Relationship between diabetic retinopathy severity and the timespan between the endocrinopathy diagnosis and the first ophthalmic examination

Preti, Rony Carlos; Motta, Augusto; Júnior, Otacílio de Oliveira Maia; Morita, Celso; Nascimento, Vinícius Paganini; Monteiro, Mário Luiz Ribeiro; Takahashi, Walter Yukihiko

doi:10.1590/s0004-27492010000300006

Cited by 9 publications

(9 citation statements)

References 11 publications

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“…4,5 With economic development and life improvement, the diabetic population is estimated to be 92.4 million in adults in China, 6 and at least 20% may have complications such as DR. 7,8 DR is a microvascular complication that develops in more than 75% of patients with a 20-year duration of type II diabetes and in all patients with type I diabetes. 2 Annual fundus screening and timely intervention by laser therapy in patients with diabetes is the standard of care to prevent visual impairment and blindness from DR. [9][10][11] The bulk of the evidence shows that prompt panretinal photocoagulation (PRP) and focal (direct or grid) laser treatment reduced the risk for severe visual loss compared with deferral of treatment over the long term.…”

mentioning

confidence: 99%

Analysis of reasons for noncompliance with laser treatment in patients of diabetic retinopathy

Hua

Cao

Cui

et al. 2017

Canadian Journal of Ophthalmology

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Objective-To identify the underlying reasons for noncompliance among Chinese patients undergoing laser photocoagulation treatment for diabetic retinopathy (DR). Design-Prospective cohort study.Participants-A total of 262 patients with DR with indications for panretinal photocoagulation and focal laser treatment were recruited.Methods-Those who did not complete the prescribed laser treatment were categorized into 2 types of defaulters: Type 1 defaulters were those who did not initiate laser treatment as scheduled; type 2 defaulters were those who did not complete the entire laser sessions, including terminating midterm or defaulting prompt supplement of laser treatment. A standardized questionnaire was given to the 2 types of defaulters to collect information about the reasons for noncompliance. Data were analyzed and subjected to χ 2 test or Fisher exact statistical tests.Results-The noncompliance rate was 45.5%, which is significantly greater than some developed countries. Unawareness of the necessity for treatment and unawareness of the importance to complete treatment were 2 main reasons leading to noncompliance, representing 28.8% and 36.0%, respectively. Unawareness of the necessity for treatment and fear of laser treatment were more important for type 1 defaulters (29 vs 6 and 11 vs 0, respectively), whereas unawareness of completeness of laser treatment was overweighed in type 2 defaulters (27 vs 13 patients; all P < 0.01). These results were likely related to the lack of knowledge about the potential consequences of DR, the underlying principle of laser treatment, and panretinal photocoagulation procedures.Conclusions-Developing appropriate education programs targeting specific reasons will help to improve the compliance in patients with DR. The bulk of the evidence shows that prompt panretinal photocoagulation (PRP) and focal (direct or grid) laser treatment reduced the risk for severe visual loss compared with deferral of treatment over the long term. [12][13][14][15][16][17] Several studies in the United States have shown that many patients with diabetes fail to seek or receive dilated eye examination and timely treatment according to guidelines, and the average compliance rate may vary from approximately 30% to 60%. 18-20 A variety of factors contributed to the high noncompliance rate, such as transport, absence of a decision maker, fear of laser treatment, socioeconomic barriers, health system barriers, educational barriers, and cultural barriers. [21][22][23] According to our clinical experience, the same issues occurred in Chinese patients with diabetes, but the underlying factors were unclear. Moreover, many patients defaulted from the laser treatment in progress, although many reports showed that the supplementary laser photocoagulation and the subsequent follow-up were as important as the initial laser sessions. [24][25][26] The literature shows the value of educational programs in improving patient adherence to guidelines when the programs targeted specific reasons behind the noncompli...

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mentioning

confidence: 99%

Analysis of reasons for noncompliance with laser treatment in patients of diabetic retinopathy

Hua

Cao

Cui

et al. 2017

Canadian Journal of Ophthalmology

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“…Namun, dikarenakan pada keadaan retinopati diabetika sering ditemukan keadaan neuropati autonomik diabetika, maka pupil penderita diabetes melitus sering sulit lebar. 4,5 Oleh karena itu, konsentrasi obat midriatikum yang diberikan harus lebih tinggi dibanding dengan orang tanpa diabetes untuk mencapai efek midriatikum yang sama. Di samping itu, dikarenakan epitel kornea itu mempunyai efek sawar terhadap seluruh obat yang diteteskan maka konsentrasi obat yang mencapai struktur di dalam bola mata akan berkurang.…”

Section: Pendahuluanunclassified

“…Keadaan pupil yang berdilatasi sangatlah diperlukan untuk menilai keadaan mata, terutama segmen posterior mata tersebut. 5 Otot spingter iris ini mempunyai reseptor muskarinik terhadap asetilkolin. Reseptorreseptor ini tidak secara langsung berhubungan dengan channel ion antarmembran namun juga terhadap sekelompok reaksi yang bertingkat dari fosforilasi yang menyebabkan messenger sekunder intraokular lepas sehingga pada akhirnya akan menyebabkan otot berkontraksi.…”

Section: Pembahasanunclassified

Efektivitas Penambahan Natrium Diklofenak terhadap Larutan Obat Dilatasi Pupil pada Pasien Retinopati Diabetik

Kartasasmita¹,

Sovani²,

Setyohadji³

et al. 2017

mkb

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AbstrakPemeriksaan fundus memerlukan akses visualisasi yang baik. Pada penderita diabetes melitus, pupil sulit lebar menggunakan obat pelebar pupil standar sehingga perlu ditambahkan agen pelebar pupil. Penelitian ini dilakukan di Rumah Sakit Mata Cicendo periode Januari sampai Juli 2014 menggunakan metode double masked rendomized cotrolled trial terhadap 64 mata dari 32 subjek penelitian yang telah didiagnosis menderita retinopati diabetika dengan tingkat yang sama antara mata kiri dan kanan. Dibuat larutan kombinasi campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, 10 mL fenilefrin 5% dan 10 ml 0,1% Na diklofenak (larutan I) dan campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, dan 10 mL fenilefrin 5% (larutan II). Setiap subjek mendapat salah satu larutan pada mata dan larutan yang lain pada sebelahnya secara acak. Dilakukan pemantauan dengan cara memotret pupil pada menit ke-15, 20, dan 25 pada kedua mata. Lebar pupil kedua kelompok perlakuan diukur dengan perangkat lunak khusus (image processing). Dari penenelitian terdapat perbedaan bermakna antara penggunaan larutan I dan larutan II dalam melebarkan pupil baik pada menit ke-15 (t=2,02; p=0,047), menit ke 20 (t=2,23; p=0,029), dan pada menit ke-25 (t=2,041; p=0,045). Larutan kombinasi fenilefrin, tropikamid, dan natrium diklofenak menghasilkan efek dilatasi pupil yang lebih baik dibanding dengan larutan kombinasi fenilefrin dan tropikamid saja pada kasus retinopati diabetes. [MKB. 2017;49(3):199-207] Kata kunci: Dilatasi pupil, natrium diklofenak, retinopati diabetika Effectiveness of Sodium Diclofenac Addition to Pupil Dilatation Agent on Diabetic Retinopathy Patients AbstractFundus examination requires good visualization of fundus. In diabetic patients, it is difficult for the pupil to dilate using the standard pupilarry dilating agent. To achieve proper dilation, special agents have to be added to the standard dilation agent. The study was conducted in Cicendo Eye Hospital from January to July 2014, using double masked randomized controlled trial to 32 patients (64 eyes) who were diagnosed as suffering from diabetic retinopathy with the same grade on both eyes. Eye drop solutions were developed beforehand by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine, 10 mL of 5% phenylephrine, and 10 mL of 0.1% diclofenac-natrium (solution I) and also by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine and 10 mL of 5% phenylephrine (solution II). Every subject received one drop of one solution on one eye and the other solution on the other eye in randomly fashion. The observation was performed by taking photographs of the pupil on both eyes 15, 20, and 25 minutes of observation. The resulting pupil photographs were then analyzed and measured using special image processing software and compared. It was revealed that there were statistical differences in pupil dilation between solution I and solution II at 15 minutes (t=2.02; p=0.047), 20 minutes (t=2.23, p=0.029), and 25 minutes (t=2.041, p=0.045). Phenilefrine, tropicamide and diclofenac-natrium combination ...

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“…Entonces estas áreas de la retina envían señales al cuerpo para que haga crecer nuevos vasos sanguíneos. 19 Al fondo de ojo se observan: Hemorragias retinales en los 4 cuadrantes, rosarios venosos en 2 cuadrantes e IRMA en 1 cuadrante. La conducta a seguir: Regla 4 x 2 x 1 Derivación para panfotocoagulación Oftalmólogo capacitado Retinopatía proliferativa.…”

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Prevalencia y Características de Retinopatía Diabética en la Fundación DONUM, Cuenca, Julio 2016 – Febrero 2017

Arcos¹,

Maldonado²

2017

Salud

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ResumenEl objetivo fundamental es determinar la prevalencia y características de Retinopatía Diabética en la Fundación DONUM de la ciudad de Cuenca en el período Julio 2016 -Febrero de 2017. Se realizó un estudio transversal en 162 pacientes diabéticos que acudieron a la consulta externa de la fundación DONUM de la ciudad de Cuenca durante julio de 2016 a febrero 2017. Se caracterizó a la población de acuerdo a edad, sexo, residencia, valores de glucemia promedio, así como también se estableció las características de retinopatía de los mismos. Los datos obtenidos se presentaron mediante gráficos y tablas y se analizaron mediante estadística descriptiva con la aplicación de razón de prevalencia (RP) y se consideró estadísticamente significativo valores inferiores a p<0,05 con un intervalo de confianza (IC) al 95 % y fueron procesados en el programa SPSS 22. En los 162 pacientes la prevalencia de retinopatía diabética (RD) es de 38,3 %, con predominio del sexo femenino, Son mayores a 65 años (48,4 %), se consideran mestizos el 88,7 %), residencia en zonas rurales (54,8 %).Los valores de glicemia promedio están entre 100 y 140 mg/dl el (58,1 %) y el 83,9 % tienen diabetes mellitus tipo 2. En el 64,5 % se observó RD no proliferativa El 8.1 % RD no proliferativa moderada El 11.3 % presenta RD no proliferativa grave. El 9,7 % presenta RD proliferativa de bajo riesgo y solo el 3,2 % presenta RD proliferativa de alto riesgo; y el 3,2 % edema macular. La Prevalencia de Retinopatía Diabética en la fundación DONUM es alta, los más afectados son las personas de mayor edad y que padecen diabetes mellitus tipo 2.Palabras clave: Diabetes mellitus, Retinopatía diabética, Oftalmologia, Glucemia, Retina, Prevalencia. AbstractObjective: To determine the Prevalence and Characteristics of Diabetic Retinopathy in the Foundation DONUM of the city of Cuenca in the period July 2016 -February 2017. Materials and Methods: a cross-sectional study was carried out on 162 diabetic patients who attended the external consultation of the DONUM foundation of the city of Cuenca during July 2016 to February 2017. The population was characterized according to age, sex, residence, Values of glycemia, as well as establishing the characteristics of retinopathy of the same. The data obtained were presented by means of graphs and tables and analyzed by means of descriptive statistics with the application of prevalence ratio (RP), and values below p <0.05 were considered statistically significant with a 95% confidence interval (CI) and Were processed in the SPSS program 22. Results: The prevalence of diabetic retinopathy (RD) was 38.3% in the 162 patients, with a predominance of females. They were older than 65 years (48.4%), mestizos (88.7%), The mean values of glycemia are between 100 and 140 mg / dl (58.1%) and 83.9% have diabetes mellitus type 2. In 64.5% Non-proliferative RD 8.1% moderate non-proliferative RD 11.3% have severe non-proliferative RD 9.7% have low-risk proliferative RD and only 3.2% have high-risk proliferative RD. And 3.2% macular edem...

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Relationship between diabetic retinopathy severity and the timespan between the endocrinopathy diagnosis and the first ophthalmic examination

Cited by 9 publications

References 11 publications

Analysis of reasons for noncompliance with laser treatment in patients of diabetic retinopathy

Analysis of reasons for noncompliance with laser treatment in patients of diabetic retinopathy

Efektivitas Penambahan Natrium Diklofenak terhadap Larutan Obat Dilatasi Pupil pada Pasien Retinopati Diabetik

Prevalencia y Características de Retinopatía Diabética en la Fundación DONUM, Cuenca, Julio 2016 – Febrero 2017

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