Diabetic retinopathy: effects of national guidelines on the referral, examination and treatment practices of ophthalmologists and optometrists

McCarty, Catherine A.; Taylor, Kathryn I; McKay, R. James; Keeffe, Jill

doi:10.1046/j.1442-9071.2001.d01-3.x

Cited by 36 publications

(26 citation statements)

References 11 publications

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“…The presence of nephropathy was determined by urine albumin level higher than 20 μg/min for microalbuminuria and higher than 200 μg/min for macroalbuminuria or if the estimated glomerular filtration rate (eGFR) was less than 60 ml/min/1.73m 2 . Retinopathy was defined as either white or red lesions or both present in the retina according to WHO criteria [21, 22]. …”

Section: Methodsmentioning

confidence: 99%

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

et al. 2017

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Microvascular, macrovascular and neurological complications are the key causes of morbidity and mortality among type II diabetes mellitus (T2DM) patients. The aim of this study was to investigate the alterations of cardiac autonomic function of diabetic patients in relation to three types of diabetes-related complications. ECG recordings were collected and analyzed from 169 T2DM patients in supine position who were diagnosed with nephropathy (n = 55), peripheral neuropathy (n = 64) and retinopathy (n = 106) at two hospitals in the UAE. Comparison between combinations of patients with complications and a control diabetic group (CONT) with no complication (n = 34) was performed using time, frequency and multi-lag entropy measures of heart rate variability (HRV). The results show that these measures decreased significantly (p<0.05) depending on the presence and type of diabetic complications. Entropy, (median, 1st- 3rd interquartile range) for the group combining all complications (1.74,1.37–2.09) was significantly lower than the corresponding values for the CONT group (1.77, 1.39–2.24) with lag-1 for sequential beat-to-beat changes. Odds ratios (OR) from the entropy analysis further demonstrated a significantly higher association with the combination of retinopathy and peripheral neuropathy versus CONT (OR: 1.42 at lag 8) and an even OR for the combination of retinopathy and nephropathy (OR: 2.46 at lag 8) compared to the other groups with complications. Also, the OR of low frequency power to high frequency power ratio (LF/HF) showed a higher association with these diabetic-related complications compared to CONT, especially for the patient group combining all complications (OR: 4.92). This study confirms that the type of microvascular or peripheral neuropathy complication present in T2DM patients have different effects on heart rate entropy, implying disorders of multi-organ connectivity are directly associated with autonomic nervous system dysfunction. Clinical practice may benefit from including multi-lag entropy for cardiac rhythm analysis in conjunction with traditional screening methods in patients with diabetic complications to ensure better preventive and treatment outcomes in the Emirati Arab population.

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Section: Methodsmentioning

confidence: 99%

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

et al. 2017

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“…In addition, the provision of treatment guidelines for DR was found to have little impact on the healthcare management of the community, suggesting that mere dissemination of these guidelines is not adequate to change referral or treatment behaviours of physicians. 250 …”

Section: Discussionmentioning

confidence: 99%

Epidemiology of diabetic retinopathy and macular oedema: a systematic review

Williams

Airey

Baxter

et al. 2004

Eye

401

243

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Aims To systematically review the literature on the prevalence and incidence of diabetic retinopathy (DR) and macular oedema (MO). Methods A search of the bibliographic databases (Medline, Embase, CINAHL) was conducted up to October 2001. Selected relevant studies were scrutinized and included in the review. Results A total of 359 studies were included. The studies were reported in nearly 100 different journals and in over 50 countries. The majority of the studies were US-based, with large studies such as the Wisconsin Epidemiologic Study of Diabetic Retinopathy dominating the literature. The studies were quite dated and highly heterogeneous in nature in terms of patient selection with variable inclusion criteria (age range, gender, diabetes duration and type, ethnicity, comorbidity, and DR status, assessment, and classification). Conclusions There are inconsistencies between epidemiological studies, and differences in study methods may contribute to conflicting reports of prevalence and incidence of DR and MO in diabetic populations. As new therapies for DR and its associated complications emerge, the need to capture and monitor new epidemiological data becomes increasingly important to be able to assess the impact and effectiveness of these therapies. Robust, longitudinal capture of patient data is, therefore, essential to evaluate the impact of current practice on the epidemiology of diabetic eye complications.

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“…severe PDR, not responding to aggressive, extensive PRP; 3) to relieve macular or other retinal traction in advanced PDR cases, in an attempt to salvage some vision. 4) in selected cases with diffuse, severe DME not responsive to other therapies, particularly if vitreomacular traction is present.…”

Section: Role Of Vitrectomy In Managing Diabetic Retinopathymentioning

confidence: 99%

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Foreman

Keel

Xie

et al. 2017

Medical Journal of Australia

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Diabetic retinopathy: effects of national guidelines on the referral, examination and treatment practices of ophthalmologists and optometrists

Cited by 36 publications

References 11 publications

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

Association of Diabetes Related Complications with Heart Rate Variability among a Diabetic Population in the UAE

Epidemiology of diabetic retinopathy and macular oedema: a systematic review

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

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