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Clinical Analysis of Newly Diagnosed Diabetes Mellitus Patients by Abnormal Fundus Examination
摘要： Purpose: To investigate the clinical analysis of newly diagnosed diabetes mellitus (NDM) patients with abnormal fundus examination at the first visit. Methods: This retrospective study utilized the first visit medical records of 15 patients (30 eyes) who were diagnosed with NDM from February 2011 to October 2016. Results: Patients were divided into 3 groups: 1) diabetic retinopathy group including proliferative diabetic retinopathy (PDR) (3) and severe non-proliferative diabetic retinopathy (NPDR) (1); 2) retinal vascular disease group including central retinal vein occlusion (CRVO) (1), branch retinal vein occlusion (1), vitreous hemorrhage with CRVO (1) and macular edema (1); and 3) other retinal disease group including vitreous hemorrhage due to choroidal neovascular rupture (1), exudative age-related macular degeneration (3), central serous chorioretinopathy (2), and macular hole (1). All 3 PDR patients had latent autoimmune diabetes in adults (type 1.5 diabetes). The remaining 12 patients had type 2 diabetes. Three patients showed mild NPDR in the opposite eye and the other 9 patients did not have diabetic retinopathy in the opposite eye. Onset age, HbA1C and proteinuria were significantly different between the diabetic retinopathy group and the other retinal disease group (p = 0.006, p = 0.012 and p = 0.006, Mann-Whitney test). Conclusions: In patients with various retinal diseases, early detection of NDM could be achieved by performing fundoscopic imaging and systemic examination as well as basic ophthalmologic examination. In addition, patients with diabetic retinopathy should be treated promptly through ophthalmology and internal medicine consultation. For the retinal vascular disease and other retinal disease groups, not only treatment for ophthalmic diseases, but also education about diabetes treatment are important.
关键词： Latent autoimmune diabetes in adults,Newly diagnosed diabetes mellitus,Diabetic retinopathy,HbA1C
更新于2025-09-09 09:28:46
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Epidemiologie der diabetischen Retinopathie; Epidemiology of diabetic retinopathy;
摘要： Das Risiko für mikrovaskul?re Folgeerkrankungen steigt bei mittel- bis langfristiger deutlicher Erh?hung der Blutglukosespiegel. Die Pr?valenz der diabetischen Retinopathie h?ngt au?er von der Krankheitsdauer v. a. von der Patientenselektion, Risikofaktoren (Patientenalter, HbA1c [Glykoh?moglobin Typ A1c], Bluthochdruck), Diagnosekriterien, Studiendesign und der Zeit der Datenerfassung ab. In der Prim?rversorgung des Typ-2-Diabetes in Deutschland finden sich in gro?en Patientenkollektiven mit etwa 10 % deutlich geringere Retinopathiepr?valenzen als in der Sekund?r- und Terti?rversorgung mit 20–25 %. Bei Menschen mit Typ-1-Diabetes ist die Pr?valenz der Retinopathie in der Prim?rversorgung mit etwa 24 % aufgrund der l?ngeren Diabetesdauer h?her, und es gibt keinen so deutlichen Unterschied im Vergleich zur Sekund?r- und Terti?rversorgung mit 27–30 %. Auch bei 10 % der Menschen ohne Diabetes lassen sich Augenhintergrundver?nderungen feststellen, die einer sehr milden Form der Retinopathie entsprechen k?nnen. Fortgeschrittene Stadien der Retinopathie k?nnen zur Visusminderung und damit Sehbeeintr?chtigung führen. Sch?tzungsweise betrifft dies etwa 1/6 der Menschen mit Retinopathie. Die Rate an schweren, zu Erblindung führenden Formen derselben ging deutlich zurück, dank der optimierten Diagnose- und Behandlungsm?glichkeiten, besonders auch der Makulopathie.
关键词： Blutglukose,Hyperglyk?mie,Diabetes mellitus,Auge,Mikrogef??e
更新于2025-09-09 09:28:46
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Early changes in retinal structure and BMP2 expression in the retina and crystalline lens of streptozotocin-induced diabetic pigs
摘要： This study aims to evaluate early changes in retinal structure and BMP2 expression in the retina and crystalline lens by comparing streptozotocin-induced diabetic pigs and normal control group pigs. Methods: Five eye samples from five diabetic Micro-pigs (Medikinetics, Pyeongtaek, Korea) and five eye samples from five control pigs bred in a specific pathogen-free area were used. Diabetes was developed through intravenous injection of nicotinamide and streptozotocin, and the average fasting glucose level was maintained at 250 mg/dL or higher for 16 weeks. To evaluate BMP2 expression in the retina and crystalline lens, Western blotting was performed. Results: In Hematoxylin and Eosin staining, most diabetic pigs showed structural abnormalities in the inner plexiform layer. The number of nuclei in the ganglion cell layer within the range of 104 μm2 was 3.78±0.60 for diabetic pigs and 5.57±1.07 for control group pigs, showing a statistically significant difference. In immunohistochemical staining, diabetic retinas showed an overall increase in BMP2 expression. In Western blotting, the average BMP2/actin level of diabetic retinas was 1.19±0.05, showing a significant increase compared to the 1.06±0.03 of the control group retinas (P=0.016). The BMP2/actin level of diabetic crystalline lenses was similar to the control group crystalline lenses (P=0.730). Conclusions: Compared to control group pigs, the number of nuclei in the inner nuclear layer of retinas from streptozotocin-induced diabetic pigs decreased, while an increase in BMP2 expression was observed in the retina of diabetic pigs.
关键词： lens,diabetes mellitus,retina,BMP2,pigs,streptozotocin
更新于2025-09-09 09:28:46
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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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Improvement in infected wound healing in type 1 diabetic rat by the synergistic effect of photobiomodulation therapy and conditioned medium
摘要： We investigated the effects of photobiomodulation therapy (PBMT) and conditioned medium (CM) of human bone marrow mesenchymal stem cells (hBM‐MSC) individually and/or in combination on the stereological parameters and the expression of basic fibroblast growth factor (bFGF), hypoxia‐inducible factor (HIF‐1α), and stromal cell–derived factor‐1α (SDF‐1α) in a wound model infected with methicillin‐resistant Staphylococcus aureus (MRSA) in diabetic rats. CM was provided by culturing hBM‐MSCs. Type 1 diabetes mellitus (T1DM) was induced in 72 rats, divided into four groups, harboring 18 rats each: group 1 served as a control group, group 2 received PBMT, group 3 received CM, and group 4 received CM + PBMT. On days 4, 7, and 15, six animals from each group were euthanized and the skin samples were separated for stereology examination and gene expression analysis by real‐time polymerase chain reaction. In the CM + PBMT, CM, and PBMT groups, significant decreases were induced in the number of neutrophils (1460 ± 93, 1854 ± 138, 1719 ± 248) and macrophages (539 ± 69, 804 ± 63, 912 ± 41), and significant increases in the number of fibroblasts (1073 ± 116, 836 ± 75, 912 ± 41) and angiogenesis (15 230 ± 516, 13 318 ± 1116, 14 041 ± 867), compared with those of the control group (2690 ± 371, 1139 ± 145, 566 ± 90, 12 585 ± 1219). Interestingly, the findings of the stereological examination in the CM + PBMT group were statistically more significant than those in the other groups. In the PBMT group, in most cases, the expression of bFGF, HIF‐1α, and SDF‐1α, on day 4 (27.7 ± 0.14, 28.8 ± 0.52, 27.5 ± 0.54) and day 7 (26.8 ± 1.4, 29.6 ± 1.4, 28.3 ± 1.2) were more significant than those in the control (day 4, 19.3 ± 0.42, 25.5 ± 0.08, 22.6 ± 0.04; day 7, 22.3 ± 0.22, 28.3 ± 0.59, 24.3 ± 0.19) and other treatment groups. The application of PBMT + CM induced anti-inflammatory and angiogenic activities, and hastened wound healing process in a T1 DM model of MRSA infected wound.
关键词： stereology,diabetes mellitus,diabetic foot ulcer,methicillin‐resistant staphylococcal aureus,low‐level laser therapy,phobiomodulation therapy,human bone marrow mesenchymal stem cell‐conditioned medium,real‐time PCR,rat
更新于2025-09-04 15:30:14
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Spectral-Domain Optical Coherence Tomography Features in Open-Angle Glaucoma With Diabetes Mellitus and Inadequate Glycemic Control
摘要： PURPOSE. To evaluate spectral-domain optical coherence tomography (SD-OCT) features according to glycemic control status in open-angle glaucoma with diabetes mellitus. METHODS. Subjects underwent comprehensive ocular examination, visual ?eld testing, and SD-OCT imaging (Cirrus HD-OCT). The relationship between glycosylated hemoglobin (HbA1c) and OCT measurements was compared between diabetic nonglaucomatous eyes and diabetic glaucomatous eyes. Glaucoma-discriminating ability was assessed using the area under the receiver operating characteristic curves (AUCs) for OCT parameters and compared between groups relative to the glycemic control group. RESULTS. Analysis was performed on 69 nonglaucomatous and 87 glaucomatous eyes in the nondiabetic group, and on 72 nonglaucomatous and 56 glaucomatous eyes in the diabetic group. Average, inferonasal, inferior, and inferotemporal ganglion cell–inner plexiform layer (GCIPL) thicknesses were positively correlated with HbA1c in diabetic nonglaucomatous eyes (P ? 0.040, 0.037, 0.025, and 0.013, respectively). The AUC of the average cup-to-disc area ratio (CDR), vertical CDR, and cup volume in diabetic eyes with poor glycemic control was signi?cantly higher than those in nondiabetic eyes (P ? 0.011, 0.003, and 0.043, respectively). The AUC of cube volume, cube average thickness, and minimal GCIPL thickness in diabetic eyes with poor glycemic control was lower than those in nondiabetic eyes (P ? 0.006, 0.007, and 0.004, respectively). CONCLUSIONS. In this study, optic nerve head parameters had a superior ability to discriminate glaucoma in diabetic eyes with poor glycemic control. Conversely, the ability to discriminate glaucoma using macular parameters tended to be lower for diabetic eyes with inadequate glycemic control.
关键词： spectral-domain optical coherence tomography,diabetes mellitus,ganglion cell-inner plexiform layer,glaucoma
更新于2025-09-04 15:30:14