The Role of Glycemic Control and Variability in Diabetic Retinopathy

Chatziralli, Irini

doi:10.1007/s13300-017-0345-5

Cited by 34 publications

(36 citation statements)

References 21 publications

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“…In our study, to evaluate glucose variability, the SD for the average blood glucose (BG) level was measured within the two weeks prior to the HD-OCT study. However, it correlated positively only with macular center thickness confirming earlier reports of the effect of glucose fluctuations on the DR presence accompanied by DME [24,25].…”

Section: Discussionsupporting

confidence: 87%

The HD-OCT Study May Be Useful in Searching for Markers of Preclinical Stage of Diabetic Retinopathy in Patients with Type 1 Diabetes

et al. 2019

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The aim of the study was to analyze the thickness of individual retinal layers in patients with type 1 diabetes (T1D) in comparison to the control group and in relation to markers of diabetes metabolic control. The study group consisted of 111 patients with an average of 6-years of T1D duration. The control group included 36 gender- and age-matched individuals. In all patients optical coherence tomography (OCT) study was performed using HD-OCT Cirrus 5000 with evaluation of optic nerve head (ONH) parameters, thickness of retinal nerve fiber layer (RNFL) with its quadrants, macular full-thickness parameters, ganglion cells with inner plexus layer (GCIPL) and choroidal thickness (CT). Lower disc area value was observed in the study group as compared to controls (p = 0.0215). Negative correlations were found both between age at examination and rim area (R = −0.28, p = 0.0007) and between superior RNFL thickness and duration of diabetes (R = −0.20, p = 0.0336). Positive correlation between center thickness and SD for average glycemia (R = 0.30, p = 0.0071) was noted. Temporal CT correlated positively with age at examination (R = 0.21, p = 0.0127). The selected parameters the HD-OCT study may in the future serve as potential markers of preclinical phase of DR in patients with T1D.

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Section: Discussionsupporting

confidence: 87%

The HD-OCT Study May Be Useful in Searching for Markers of Preclinical Stage of Diabetic Retinopathy in Patients with Type 1 Diabetes

et al. 2019

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“…Diabetic retinopathy (DR) is a complication of diabetes that affects the eyes in subjects with type 1 or type 2 diabetes mellitus [ 1 ]. DR develops because of a chronic abnormality of glycemic control [ 2 ]. In detail, DR progresses from an initial stage where high blood glucose levels damage the microvasculature [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

PPARα Agonist Oral Therapy in Diabetic Retinopathy

2020

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Diabetic retinopathy (DR) is an eye condition that develops after chronically poorly-managed diabetes, and is presently the main cause for blindness on a global scale. Current treatments for DR such as laser photocoagulation, topical injection of corticosteroids, intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents and vitreoretinal surgery are only applicable at the late stages of DR and there are possibilities of significant adverse effects. Moreover, the forms of treatment available for DR are highly invasive to the eyes. Safer and more effective pharmacological treatments are required for DR treatment, in particular at an early stage. In this review, we cover recently investigated promising oral pharmacotherapies, the methods of which are safer, easier to use, patient-friendly and pain-free, in clinical studies. We especially focus on peroxisome proliferator-activator receptor alpha (PPARα) agonists in which experimental evidence suggests PPARα activation may be closely related to the attenuation of vascular damages, including lipid-induced toxicity, inflammation, an excess of free radical generation, endothelial dysfunction and angiogenesis. Furthermore, oral administration of selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα) agonists may induce hepatic fibroblast growth factor 21 expression, indirectly resulting in retinal protection in animal studies. Our review will enable more comprehensive approaches for understanding protective roles of PPARα for the prevention of DR development.

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“…Indeed, clinicians should strictly consider DR as a complication of diabetes, warranting a strict management of metabolic clinical outcomes. In this perspective, ophthalmologists should recommend to DR patients a correct management of glycemia and rigid compliance with diabetes therapy [ 48 , 49 ]. Furthermore, in DR management it would be useful to monitor not only the macular edema and retinal fundus, but also clinical laboratory parameters such as HbA1c, and possibly TGFβ1 serum levels.…”

Section: Discussionmentioning

confidence: 99%

TGF-β Serum Levels in Diabetic Retinopathy Patients and the Role of Anti-VEGF Therapy

Bonfiglio

Platania

Lazzara

et al. 2020

IJMS

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Transforming growth factor β1 (TGFβ1) is a proinflammatory cytokine that has been implicated in the pathogenesis of diabetic retinopathy (DR), particularly in the late phase of disease. The aim of the present study was to validate serum TGFβ1 as a diagnostic and prognostic biomarker of DR stages. Thirty-eight subjects were enrolled and, after diagnosis and evaluation of inclusion and exclusion criteria, were assigned to six groups: (1) healthy age-matched control, (2) diabetic without DR, (3) non-proliferative diabetic retinopathy (NPDR) naïve to treatment, (4) NPDR treated with intravitreal (IVT) aflibercept, (5) proliferative diabetic retinopathy (PDR) naïve to treatment and (6) PDR treated with IVT aflibercept. Serum levels of vascular endothelial growth factor A (VEGF-A), placental growth factor (PlGF) and TGFβ1 were measured by means of enzyme-linked immunosorbent assay (ELISA). Foveal macular thickness (FMT) in enrolled subjects was evaluated by means of structural-optical coherence tomography (S-OCT). VEGF-A serum levels decreased in NPDR and PDR patients treated with aflibercept, compared to naïve DR patients. PlGF serum levels were modulated only in aflibercept-treated NPDR patients. Particularly, TGFβ1 serum levels were predictive of disease progression from NPDR to PDR. A Multivariate ANOVA analysis (M-ANOVA) was also carried out to assess the effects of fixed factors on glycated hemoglobin (HbA1c) levels, TGFβ1, and diabetes duration. In conclusion, our data have strengthened the hypothesis that TGFβ1 would be a biomarker and pharmacological target of diabetic retinopathy.

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The Role of Glycemic Control and Variability in Diabetic Retinopathy

Cited by 34 publications

References 21 publications

The HD-OCT Study May Be Useful in Searching for Markers of Preclinical Stage of Diabetic Retinopathy in Patients with Type 1 Diabetes

The HD-OCT Study May Be Useful in Searching for Markers of Preclinical Stage of Diabetic Retinopathy in Patients with Type 1 Diabetes

PPARα Agonist Oral Therapy in Diabetic Retinopathy

TGF-β Serum Levels in Diabetic Retinopathy Patients and the Role of Anti-VEGF Therapy

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