat diabetic individuals, in order to promote an early diagnosis and treatment of the sight-threatening complications of diabetes.<br /><strong>Keywords:</strong> Diabetes Complications; Diabetes Mellitus; Diabetic Retinopathy.

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Younis, Naveed, Deborah M. Broadbent, Jiten P. Vora, and Simon P. Harding. "Incidence of sight-threatening retinopathy in patients with type 2 diabetes in the Liverpool Diabetic Eye Study: a cohort study." Lancet 361, no. 9353 (January 2003): 195–200. http://dx.doi.org/10.1016/s0140-6736(03)12267-2.

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Zambarakji, H. J., T. K. H. Butler, and S. A. Vernon. "Assessment of the Heidelberg Retina Tomograph in the detection of sight-threatening diabetic maculopathy." Eye 13, no. 2 (March 1999): 136–44. http://dx.doi.org/10.1038/eye.1999.40.

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Wong, Ian Yat Hin, Michael Yuxuan Ni, Irene Oi Ling Wong, Nellie Fong, and Gabriel M. Leung. "Saving sight in China and beyond: the Lifeline Express model." BMJ Global Health 3, no. 4 (August 2018): e000766. http://dx.doi.org/10.1136/bmjgh-2018-000766.

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Cataract and diabetic retinopathy are leading causes of blindness globally. Lifeline Express (LEX) has pioneered the provision of cataract surgery in rural China from custom-built trains and eye centres nationwide. Over the past two decades, LEX has provided free cataract surgery for over 180 000 patients in China. In China, half of the adult population has prediabetes and 113 million adults have diabetes. Recognising the rising threat of diabetic retinopathy, LEX has expanded to providing free diabetic retinopathy screening nationwide by establishing 29 Diabetic Retinopathy Screening Centres across China. Source of referrals included host hospitals, the community and out-reach mobile vans equipped with fundus cameras. Fundi photos taken in the mobile vans were electronically transferred to primary graders. LEX also leveraged the widespread smartphone use to provide electronic medical reports via WeChat, the most popular instant messenger app in China. From April 2014 to December 2016, 34 506 patients with diabetes underwent screening, of which 27.2% (9,396) were identified to have diabetic retinopathy. China’s latest national health strategy (‘Healthy China 2030 Plan’) has championed the ‘prevention first’ principle and early screening of chronic diseases. LEX has accordingly evolved to extend its services to save sight in China—from cataract surgery to diabetic retinopathy screening and most recently outreaching beyond its national borders in a pilot South–South collaboration. With health at the top of the China’s developmental agenda and the country’s growing role in global health—LEX’s large-scale telemedicine-enabled programme could represent a potentially scalable model for nationwide diabetic retinopathy screening elsewhere.

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Symes, Richard J., Gerald Liew, and Adnan Tufail. "Sight-threatening diabetic eye disease: an update and review of the literature." British Journal of General Practice 64, no. 627 (September 29, 2014): e678-e680. http://dx.doi.org/10.3399/bjgp14x682033.

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Forster, Alice S., Angus Forbes, Hiten Dodhia, Clare Connor, Alain Du Chemin, Sobha Sivaprasad, Samantha Mann, and Martin C. Gulliford. "Non-attendance at diabetic eye screening and risk of sight-threatening diabetic retinopathy: a population-based cohort study." Diabetologia 56, no. 10 (June 22, 2013): 2187–93. http://dx.doi.org/10.1007/s00125-013-2975-0.

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Shete, Mayank, Saahil Sabnis, Srijan Rai, and Gajanan Birajdar. "Diabetic Retinopathy Severity Detection using Convolutional Neural Network." ITM Web of Conferences 32 (2020): 01012. http://dx.doi.org/10.1051/itmconf/20203201012.

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Diabetic Retinopathy is one of the most prominent eye diseases and is the leading cause of blindness amongst adults. Automatic detection of Diabetic Retinopathy is important to prevent irreversible damage to the eye-sight. Existing feature learning methods have a lesser accuracy rate in computer aided diagnostics; this paper proposes a method to further increase the accuracy. Machine learning can be used effectively for the diagnosis of this disease. CNN and transfer learning are used for the severity classification and have achieved an accuracy of 73.9 percent. The use of XGBoost classifier yielded an accuracy of 76.5 percent.

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Prathiba, Vijayaraghavan, and Mohan Rema. "Teleophthalmology: A Model for Eye Care Delivery in Rural and Underserved Areas of India." International Journal of Family Medicine 2011 (July 17, 2011): 1–4. http://dx.doi.org/10.1155/2011/683267.

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Objectives. To describe the application of teleophthalmology in rural and underserved areas of India. Study Design. This paper describes the major teleophthalmology projects in India and its benefits. Results. Teleophthalmology is the use of telecommunication for electronic transfer of health-related data from rural and underserved areas of India to specialities in urban cities. The MDRF/WDF Rural Diabetes Project has proved to be very beneficial for improvement of quality health care in Tamilnadu and can be replicated at the national level. This community outreach programme using telemedicine facilities has increased awareness of eye diseases, improved access to specialized health care, helped in local community empowerment, and provided employment opportunities. Early detection of sight threatening disorders by teleophthalmology and prompt treatment can help decrease visual impairment. Conclusion. Teleophthalmology can be a very effective model for improving eye care delivery system in rural and underserved areas of India.

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Cotton, Paul. "Advances in Diabetic Retinopathy Could Save Sight, Money With More Frequent Eye Exams." JAMA: The Journal of the American Medical Association 264, no. 20 (November 28, 1990): 2608. http://dx.doi.org/10.1001/jama.1990.03450200014002.

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Cotton, P. "Advances in diabetic retinopathy could save sight, money with more frequent eye exams." JAMA: The Journal of the American Medical Association 264, no. 20 (November 28, 1990): 2608. http://dx.doi.org/10.1001/jama.264.20.2608.

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Rajalakshmi, Ramachandran, UmeshC Behera, Harsha Bhattacharjee, Taraprasad Das, Clare Gilbert, GV S. Murthy, HiraB Pant, Rajan Shukla, and on behalf of the SPEED Study group. "Spectrum of eye disorders in diabetes (SPEED) in India. Report # 2. Diabetic retinopathy and risk factors for sight threatening diabetic retinopathy in people with type 2 diabetes in India." Indian Journal of Ophthalmology 68, no. 13 (2020): 21. http://dx.doi.org/10.4103/ijo.ijo_21_19.

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ElGohary, Sherif H., Shaimaa A. Azab, Mohamed K. Metwally, and Noha S. Hassan. "Numerical Computational Study of Photoacoustic Signals from Eye Models to Detect Diabetic Retinopathy." Open Biomedical Engineering Journal 14, no. 1 (April 23, 2020): 11–19. http://dx.doi.org/10.2174/1874120702014010011.

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Introduction: Detection of Diabetic Retinopathy (DR) is essential in clinical ophthalmology as it may prevent sight degradation. In this paper, a complete Photoacoustic (PA) analysis is implemented to detect DR in three different eye models representing a healthy eye as well as two abnormal eyes exhibiting Non-Proliferative Retinopathy (NPDR), and Proliferative Retinopathy (PDR) Methods & Materials: Monte Carlo method was used to simulate the interaction of a 0.8 ns duration laser pulse with eye tissues at 750 nm wavelength. Thermal, structural and acoustical analyses were performed using the Finite Element Method (FEM). Results: The results showed that there is a significant change in the amplitude of the detected PA signal for abnormal eye tissues in the retina (P < 0.05) as compared to healthy eye tissues. The maximum amplitude of the received PA signal in the NPDR and the PDR eye models is 5% and 33%, respectively, which are greater than those observed in the healthy eye. Conclusion: These results may provide insights into using PA imaging to detect DR.

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Pinazo-Durán, María D., Vicente Zanón-Moreno, José J. García-Medina, J. Fernando Arévalo, Roberto Gallego-Pinazo, and Carlo Nucci. "Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review." BioMed Research International 2016 (2016): 1–10. http://dx.doi.org/10.1155/2016/6215745.

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Coexistence of several ocular diseases is more frequent than suspected. In spite of the refractive errors, one or more of the following can be detected simultaneously: glaucoma, cataracts, uveitis, age-related macular degeneration, and dry eyes. In addition, as people age, ocular comorbidities are much more usually seen. Specific diseases are openly acknowledged to affect the eyes and vision, such as diabetes mellitus, hypertension blood pressure, arthritis, hyperthyroidism, neurodegenerative disorders, hematologic malignancies, and/or systemic infections. Recent advances in early diagnosis and therapy of the ophthalmic pathologies have reinforced patient options to prevent visual impairment and blindness. Because of this, it is essential not to overlook sight-threatening conditions such as the ocular comorbidities and/or the eye involvement in the context of systemic disorders. Moreover, the important role of the multidisciplinary cooperation to improve and sustain management of patients affected with eclectic ocular comorbidities and/or systemic disorders with eye repercussion is specifically addressed. This review intends to shed light on these topics to help in making opportune diagnosis and appropriately managing the affected patients.

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Raizada, Nishant, Viveka P. Jyotsna, Devasenathipathy Kandasamy, Immaculata Xess, Alok Thakar, and Nikhil Tandon. "Invasive fungal rhinosinusitis in patients with diabetes." Journal of Infection in Developing Countries 12, no. 09 (September 30, 2018): 787–93. http://dx.doi.org/10.3855/jidc.9699.

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Introduction: We report the clinical and radiological features as well as outcomes of invasive fungal rhinosinusitis in patients with diabetes from a tertiary care center in North India. Methodology: All patients admitted with a diagnosis of invasive fungal rhinosinusitis with pre-existing or newly diagnosed diabetes from 1st January 2008 to 31st December 2015 were included. Hospital records were used to identify clinical features, biochemical investigations and treatment modalities used. The imaging findings were reported at baseline, 30, 60,90 and 120 days of admission and progression of disease was reported as static, worse or improved. The outcomes were sight loss and survival at end of hospital stay. Results: 22 patients of invasive fungal sinusitis and diabetes were identified. At presentation, 5 had ketoacidosis, all of whom died at the end of hospital stay. Loss of vision in one eye was seen in 70% cases. The survival at end of hospital stay was 72.7% and at six months after end of study period was 57.8%. No patients had radiological improvement at day 30 imaging (including those who subsequently improved). Conclusion: Radiological improvement is not apparent before two months of therapy. Ketoacidosis is a predictor of mortality in invasive fungal sinusitis with diabetes.

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Lee, Elin, Srinivasan Sanjay, and Tiakumzuk Sangtam. "Knowledge, attitudes and practice patterns of patients with diabetes mellitus and diabetic retinopathy in an urban eye clinic in Singapore." Asian Journal of Ophthalmology 14, no. 2 (August 14, 2015): 53–67. http://dx.doi.org/10.35119/asjoo.v14i2.79.

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Background: Diabetes mellitus (DM) is a global health concern, the prevalence of which is predicted to increase in the coming years. Consequently, the prevalence of diabetic retinopathy (DR) is expected to rise. Therefore, identification of prevailing knowledge, attitudes and practice patterns (KAPP) of patients to address knowledge gaps and provide preventive education about DM and DR could reduce potentially sight-threatening complications. Our objectives were to assess KAPP of patients with DM and DR, factors influencing KAPP and impact of education on their KAPP.Methods: A questionnaire based survey among diabetic patients in an eye clinic in Singapore. A response rate of 92.6% was achieved. Participants were administered a set of questions about KAPP on DM and DR before and after educating them about DR.Results: Knowledge of DM and DR was noted in 57.0% and 29.0% of participants respectively. Good attitude and practice patterns were found in nearly 60% and above of the patients. Participants with more knowledge base had better attitude and practice patterns. Higher educational level, Indian ethnicity and longer duration of DM had a positive influence on KAPP. There was a statistically significant (p < 0.05) impact of education on KAPP among patients with DM and DR.Conclusions: The knowledge, attitude and practice patterns among patients were variable. A low proportion of knowledge of DR was noted which increased to almost three times after education. There is a need to actively implement educational strategies among patients with DM and DR.

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Forster, Alice S., Angus Forbes, Hiten Dodhia, Clare Connor, Alain Du Chemin, Sobha Sivaprasad, Samantha Mann, and Martin C. Gulliford. "Erratum to: Non-attendance at diabetic eye screening and risk of sight-threatening diabetic retinopathy: a population-based cohort study." Diabetologia 56, no. 10 (July 5, 2013): 2341. http://dx.doi.org/10.1007/s00125-013-2990-1.

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Nugawela, Manjula D., Sarega Gurudas, A. Toby Prevost, Rohini Mathur, John Robson, Wasim Hanif, Azeem Majeed, and Sobha Sivaprasad. "Ethnic Disparities in the Development of Sight-Threatening Diabetic Retinopathy in a UK Multi-Ethnic Population with Diabetes: An Observational Cohort Study." Journal of Personalized Medicine 11, no. 8 (July 28, 2021): 740. http://dx.doi.org/10.3390/jpm11080740.

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There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of people registered with 134 general practices in East London during the period from January 2007–January 2017. There were 58,216 people with T2DM eligible to be included in the study. Among people with newly diagnosed T2DM, Indian, Pakistani and African ethnic groups showed an increased risk of DR with Africans having highest risk of STDR compared to White ethnic groups (HR: 1.36 95% CI 1.02–1.83). Among those with prevalent T2DM, Indian, Pakistani, Bangladeshi and Caribbean ethnic groups showed increased risk of DR and STDR with Indian having the highest risk of any DR (HR: 1.24 95% CI 1.16–1.32) and STDR (HR: 1.38 95% CI 1.17–1.63) compared with Whites after adjusting for all covariates considered. It is important to optimise prevention, screening and treatment options in these ethnic minority groups to avoid health inequalities in diabetes eye care.

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Harding, S. P., D. M. Broadbent, C. Neoh, M. C. White, and J. Vora. "Sensitivity and specificity of photography and direct ophthalmoscopy in screening for sight threatening eye disease: the Liverpool diabetic eye study." BMJ 311, no. 7013 (October 28, 1995): 1131–35. http://dx.doi.org/10.1136/bmj.311.7013.1131.

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Barnard, Katharine D., and Jill Weissberg-Benchell. "Psychosocial Aspects and Diabetes Technology – Head to Head or Hand in Hand?" European Endocrinology 12, no. 1 (2016): 35. http://dx.doi.org/10.17925/ee.2016.12.01.35.

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Diabetes technologies have progressed rapidly over recent years with a dedicated conference entering its 10th year, stronger and larger than ever. The long-awaited automated insulin delivery systems represent the latest devices in engineering excellence however it is important that we do not lose sight of the fact that there is a person at the end of this technology, simply wanting a better life with diabetes with reduced diabetes burden. This commentary explores the relationship between technology and the psychosocial aspects of that technology in the context of user experience, clinical guidelines and the inclusion of psychosocial aspects alongside medical outcomes in research trials.

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Porta, M. "Diabetic Retinopathy and Metabolic Control." European Journal of Ophthalmology 3, no. 4 (October 1993): 207–15. http://dx.doi.org/10.1177/112067219300300406.

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Retinopathy is probably the first long-term complication of diabetes mellitus to become clinically evident, possibly because the retina is the only microvascular bed that can be observed directly and repeatedly. This makes it a good model for studying the pathogenesis and natural history of diabetic microangiopathy. Most of the proposals to account for its pathogenesis invoke mechanisms that depend directly on the circulating and tissue levels of glucose: protein glycosylation, activation of the “polyol pathway”, abnormalities of vascular endothelium, altered capillary blood flow. Several population studies and clinical trials suggest that the degree of metabolic control maintained over the years influences the rates of appearance and progression of retinopathy. However, on an individual basis, factors independent of control may intervene, making some patients more or less prone to this complication. Animal models also suggest that the progression of retinopathy may become irreversible from its very early stages. From a clinical point of view, it is difficult to establish a satisfactory definition of “good” control and approaching it may increase the risk of dangerous hypoglycemia and weight gain. Diabetes and eye specialists are thus left to strive for the best possible, sensible, metabolic control but must also rely on early diagnosis and treatment for the sight-threatening complications of diabetes.

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Eszes, Dóra J., Dóra J. Szabó, Greg Russell, Phil Kirby, Edit Paulik, László Nagymajtényi, Andrea Facskó, Morten C. Moe, and Beáta É. Petrovski. "Diabetic Retinopathy Screening Using Telemedicine Tools: Pilot Study in Hungary." Journal of Diabetes Research 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/4529824.

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Introduction.Diabetic retinopathy (DR) is a sight-threatening complication of diabetes. Telemedicine tools can prevent blindness. We aimed to investigate the patients’ satisfaction when using such tools (fundus camera examination) and the effect of demographic and socioeconomic factors on participation in screening.Methods.Pilot study involving fundus camera screening and self-administered questionnaire on participants’ experience during fundus examination (comfort, reliability, and future interest in participation), as well as demographic and socioeconomic factors was performed on 89 patients with known diabetes in Csongrád County, a southeastern region of Hungary.Results.Thirty percent of the patients had never participated in any ophthalmological screening, while 25.7% had DR of some grade based upon a standard fundus camera examination and UK-based DR grading protocol (Spectra™ software). Large majority of the patients were satisfied with the screening and found it reliable and acceptable to undertake examination under pupil dilation; 67.3% were willing to undergo nonmydriatic fundus camera examination again. There was a statistically significant relationship between economic activity, education and marital status, and future interest in participation.Discussion.Participants found digital retinal screening to be reliable and satisfactory. Telemedicine can be a strong tool, supporting eye care professionals and allowing for faster and more comfortable DR screening.

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Haider, Sajjad, Rasiah Thayakaran, Anuradha Subramanian, Konstantinos A. Toulis, David Moore, Malcolm James Price, and Krishnarajah Nirantharakumar. "Disease burden of diabetes, diabetic retinopathy and their future projections in the UK: cross-sectional analyses of a primary care database." BMJ Open 11, no. 7 (July 2021): e050058. http://dx.doi.org/10.1136/bmjopen-2021-050058.

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ObjectivesTo estimate the current disease burden, trends and future projections for diabetes mellitus (DM) and diabetic retinopathy (DR) in the IQVIA Medical Research Data (IMRD).Participants/design/settingWe performed a cross-sectional study of patients aged 12 and above to determine the prevalence of DM and DR from the IMRD database (primary care database) in January 2017, involving a total population of 1 80 824 patients with DM. We also carried out a series of cross-sectional studies to investigate prevalence trends, and then applied a double exponential smoothing model to forecast the future burden of DM and DR in the UK.ResultsThe crude DM prevalence in 2017 was 5.2%. The DR, sight-threatening retinopathy (STR) and diabetic maculopathy prevalence figures in 2017 were 33.78%, 12.28% and 7.86%, respectively, in our IMRD cross-sectional study. There were upward trends in the prevalence of DM, DR and STR, most marked and accelerating in STR in type 1 DM but slowing in type 2 DM, and in the overall prevalence of DR.ConclusionOur results suggest differential rising trends in the prevalence of DM and DR. Preventive strategies, as well as treatment services planning, can be based on these projected prevalence estimates. Improvements that are necessary for the optimisation of care pathways, and preparations to meet demand and capacity challenges, can also be based on this information. The limitations of the study can be overcome by a future collaborative study linking DR screening and hospital eye services data.

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Aragonès, Gemma, Sheldon Rowan, Sarah G Francisco, Wenxin Yang, Jasper Weinberg, Allen Taylor, and Eloy Bejarano. "Glyoxalase System as a Therapeutic Target against Diabetic Retinopathy." Antioxidants 9, no. 11 (October 30, 2020): 1062. http://dx.doi.org/10.3390/antiox9111062.

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Hyperglycemia, a defining characteristic of diabetes, combined with oxidative stress, results in the formation of advanced glycation end products (AGEs). AGEs are toxic compounds that have adverse effects on many tissues including the retina and lens. AGEs promote the formation of reactive oxygen species (ROS), which, in turn, boost the production of AGEs, resulting in positive feedback loops, a vicious cycle that compromises tissue fitness. Oxidative stress and the accumulation of AGEs are etiologically associated with the pathogenesis of multiple diseases including diabetic retinopathy (DR). DR is a devastating microvascular complication of diabetes mellitus and the leading cause of blindness in working-age adults. The onset and development of DR is multifactorial. Lowering AGEs accumulation may represent a potential therapeutic approach to slow this sight-threatening diabetic complication. To set DR in a physiological context, in this review we first describe relations between oxidative stress, formation of AGEs, and aging in several tissues of the eye, each of which is associated with a major age-related eye pathology. We summarize mechanisms of AGEs generation and anti-AGEs detoxifying systems. We specifically feature the potential of the glyoxalase system in the retina in the prevention of AGEs-associated damage linked to DR. We provide a comparative analysis of glyoxalase activity in different tissues from wild-type mice, supporting a major role for the glyoxalase system in the detoxification of AGEs in the retina, and present the manipulation of this system as a therapeutic strategy to prevent the onset of DR.

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Gruener, Anna M., Felicity Allen, Miles R. Stanford, and Elizabeth M. Graham. "Aspergillus fumigatusEndophthalmitis with Necrotizing Scleritis following Pars Plana Vitrectomy." Case Reports in Ophthalmological Medicine 2016 (2016): 1–3. http://dx.doi.org/10.1155/2016/9289532.

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We present a case ofAspergillus fumigatusendophthalmitis complicated by necrotizing scleritis in a 68-year-old man with diet-controlled diabetes, after retinal detachment repair. He was initially treated with systemic steroids for surgically induced necrotizing scleritis following routine pars plana vitrectomy. An additional diagnosis of endophthalmitis was made when the patient developed a hypopyon. Repeat vitreous culture isolatedAspergillus fumigatus. Symptoms improved following antifungal treatment leaving the patient with scleromalacia and an advanced postoperative cataract. Fungal scleritis and endophthalmitis are rare complications of intraocular surgery with sight-threatening consequences, and, as this case demonstrates, may even occur concomitantly. The overlapping features of both conditions can make differentiating one from the other difficult. A fungal aetiology should be considered in cases of postoperative scleritis and endophthalmitis that are protracted and refractory to standard therapy. Even in cases of early diagnosis and treatment, visual outcomes inAspergillusendophthalmitis and scleritis are variable and often disappointing, not infrequently necessitating enucleation of a painful blind eye.

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Reddy, SC, YM Khin, MI Nurjahan, and A. Ramli. "Retinopathy in type 2 diabetic patients with microalbuminuria." Nepalese Journal of Ophthalmology 5, no. 1 (March 26, 2013): 69–74. http://dx.doi.org/10.3126/nepjoph.v5i1.7830.

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Objective: To determine the prevalence of retinopathy in type 2 diabetic patients with micoalbuminuria and to evaluate the association of risk factors with prevalence of retinopathy in these patients. Material and methods: A fundus examination of 137 patients suffering from type 2 diabetes mellitus with microalbuminuria was done, with direct ophthalmoscope/ binocular indirect ophthalmoscope after dilating the pupils with 1 % tropicamide eye drops. Retinal changes were graded as no retinopathy, non-proliferative retinopathy, proliferative retinopathy and maculopathy. The association of the duration of diabetes, control of diabetes, hypertension, hyperlipidemia, smoking, obesity and peripheral neuropathy was assessed with the prevalence of retinopathy in these patents. Results: The mean age of the patients was 58 years (range 35 - 79 years); 62 % were females, and 49.6 % were Chinese. Diabetic retinopathy was seen in 36.5 % of the patients — non proliferative in 29.2 %, proliferative in 7.3 % and maculopathy in 5.1 % of patients. A longer duration of diabetes (p = 0.002), poor control of diabetes (p = 0.002), presence of hypertension (p = 0.03), and presence of peripheral neuropathy (p = 0.001) were significantly associated with the prevalence of retinopathy; while hyperlipidemia (p = 0.29), smoking (p = 0.43) and obesity (p = 0.43) were not associated with retinopathy. Conclusion: Retinopathy was seen in 36.5 % of type 2 diabetic patients with microalbuminuria; 7.3 % had proliferative retinopathy and 5.1 % maculopathy (both sight threatening changes). All diabetic patients with microalbuminuria should be screened for retinopathy so that treatment can be instituted in the required patients to prevent ocular morbidity/ blindness. Nepal J Ophthalmol 2013; 5(9):69-74 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7830

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Cuadros, Jorge, and George Bresnick. "EyePACS: An Adaptable Telemedicine System for Diabetic Retinopathy Screening." Journal of Diabetes Science and Technology 3, no. 3 (May 2009): 509–16. http://dx.doi.org/10.1177/193229680900300315.

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Background: Annual retinal screening of patients with diabetes is the standard clinical practice to prevent visual impairment and blindness from diabetic retinopathy. Telemedicine-based diabetic retinopathy screening (DRS) in primary care settings can effectively detect sight-threatening retinopathy and significantly increase compliance with annual retinal exams. EyePACS is a license-free Web-based DRS system designed to simplify the process of image capture, transmission, and review. The system provides a flexible platform for collaboration among clinicians about diabetic retinopathy. Methods: Primary clinic personnel (i.e., nursing, technical, or administrative staff) are trained and certified by the EyePACS program to acquire retinal images from standard digital retinal cameras. Relevant clinical data and eight high-resolution images per patient (two external and six retinal images) are encrypted and transmitted to a secure Internet server, using a standard computer and Web browser. Images are then interpreted by certified EyePACS reviewers or local eye care providers who are certified through the EyePACS Retinopathy Grading System. Reports indicating retinopathy level and referral recommendations are transmitted back to primary care providers through the EyePACS Web site or through interfaces between EyePACS and Health Level 7-compliant electronic medical records or chronic disease registries. Results: The pilot phase of the EyePACS DRS program in California (2005–2006) recorded 3562 encounters. Since 2006, EyePACS has been expanded to over 120 primary care sites throughout California and elsewhere recording over 34,000 DRSs. The overall rate of referral is 8.21% for sight-threatening retinopathy and 7.83% for other conditions (e.g., cataract and glaucoma). Conclusion: The use of license-free Web-based software, standard interfaces, and flexible protocols has allowed primary care providers to adopt retinopathy screening with minimal effort and resources.

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Aamodt, Marianne, and Vibeke Sundling. "Screening of Diabetes Retinopathy in Optometry: Assessment of a Web-based Training Protocol." Scandinavian Journal of Optometry and Visual Science 10, no. 1 (July 11, 2017): 18–22. http://dx.doi.org/10.5384/sjovs.vol10i1p18-22.

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Diabetic retinopathy is a sight threatening complication of diabetes mellitus. Regular eye examinations by trained health professionals can help prevent this. Although ophthalmologists have screening responsibility in Norway today, Norwegian optometrists regularly examine the ocular health of a large part of the population. The exact number of people with diabetes in Norway is unknown, and many are likely undiagnosed. Optometrists should be able to detect and grade diabetic retinopathy and ensure proper management of these patients. Previous studies in Norway have shown that optometrists need improved diagnostic skills to provide screening according to recommended standards. This study investigated the effect of web-based targeted training on the optometristsâ€™ ability to detect, classify and manage patients with diabetic retinopathy. The study had an experimental prospective design. Eighteen optometrists working in optometric practice in Norway participated in a web-based survey "Visual Identification and Management of Ocular Conditions" (VIMOC) related to diabetic retinopathy before and after a minimal web-based training protocol. In the VIMOC, the optometrists assessed 14 retinal digital photographs of people with known diabetes. An ophthalmologistâ€™s assessment and grading of the images was considered as the gold standard. The prevalence of retinopathy in the sample was set to 50% to prevent false high specificity. The web-based training significantly improved the optometristsâ€™ diagnostic sensitivity, but did not significantly improve specificity. The diagnostic sensitivity before training was 71.4% (SD = 19.6). After training, the sensitivity was 85.71% (SD = 12.9). However, only six (33%) of the optometrists achieved the recommended screening standard; sensitivity of 80% or better and specificity of 95% of better. Web-based training in screening for diabetic retinopathy significantly improved optometristsâ€™ screening and grading skills. Specific training in diabetes and screening for diabetic retinopathy are of great importance for detection and management of patients with diabetes by optometrists.

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Brazionis, Laima, Anthony Keech, Christopher Ryan, Alex Brown, David O'Neal, John Boffa, Sven-Erik Bursell, and Alicia Jenkins. "Associations with sight-threatening diabetic macular oedema among Indigenous adults with type 2 diabetes attending an Indigenous primary care clinic in remote Australia: a Centre of Research Excellence in Diabetic Retinopathy and Telehealth Eye and Associated Medical Services Network study." BMJ Open Ophthalmology 6, no. 1 (July 2021): e000559. http://dx.doi.org/10.1136/bmjophth-2020-000559.

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ObjectiveTo identify factors associated with sight-threatening diabetic macular oedema (STDM) in Indigenous Australians attending an Indigenous primary care clinic in remote Australia.Methods and analysisA cross-sectional study design of retinopathy screening data and routinely-collected clinical data among 236 adult Indigenous participants with type 2 diabetes (35.6% men) set in one Indigenous primary care clinic in remote Australia. The primary outcome variable was STDM assessed from retinal images.ResultsAge (median (range)) was 48 (21–86) years, and known diabetes duration (median (range)) was 8.0 (0–24) years. Prevalence of STDM was high (14.8%) and similar in men and women. STDM was associated with longer diabetes duration (11.7 vs 7.9 years, respectively; p<0.001) and markers of renal impairment: abnormal estimated Glomerular Filtration Rate (eGFR) (62.9 vs 38.3%, respectively; p=0.007), severe macroalbuminuria (>300 mg/mmol) (20.6 vs 5.7%, respectively; p=0.014) and chronic kidney disease (25.7 vs 12.2%, respectively; p=0.035). Some clinical factors differed by sex: anaemia was more prevalent in women. A higher proportion of men were smokers, prescribed statins and had increased albuminuria. Men had higher blood pressure, but lower glycated Haemoglobin A1c (HbA1c) levels and body mass index, than women.ConclusionSTDM prevalence was high and similar in men and women. Markers of renal impairment and longer diabetes duration were associated with STDM in this Indigenous primary care population. Embedded teleretinal screening, known diabetes duration-based risk stratification and targeted interventions may lower the prevalence of STDM in remote Indigenous primary care services.Trial registration numberAustralia and New Zealand Clinical Trials Register: ACTRN 12616000370404.

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Canadanovic, Vladimir, Nikola Babic, Sofija Davidovic, Aleksandar Miljkovic, Stefan Brunet, and Sava Barisic. "Outcome of cataract surgery in diabetic patients." Medical review 71, no. 7-8 (2018): 217–21. http://dx.doi.org/10.2298/mpns1808217c.

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Introduction. The association between diabetes and cataract formation has been shown in many clinical studies. Development of cataract occurs more frequently and at an earlier age in diabetic patients. Due to the increasing prevalence of diabetes worldwide, the incidence of diabetic cataracts steadily rises. While the overall outcomes of cataract surgery are excellent, patients with diabetes may have poorer vision outcomes than those without diabetes. The objective of this study was to evaluate the visual outcomes (visual acuity and visual function), intraoperative and postoperative complications of cataract surgery, and to assess the final surgical outcomes. Material and Methods. The prospective study included 128 patients (133 eyes) with cataract and diagnosis of diabetes mellitus type 2 at least 5 years prior to cataract surgery, operated at the Eye Clinic, Clinical Center of Vojvodina, Novi Sad. A full medical history included patients? age, the time since the diagnosis of diabetes, current management of diabetes, blood pressure and assessment of glycemic control using glycosylated hemoglobin. All patients underwent complete ophthalmological examination before cataract surgery, and were re-examined 7 days, one and six months after the surgery. Results. The mean age of patients at the time of surgery was 63.5 years (SD ? 6.5, range 57 - 70 years) with mean duration of diabetes 8.5 years. The glycosylated haemoglobin level in the group treated with insulin was 6.8 vs. 8.2 in patients on oral medications (p < 0.05). Diabetes mellitus was accompanied by other systemic diseases in 81 patients (63.28%), whereas 45 of 133 operated eyes (33.83%) had other ocular diseases. Intraoperative complications occurred in 20 of 133 operated eyes (15%): posterior capsular rupture with vitreous loss, intraoperative miosis, iris hemorrhage and suprachoroidal hemorrhage. Conclusion. Cataract surgery with intraocular lens implantation is an effective and safe surgical procedure in diabetic patients, and sight threatening complications are rare. Our study confirmed that visual acuity after surgery in diabetic patients depends on the severity of diabetic retinopathy at the time of surgery.

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Kossler, Andrea, Connie Martin Sears, and Chrysoula Dosiou. "Hearing Loss and Teprotumumab." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A839. http://dx.doi.org/10.1210/jendso/bvab048.1713.

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Abstract Thyroid eye disease (TED) is an unpredictable autoimmune inflammatory disease which can be sight-threatening, debilitating, and disfiguring. Teprotumumab (IV infusion every 3 weeks x 8 doses) was recently approved as the first and only FDA-approved drug for TED in 2020. Phase 2 and 3 studies showed significant improvement in proptosis, double vision, soft tissue inflammation and quality of life for patients with active moderate to severe TED. Side effects were experienced by 85% of patients on teprotumumab. Hearing loss symptoms were reported in 10% of patients and were reported to be reversible upon stopping the drug. Objective: To explore the incidence of hearing loss symptoms and sensorineural hearing loss in patients treated with teprotumumab. Methods: All patients, followed at one institution, treated with at least 4 infusions of teprotumumab were evaluated. Charts were evaluated for baseline hearing symptoms and hearing symptoms during or after therapy with teprotumumab. Those patients with hearing symptoms were referred for audiogram testing and patulous eustachian tube (PET) testing. Results: Twenty-eight patients were included in this analysis. Thirteen patients (46%) complained of hearing symptoms. The most common symptoms were autophony or an ear plugging sensation and hearing loss or muffled hearing. Hearing symptoms developed after a mean of 3.6 infusions. Of the patients with hearing symptoms, three patients (23%) had sensorineural hearing loss documented on audiogram (n=2) or patulous eustachian tube (n=1) documented on PET testing. To date, the patient with PET has experienced some improvement, but not resolution, of her symptoms. The two patients with documented sensorineural hearing loss have not experienced a significant improvement in hearing, on audiogram, on average 3 months after stopping teprotumumab. Conclusion: Teprotumumab is a promising new therapy for active moderate to severe thyroid eye disease. Providers should consider performing a baseline audiogram with PET testing and performing audiograms with PET testing for patients that develop hearing symptoms during or after therapy. Hearing loss is a concerning adverse event and its mechanism and reversibility should be further studied.

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Yamashita, Eiji. "Astaxanthin as a Medical Food." Functional Foods in Health and Disease 3, no. 7 (July 3, 2013): 254. http://dx.doi.org/10.31989/ffhd.v3i7.49.

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Astaxanthin is a red pigment that belongs to the carotenoid family like β-carotene. And it’s found in seafood such as crustaceans: shrimp and crabs and fish: salmon and sea bream. Recently, astaxanthin has been reported to have antioxidant activity up to 100 times more potent than that of vitamin E against lipid peroxidation and about 40 times more potent than that of β-carotene on singlet oxygen quenching. Astaxanthin does not show any pro-oxidant activity and its main sight of action is on/in the cell membrane. Various important benefits to date have suggested for human health such as immunomodulation, anti-stress, anti-inflammation, LDL cholesterol oxidation suppression, enhanced skin health, improved semen quality, attenuating eye fatigue, sport performance and endurance, limiting exercised induced muscle damage, suppressing the development of life-style related diseases such as obesity, atherosclerosis, diabetes, hyperlipidemia and hypertension. Nowadays, the research and demand for natural astaxanthin in human health application are explosively growing worldwide. Especially, the clinicians use the astaxanthin extracted from the microalgae, Haematotoccus pluvialis as an add-on supplementation for the patients who are unsatisfied with the current medications or who can’t receive any medications because of their serious symptom. For example, the treatment enhances their daily activity levels or QOL in heart failure or benign prostatic hypertrophy/lower urinary tract symptom patients Other studies and trials are under way on chronic diseases such as non-alcoholic steatohepatitis, diabetes and CVD. We may call astaxanthin “a medical food” in the near future.Keywords: astaxanthin, medical food, Haematococcus, add-on supplementation

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Lois, Noemi, Jonathan Cook, Stephen Aldington, Norman Waugh, Hema Mistry, William Sones, Danny McAuley, et al. "Effectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD)." BMJ Open 9, no. 6 (June 2019): e027795. http://dx.doi.org/10.1136/bmjopen-2018-027795.

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IntroductionDiabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) are the major causes of sight loss in people with diabetes. Due to the increased prevalence of diabetes, the workload related to these complications is increasing making it difficult for Hospital Eye Services (HSE) to meet demands.Methods and analysisEffectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD) is a prospective, case-referent, cross-sectional diagnostic study. It aims at determining the diagnostic performance, cost-effectiveness and acceptability of a new form of surveillance for people with stable DMO and/or PDR, which entails multimodal imaging and image review by an ophthalmic grader, using the current standard of care (evaluation of patients in clinic by an ophthalmologist) as the reference standard. If safe, cost-effective and acceptable, this pathway could help HES by freeing ophthalmologist time. The primary outcome of EMERALD is sensitivity of the new surveillance pathway in detecting active DMO/PDR. Secondary outcomes include specificity, agreement between new and the standard care pathway, positive and negative likelihood ratios, cost-effectiveness, acceptability, proportion of patients requiring subsequent full clinical assessment, unable to undergo imaging, with inadequate quality images or indeterminate findings.Ethics and disseminationEthical approval was obtained for this study from the Office for Research Ethics Committees Northern Ireland (reference 17/NI/0124). Study results will be published as a Health Technology Assessment monograph, in peer-reviewed national and international journals and presented at national/international conferences and to patient groups.Trial registration numberNCT03490318andISRCTN10856638.

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Geethadevi, Malavika, Bindu Thampi, Joosadima Antony, Remya Raghavan, Rekha R. Sasidharan, and Ajith Mohan. "A study of knowledge, attitude and practice in diabetic retinopathy among patients attending a primary health care centre." International Journal of Research in Medical Sciences 6, no. 9 (August 25, 2018): 3020. http://dx.doi.org/10.18203/2320-6012.ijrms20183637.

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Background: Diabetic retinopathy is a major cause of preventable blindness. Sufficient knowledge about the disease can prevent sight threatening complications. Aim of this study is to evaluate the knowledge and its influence on attitude and practice in diabetic retinopathy among patients attending a primary health centre.Methods: A knowledge attitude practice questionnaire was prepared and pretested in a sample group of representative population. The response was analyzed as to whether the questions were understood or not. Social workers were trained in administering questionnaire. Diabetic patients were given questionnaires at primary health centre and filled in the presence of social workers.Results: Out of 324 patients 60.8% had no knowledge of diabetic retinopathy compared to 39.19% who had knowledge (p <0.001). Knowledge was more in age <40 years (82.60%) and least in 51-60 years (29.34%) (p<0.001) and more among females (38.59%) than males (61.4%). Knowledge was significantly higher among upper socioeconomic group (77.8%). About 83.46% in knowledge group had right attitude which was significantly higher than non knowledge group (32.48%) (p<0.001). 42.51% in knowledge group had practice of visiting ophthalmologist for eye check-up which was significantly higher than non knowledge group (13.19%) (p<0.001).Conclusions: The attitude and practice of diabetic retinopathy was statistically significant in knowledge group compared to those who had no knowledge of diabetic retinopathy. Improving knowledge about diabetic retinopathy through awareness campaigns can increase attitude and practice. Early detection can help in preventing sight threatening complications of diabetic retinopathy.

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Limwattanayingyong, Jirawut, Variya Nganthavee, Kasem Seresirikachorn, Tassapol Singalavanija, Ngamphol Soonthornworasiri, Varis Ruamviboonsuk, Chetan Rao, et al. "Longitudinal Screening for Diabetic Retinopathy in a Nationwide Screening Program: Comparing Deep Learning and Human Graders." Journal of Diabetes Research 2020 (December 15, 2020): 1–8. http://dx.doi.org/10.1155/2020/8839376.

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Objective. To evaluate diabetic retinopathy (DR) screening via deep learning (DL) and trained human graders (HG) in a longitudinal cohort, as case spectrum shifts based on treatment referral and new-onset DR. Methods. We randomly selected patients with diabetes screened twice, two years apart within a nationwide screening program. The reference standard was established via adjudication by retina specialists. Each patient’s color fundus photographs were graded, and a patient was considered as having sight-threatening DR (STDR) if the worse eye had severe nonproliferative DR, proliferative DR, or diabetic macular edema. We compared DR screening via two modalities: DL and HG. For each modality, we simulated treatment referral by excluding patients with detected STDR from the second screening using that modality. Results. There were 5,738 patients (12.3% STDR) in the first screening. DL and HG captured different numbers of STDR cases, and after simulated referral and excluding ungradable cases, 4,148 and 4,263 patients remained in the second screening, respectively. The STDR prevalence at the second screening was 5.1% and 6.8% for DL- and HG-based screening, respectively. Along with the prevalence decrease, the sensitivity for both modalities decreased from the first to the second screening (DL: from 95% to 90%, p = 0.008 ; HG: from 74% to 57%, p < 0.001 ). At both the first and second screenings, the rate of false negatives for the DL was a fifth that of HG (0.5-0.6% vs. 2.9-3.2%). Conclusion. On 2-year longitudinal follow-up of a DR screening cohort, STDR prevalence decreased for both DL- and HG-based screening. Follow-up screenings in longitudinal DR screening can be more difficult and induce lower sensitivity for both DL and HG, though the false negative rate was substantially lower for DL. Our data may be useful for health-economics analyses of longitudinal screening settings.

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Agboeze, Matthias U., Ruphina U. Nwachukwu, Michael O. Ugwueze, and Maryrose N. Agboeze. "Health Status of Widows as a Correlate of Their Participation in Community Development Projects in Nsukka, Enugu State, Nigeria." Global Journal of Health Science 12, no. 7 (May 14, 2020): 72. http://dx.doi.org/10.5539/gjhs.v12n7p72.

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OBJECTIVES: This study seeks to examine the health status of widows and investigate its effect on their participation in community development projects. METHODS: A cross-sectional study was conducted on the widows and non-widows in six communities out of the 18 communities in Nsukka local government area of Enugu state, Nigeria from 15 January to 29 March 2019. The respondents were tested clinically based on the following health indices; blood pressure, blood sugar level, malaria parasite and typhoid. The widows were also asked the extent to which their health conditions affect their participation in community development projects. RESULTS: The mean blood pressure level of the widows is 160.2100.4Mm/Hg  while their mean blood sugar level is 129.8 Mg/dl. 55% of the widows tested positive to typhoid while another 53% tested positive to malaria parasite. Majority (72%) of the widows revealed that health condition such as poor eye sight; arthritis; rheumatism; high blood pressure; diabetes; malaria; typhoid; cough and ulcer limit their participation in community development projects. CONCLUSIONS: The widows in Nsukka have a poor health status when compared to the non-widows in the region, which to a great extent, limits their participation in the community development projects available to them. Therefore, there is a very strong correlation between the health status of widows in Nsukka and their participation in the community development projects.

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Journal articles on the topic 'Diabetes on eye sight'

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