Early glycaemic control for maintaining visual function in type 1 diabetes: The Oulu cohort study of diabetic retinopathy

Hautala, Nina; Siiskonen, Mira; Hannula, Virva; Järvinen, Kaisu; Falck, Aura

doi:10.1177/1120672117750053

Cited by 8 publications

(3 citation statements)

References 26 publications

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“…PRP has been the golden standard for treating PDR for decades. Although successful at preventing blindness, however, PRP commonly causes retinal damage and visual side effects, including constricted visual fields, reduced visual acuity, altered colour vision, impaired dark adaptation and decreased contrast sensitivity 19 20. Moreover, PRP may be unavailable for patients with VH due to poor retinal visibility.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

2019

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ObjectiveTo evaluate the occurrence of vitreous haemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR) and the efficacy of intravitreal bevacizumab (IVB) for VH in 5-year real-life data.Methods and analysis850 adult patients with type 1 (T1D) or type 2 diabetes (T2D) with PDR were screened for VH. The effect of IVB was evaluated by the clearage of VH and the change in best corrected visual acuity (BCVA). The rates of VHs, reinjections, macular oedema, complications, additional treatments and outcomes of spontaneous resorption, panretinal photocoagulation or pars plana vitrectomy (PPV) for VH were also investigated.ResultsVH occurred in 16% of patients with T1D and 9% of patients with T2D with PDR. 336 VHs in 140 eyes of 103 patients were documented. VH was cleared in 92% of cases in less than 3 months by the initial IVB. IVB was superior to other treatment methods in shortening the time for clearance of VH (Kaplan-Meier, p<0.0001). The average rate of IVB reinjections was 1.7±1.1 and the reinjection interval was 7.2±3.9 weeks. BCVA increased 0.73±0.04 logarithm of the minimum angle of resolution units after IVB (generalised estimating equations, p=0.0004). In 5 years, the patients had 2.2±2.7 recurrence of VHs. A simultaneous 72% decrease in the rate of PPVs was documented (p<0.0001).ConclusionVH occurs mostly in patients with T1D. The therapeutic effect of IVB for VH was significant and led to improved clearance of VH and visual outcome. Moreover, IVB prevented persistent and recurrent VHs and decreased the need for costly PPV.

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Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

2019

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“…However, it is not uncommon for clinicians to diagnose cataracts in young T1D patients, among some even preceding their T1D presentations [ 14 – 17 ]. The prevalence varies greatly between 0.7% and 29% [ 18 , 19 ]. According to the Wisconsin Epidemiologic Study of Diabetic Retinopathy, the 10‐year cumulative incidence of cataract surgery was 8% in young diabetic patients [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study

Shen

Lee

et al. 2020

International Journal of Endocrinology

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Background. Chronic hyperglycemia in type 1 diabetes (T1D) patients results in ocular problems over time, but only a few studies emphasized on cataracts. Aim. To evaluate the epidemiology of cataracts in the T1D population. Method. A two-part study was conducted using data from the National Health Insurance Research Database in Taiwan. Information from the Longitudinal Health Insurance Database (LHID) was served as a template of the general population. In the first part, a total of 3,622 T1D cases registered between 1998 and 2007 were enrolled and compared with a matched group from the LHID. For identifying risk factors of cataracts in the T1D population in the second part, a total of 9032 T1D cases registered between 1998 and 2013 were included. Result. Compared to the LHID, the hazard ratio (HR) of cataracts in the T1D group was 5.81 (95% CI 4.60–7.33), and the HR was higher in females (6.29, 95% CI 4.63–8.55). The peak incidence of cataracts occurred between age 20 and 29 in the T1D group, while in the LHID, it was after 60. The overall incidence of cataracts in the T1D group was 9.1%. In T1D patients with cataracts, they were found with higher rates of associated diabetic complications. Conclusion. Compared to the nondiabetic population, cataracts seemed more rampant and premature in T1D patients, especially those of female gender. Early ophthalmologic examination should be considered in T1D patients.

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“…Long-term studies on the relationship between the level of glucose control reflected by the examination of HbA 1c levels and diabetic retinopathy in juvenile patients with type 1 diabetes have been recently presented by Swedish authors [10]. Other authors have also presented the results of similar studies [11][12][13]. A comprehensive discussion of recommendations for the diagnosis and treatment of ophthalmologic complications in diabetes is presented in the recommendations of the Diabetes Poland [14].…”

Section: Introductionmentioning

confidence: 99%

Ophthalmologic disorders in adolescents with type 1 diabetes

Pilśniak

Wylęgała

Otto-Buczkowska

2020

Clinical Diabetology

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Chronic complications of diabetes, including damage to the eye, are seen in patients with type 2 diabetes often soon after diagnosis. This type of diabetes is often diagnosed after a long period of unrecognized and untreated disease. Type 1 diabetes is one of the most common metabolic diseases diagnosed in children, and is associated with the risk of developing multiple chronic complications. Diabetic eye disease can be associated with abnormalities in various eye structures. It should be remembered that early changes in the organ of vision may not give clear clinical symptoms. Their detection requires the use of modern diagnostic methods, which also allow early detection of changes that threaten damage to the eye. The degree of metabolic control, the presence of dyslipidemia, as well as micro-and macroangiopathy affect the development of chronic complications, including changes in the eye. Damage to small blood vessels leads to changes in retinal perfusion and to macular edema. As a result of these changes, diabetic retinopathy develops. Early diagnosis of the above complications allows prevention of their development.

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Early glycaemic control for maintaining visual function in type 1 diabetes: The Oulu cohort study of diabetic retinopathy

Cited by 8 publications

References 26 publications

Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

High Risk of Early Cataracts in Young Type 1 Diabetes Group: A Nationwide Cohort Study

Ophthalmologic disorders in adolescents with type 1 diabetes

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