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Diabetic macula

Jessica Lee, Richard Rosen
Diabetic retinopathy is a progressive microvascular disease that leads to increased vessel permeability, retinal ischemia, and retinal neovascularization. Optical coherence tomography angiography (OCTA) is a novel angiography technique that has the capability to advance our understanding of diabetic eye disease by providing high-resolution images of retinal and choroidal microvasculature blood flow and structure. Using OCTA, the vascular changes of diabetic retinopathy including microaneurysms, retinal non-perfusion, intraretinal microvascular abnormalities, and neovascularization can be clearly visualized...
December 2016: Current Diabetes Reports
Sarni Suhaila Rahim, Vasile Palade, James Shuttleworth, Chrisina Jayne
Digital retinal imaging is a challenging screening method for which effective, robust and cost-effective approaches are still to be developed. Regular screening for diabetic retinopathy and diabetic maculopathy diseases is necessary in order to identify the group at risk of visual impairment. This paper presents a novel automatic detection of diabetic retinopathy and maculopathy in eye fundus images by employing fuzzy image processing techniques. The paper first introduces the existing systems for diabetic retinopathy screening, with an emphasis on the maculopathy detection methods...
March 16, 2016: Brain Informatics
Guillaume Soudier, Alain Gaudric, Vincent Gualino, Pascale Massin, Mathieu Nardin, Ramin Tadayoni, Claude Speeg-Schatz, David Gaucher
BACKGROUND AND OBJECTIVE: Dome-shaped macula (DSM) has recently been described with myopic staphyloma, which may cause decreased vision. The purpose of this study was to evaluate the choroidal thickness of eyes with and eyes without DSM. METHODS: A total of 26 eyes with DSM were paired based on axial length with 26 eyes without DSM. All patients underwent spectral-domain OCT examination using the 7-line EDI (enhanced depth imaging) protocol. The mean choroidal thickness was measured using Early Treatment Diabetic Retinopathy Study (ETDRS) grid areas...
October 14, 2016: Ophthalmologica. Journal International D'ophtalmologie
Gülizar Demirok, Mehmet Fatih Kocamaz, Yasemin Topalak, Yeşim Altay, Burcu Tabakci, Ahmet Şengün
PURPOSE: To evaluate the changes in the macular ganglion cell complex (GCC) thickness and central macular thickness (CMT) as measured by spectral domain optical coherence tomography (OCT) post-argon laser panretinal photocoagulation (PRP). METHODS: The medical records of 25 patients with proliferative diabetic retinopathy (PDR) who underwent PRP, 29 patients with non-proliferative diabetic retinopathy (NPDR), and 29 patients with diabetes but without diabetic retinopathy (DR) were analyzed...
August 10, 2016: Seminars in Ophthalmology
Yasir J Sepah, Mohammad Ali Sadiq, David Boyer, David Callanan, Ron Gallemore, Michael Bennett, Dennis Marcus, Lawrence Halperin, Muhammad Hassan, Peter A Campochiaro, Quan Dong Nguyen, Diana V Do
PURPOSE: To compare 2.0 mg ranibizumab (RBZ) injections with 0.5 mg RBZ for eyes with center-involved diabetic macular edema (DME). DESIGN: Randomized, controlled, double-masked (to the dose), interventional, multicenter clinical trial. PARTICIPANTS: A total of 152 patients (152 eyes) with DME. METHODS: Eligible eyes were randomized in a 1:1 ratio to 0.5 mg (n = 77) or 2.0 mg (n = 75) RBZ. Study eyes received 6 monthly mandatory injections followed by as-needed injections until month 24...
October 1, 2016: Ophthalmology
Sinan Onal, Xin Chen, Veeresh Satamraju, Maduka Balasooriya, Humeyra Dabil-Karacal
Detecting the position of retinal structures, including the fovea center and macula, in retinal images plays a key role in diagnosing eye diseases such as optic nerve hypoplasia, amblyopia, diabetic retinopathy, and macular edema. However, current detection methods are unreliable for infants or certain ethnic populations. Thus, a methodology is proposed here that may be useful for infants and across ethnicities that automatically localizes the fovea center and segments the macula on digital fundus images. First, dark structures and bright artifacts are removed from the input image using preprocessing operations, and the resulting image is transformed to polar space...
July 2016: Journal of Medical Imaging
Sidney A Schechet, Eva DeVience, John T Thompson
PURPOSE: To examine the effect of internal limiting membrane (ILM) removal on epiretinal membrane (ERM) surgery by comparing best-corrected visual acuity (BCVA), optical coherence tomography central macular thickness (CMT) changes, ERM recurrence, and need for repeat surgery. METHODS: Retrospective study of 251 consecutive patients (251 eyes) who underwent pars plana vitrectomy for idiopathic ERM by a single surgeon with over 1 year of follow-up data. Data were collected preoperatively and postoperatively at 3 months, 1 year, 2 years, and at the last visit...
September 9, 2016: Retina
Muneera A Abunajma, Hassan Al-Dhibi, Emad B Abboud, Yahya Al Zahrani, Essam Alharthi, Abdullah Alkharashi, Nicola G Ghazi
PURPOSE: To investigate the outcomes of pars plana vitrectomy (PPV) for chronic diabetic traction macular detachment (CTMD). METHODS: Ninety-six eyes that underwent PPV for CTMD of at least 6 months duration were retrospectively analyzed. Retinal reattachment rate, final vision, and prognostic factors for poor visual outcome were the main outcome measures. RESULTS: All eyes had long-standing TMD (median 12, range: 6-70 months). The median postoperative follow-up was 15 (range: 3-65) months...
2016: Clinical Ophthalmology
Carmelina Trimboli-Heidler, Kelly Vogt, Robert A Avery
PURPOSE: To determine the influence of volume averaging on retinal layer thickness measures acquired with spectral-domain optical coherence tomography (SD-OCT) in children. METHODS: Macular SD-OCT images were acquired using three different volume settings (i.e., 1, 3, and 9 volumes) in children enrolled in a prospective OCT study. Total retinal thickness and five inner layers were measured around an Early Treatment Diabetic Retinopathy Scale (ETDRS) grid using beta version automated segmentation software for the Spectralis...
August 2016: Translational Vision Science & Technology
In Boem Chang, Jeong Hyun Lee, Jae Suk Kim
PURPOSE: To evaluate changes in choroidal thickness in and outside the macula as a result of hemodialysis (HD) in patients with end-stage renal disease. METHODS: Patients with end-stage renal disease treated with maintenance HD in the Dialysis Unit of Sanggye Paik Hospital, Seoul, South Korea, were included in this study. The choroidal thickness was measured in and outside the macula before and after HD (paired t-test). Choroidal thickness in the macula was measured at the foveal center and 1...
August 23, 2016: Retina
Hisham S Alkuraya, Saeed M Al-Gehedan, Abdulrahman M Alsharif, Tariq Alasbali, Nancy M Lotfy, Rajiv Khandekar
INTRODUCTION: We compared the thickness of the peripapillary retinal nerve fiber layer (RNFL) in patients with diabetic macular edema (DME) and/against the thickness in the normal population. METHODS: This cross-sectional study compared the RNFL thickness in patients with DME (DME group) using optical coherence tomography (OCT) to a comparable group of healthy (nondiabetic) patients (control group). Measurements were performed in different/the four peripapillary quadrants and in the macula region for the fovea, parafoveal, and perifoveal areas...
July 2016: Middle East African Journal of Ophthalmology
António Campos, Elisa J Campos, João Martins, António Francisco Ambrósio, Rufino Silva
Diabetic macular oedema (DMO) is the leading cause of vision loss in the working-age population. Blood-retinal barrier (BRB) dysfunction in diabetic retinopathy (DR), mainly at the level of the retinal vessels, has long been related with leakage and fluid accumulation, leading to macular oedema. However, the nourishment of the macula is provided by the choroid and a diabetic choroidopathy has been described. Therefore, there has been a growing interest in studying the role of the choroid in the pathophysiology of DR and DMO, mainly by optical coherence tomography (OCT)...
August 22, 2016: Acta Ophthalmologica
Kanmin Xue, Elizabeth Yang, N Victor Chong
AIMS: To characterise differential pathogeneses of diabetic macular oedema (DMO) using ultra-widefield fluorescein angiography (UWFA) and evaluate responses to anti-vascular endothelial growth factor (anti-VEGF) therapy. METHODS: Ninety-nine eyes (73 consecutive patients) with anti-VEGF naïve DMO underwent UWFA and optical coherence tomography, of which 60 with central retinal thickness (CRT) >400 μm received monthly intravitreal ranibizumab injections. Best-corrected visual acuity (BCVA) and CRT were measured at baseline and after three injections...
August 16, 2016: British Journal of Ophthalmology
Sherry J Bass, Jacqueline Westcott, Jerome Sherman
PURPOSE: The prognosis of success with vision therapy in refractive "amblyopia" associated with the syndrome of myelinated nerve fibers (MRNF), optic disc hypoplasia, and myopia is reported to be poorer than that of anisomyopic amblyopia without these features. The reason for the poorer prognosis has not been well understood. The purpose of this study was to perform spectral domain (SD) ocular coherence tomography (OCT) to determine if there is a structural etiology that may explain the poorer prognosis...
October 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Johanna Schmidt, Sven Peters, Lydia Sauer, Dietrich Schweitzer, Matthias Klemm, Regine Augsten, Nicolle Müller, Martin Hammer
PURPOSE: To discriminate non-proliferative diabetic retinopathy (NPDR) patients from healthy controls by fluorescence lifetime imaging ophthalmoscopy (FLIO). METHODS: A prototype FLIO (Heidelberg-Engineering, Heidelberg, Germany) was used to examine the retina of 33 patients and 28 controls. As increased fluorescence of the diabetic lens is known, the lenses of 34 patients and 24 controls were investigated as well. Time-resolved decay was detected in two spectral channels (ch1: 498-560 nm, ch2: 560-720 nm) and approximated by a series of three exponential functions yielding in lifetimes (τ1 , τ2 , τ3 ), amplitudes (α1 , α2 , α3 ) and their amplitude-weighted means (τm )...
August 13, 2016: Acta Ophthalmologica
Gavin S Tan, Ning Cheung, Rafael Simó, Gemmy C M Cheung, Tien Yin Wong
Diabetic macular oedema, characterised by exudative fluid accumulation in the macula, is the most common form of sight-threatening retinopathy in people with diabetes. It affects one in 15 people with diabetes resulting in more than 20 million cases worldwide. Few epidemiological studies have been done to specifically investigate risk factors for diabetic macular oedema, although poor glycaemic and blood pressure control are associated with the presence and development of the disorder. The pathophysiological processes begin with chronic hyperglycaemia, and interplay between vascular endothelial growth factor (VEGF) and inflammatory mediators...
August 2, 2016: Lancet Diabetes & Endocrinology
Mayss Al-Sheikh, Handan Akil, Maximilian Pfau, SriniVas R Sadda
PURPOSE: We compared the area of the foveal avascular zone (FAZ) and macular capillary network density at different retinal layers using swept-source optical coherence tomography angiography (OCT-A) in normal individuals and patients with diabetic retinopathy (DR). METHODS: Images (a 3 × 3 mm cube centered on the fovea) were acquired in 40 eyes of 22 normal individuals and 28 eyes of 18 patients with varying levels of DR using a swept-source OCT-A device (central wavelength 1050 nm; A-scan-rate of 100,000 scans per second)...
July 1, 2016: Investigative Ophthalmology & Visual Science
Brooke Lw Nesmith, Agustina C Palacio, Yam Schaal, Akash Gupta, Shlomit Schaal
PURPOSE: To quantify the changes in vitreomacular interactions that occur with aging in diabetic eyes in comparison with age-matched control eyes. METHODS: Spectral-domain optical coherence tomography (Spectralis; Heidelberg Engineering) foveal scans of diabetic patients, without evidence of cystoid macular edema, were included. Twenty-five raster foveal scans were performed on every subject. Area of vitreomacular adhesion was delineated using the Spectralis drawing tool and calculated in square millimeter...
July 28, 2016: Retina
Hiddo J L Heerspink, Bruce A Perkins, David H Fitchett, Mansoor Husain, David Z I Cherney
Sodium-glucose cotransporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, are now widely approved antihyperglycemic therapies. Because of their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. Perhaps more important are the osmotic diuretic and natriuretic effects contributing to plasma volume contraction, and decreases in systolic and diastolic blood pressures by 4 to 6 and 1 to 2 mm Hg, respectively, which may underlie cardiovascular and kidney benefits...
September 6, 2016: Circulation
Ichiro Maruko, Hisaya Arakawa, Hideki Koizumi, Reiko Izumi, Hiromi Sunagawa, Tomohiro Iida
PURPOSE: To evaluate the age-dependent morphologic alterations in the outer retina and choroid at the macula using swept-source optical coherence tomography (OCT). METHODS: Thirty eyes (30 normal subjects; average age, 49 years) were examined; five (age range, third-eighth decades of life) had refractive errors of ±2 diopters or less and no fundus abnormalities. An Early Treatment Diabetic Retinopathy Study (ETDRS) map of the outer retinal and choroidal thickness was constructed using swept-source OCT...
2016: PloS One
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