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Assesment of Conjunctival Microangiopathy in a Patient with Diabetes Mellitus Using the Retinal Function Imager
摘要： Diabetes mellitus (DM) is notorious for causing retinal microangiopathy, but bulbar conjunctival microangiopathy (CM) mirroring the established retinal vessel changes, has also been observed. Recent studies suggest that CM occurs in all DM patients in various degrees depending on disease severity and occur even before non-proliferative retinopathy develops. Thus, CM might provide a means of early detection or even form a basis for early intervention of disease progression in DM patients. Herein we present - to our knowledge for the first time-the feasibility and applicability in diagnostic imaging of CM in a diabetic patient using a commercially available Retinal Function Imager (RFI, Optical Imaging Ltd, Rehovot, Israel).
关键词： Retinal function imager,Optical imaging,Diabetes mellitus,Conjunctival microangiopathy,Retinal microangiopathy
更新于2025-09-09 09:28:46
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Patients with Advanced Diabetic Retinopathy’s Understanding of Diabetes Mellitus and Their Diabetic Eye Disease: A survey of 100 patients currently undergoing treatment for Diabetic Retinopathy in a Large Retinal Practice
摘要： Objective: To better understand what patients with advanced diabetic retinopathy understand about their DED and treatment, control of their diabetes, and risk factors for disease progression, and to assess which areas clinicians may want to target for education to increase patient understanding. Methods: 100 consecutive patients with at least 5 previous visits to a retinal clinic were surveyed to better understand patients’ understanding of diabetes mellitus (DM), diabetic eye disease (DED), and the treatments they were receiving for DM and their DED. Demographic information (age, gender, educational status, ethnicity, language, duration and treatments for DM) was collected, along with information about treatments and understanding of risk and modifiable factors about DM. Data was verified against the chart. Results: 100 surveys were completed; 97% of patients said they “understand DM”. 61% of patients were 60 years or older, and half of the patients had done some post-secondary educational training. The ethnic breakdown included 27% Caucasian and 38% Hispanic. Fasting blood glucose (FBG) was known in 89% of patients and when asked the range of FBG: 6% did not know; 17% had FBG as >160 mg/dl; and 35% had a FBG of <130 mg/dl. Regarding controlling their DM, 74% of patients did not identify exercise and 33% did not identify dietary habit as important in control. 95% identified blood pressure (BP) as important to monitor. 39% were unable to identify their current BP range, 31% identified their systolic BP as ≥ 130mmHg, and 7% described it as usually >150mmHg. Patients were asked to identify DM related ocular complications: 23% said bleeding; 7% said diabetic macular edema; and 73% said blindness or visual loss. As patient age increased, the ability to correctly identifying current treatments, and knowledge of hemoglobin A1C (HbA1C), decreased. Ability to correctly identify HbA1C increased with increasing education. Conclusions: This survey shows patient misunderstanding in how DM is treated, risk factors for DM, and how monitoring should be done. Emphasis is likely needed in diet modification and exercise for control of DM. Patients may be at risk for poor understanding of DM care/treatment (particularly those with lower educational achievement, or more elderly). Additional resources may need to be developed for sub-sets of patients.
关键词： Diabetic eye disease,Patient understanding,Diabetes mellitus,Risk factors,Diabetic retinopathy,Hemoglobin A1C
更新于2025-09-09 09:28:46
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“Guide Star” Assisted Noninvasive Photoacoustic Measurement of Glucose
摘要： A novel “guide star” assisted photoacoustic (GSPA) method for noninvasive glucose measurement has been proposed. Instead of receiving PA signals that are directly generated by tissue, a virtual photodiode is employed to amplify the PA signal difference regarding amplitude and peak arrival time caused by glucose concentration variations in an indirect way. Being different from traditional PA spectroscopy, this method can improve sensitivity and accuracy by optimizing optical path lengths (or tissue thickness). On the other hand, being superior to near-infrared (NIR) spectroscopy, it utilizes both optical absorption and acoustic propagation velocity information offered by PA signals. Theoretical analysis and simulation have been done to illustrate how the concentration change affects the PA waveform. In vitro experiments on aqueous glucose solution were conducted with concentrations varying in human physiological range (50~350 mg/dL). Performance of quartz cuvettes with 1-mm and 2-mm optical path lengths were compared in terms of correlation quality (R2), degree of agreement (Bland-Altman plot) and clinical accuracy (Clarke’s Error Grid analysis) to demonstrate the scalability of sensitivity provided by the indirect method. Longer optical length shows better sensitivity and accuracy in this case. Moreover, detection was also done on human blood serum to further prove the potential of the proposed method for clinical application. Our proposed method provides solution to enhance sensitivity, facilitating development of portable and low-cost PA sensors with low power laser diodes for noninvasive glucose monitoring and other applications.
关键词： near-infrared,photoacoustics,virtual photodiode,noninvasive glucose monitoring,Diabetes Mellitus
更新于2025-09-09 09:28:46
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High-Fat Diet–Induced Retinal Dysfunction
摘要： PURPOSE. The purpose of this study was to investigate the impact of obesity-induced prediabetes/early diabetes on the retina to provide new evidence on the pathogenesis of type 2 diabetes–associated diabetic retinopathy (DR). METHODS. A high-fat diet (HFD)–induced obesity mouse model (male C57BL/6J) was used in this study. At the end of the 12-week HFD feeding regimen, mice were evaluated for glucose and insulin tolerance, and retinal light responses were recorded by electroretinogram (ERG). Western immunoblot and immunohistochemical staining were used to determine changes in elements regulating calcium homeostasis between HFD and control retinas, as well as unstained human retinal sections from DR patients and age-appropriate controls. RESULTS. Compared to the control, the scotopic and photopic ERGs from HFD mice were decreased. There were signi?cant decreases in molecules related to cell signaling, calcium homeostasis, and glucose metabolism from HFD retinas, including phosphorylated protein kinase B (pAKT), glucose transporter 4, L-type voltage-gated calcium channel (L-VGCC), and plasma membrane calcium ATPase (PMCA). Similar changes for pAKT, PMCA, and L-VGCC were also observed in human retinal sections from DR patients. CONCLUSIONS. Obesity-induced hyperglycemic and prediabetic/early diabetic conditions caused detrimental impacts on retinal light sensitivities and health. The decrease of the ERG components in early diabetes re?ects the decreased neuronal activity of retinal light responses, which may be caused by a decrease in neuronal calcium signaling. Since PI3K-AKT is important in regulating calcium homeostasis and neural survival, maintaining proper PI3K-AKT signaling in early diabetes or at the prediabetic stage might be a new strategy for DR prevention.
关键词： obesity,type 2 diabetes,retinopathy,high-fat diet,calcium homeostasis
更新于2025-09-09 09:28:46
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Telemedicine-based diabetic retinopathy screening programs: an evaluation of utility and cost-effectiveness
摘要： Diabetes is the main cause of blindness among working age adults, although treatment is highly effective in preventing vision loss. Eye examinations are recommended on a yearly basis for most patients for timely detection of retinal disease. Telemedicine-based diabetic retinopathy screening (TMDRS) programs have been developed to identify patients with sight-threatening diabetic eye disease because patients are often noncompliant with recommended live eye examinations. This article reviews the cost-effectiveness of the various forms of TMDRS. A review of relevant articles, mostly published since 2008, shows that societal benefits generally outweigh the costs of TMDRS. However, advances in technology to improve efficacy, lower costs, and broaden screening to other sight-threatening conditions, such as glaucoma and refractive error, are necessary to improve the sustainability of TMDRS within health care organizations. Patient satisfaction with these telemedicine programs is generally high. New models of shared care with primary care providers and staff are emerging to improve patient engagement and follow-up care when individuals are found to have sight-threatening eye disease. TMDRS programs are growing and provide valuable clinical benefit. The cost-utility is currently well proven in locations with limited access to regular eye care services, such as rural areas, poor communities, and prison systems; however, improvements over time are necessary for these programs to be cost-effective in mainstream medical settings in the future.
关键词： telemedicine,retinopathy,retinal imaging,diabetes
更新于2025-09-09 09:28:46
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[IEEE 2018 International Conference on Current Trends towards Converging Technologies (ICCTCT) - Coimbatore, India (2018.3.1-2018.3.3)] 2018 International Conference on Current Trends towards Converging Technologies (ICCTCT) - Non Invasive Blood Glucose Detection along with an Assistive Diabetes Monitoring App
摘要： A Diabetes monitoring method has been developed using the blood glucose measurement made non-invasively. Glucose is the prime factor which is considered for the diagnosis of Diabetes mellitus. The common method for determining the glucose content in blood involves hand pricking by taking the blood samples. Regular pricking can cause pain and inconvenience which can even lead to calluses on the fingers and poor blood flow. Non-invasive technique is the recent advancement which does not involve drawing of any human interstitial fluids. The paper involves the design of a noninvasive glucose level detector using the Near Infrared (NIR) Spectroscopy concept and a smart device. The signals send through the fingertip will be absorbed based on vibrational movements. The result is obtained as voltage variations. The data thus obtained is then interfaced to an android device via Bluetooth to a monitoring android application which assist in keeping track of the glucose level.
关键词： Arduino,NIR Spectroscopy,Non invasive,Glucose,Diabetes,Android app
更新于2025-09-09 09:28:46
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Phacoemulsification without preoperative mydriasis in patients with age-related cataract associated with type 2 diabetes
摘要： Aim: To study the effect of intracameral injection of preservative-free lignocaine to induce pupil dilatation, without using any preoperative dilating eyedrops or intraoperative mydriatics in patients with age-related cataract associated with type 2 diabetes mellitus. Design: This was a prospective, observational, and interventional case series conducted at a tertiary eyecare center in rural India. Materials and methods: A total of 32 patients underwent phacoemulsification under topical anesthesia for visually significant cataract. Preoperative pupillary diameter was measured 3 days prior to surgical procedure under mydriatics (tropicamide 0.8%, phenylephrine hydrochloride 5%). Intraoperative pupillary dilatation was achieved by 1% intracameral lignocaine solution alone. Effective phacoemulsification time (EPT), total surgical time, and final pupillary diameter were recorded at the conclusion of surgery. Results: The average duration of diabetes was 11.2 (range 5–25) years. There was no difference in dilatation by preoperative pupil-dilating drops (5.2±0.5 mm, range 3–8.3 mm) and intracameral 1% lignocaine during the surgical procedure (P=0.63). There was a negative correlation (r=-0.92) between diabetes duration and dilatation of pupils with dilating drops and intracameral lignocaine. The duration of the surgery, EPT, and phacoemulsification chop had statistically insignificant effects on mydriasis, while the grade of the nucleus had a statistically significant effect on mydriasis. Intracameral lignocaine had no significant effect on blood pressure or pulse. There were no surgical complications that could have compromised the visual outcome. None of the patients developed macular edema in a follow-up period of 3 months; 28 patients (87.5%) had best-corrected visual acuity from 20/30 to 20/20. Conclusion: Intracameral lignocaine 1% provides sufficient mydriasis for the safe phacoemulsification of cataract in patients with type 2 diabetes of variable duration.
关键词： phacoemulsification,type 2 diabetes,intracameral lignocaine,topical anesthesia,intracameral mydriatic solution
更新于2025-09-04 15:30:14
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[IEEE 2018 48th European Microwave Conference (EuMC) - Madrid, Spain (2018.9.23-2018.9.27)] 2018 48th European Microwave Conference (EuMC) - Non-invasive Detection and Monitoring of Sustained Glycemic Fluctuations using Mm-Wave Spectroscopy
摘要： The biomedical industry has prominently grown during the last decades that has led to the introduction of new non-invasive techniques in the medical field. Particularly, microwave and mm-wave spectroscopy are good candidates for such goals. Recently, we have demonstrated that mm-wave spectroscopy in the W-band has great potential for the non-invasive detection of hyperglycemia typically associated to diabetes using animal models. In such approach a clear discrimination, based on blind classification, between hyperglycemic and control cases was achieved. In this work, the same spectroscopic technique is used to dynamically detect and monitor drug-induced diabetes on a group of mice. Our results provide strong evidence that sustained glycemic fluctuations can be closely followed by the proposed method with a temporal resolution of a few days.
关键词： Mm-wave,Diabetes,Hyperglycemia,Non-invasive diagnostics,spectroscopy,Functional Principal Component Analysis
更新于2025-09-04 15:30:14
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OCT-Leakage: A New Method to Identify and Locate Abnormal Fluid Accumulation in Diabetic Retinal Edema
摘要： To identify retinal extracellular fluid changes and their correlation with increased retinal thickness (RT) in eyes with subclinical and clinical macular edema in diabetes type 2. A cohort of 48 eyes from 48 type 2 diabetic patients with mild or moderate nonproliferative diabetic retinopathy (Early Treatment Diabetic Retinopathy Study levels 20/35) were classified as having normal RT (10), subclinical macular edema (30), or clinical macular edema (8). They were examined with Cirrus spectral-domain optical coherence tomography (OCT) at baseline visits (ClinicalTrials.gov number, NCT01145599) in the Coimbra center. Results from automated analysis of the retinal extracellular space, using our OCT-Leakage algorithm to identify sites of low optical reflectivity, were compared with those from a control group of 25 healthy eyes. The highest increases in RT in the eyes with subclinical and clinical macular edema were found in the inner nuclear layer (INL). These increases were, on average, 49.9% in subclinical macular edema and 104.7% in clinical macular edema. Extracellular space increases in the INL that were identified with the OCT-Leakage algorithm showed a strong positive correlation with the increases in RT in the central subfield (r ? 0.71, P < 0.001). Increases in number of sites with lower optical reflectivity positively correlate with the increase in RT in the initial stages of macular edema in diabetes type 2. Diabetic macular edema is represented mainly by extracellular fluid accumulation that preferentially involves the INL of the retina.
关键词： diabetes,optical coherence tomography,macular edema,retinal leakage,blood-retinal barrier
更新于2025-09-04 15:30:14
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The Use of Copper Oxide Thin Films in Gas-Sensing Applications
摘要： In this work, the latest achievements in the field of copper oxide thin film gas sensors are presented and discussed. Several methods and deposition techniques are shown with their advantages and disadvantages for commercial applications. Recently, CuO thin film gas sensors have been studied to detect various compounds, such as: nitrogen oxides, carbon oxides, hydrogen sulfide, ammonia, as well as several volatile organic compounds in many different applications, e.g., agriculture. The CuO thin film gas sensors exhibited high 3-S parameters (sensitivity, selectivity, and stability). Furthermore, the possibility to function at room temperature with long-term stability was proven as well, which makes this material very attractive in gas-sensing applications, including exhaled breath analysis.
关键词： nanomaterials,gas sensors,exhaled acetone detection,diabetes
更新于2025-09-04 15:30:14