Presentation
This study, “Association Between Obstructive Sleep Apnea and DME in Patients With Type 2 Diabetes,” was presented by Juifan Chiang at AAO 2019. [mdmag.com]
DRCR.net Protocol T based on presenting vision ( 8 ) Full table Many patients on anti-VEGFs, however, still require macular laser photocoagulation. [aes.amegroups.com]
I decide on the treatment depending on clinical, angiographic and tomographic presentations. [elsevier.es]
Presented at Subspecialty Day, American Academy of Ophthalmology. ; November 2015., Las Vegas, NV.. Singer MA. Results of the Optimeyes phase 2 study. Presented at World of Ophthalmology Congress. ; February 2016. ; Guadalajara, Mexico.. [healio.com]
Retinal neuronal abnormalities are present well before the retinal microvascular injury. [eyewiki.aao.org]
Entire Body System
- Rigor
As a consequence of recent rigorous clinical trials, laser photocoagulation is no longer recommended for the treatment of diabetic macular edema (DME), and anti-vascular endothelial growth factor therapy has emerged as first-line therapy. [karger.com]
Eyes
- Cotton Wool Spots
Cotton wool spots represent focal areas of retinal ischemia. Nonproliferative disease progresses to proliferative retinopathy when neovascularization develops. [mdedge.com]
Soft exudates, otherwise termed cotton wool spots, arise when there is a block in the flow of axoplasm in the retinal nerve fiber layer which occurs due to focal ischemia. [karger.com]
Workup
[…] with diabetic nephropathy should be observed more closely Lipid and triglyceride levels: Elevated triglyceride and lipid levels increase the risk of retinopathy, while normalization of lipid levels reduces retinal leakage and deposition of exudates See Workup [emedicine.medscape.com]
Timing of ocular therapy on the other hand is very important, suggesting early ocular intervention and systemic workup should not substantially delay retinal therapy. [karger.com]
Treatment
Treatment Treatment is focused on reestablishing BRB, modulating inflammatory and angiogenic factors. [elsevier.es]
These studies demonstrate a significant increase in accuracy, which in synergy with a more complete treatment has been basis for a faster onset of the treatment effect and an overall reduction in laser re-treatments. [od-os.com]
The US Food and Drug Administration (FDA) approved Lucentis for the treatment of diabetic macular edema in August 2012. [clinicaltrialsarena.com]
Diabetic retinopathy treatment: Lasers Laser treatment of diabetic eye disease generally targets leaking blood vessels or damaged tissue in the retina. [allaboutvision.com]
[…] the treatment of patients with DMO. [aes.amegroups.com]
Prognosis
Conclusion: DME exhibits five different morphologic patterns on OCT having different prognosis values. Correlation between macular morphology and function was obvious. [omicsonline.org]
Although laser therapy slows the progression of vision loss in patients with DME, it rarely results in improvement of vision. 10 With the advent of intravitreal pharmacologic agents, the prognosis of DME has changed from stabilization to improvement of [retinatoday.com]
The fact that female patients had a poorer BCVA prognosis in our study we put down to chance. No other study has documented this issue. [journals.plos.org]
Prognosis Untreated, diabetic macular oedema is a sight threatening condition. It is more likely to progress and cause vision loss in diabetics with sub-optimal diabetes control. [healthengine.com.au]
[…] intraocular pressure Cataract (common after steroid intravitreal injections) Glaucoma (common after steroid intravitreal injections) PPV Retinal tears and retinal detachment Vitreous hemorrhage Elevated intraocular pressure Endophthalmitis Cataract Prognosis [eyewiki.aao.org]
Etiology
Diabetic Macular Edema Disease Diabetic Macular Edema (DME) [1] Etiology Chronic hyperglycemia is the major risk factor of diabetic macular edema. [eyewiki.aao.org]
Corticosteroid agents Background VEGF certainly plays a major role in the etiology of DME; however, other factors are at play. [touchophthalmology.com]
Epidemiology
According to the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), diabetic retinopathy will affect 99% of patients with type 1 DM (T1DM) and 60% of patients with type 2 DM (T2DM) after 20 years of having diabetes. 4 Diabetic retinopathy [mdedge.com]
A study by Wisconsin Epidemiologic observed that over a 10-year period, more than 19% of people with diabetes were diagnosed with diabetic macular oedema. [clinicaltrialsarena.com]
The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984 ; 91 : 1464 - 74. 3. Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. [smj.org.sg]
Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis. 2015;2:17. 3. Das A, McGuire PG, Rangasamy S. Diabetic macular edema: pathophysiology and novel therapeutic targets. Ophthalmology. 2015;122:1375–94. 4. [nature.com]
The Wisconsin Epidemiologic Study of Diabetic Retinopathy found that approximately 20% of patients with T1DM and 14% to 25% of patients with T2DM developed DME over 10 years. [ajmc.com]
Pathophysiology
Fluorescent angiography (FAG) is a contrast study which confirms the presence of DME and classifies it as focal and diffuse, which guides the pathophysiology. [elsevier.es]
Diabetic macular edema: pathophysiology and novel therapeutic targets. Ophthalmology. 2015;122:1375–94. 4. Nguyen QD, Brown DM, Marcus DM, Boyer DS, Patel S, Feiner L, RISE and RIDE Research Group. et al. [nature.com]
The duration of diabetes and the integrated elevation of blood glucose reflected in the glycated hemoglobin (HbA1C) have proven pathophysiological importance. [ijo.in]
In both DR and DME, chronic hyperglycemia causes an upregulation of vascular endothelial growth factor (VEGF), thus increasing vascular permeability and increased angiogenesis. 5,22-25 While the underlying pathophysiology of DME is VEGF mediated, there [ajmc.com]
Pathophysiology The exact pathogenesis of DME is still unclear. Recent evidence indicates that diabetic retinopathy (DR) is a neurovascular disease of the retina. [eyewiki.aao.org]
Prevention
Detecting DME early during a retina eye exam and before symptoms develop is the best way to prevent vision loss. How can DME be prevented? Three Key Tips for Preventing DME 1. Know the vital numbers: blood sugars, blood pressure, and weight. 2. [diatribe.org]
Early detection is the best way to prevent vision loss. [healthline.com]
Prevention Control blood pressure Control blood sugar Control lipid levels Follow eye exam schedule Regular dilated eye exams may not prevent diabetic retinopathy, but it certainly can reduce the risk of developing more severe complications from the disease [ceenta.com]
To reduce the risk of glaucoma, your eye doctor might recommend preventive use of glaucoma eye drops or even glaucoma surgery. [allaboutvision.com]
Keeping your glycemic levels as close to normal as possible may delay or even prevent the development of DR and DME. [iluvien.com]