Rapid Development During Puberty of Proliferative Retinopathy After Strict Diabetic Control

Lawrence, J. R.; Bedford, Guy; Thomson, R. M.

doi:10.1016/s0140-6736(85)90380-0

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…The risk of progression from severe NPDR or early proliferative DR (PDR) to high‐risk severe PDR is approximately 25% over 4 to 6 months, and this risk may increase to 50% with intensive glycaemic control . Initial worsening in the DCCT occurred within 12 months, consistent with other studies showing worsening within 3 to 12 months of the commencement of intensive insulin treatment …”

Section: Discussionsupporting

confidence: 78%

“…Clinical reports of severe visual impairment associated with EW are balanced by those that describe transient and apparently reversible effects on vision . Moskalets et al reported 6 of 122 patients with T1DM who had little or no retinopathy at baseline developed severe retinopathy, neovascularisation despite laser photocoagulation and vitreous haemorrhage within 1 year intensive glycaemic control .…”

Section: Discussionmentioning

confidence: 99%

“…12 Initial worsening in the DCCT occurred within 12 months, 7 consistent with other studies showing worsening within 3 to 12 months of the commencement of intensive insulin treatment. 5,6,8,10,[13][14][15][16][17][18][19][20] Despite having been described in the literature, the pathogenesis of EW is not well understood. It has been shown that frequency and severity of EW was associated with more advanced DR at baseline, higher HbA1c levels, and longer duration of diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, while glucose may be protective to neurons in the context of retinal hypoxia, long-term hyperglycaemia is deleterious to both to retinal neurons and the microvasculature. 48 Clinical reports of severe visual impairment associated with EW 14,[16][17][18][19]49 are balanced by those that describe transient and apparently reversible effects on vision. [4][5][6]8,50 Moskalets et al reported 6 of 122 patients with T1DM who had little or no retinopathy at baseline developed severe retinopathy, neovascularisation despite laser photocoagulation and vitreous haemorrhage within 1 year intensive glycaemic control.…”

Section: Discussionmentioning

confidence: 99%

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Early worsening of diabetic retinopathy due to intensive glycaemic control

Lim

Wijngaarden

Harper

et al. 2018

Clinical Exper Ophthalmology

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The prevalence of diabetes and diabetic retinopathy is increasing around the world. Glycaemic control is important in reducing the long‐term risk of complications of diabetes, however intensive glycaemic control, particularly in patients with longstanding and poorly controlled diabetes, is associated with the risk of early worsening of diabetic retinopathy and vision loss. We present two clinical cases to illustrate the presentation of early worsening and to highlight a role for intravitreal anti‐vascular endothelial growth factor therapies in ameliorating this phenomenon, as well as a review of the current understanding of this phenomenon. We emphasise the importance of identifying individuals at risk of early worsening of diabetic retinopathy and recommend regular ophthalmological review during the period of intensive glycaemic control to ensure optimal visual outcomes.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%