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

The effect of chronic changes in serum glucose concentration on refraction was studied by increasing the dose of insulin or chlorpropamide in 10 diabetic patients who initially had relatively high glucose concentrations. In every case when serum glucose concentration was reduced the vision became less myopic or more hyperopic. To assess acute changes. 10 diabetics (including four with aphakic eyes) were given an intravenous injection of glucose. In patients with intact lenses the vision became more myopic or less hyperopic following the administration of glucose, but in the aphakic eyes hyperopia increased. It is concluded from both the acute and chronic studies that higher levels of serum glucose concentration produce myopia and lower levels produce hyperopia. Furthermore, these changes are related to changes in the optical properties of the crystallin lens.
Diabetes 1976 Jan
PMID:Relationship of serum glucose concentration to changes in refraction. 124 66

The influence of diabetic dysregulation on refraction was analysed by a short-term and a long-term approach. a) Out of 15 patients admitted due to high blood sugars and followed over weeks, 11 showed refractive fluctuation of 1-6.5 D, in either direction-often with excess hypermetropia, while 4 appeared refractively stable. In those with refractive change a transient increase of lens thickness was suggested from ultrasound measurements. b) Diabetes control was evaluated retrospectively in 74 adult diabetics, mainly based on repeated 24 h urine glucose determinations over a 6-year period. As a group, those with low myopia did not score worse than those who had stayed emmetropic. Among the myopes, diabetes duration was longer in the subgroup where diabetes preceded myopia onset. - All considered, we found no support for dysregulation per se as an underlying factor behind the 'diabetic myopia' previously reported from our clinic.
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PMID:Refraction in diabetics during metabolic dysregulation, acute or chronic. With special reference to the diabetic myopia concept. 239 2

This discussion reviews drugs that affect the eye, including antihyperglycemic agents; corticosteroids; antirheumatic drugs (quinolines, indomethacin, and allopurinol); psychiatric drugs (phenothiazine, thioridazine, and chlorpromazine); drugs used in cardiology (practolol, amiodarone, and digitalis gylcosides); drugs implicated in optic neuritis and atrophy, drugs with an anticholinergic action; oral contraceptives (OCs); and topical drugs and systemic effects. Refractive changes, either myopic or hypermetropic, can occur as a result of hyperglycemia, and variation in vision is sometimes a presenting symptom in diabetes mellitus. If it causes a change in the refraction, treatment of hyperglycemia almost always produces a temporary hypermetropia. A return to the original refractive state often takes weeks, sometimes months. There is some evidence that patients adequately treated with insulin improve more rapidly than those taking oral medication. Such patients always should be referred for opthalmological evaluation as other factors might be responsible, but it might not be possible to order the appropriate spectacle correction for some time. The most important ocular side effect of the systemic adiministration of corticosteroids is the formation of a posterior subcapsular cataract. Glaucoma also can result from corticosteroids, most often when they are applied topically. Corticosteroids have been implicated in the production of benign intracranial hypertension, which is paradoxical because they also are used in its treatment. The most important side effect of drugs such as chloroquine and hydroxychloroquine is an almost always irreversible maculopathy with resultant loss of central vision. Corneal and retinal changes similar to those caused by the quinolines have been reported with indomethacin, but there is some question about a cause and effect relationship. The National Registry of Drug Induced Ocular Side Effects in the US published 30 case histories of cataract suspected to be induced by allopurinol; numerous additional cases have been reported to the registry since. Phenothiazine, with an estimated 3% incidence of side effects, appears to be safer than other antipsychotic drugs, but the rate of ocular effects increases with the duration of therapy. Thioridazine and chlorpromazine are known to cause lens deposits and pigmentary retinopathy. There is a significantly high prevalence of thrombophlebitis and pseudotumor cerebri among women who use OCs and thrombotic retinal vascular disease, such as retinal vein occulsion, might be linked with them. It also is probable that, because of altered hydration of the cornea, there is a decreased tolerance to contact lenses.
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PMID:Drugs affecting the eye. 286 12

Diabetes causes cataract and certain physical changes in the lens. The diabetic lens is larger than the non-diabetic and shows greater light scatter and fluorescence. Both hyperglycaemia and lowering of blood glucose case refractive changes and hypermetropia is the most common. Classical 'snow-flake' juvenile cataract associated with hyperglycaemia is now rare. It has an osmotic mechanism. Diabetes is a risk factor for cataract in adults which is duration dependent, more frequent in women and leads to earlier surgery. It resembles non-diabetic senile cataract. Extracapsular cataract extraction is the method of choice for diabetic cataract with a better visual result and less risk of rubeosis iridis. A posterior chamber implant may still permit retinal photocoagulation if necessary. Diabetic retinopathy is still the leading cause of blindness in the working age group. The beneficial effect of photocoagulation has been shown by randomized controlled trials to be long-lasting for both proliferative retinopathy and maculopathy. Therefore there is a need for screening, especially for those with proliferative disease which may be present without symptoms. A knowledge of risk factors will enhance detection rate with duration as the strongest determinant for retinopathy. Any screening modality should be highly sensitive as well as specific. The role of different professionals as potential screeners should be considered. Adequate provisions include facilities for checking vision and for dimming ambient lighting. Mydriasis and a good ophthalmoscope light will increase detection rate. The use of a 45 degrees non-mydriatic camera is unlikely to supplant the use of an ophthalmoscope as a single field is likely to miss important lesions. A 60 degrees camera may confer a large enough field and the use of transparencies will provide magnification when films are projected but the camera is more difficult to use. A list of features chosen by a recent study to characterize sight-threatening retinopathy is included and their presence indicates the need for referral to an ophthalmic clinic for treatment or close observation.
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PMID:Cataract and retinopathy: screening for treatable retinopathy. 309 17

Scheimpflug photography of lenses with transient hypermetropia in cases of diabetes mellitus revealed an enlargement of the axial diameter of the cortex and especially of the nucleus of the lens. This transient hypermetropia is thought to stem from a decrease in the refractive index of the lens cortex and nucleus.
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PMID:[Evaluation of Scheimpflug photographs in transitory hypermetropia]. 331 65

For generations it has been taught that myopic change is the principal response to hyperglycaemia in diabetes mellitus. Recently, however, a hyperopic concept has been advanced, to suggest that a change towards hypermetropia has possibly become the more frequent finding in diabetics with unstable refraction. The present sample comprises 32 cases of newly discovered diabetes and 40 cases of long duration, most cases being insulin-dependent. Of the former 47% showed a refractive change around the recognized onset of diabetes, in some cases prior to detection and admission, but mostly after institution of insulin therapy; in 14/15 the change was towards hypermetropia. Of the longstanding cases 20% showed refractive change (while 80% did not) in association with poor metabolic control, equally towards myopia/hypermetropia. It was not possible to point out an association with specific patterns of metabolic dysregulation. The results are further discussed in relation to previous refraction studies demonstrating an increased myopia prevalence in diabetics in general, as compared to non-diabetics. Apparently this cannot be explained merely by a possibly overlooked transient refractive change under periods of poor metabolic control.
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PMID:Refractive change in diabetes mellitus around onset or when poorly controlled. A clinical study. 355 82

A case-control study of 225 patients with branch retinal vein occlusion (BRVO) and 100 age-matched controls was conducted to assess potential clinical risk factors for BRVO. Male gender, hypertension, and hyperopia were significantly more prevalent in patients with BRVO. There was no significant association with race, diabetes, or chronic open-angle glaucoma.
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PMID:Risk factors of branch retinal vein occlusion. 407 73

The rabbit eye is hyperopic by approximately 4D. The induction of diabetes leads to a further enhancement in the degree of hyperopia. This enhancement is attenuated substantially by flavonoids as inhibitors of aldose reduction. The development of refractive changes in diabetic lens involves aldose reductase catalyzed polyol synthesis.
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PMID:Refractive change in alloxan diabetic rabbits. Control by flavonoids I. 678 22

The case of a 45-year-old woman with gyrate atrophy of the choroid and retina is documented. Additional features in this case, to the authors' knowledge not previously described in gyrate atrophy, are massive cystinuria, massive lysinuria, axial hypermetropia and diabetes. Gyrate atrophy is a rare autosomal recessive degenerative disease of the choroid and retina and is accompanied by defective ornithine metabolism. Simell and Takki demonstrated the association with hyperornithinaemia in 1973. The main metabolic features are those of hyperornithinaemia and ornithuria caused by a deficiency of the mitochondrial matrix enzyme, ornithine aminotransferase (OAT). The responsible human gene has been localised to chromosome 10. Despite the generalised deficiency of OAT, the literature indicates significant pathological involvement of the eye only. Ophthalmological features of the disease are myopia (up to 10-20 dioptres), night blindness, constricted visual fields and complicated cataracts. The clinical picture has been detailed previously by various authors. The case of a 45-year-old woman with gyrate atrophy and hyperornithinaemia is documented here. She has been followed up for 12 years and fully investigated. Additional features in this case, to our knowledge not previously described in gyrate atrophy, are massive cystinuria, massive lysinuria, axial hypermetropia and diabetes.
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PMID:Gyrate atrophy of the choroid and retina with hyperornithinaemia, cystinuria and lysinuria. 795 31

The clinical courses of 10 eyes of five diabetic patients who exhibited bilateral transient hyperopia (maximum: 1:1-4.9 dioptres, spherical equivalent) after initiation of strict control of diabetes with or without insulin are reported. The hyperopia occurred within a few days after abrupt decrease in plasma glucose, progressed to maximum at days 7-14, and regressed gradually over 1 month thereafter. Transient cycloplegia had no effect on refractive error. During hyperopia, there were no significant changes in axial length or corneal curvature. However, thickened lens, decreased anterior chamber depth, and transient cataract were observed to significant degrees. It is suggested that the transient hyperopia, with lens swelling and opacity, was caused by decreased lens refractive index following water influx.
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PMID:Transient hyperopia with lens swelling at initial therapy in diabetes. 845 4


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