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Query: UMLS:C0011849 (diabetes)
 277,896 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Using the age-sex-specific data collected in the Framingham Heart Study 1948--1964 together with ophthalmic diagnoses made in the Framingham Eye Study in 1973--1975, the following variables were found to be associated with senile cataract: education, casual blood sugar, systemic blood pressure, height, vital capacity, serum phospholipid and hand strength; with senile macular degeneration: systemic blood pressure, height, vital capacity, left ventricular hypertrophy, hand strength and history of lung infection; with diabetic retinopathy: casual blood sugar, urine sugar and other specific elements of diabetes; with ocular hypertension: systemic blood pressure, height, casual blood sugar and pulse rate. No variables were identified as associated with open-angle glaucoma. The paper stresses the need for corroboration of these findings, which may be a mix of real and chance associations, and the need for additional analyses before any of these associations are considered evidence of factors related to risk of ophthalmic disease.
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PMID:The Framingham Eye Study. II. Association of ophthalmic pathology with single variables previously measured in the Framingham Heart Study. 14 82

The widespread use of corticosteroids in clinical practice emphasises the need for a thorough understanding of their metabolic effects. In general, the actions of corticosteroids on carbohydrate, protein, and lipid metabolism result in increased hepatic capacity for gluconeogenesis and enhanced catabolic actions upon muscle, skin, lymphoid, adipose and connective tissues. Because of the morbidity associated with steroid therapy, the clinician must carefully consider in each case the gains that can reasonably be expected from corticosteroid therapy versus the inevitable undesirable side effects of prolonged therapy. Thus, it is important to remember that the enhanced anti-inflammatory activity of the various synthetic analogues of cortisol is not dissociated from the expected catabolic actions of glucocorticoid hormones. Replacement therapy with physiological doses of cortisol in primary or secondary adrenal insufficiency is intended to simulate the normal daily secretion of cortisol. Short term, high dose suppressive glucocorticoid therapy is indicated in the treatment of medical emergencies such as necrotising vasculitis, status asthmaticus and anaphylactic shock. With improvement of the underlying disorder, the steroid dosage can be rapidly tapered and then discontinued over a 2 to 3 day period. Long term, high dose suppressive therapy is often commonly used to treat certain diseases (see sections 4.7.2 and 4.7.3). In this setting, suppression of the hypothalamic-pituitary-adrenal axis may persist for as long as 9 to 12 months following steroid withdrawal if steroid doses are administered in the supraphysiological range for longer than 2 weeks. In general, higher doses, longer duration of usage, and frequent daily administration are all correlated with the severity of pituitary ACTH suppression. When steroid therapy is to be withdrawn, gradual tapering of the dosage is necessary; the steroid dosage should also be given as a single morning dose if possible. Rapid or total withdrawal of the steroid therapy may be associated with exacerbation of the underlying disease or with a steroid withdrawal syndrome. An additional important point to remember in any withdrawal programme is that the steroid dosage should be appropriately increased for an exacerbation of the underlying disease or for intercurrent major stress. Alternate day therapy is recommended as a steroid maintenance programme for patients requiring high dose glucocorticoid therapy over a prolonged period of time. Thus, it is usually employed to maintain a therapeutic benefit which had previously been extablished by daily steroid treatment. Complications resulting from corticosteroid therapy include: (1) proximal muscle weakness; (2) osteopenia; (3) unmasking of latent diabetes mellitus; (4) sodium retention and/or elevation of mean arterial blood pressure; (5) adverse psychiatric reactions; (6) development of glaucoma; and (7) reactivation of latent infections (such as tuberculosis).
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PMID:Corticosteroids: clinical pharmacology and therapeutic use. 20 58

The analysis of IgE in aqueous humor yielded an average concentration of 3.4 +/- 0.97 U/ml for 22 cataract patients and 5.5 +/- 3.42 U/ml for five uveitis patients. The IgE level in aqueous humor (IgEa.h.) of the cases examined is most probably, beside hematoocular diffusion of serum IgEs, the result of intra-ocular IgE production. In comparison with (mostly normal) IgEs levels, the IgEa.h. concentration appears relatively elevated, not only with uveitis patients, but also with cataract patients, above all when lenticular opacity is accompanied by other ophthalmic diseases (glaucoma, high myopia, diabetes). This "increase" of IgEa.h. concentration in very probably due to the radioimmunosorbent (RIST) technique employed, the most sensitive method available at the time of the present study. Thus, the calculated IgEa.h. value in the cataractous eyes should be regarded simply as approximate to the normal IgEa.h. concentration. These values are of clinical significance however, since a reference IgEa.h. mean-value is indispensable to the interpretation of pathologically high IgEa.h. levels and ethics do not permit of IgEa.h. determination in healthy eyes. The mean IgEa.h. levels of the delayed-type uveitis and cataract patients examined reveal no significant differences. IgEa.h. determination could make a contribution to the etiological clarification of, for example, immediate-type uveitis cases and intra-ocular parasitosis and serve as an appropriate model to study intra-ocular immunomechanisms.
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PMID:Immunoglobulin E in human aqueous humor and corresponding serum. A physiopathological and clinical study. 31 97

Some hypothesized risk factors in chronic open-angle glaucoma were investigated in a sample of 87 patinets with glaucoma and 87 matched controls. A significant positive association was found with diabetes, a systolic blood pressure/intraocular pressure (BP/IOP) ratio less than 5.75, and the taking of medication for systemic hypertension. No significant association was found with a history of smoking or an elevated systemic blood pressure. Analysis indicates that the systolic BP/IOP index may be useful as a screening test for the detection of glaucoma in samples where the prevalence of glaucoma is high.
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PMID:Relative risk factors in chronic open-angle glaucoma: an epidemiological study. 32 56

For the last 10 years 500 iridencleisis and 250 trepanotrabeculectomies were performed. For this study are subjected only 205 cases of basal and total iridencleisis and 100 cases of trepanotrabeculectomy, performed in chronic open and chronic closed angle glaucoma. The authors point out that some common factors play the role on the final results, independently of the type of the operation. It was observed that the results were worse in patients having the diabetes and/or arterial hypertension, when the operation is performed in the advanced age or in the late stage of glaucoma, and also if the eye was already operated. To evaluate the result of the operations (basal and total iridencleisis, trepanotrabeculectomy) the authors estimate that is not enough to take the intraocular tension as the unic parameter, one should take in consideration also the visual field, visual acuity and also the state of the optic disc in the follow-up period (see Tbl. 4). This period should not be shorter than one year. With the trepanotrabeculectomy (85%) and with total iridencleisis (86,5%) the intraocular tensions could be normalised in the higher percentage than with the basal iridencleisis (75,5%). On the other hand, if one take also the other parameters for the evaluation (visual field, visual acuity, status of the optic disc) one could conclude that the best result was achieved with trepanotrabeculectomy (80% the complete consolidation), and than with total iridencleisis (69,4%) or basal iridencleisis (67%). In trepanotrabeculectomy the peroperative and postoperative complications are rare.
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PMID:[Comparative results of trepanotrabeculectomy and iridencleisis in primary glaucoma]. 44 10

In 3 patients a spontaneous haemorrhage in the anterior chamber originated from vascular tufts at the pupillary border. These vascular tufts were hardly visible by slitlamp observation, but could be visualized well with fluorescein angiography. The patients were aged 50 years or more and in 2 of them the vascular tufts were found in both eyes. The haemorrhages disappeared spontaneously under conservative therapy and only in 1 case caused a transient glaucoma. Of 115 randomly chosen out-patients, 4 cases were found with the same vascular tufts on the pupillary border, but without any symptom. All the patients who had vascular tufts, with or without haemorrhage in the anterior chamber, were in the sixth decade or older. We think that these vascular lesions are caused by cardiovascular diseases and by elevated venous pressure caused by intrathoracic processes. Diabetes and intraocular diseases were excluded in our patients.
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PMID:Vascular tufts of the pupillary border causing a spontaneous hyphaema. 53 May 46

Within medical diagnostic "check-up" programs intraocular pressure measurements by applanation tonometry from 8899 patients (5924 men, 66.6%; 2975 women, 33.4%) were statistically evaluated. The frequency of each i.o. pressure show no Gaussian distribution but is skewed to the right with marked excess to higher values of i.o. pressure. Correlation of mean i.o. pressure with age shows (starting in the group of the 20-24 years old to the 75-79 years old persons) a rather linear progression of i.o. pressure. The mean value of i.o. pressure (n = 17,798 eyes) was x = 16.25 mm Hg, the standard deviation +/- 3.45, the standard deviation of the mean +/- 0.03 mm Hg. In men in 2.18% in women in 1.81% higher i.o. pressure than 21 mm Hg was found. I.o. pressure higher than 24 mm Hg have 0.66% of the men and 0.58% of the women. Patients forty years old and elder showing in 4.92% of the men and 4.88% of the women higher i.o. pressure than 21 mm Hg. In patients fifty-five years old and elder in 5.75% of the men and respectively in 6.69% of the women i.o. pressure higher than 21 mm Hg was found. Incidences of elevated i.o. pressure from patients over forty years old in ten years steps are presented. In 103 patients with unilaterally i.o. pressure higher than 24 mm Hg 12% presents manifest diabetes mellitus. The usefullness of applanation tonometry as a practicable screening method for early glaucoma detection within medical diagnostic "check-up" programs is outlined. Advantages of data-aquisition and -processing systems to continue those studies are emphasized.
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PMID:[Applanation tonometry within medical diagnostic "check-up" programs (author's transl)]. 63 67

In 66 patients with a rubeosis iridis due to diabetes mellitus (25), old central retinal vein occlusion (22), long-standing secondary angle-closure glaucoma (6), total old retinal detachment (3) and chronic uveitis (10), iris angiography was performed. Typical angiographical findings were found in some of the cases. One can differentiate the different modes of formation of the new vessels; angiographically, rubeosis iridis is never a congestion of preexisting vessels but rather an active vascular proliferation which is always permeable to fluorescein.
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PMID:[Irisangiography of rubeosis iridis]. 63 61

Twenty-six of 75 eyes undergoing pars plana vitrectomy developed significant corneal complications requiring treatment. Slow or nonhealing epithelial abrasions, recurrent corneal erosion, and microcystoid and striate keratitis were among the most frequent problems. Significant predisposing factors included diabetes, surgical trauma such as epithelial debridement and prolonged operative time, aphakia, and postoperative glaucoma or hyphema. Corneal complications may be minimized with careful preoperative and operative precautions.
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PMID:Postvitrectomy keratopathy. 65 44

To minimize the risk of visual loss in diabetic patients, recognition of early signs of oculopathy is essential. Diabetes-associated third-nerve palsy is manifested by unilateral ptosis and exotropia. Symptoms of closed-angle glaucoma are intense pain, halos around lights, and blurred vision. Open-angle glaucoma does not necessarily produce symptoms and is treated medically. A gradual decrease in visual acuity, sometimes associated with photophobia and difficulty in night driving, and monocular diplopia, are manifestations of cataract. The patient with "background" retinopathy usually complains of blurred or distorted central vision. Once the macula is involved, vision progressively decreases. Although the relationship of metabolic control to retinopathy has not been settled, evidence indicates that good medical control of the disease may delay onset of vascular complications.
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PMID:Four common ocular complications of diabetes--and how to treat them. 71 Aug 91


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