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https://www.readbyqxmd.com/read/28430872/optimal-screening-schedules-for-disease-progression-with-application-to-diabetic-retinopathy
#1
Ionut Bebu, John M Lachin
Clinical management of chronic diseases requires periodic evaluations. Subjects transition between various levels of severity of a disease over time, one of which may trigger an intervention that requires treatment. For example, in diabetic retinopathy, patients with type 1 diabetes are evaluated yearly for either the onset of proliferative diabetic retinopathy (PDR) or clinically significant macular edema (CSME) that would require immediate treatment to preserve vision. Herein, we investigate methods for the selection of personalized cost-effective screening schedules and compare them with a fixed visit schedule (e...
April 20, 2017: Biostatistics
https://www.readbyqxmd.com/read/28430372/retinal-nerve-fibre-layer-thickness-is-reduced-in-metabolic-syndrome
#2
R Zarei, P Anvari, Y Eslami, G Fakhraie, M Mohammadi, A Jamali, M Afarideh, A Ghajar, S Heydarzade, A Esteghamati, S Moghimi
AIMS: To investigate retinal nerve fibre layer (RNFL) thickness in people with metabolic syndrome (MetS) and healthy controls. METHODS: A cross-sectional study was performed from March 2014 to January 2016. All participants underwent anthropometric and serological biochemical measurements, ophthalmological examination, and spectral-domain optical coherence tomography (SD-OCT). Individuals with elevated intraocular pressure, glaucoma, diabetic retinopathy and other ocular disorders were excluded...
April 21, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28430335/reading-ability-and-quality-of-life-in-stargardt-disease
#3
Vittoria Murro, Andrea Sodi, Giovanni Giacomelli, Dario P Mucciolo, Monica Pennino, Gianni Virgili, Stanislao Rizzo
PURPOSE: To study the reading performance of patients with Stargardt disease (STGD) and the relationship between clinical vision measurements and vision-related quality of life (VRQOL). METHODS: We studied both eyes of 16 patients with STGD. Each patient was examined for best-corrected visual acuity (Early Treatment Diabetic Retinopathy Study [ETDRS]), reading ability (MNREAD and REX charts), contrast sensitivity (Pelli-Robson charts), fixation study (MP1 microperimeter), and VRQOL (25-item National Eye Institute Visual Function Questionnaire [NEI VFQ-25])...
April 14, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28429904/effect-of-lutein-supplementation-on-visual-function-in-nonproliferative-diabetic-retinopathy
#4
Ping-Chuan Zhang, Chang-Rui Wu, Zhi-Lun Wang, Li-Yuan Wang, Yue Han, Shu-Liu Sun, Qing-Shan Li, Le Ma
BACKGROUND AND OBJECTIVES: The purpose of this study was to determine whether supplementation with lutein improved visual function in patients with nonproliferative diabetic retinopathy (NPDR). METHODS AND STUDY DESIGN: In this randomized, double-blind, placebo-controlled trial, 31 patients with NPDR were assigned randomly to 10 mg/d of lutein or identical placebo for 36 weeks. Visual performance indices, including visual acuity (VA), contrast sensitivity (CS) and glare sensitivity (GS) at four different spatial frequencies, were measured at baseline, week 18 and 36...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28429383/altered-eigenvector-centrality-is-related-to-local-resting-state-network-functional-connectivity-in-patients-with-longstanding-type-1-diabetes-mellitus
#5
Eelco van Duinkerken, Menno M Schoonheim, Richard G IJzerman, Annette C Moll, Jesus Landeira-Fernandez, Martin Klein, Michaela Diamant, Frank J Snoek, Frederik Barkhof, Alle-Meije Wink
INTRODUCTION: Longstanding type 1 diabetes (T1DM) is associated with microangiopathy and poorer cognition. In the brain, T1DM is related to increased functional resting-state network (RSN) connectivity in patients without, which was decreased in patients with clinically evident microangiopathy. Subcortical structure seems affected in both patient groups. How these localized alterations affect the hierarchy of the functional network in T1DM is unknown. Eigenvector centrality mapping (ECM) and degree centrality are graph theoretical methods that allow determining the relative importance (ECM) and connectedness (degree centrality) of regions within the whole-brain network hierarchy...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28428895/suppression-of-retinal-neovascularization-by-inhibition-of-galectin-1-in-a-murine-model-of-oxygen-induced-retinopathy
#6
Ning Yang, Wenxi Zhang, Tao He, Yiqiao Xing
Galectin-1 (Gal-1) has been proved to be an important factor in the process of tumor angiogenesis recently. As a small molecule, OTX008 serves as a selective inhibitor of Gal-1. In this study, the role of Gal-1 and the antiangiogenic effect of OTX008 on retinal neovascularization (RNV) were investigated using a mouse model of oxygen-induced retinopathy. The outcome indicated that Gal-1 was overexpressed and closely related to retinal neovessels in OIR. After intravitreal injection of OTX008 at P12, the RNV was significantly reduced at P17, measuring by cross-sectional H&E staining and whole-mount fluorescence...
2017: Journal of Ophthalmology
https://www.readbyqxmd.com/read/28428052/opening-eyes-to-nanomedicine-where-we-are-challenges-and-expectations-on-nanotherapy-for-diabetic-retinopathy
#7
REVIEW
Elisa J Campos, António Campos, João Martins, António Francisco Ambrósio
People affected with ocular diseases will significantly increase over the next decades, and, consequently, a substantial increase in health costs is expected. Diabetic retinopathy is the most common chronic complication of diabetes. The treatment of eye diseases affecting the posterior segment, such as diabetic retinopathy, is quite challenging due to the anatomy, physiology and biochemistry of the eye. Therefore, the development of new therapeutics for posterior eye diseases has been a major focus of pharmaceutical research in the area of vision sciences...
April 17, 2017: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/28427074/enzymatic-vitreolysis-for-vitreomacular-traction-in-diabetic-retinopathy
#8
Stanislao Rizzo, Daniela Bacherini
Vitreomacular traction (VMT) is one of many possible factors involved in the etiology of diabetic macular edema (DME). Pharmacologic vitreoretinal separation is a potential alternative to vitrectomy for VMT in diabetic retinopathy. Small case series have been published on the use of enzymatic vitreolysis in tractional DME, and demonstrate that the enzymatic release of the posterior vitreous cortex is more likely following the injection of plasmin enzyme. Further prospective and randomized clinical trials are necessary to evaluate the clinical relevance of ocriplasmin for vitreomacular traction in diabetic retinopathy, and additional studies are needed to determine more accurately which patients might benefit most from this treatment and how often and at what concentration ocriplasmin should be administered...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427073/surgical-management-and-techniques
#9
Marco Codenotti, Lorenzo Iuliano, Gisella Maestranzi
Technical advancements have substantially extended the indications for surgery in diabetic retinopathy (DR) during the last 40 years, from the traditional indications including non-clearing vitreous hemorrhage, traction retinal detachment (RD), and traction-rhegmatogenous RD, to epiretinal membrane (ERM), vitreomacular traction, diffuse macular edema, neovascular glaucoma, and anterior hyaloid fibrovascular proliferation. The goals of vitreoretinal surgery in DR are multiple: clearing media opacities, release of traction (anteroposterior and/or tangential), segmentation and/or removal of traction bands, peeling of ERMs, hemostasis, laser photocoagulation, and tamponade of retinal breaks with gas or silicone oil...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427072/anti-vascular-endothelial-growth-factor-injections-the-new-standard-of-care-in-proliferative-diabetic-retinopathy
#10
Xintong Li, Marco A Zarbin, Neelakshi Bhagat
For decades, panretinal photocoagulation (PRP) has been the standard of care for the treatment of proliferative diabetic retinopathy (PDR). The relatively recent advent of anti-vascular endothelial growth factor (VEGF) formulations for intravitreal injection has provided a fresh perspective on PDR treatment, especially in eyes with concurrent diabetic macular edema (DME). The anti-VEGF agent ranibizumab has demonstrated a potentially protective effect on eyes with DME in terms of progression to PDR in the RIDE/RISE trials, as has aflibercept in the VIVID/VISTA trials...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427071/is-laser-still-important-in-diabetic-macular-edema-as-primary-or-deferral-therapy
#11
Maurizio Battaglia Parodi, Francesco Bandello
Laser treatment was used in the past to reduce the visual loss due to diabetic macular edema. The recent advent of anti-vascular endothelial growth factor (anti-VEGF) has completely revolutionized the management of diabetic retinopathy, with a significant improvement in the overall prognosis. Nevertheless, macular laser can still be applied in selected cases characterized by retinal thickness ≤400 microns, high visual acuity, extrafoveal location, and contraindications to the intravitreal approach with anti-VEGF and steroids...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427070/practical-lessons-from-protocol-t-for-the-management-of-diabetic-macular-edema
#12
Lekha Mukkamala, Neelakshi Bhagat, Marco Zarbin
PURPOSE: To review the results of Diabetic Retinopathy Clinical Research Network Protocol T, as applied to clinical practice. METHODS: Review of major publications reporting the results of Protocol T, a randomized single-masked (in year-1 only), multicenter clinical trial comparing aflibercept, bevacizumab, and ranibizumab as treatment option for center-involving diabetic macular edema (DME). The main outcome measures were change in visual acuity (VA), central subfield thickness (CST) on optical coherence tomography, cost effectiveness, burden of care, and safety...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427069/practical-lessons-from-protocol-i-for-the-management-of-diabetic-macular-edema
#13
Lekha Mukkamala, Neelakshi Bhagat, Marco A Zarbin
Protocol I, a multicenter randomized clinical trial, compared the visual outcomes of patients treated with 0.5 mg intravitreal ranibizumab with either prompt or deferred (by 24 weeks laser), 4 mg intravitreal triamcinolone with prompt laser, or sham injection with prompt laser for the treatment of center-involving diabetic macular edema (DME). A total of 854 adult patients with type I or II diabetes and any level of non-proliferative diabetic retinopathy or proliferative retinopathy with adequate panretinal photocoagulation, with best-corrected visual acuity (BCVA) of 78 to 24 ETDRS letters (Snellen equivalent of 20/32 to 20/320) and visual loss attributed to macular edema, or retinal thickening with central subfield thickness of at least 250 µm by OCT were enrolled...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427066/intravitreal-ranibizumab-in-diabetic-macular-edema-long-term-outcomes
#14
Ilaria Zucchiatti, Francesco Bandello
Intravitreal ranibizumab (RBZ) has been shown in multiple randomized clinical trials to be a valuable treatment for diabetic macular edema (DME), promoting a significant improvement in best-corrected visual acuity (BCVA) and in anatomic outcomes. Compared to sham (RISE and RIDE studies), RBZ rapidly and sustainably improved BCVA and decreased macular edema at 2 years, reducing the risk of further vision loss, with low rates of local or systemic side effects. Compared to macular laser photocoagulation (READ-2 study), RBZ provided a greater improvement in BCVA and regression in foveal thickness, but required a higher number of injections compared to patients treated with both RBZ and laser...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427065/emerging-simplified-retinal-imaging
#15
Ashish Sharma
Diabetic retinopathy (DR), a major microvascular complication of diabetes, has a significant impact on the world's health systems. Globally, the number of people with DR will grow from 126.6 million in 2010 to 191.0 million by 2030, and it is estimated that the number with vision-threatening diabetic retinopathy will increase from 37.3 million to 56.3 million if prompt action is not taken. Lack of early diagnosis and management is the leading cause of blindness in working-age populations The gap between demand and annual eye examinations has been a big challenge...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427064/emerging-issues-for-ultra-wide-field-angiography
#16
Alessandro Rabiolo, Luigi Antonio De Vitis, Riccardo Sacconi, Adriano Carnevali, Lea Querques, Francesco Bandello, Giuseppe Querques
Fluorescein angiography (FA) is a useful test in patients affected by diabetic retinopathy (DR) to evaluate the blood-retinal barrier integrity and the presence of non-perfused areas, vascular leakage, microvascular abnormalities, and neovascularization. The peripheral retina is involved in most DR lesions, and, thus, its proper visualization is crucial for the screening, diagnosis, monitoring, treatment, and prognosis of DR. To expand the field of view, wide-field and ultra-wide-field imaging have been developed, allowing images up to 200° of retinal surface in one single photo...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427062/emerging-issues-for-optical-coherence-tomography
#17
Luisa Pierro, Alessandro Rabiolo
Almost 25 years after its introduction, optical coherence tomography (OCT) is still a crucial test in the evaluation of patients affected by diabetic retinopathy. In this chapter, the authors provide an extensive overview of the posterior segment pathological changes induced by diabetes, characterized using OCT. OCT plays a key role in diabetic macular edema (DME) as it assesses related retinal changes both in a qualitative (i.e., DME pattern, presence and aspects of cysts, fluid localization, integrity, and reflectivity of retinal layers) and quantitative (i...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427061/emerging-insights-into-pathogenesis
#18
Edoardo Midena, Elisabetta Pilotto
Diabetic retinopathy (DR) is a frequent complication of diabetes mellitus (DM). Persistent hyperglycemia leads to the activation of multiple cellular pathways involved in the pathogenesis of DR, resulting in increased inflammation, oxidative stress, and vascular dysfunction. DR has been considered a "chronic, low-grade inflammatory disease of the retina". However, an increasing body of evidence suggests that inflammation and neurodegeneration both occur in human diabetes even before the development of clinical signs of DR...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427060/the-eye-as-a-window-to-the-microvascular-complications-of-diabetes
#19
Gianpaolo Zerbini, Silvia Maestroni, Valentina Turco, Antonio Secchi
Although microvascular complications of diabetes (retinopathy, neuropathy, and nephropathy) affect different organs, they are strongly correlated to each other. Based on recent data, their onset and progression could be directly monitored, focusing our attention only on the eye. When confirmed and standardized, this approach could allow one to simplify the way in which we follow the progression of different diabetic complications, and thus establish new strategies aimed at preventing, treating and, hopefully, inducing the remission of microvascular complications of diabetes...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427059/the-burden-of-diabetes-emerging-data
#20
Paola Maffi, Antonio Secchi
In recent times, the global prevalence of diabetes has increased substantially, reaching 8.3% in 2014, which corresponds to 387 million patients. Studies in Europe and USA have shown increased incidence of type 1 Diabetes (T1D) over time at a rate of 3-5% per year. Another most worrying feature of the rapid increase of diabetes is the emergence of type 2 Diabetes (T2D) in children, adolescents, and young adults. The well-known behavioral risks factors and epigenetic mechanisms recently observed require an integrated approach to prevent T2D...
2017: Developments in Ophthalmology
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