Diabetic Retinopathy

Antonetti, David A.; Klein, Michael L.; Gardner, Thomas W.

doi:10.1056/nejmra1005073

Cited by 1,346 publications

(1,172 citation statements)

References 101 publications

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“…In contrast, studies on type 2 diabetes are scarce and the findings are inconclusive based on the limited evidence [112]. Future research is still needed to assess the ability of retinal vascular caliber measures to provide clinically useful prognostic information that might add to risk prediction of diabetic retinopathy over and above the contribution from traditional risk factors, including glycemic levels and the duration of diabetes [113]. …”

Section: Retinal Vascular Caliber and Ocular Diseasesmentioning

confidence: 99%

Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives

Ikram¹,

Ong

Cheung³

et al. 2012

Ophthalmologica

176

187

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The retinal vasculature provides a unique window to assess vascular health noninvasively and directly in vivo. Advances in fundus photography and retinal image analysis techniques have enabled the objective and accurate assessment of quantitative retinal vascular caliber measurement. Over the last decade, large population-based studies have shown that retinal vascular calibers are associated with a wide range of subclinical (e.g. atherosclerosis, inflammation and endothelial dysfunction) and clinical cardiovascular diseases (hypertension, diabetes mellitus, stroke, kidney and heart diseases). However, while retinal image analysis provided exciting possibilities to study the pathogenesis of these diseases, its direct applicability in a clinical setting as a ‘test' to predict cardiovascular diseases is yet to be established, particularly within the context of being used as a population screening tool. Nevertheless, with continual development of retinal imaging techniques and newer understanding of the clinical significance of these retinal changes, there remains scope for the development of retinal vascular caliber measurements as a biomarker for vascular disease risk assessment in targeted areas and patient subgroups (e.g. patients with diabetes, suspected hypertension and stroke).

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Section: Retinal Vascular Caliber and Ocular Diseasesmentioning

confidence: 99%

Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives

Ikram¹,

Ong

Cheung³

et al. 2012

Ophthalmologica

176

187

View full text Add to dashboard Cite

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“…Four main alterations characterize these early stages: microaneurysms (MA)/haemorrhages, alteration of the blood-retinal barrier (BRB), capillary closure, and alterations in the neuronal and glial retina cells [3]. The monitoring of the initial DR alterations by multimodal macula mapping [4] identified 3 different progression phenotypes in non-proliferative DR (NPDR) [5].…”

Section: Introductionmentioning

confidence: 99%

Genetic Variants in ICAM1, PPARGC1A and MTHFR Are Potentially Associated with Different Phenotypes of Diabetic Retinopathy

Simões¹,

Lobo

Egas³

et al. 2014

Ophthalmologica

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Purpose: To explore phenotype-genotype correlations that may contribute to a better understanding of diabetic retinopathy (DR). Procedures: An exploratory association study was performed to identify genetic variants associated with non-proliferative DR (NPDR) in 307 type 2 diabetic patients who were previously stratified into 3 different phenotypes of NPDR progression. The 307 patients were genotyped for 174 single nucleotide polymorphisms of 11 candidate genes (ACE, AGER, AKR1B1, ICAM1, MTHFR, NOS1, NOS3, PPARGC1A, TGFB1, TNF and VEGFA). Results: Significant associations were observed for PPARGC1A rs16874120 with phenotype A (odds ratio, OR = 0.60, 95% confidence interval, CI 0.36-0.99), ICAM1 rs1801714 with phenotype B (OR = 3.32, 95% CI 1.05-10.50) and both PPARGC1A rs10213440 (OR = 2.00, 95% CI 1.07-3.73) and MTHFR rs1801133 (OR = 1.84, 95% CI 1.08-3.11) with phenotype C. Conclusions: Results indicate that specific gene variants in ICAM1, PPARGC1A and MTHFR are associated with different NPDR phenotypes, being likely candidates to explain different disease mechanisms underlying the different phenotypes. This is the first study to show correlations between specific gene variants and NPDR phenotypes, opening new perspectives on DR.

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“…4 Antonetti et al, proposed a mechanism for diabetic retinopathy which involved inflammatory pathways including VEGF and other angiogenic mediators. 5 Navarro JF proposed that activated innate immunity and inflammation are relevant factors in the pathogenesis of diabetes, with convincing data that type 2 diabetes includes an inflammatory component. 6 Woo et al, proved that elevated systemic neutrophil count is associated with the presence and severity of retinopathy as well as diabetes.…”

Section: Discussionmentioning

confidence: 99%

Study of relationship between WBC count and Diabetic complications

2017

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Background: There is plenty of evidence to support the fact that inflammation is a risk factor for atherosclerotic diseases and other lifestyle related diseases like diabetes and obesity. Elevated leukocyte count is associated with insulin resistance and is also associated with macro and micro vascular complications in diabetes. This study aimed to investigate the relation between peripheral total and differential WBC count in diabetes and its complications.Methods: This was a cross sectional observational study. It was carried out in the outpatient wing of Department of Medicine, M. G. M. Medical College and M.Y. Hospital. A total of 130 consecutive consenting diabetic patients (type 2) were selected. Those with any obvious stressful condition like acute illness were excluded. All the participants were screened for retinopathy, neuropathy, cerebrovascular disease and cardiovascular disease by history and clinical examination and had their height, weight, waist circumference, hip circumference and white blood cell counts notedResults: In the present study, most of the patients were middle aged patients (46 out of 130 were in age group 51-60 years) and were obese (60/130 had BMI of 26 to 30) with most of them having abdominal obesity (87% males i.e. 48/55 had waist hip ratio >0.90, 56% females i.e. 42/75 had waist hip ratio >0.85). It was found that, amongst 130 patients with type 2 diabetes 56% have WBC counts on the higher side of the normal range i.e. 7000-11000/cu mm. Polymorphs were also on higher side of the normal range in 47% of patients i.e. PMN= 61-70% and 26% had polymorphs above 70%. About 61% patients had monocyte count >6%. Out of the 130 patients, 35 had retinopathy, 57 had neuropathy and 9 had nephropathy as micro vascular complications while as macro vascular complications, 9 had a history of CVA, 14 had CAD and 4 had PVD. Also, maximum patients having micro and macro vascular complications had WBC counts in the range of 7000-11000.Conclusions: An elevated leukocyte count even within the normal range was associated with chronic complications in type 2 diabetes and can be used to predict development of micro and macro vascular complications in patients diagnosed with type 2 diabetes.

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Diabetic Retinopathy

Cited by 1,346 publications

References 101 publications

Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives

Retinal Vascular Caliber Measurements: Clinical Significance, Current Knowledge and Future Perspectives

Genetic Variants in ICAM1, PPARGC1A and MTHFR Are Potentially Associated with Different Phenotypes of Diabetic Retinopathy

Study of relationship between WBC count and Diabetic complications

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