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

Expulsive choroidal haemorrhage is a dramatic and serious complication of cataract surgery that occurred in five patients out of ten thousand consecutive cataract surgeries performed by the author during the year 1989 and 1990. Report about this dreaded complication after cataract surgery are scanty and as far as I can remember I have not seen any report in Indian ophthalmic literature recently. Since cataract surgery forms the major part of intra ocular surgeries performed in our country, I thought it would be appropriate to report about this rare complication which may occur to all of us. Out of five cases 3 were males and 2 were females in the age group ranging between 45-72 years. Two eyes regained vision up to 6/12 after intra operative expulsive haemorrhage. All the eyes were salvaged by doing anterior sclerotomy. Diabetes, hypertension, glaucoma and myopia are the commonest predisposing factors.
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PMID:Expulsive choroidal haemorrhage. 130 Feb 98

Senile cataract is the major cause of curable blindness in Tunisia (51%). Other factors than advanced age seem to play a role in senile cataract. The simultaneous of senile cataract with the trachoma makes the surgical operation problematic. In order to evaluate the frequency of such risk factors, we have realized a prospective study in two groups of patients recruited in 4 hospitals centers in Tunisia. The two groups of patients were homogenous regarding to age (more than 45 old year) sex and geographic origins. Cataract was present in the first group (287), but not in the second group (169) risk factors which were evidenced are: diabetes or abnormal glucose test tolerance, high systemic blood pressure, especially diastolic, low education and non professional occupation, family history of cataract. Evolutive trachoma was found in 5.1% of cases compared to only 0.6% in controls (p = 0.02). Trachoma sequela were found in the two groups. The importance of an evaluation of such risk factors in senile cataract is raised.
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PMID:[Senile cataract and trachoma in Tunisia]. 134 67

Chromium (Cr) is of known biological importance, necessary for the maintenance of normal glucose metabolism. There is a lower level of blood Cr concentrations in cases of diabetes. Diabetes carries a risk of cataract development, so the potential effects of Cr on the eye may need to be studied in more depth. The presence of this trace element in both normal and cataractous human lenses has to our knowledge not been investigated so far. The concentration of total Cr in 61 human lenses and 38 blood samples was determined by electrothermal atomic absorption spectrometry with Zeeman effect (EAASZ). Analysis of the levels of Cr in human lenses shows a significant difference between normal and diabetic populations, and an absence of difference between senile and diabetic populations.
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PMID:A study of chromium in human cataractous lenses and whole blood of diabetics, senile, and normal population. 137 49

Diabetes is known to be associated with an increase in aldose reductase activity, platelet hyperaggregability, lipid peroxidation, and cataract formation. A molecule, D-myo-inositol 1,2,6-trisphosphate (PP-56), derived from phytic acid, could in principle, by supplying myoinositol to tissues and acting as an antioxidant, counteract some of the manifestations of diabetes. Thus, the effects of PP-56 on platelet aggregation, fatty acids, and polyols were investigated in uncontrolled streptozotocin-induced diabetes in rat in relation to cataract and lipid peroxidation. A decrease in the response of platelet aggregation to thrombin and ADP (P less than 0.05, P less than 0.001) and in the level of sorbitol and the ratio sorbitol/myo-inositol (P less than 0.01) in platelets was observed in the rats treated by PP-56 for 7-8 weeks. These beneficial effects were associated with an incidence of cataract reduced by 26 to 44% (P less than 0.05 to P less than 0.001) depending on the duration of treatment. They were also accompanied by a significant lower plasma level of malondialdehyde (P less than 0.05), and, more markedly, of conjugated dienes (P less than 0.001) as well as an increase in platelet lipids of the 20:4(n-6)/20:3(n-6) ratio, an index of delta 5 desaturase activity. PP-56 appears to modulate fatty acid desaturases and aldose reductase in platelets and delay by a few weeks the development of cataract in this acute model of diabetes.
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PMID:Effect of D-myo-inositol on platelet function and composition and on cataract development in streptozotocin-induced diabetic rats. 138 35

Cataract is responsible for 50% of world blindness, with at present an estimated backlog of 13.5 million cases in need of surgery. Low-cost cataract surgery must be made more available in developing countries, making use of alternative approaches for outpatient surgery and optimal management of available resources. Trachoma control needs to be targeted at the worst affected areas in endemic countries, with more emphasis on behavioural, educational and community aspects of the disease. Vitamin A deficiency and xerophthalmia control are becoming matters of maternal and child health care, with early intervention during infancy in view of the mortality issue. There are good prospects for the prevention of blindness from onchocerciasis, through the availability of ivermectin, but large-scale distribution schemes are still needed in most of the African countries concerned. The early detection and management of open-angle glaucoma still poses a major problem in developing countries, and further development of appropriate technology is needed in this field. Another area where more efforts are needed is ocular trauma, which is commonly the cause of unilateral loss of vision. General preventive measures must be enforced and better training provided to health personnel to deal competently with such cases, in order to prevent late complications. Diabetes, finally, is on the increase in many developing countries, giving rise to problems in dealing effectively with the ensuing retinopathy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Present challenges in the global prevention of blindness. 138 40

Following routine extracapsular cataract and posterior chamber implant surgery, recovery of the blood aqueous barrier (BAB) was quantified by sequential anterior chamber fluorophotometry. This was correlated with surgical details and postoperative findings to ascertain those factors which were related to excessive damage of the BAB immediately after surgery and to failure to recover a normal BAB by 3 months postoperatively. A cohort of 84 patients was followed. In the early postoperative period excessive levels of damage to the BAB were related to iris damage (p < 0.01) and diabetes mellitus (p < 0.01). By 3 months, 79% of the eyes had recovered normal BABs and 21% (18 eyes) had persisting excessive fluorescence which correlated with an abnormal pupil shape (p < 0.02) and the development of posterior synechiae (p < 0.001).
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PMID:Continued breakdown of the blood aqueous barrier following cataract surgery. 139 May 24

Water-soluble crystallins were obtained from clear human lenses of different age (4-81-year-olds) and lenses of individuals showing senile or diabetic cataracts. Levels of early glycation products were high in the high molecular weight material (HM) and the alpha-crystallin fractions, compared with beta- and gamma-crystallins. This difference becomes more prominent upon aging. The content of total early glycation products in HM and alpha-crystallin increases clearly with age, whereas levels remain relatively constant in the beta- and gamma-crystallins. There is an elevation of early products in cataractous lenses from diabetic individuals compared with those suffering from senile cataract. Specific non-tryptophan fluorescence (excitation/emission wavelengths 370/440 nm), used as an indicator for late glycation products, increased dramatically with age and was 2-fold higher in the diabetic subjects. Levels of fluorescence decreased in the order HM > alpha- > beta- > gamma-crystallins. The results suggest an increase in glycation rate in alpha-crystallin as a result of aging and diabetes, while the rate of glycation of beta- and gamma-crystallins remains almost constant.
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PMID:Glycation of crystallins in lenses from aging and diabetic individuals. 145 95

All 98 elderly patients who were known to have diabetes on the lists of two inner-city general practices were interviewed and examined in their own homes. They were characterized in terms of their prevalence of vascular complications, metabolic control, perceived health (measured by the Nottingham Health Profile), frequency of hospital and general practice contacts and use of domiciliary 'support services' and compared to 98 control subjects with an identical age/gender distribution. Mean haemoglobin A1 in the diabetic patients was 9.9 +/- 2.5%, few of them had suffered severe hyperglycaemia (10%) or hypoglycaemia (5%) and they were little more obese than controls (mean body mass index 26.2 +/- 4.2 vs 24.6 +/- 4.1 kg m-2; 95% confidence interval for the difference 0.4-2.8; p < 0.01). All complications were more prevalent in diabetic patients and the difference was statistically significant for visual impairment, strokes, impaired mental test scores, absent vibration sense, and absent leg pulses. Cataract was more common than retinopathy as a cause of visual disability. Diabetic patients perceived their health to be much worse than controls and were more often depressed. No measure of perceived health correlated with haemoglobin A1. We conclude that care of the diabetic elderly should not be too narrowly focused on 'metabolic' goals.
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PMID:A community survey of diabetes in the elderly. 147 28

The quality of care rendered in ambulatory ophthalmic surgical centers is subject to the standards outlined in the Health Care Financing Administration's "Outpatient Surgery Generic Quality Screen Guidelines." Ophthalmic Surgery accounts for 28.2% of all ambulatory surgery performed in the United States. Diabetes, respiratory disorders, renal failure, and hypertension are a few of the clinical problems that are handled in a nontraditional fashion in ophthalmic surgery facilities throughout the United States with excellent results and low incidence of complications. Trends in the clinical management of patients in ophthalmic surgical centers are described by data obtained in a survey conducted by the anesthesia and surgical staff of the Parris-Castoro Cataract and Laser Center in Bel Air, MD. The survey addressed the current trends in obtaining history and physicals, electrocardiograms, chest radiographs, and laboratory studies before outpatient ophthalmic surgery.
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PMID:Ambulatory ophthalmic surgery and the Health Care Financing Administration's Outpatient Surgery Generic Quality Screen Guidelines. 147 82

Cataract is the major cause of blindness worldwide and at present the only approved treatment in many countries including the UK and USA is surgical removal of the lens. In other countries various anti-cataract drugs are available without proof of their efficacy. Research is continuing into the possible benefits of several groups of drugs and some vitamins. The first to be studied were sorbitol-lowering agents (aldose reductase inhibitors) based on the sorbitol hypothesis for diabetic cataract. Sorbitol-lowering agents have distinct effects in vitro and many of them delay the development of cataract in galactose-fed rats. A few delay cataract in diabetic rats but none have been proved effective in clinical trials, although these continue. Aspirin, paracetamol (acetaminophen) and ibuprofen delay diabetic cataract in rats, and have been shown to delay other experimental cataracts. Case-control studies from 3 continents indicate that these drugs, or at least aspirin, protect against cataract. Results of studies on all 3 drugs indicate a benefit even at low doses. Population-based studies did not identify any protection against early lens opacities but tiny opacities that do not impair vision are not a problem. Bendazac protects lens proteins in vitro and delays cataractogenesis in x-irradiated rats. In humans, it reached the clinical trial stage but most trials have been small and with subjective criteria of opacification. One objectively monitored trial suffered from a high drop-out rate. Other preparations studied less extensively include vitamins, aminoguanidine to prevent protein cross-linking in diabetes and agents designed to boost glutathione levels. It is probable that some agents which may delay or prevent cataract will be proved effective soon, and in the end there may be different drugs to delay cataract in different high risk groups. This is what might be expected of a multifactorial disease, although compounds that intervene in the final common pathways to cataract could have a broad efficacy.
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PMID:Pharmacological treatment strategies in age-related cataracts. 150 43


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