The Diabetic Retinopathy Barometer Study: Global perspectives on access to and experiences of diabetic retinopathy screening and treatment

Cavan, David; Makaroff, Lydia; Fernandes, J; Sylvanowicz, Michelle; Ackland, Peter; Conlon, John; Chaney, David; Malhi, Avleen; Barratt, Jane

doi:10.1016/j.diabres.2017.03.023

Cited by 76 publications

(55 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Diabetic macular edema (DME) is a common complication of diabetic retinopathy, characterized by ischemic swelling of the central area of the retina, known as the macula [1]. Its prevalence in patients with diabetic retinopathy increases with the duration of diabetes and is estimated to be between 2.7% and 11% [2][3][4]. As population age and life expectancy increase, the prevalence of diabetes-and thus DME-is expected to rise [3].…”

Section: Introductionmentioning

confidence: 99%

Outcomes in diabetic macular edema switched directly or after a dexamethasone implant to a fluocinolone acetonide intravitreal implant following anti-VEGF treatment

et al. 2019

View full text Add to dashboard Cite

Aims Fluocinolone acetonide (FAc) is an intravitreal corticosteroid implant approved for the second-line treatment of diabetic macular edema (DME). This study compared outcomes of patients with DME switched directly to an FAc implant, versus indirectly via dexamethasone, after anti-VEGF therapy failure. Methods This is a retrospective, single-center chart review. Patients were assigned to Group A (switched to FAc after anti-VEGF) or Group B (switched to dexamethasone and then to FAc after > 4 months). Charts were reviewed for best-corrected visual acuity (BCVA), central macular thickness (CMT), intraocular pressure (IOP) and cataract development. Results Forty-nine eyes were included. BCVA increased and CMT decreased with anti-VEGF (both groups), and dexamethasone (Group B only), but regressed after stopping treatment. With FAc, BCVA increased rapidly and significantly: increases were maintained up to 36 months (P < 0.001), except at 18 and 9 months in Groups A and B, respectively. Significant CMT reductions (P < 0.001) were evident after 3 months and maintained up to 36 months in both groups. IOP increase > 21 mmHg occurred in 14 patients (nine in Group A, five in Group B): all were sufficiently treated with IOP-lowering drops. Nineteen phakic eyes (73.1%) developed cataract: seven underwent phaco-emulsification (two in Group A, five in Group B). Conclusions Similar functional and anatomical improvements occurred in FAc-treated eyes, regardless of whether they first received dexamethasone or switched directly to FAc after anti-VEGF. Safety signals were consistent with corticosteroid class effects. Early switch to FAc could benefit patients who respond insufficiently to anti-VEGF. Keywords Diabetic macular edema • Fluocinolone acetonide • Dexamethasone • Second-line treatment • Best-corrected visual acuity • Central macular thickness This article belongs to the topical collection Eye Complications of Diabetes managed by Giuseppe Querques.

show abstract

Section: Introductionmentioning

confidence: 99%

Outcomes in diabetic macular edema switched directly or after a dexamethasone implant to a fluocinolone acetonide intravitreal implant following anti-VEGF treatment

et al. 2019

View full text Add to dashboard Cite

show abstract

“…According to the ophthalmologists, the majority of cases were reported when the severity was visible. From this finding, it can be concluded that there is a need to carry out effective screening and awareness camps to make the society aware of this complication at an early stage (Cavan et al, ). To prevent development of this condition at an early stage, there is a need to develop advanced tools for its detection.…”

Section: Introductionmentioning

confidence: 99%

Cognitive dysfunction: A growing link between diabetes and Alzheimer's disease

Jash

Gondaliya

Kirave

et al. 2019

Drug Development Research

View full text Add to dashboard Cite

Diabetes mellitus (DM) is a gradually rising metabolic disease which is currently affecting millions of people worldwide. Diabetes is associated with various complications like nephropathy, neuropathy, retinopathy, diabetic foot, cognitive impairment, and many more. Evidence suggests that cognitive dysfunction is a rising complication of diabetes which adversely affects the brain of patients suffering from diabetes. Age‐related memory impairment is a complication having its major effect on people suffering from diabetes and Alzheimer's. Patients suffering from diabetes are at two times higher risk of developing cognitive dysfunction as compared with normal individuals. Multiple factors which are involved in diabetes related complications are found to play a role in the development of neurodegeneration in Alzheimer's. The problem of insulin deficiency and insulin resistance is well reported in diabetes but there are many studies which suggest dysregulation of insulin levels as a reason behind the development of Alzheimer's. As the link between diabetes and Alzheimer disease (AD) is deepening, there is a need to understand the plausible tie‐ins between the two. Emerging role of major factors like insulin imbalance, advanced glycation end products and micro‐RNA's involved in diabetes and Alzheimer's have been discussed here. This review helps in understanding the plausible mechanism underlying the pathophysiology of amyloid beta (Aβ) plaque formation and tau hyperphosphorylation as well provides information about studies carried out in this area of research. The final thought is to enhance the scientific knowledge on this correlation and develop future therapeutics to treat the same.

show abstract

“…3 The uptake of retinal screening depends on context specific factors related to the service provider, the wider organization and structure of the health system, and the patient,. [9][10][11] A crucial limitation to deliver DR screening in LMICs is the low availability of ophthalmologists, particularly in sub-Saharan Africa (SSA), where the mean ophthalmologist density per million population is 3.7. 12 In this context, it is not realistic to rely on ophthalmologists to examine the retinas of the growing population of people living with diabetes (PLWD) unless it is at the expense of the delivery of other critical eye care services.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of task-shifting for the detection of diabetic retinopathy in low- and middle-income countries: a rapid review protocol.

Bascarán

Mwangi

D’Esposito

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Diabetic retinopathy is the most common ocular complication of diabetes and a cause of vision loss in adults. Diabetic retinopathy screening leading to early identification of the disease, followed by timely treatment, can prevent vision loss in people living with diabetes. A key barrier to the implementation of screening services in low- and middle-income countries is the low number of ophthalmologists per million population. Interventions that shift screening to non-ophthalmology cadres have been implemented in programmes in low- and middle-income countries and are routinely used in high-income countries. Methods We will search MEDLINE, Embase, Global Health and Cochrane Register of Studies for studies reporting task-shifting interventions for diabetic retinopathy detection. The review will include studies published in the last 10 years in the English language. We will include any interventional or observational comparative study measuring outcomes in terms of participation or access to diabetic retinopathy detection services (uptake) and quality of diabetic retinopathy detection services (detection, severity, diagnostic accuracy). For included studies cost-effectiveness of the task-shifting intervention will also be presented. Two reviewers will screen search results independently. The risk of bias assessment and data extraction will be carried out by one reviewer with verification of 10% of the papers by a second reviewer. The results will be synthesised narratively. Discussion The aim of this rapid review is to summarise the published literature reporting the effectiveness of task-shifting interventions for the detection of diabetic retinopathy by non-ophthalmologists low- and middle-income countries. The results will be of interest to policy makers and programme managers tasked with designing and implementing services to prevent and manage diabetes and its complications in similar settings. Rapid review registration OSF: osf.io/h5wgr

show abstract

The Diabetic Retinopathy Barometer Study: Global perspectives on access to and experiences of diabetic retinopathy screening and treatment

Cited by 76 publications

References 11 publications

Outcomes in diabetic macular edema switched directly or after a dexamethasone implant to a fluocinolone acetonide intravitreal implant following anti-VEGF treatment

Outcomes in diabetic macular edema switched directly or after a dexamethasone implant to a fluocinolone acetonide intravitreal implant following anti-VEGF treatment

Cognitive dysfunction: A growing link between diabetes and Alzheimer's disease

Effectiveness of task-shifting for the detection of diabetic retinopathy in low- and middle-income countries: a rapid review protocol.

Contact Info

Product

Resources

About