The association between different hypoglycemic regimens and postoperative diabetic macular edema after vitrectomy in the Japanese patients with proliferative diabetic retinopathy

Lei, Chunyan; Zhang, Yun; Zhang, Meixia

doi:10.3389/fendo.2022.764254

Cited by 2 publications

(1 citation statement)

References 49 publications

(21 reference statements)

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“…An unhealthy lifestyle is the main reason for the shift in the therapeutic regimen for patients with T2DM ( 19 ), starting with glucose-lowering medicines, followed by low-dose insulin, and then increasing the insulin dosage. Over time, the function of islet cells is impaired with insufficient insulin secretion, leading to a growing demand for exogenous insulin dosage ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a predictive risk model based on retinal geometry for an early assessment of diabetic retinopathy

et al. 2022

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AimsThis study aimed to develop and validate a risk nomogram prediction model based on the retinal geometry of diabetic retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM) and to investigate its clinical application value.MethodsIn this study, we collected the clinical data of 410 patients with T2DM in the Second Affiliated Hospital of Chongqing Medical University between October 2020 and March 2022. Firstly, the patients were randomly divided into a development cohort and a validation cohort in a ratio of 7:3. Then, the modeling factors were selected using the least absolute shrinkage and selection operator (LASSO). Subsequently, a nomogram prediction model was built with these identified risk factors. Two other models were constructed with only retinal vascular traits or only clinical traits to confirm the performance advantage of this nomogram model. Finally, the model performances were assessed using the area under the receiver operating characteristic curve (AUC), calibration plot, and decision curve analysis (DCA).ResultsFive predictive variables for DR among patients with T2DM were selected by LASSO regression from 33 variables, including fractal dimension, arterial tortuosity, venular caliber, duration of diabetes mellitus (DM), and insulin dosage (P< 0.05). A predictive nomogram model based on these selected clinical and retinal vascular factors presented good discrimination with an AUC of 0.909 in the training cohort and 0.876 in the validation cohort. By comparing the models, the retinal vascular parameters were proven to have a predictive value and could improve diagnostic sensitivity and specificity when combined with clinical characteristics. The calibration curve displayed high consistency between predicted and actual probability in both training and validation cohorts. The DCA demonstrated that this nomogram model led to net benefits in a wide range of threshold probability and could be adapted for clinical decision-making.ConclusionThis study presented a predictive nomogram that might facilitate the risk stratification and early detection of DR among patients with T2DM.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a predictive risk model based on retinal geometry for an early assessment of diabetic retinopathy

et al. 2022

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The change of diabetic macular edema post vitrectomy in patients with proliferative diabetic retinopathy

Zhou¹,

Mei²,

Lin³

et al. 2023

Preprint

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Purpose To investigate the change of diabetic macular edema (DME) post vitrectomy and its risk factors.Methods Retrospective study design. This study included 365 eyes of 330 patients who underwent vitrectomy for proliferative diabetic retinopathy with gradable optical coherence tomography imaging from January 2018 to March 2022. The incidence of post vitrectomy DME (PV-DME) was defined as patients with a central retinal thickness (CRT) > 300 µm by optical coherence tomography among patients without preoperative DME.Results The cumulative incidence of PV-DME at 3 months was 40.1% (89/222), with its majority subtype of single diffused retinal thickening (66.2%) followed by single cystoid macular edema (27.0%). Multivariate Cox regression analysis indicated that a thicker preoperative CRT (HR = 1.01, 95% CI 1.00–1.02) and intraoperative internal limiting membrane peeling (HR = 3.18, 95% CI 1.85–5.47) were associated with the presence of PV-DME, while intraoperative intravitreal injection of triamcinolone acetonide (HR = 0.28, 95% CI 0.13–0.57) was protective against PV-DME. In eyes with preoperative DME (n = 143), the CRT decreased gradually from 468.3 ± 177.7 µm preoperatively to 409.5 ± 151.0 µm (P = 0.027), 377.4 ± 141.9 µm (P < 0.001), and 368.0 ± 157.6 µm (P < 0.001) at 7 days, 1 month, and 3 months postoperatively, respectively. Multivariate linear regression analysis indicated that only a thicker preoperative CRT (β = 0.77, 95% CI 0.63–0.92) was associated with a decreasing postoperative CRT.Conclusion PV-DME is a very common postoperative complication in patients with proliferative diabetic retinopathy. Triamcinolone acetonide could prevent its formation. Attention should be paid to patients with a thicker preoperative CRT and internal limiting membrane peeling.

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The association between different hypoglycemic regimens and postoperative diabetic macular edema after vitrectomy in the Japanese patients with proliferative diabetic retinopathy

Cited by 2 publications

References 49 publications

Development and validation of a predictive risk model based on retinal geometry for an early assessment of diabetic retinopathy

Development and validation of a predictive risk model based on retinal geometry for an early assessment of diabetic retinopathy

The change of diabetic macular edema post vitrectomy in patients with proliferative diabetic retinopathy

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