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

A randomized controlled study covering a two-year pre-treatment and a five-year post-treatment period was performed in 42 patients with diabetic retinopathy given photocoagulation treatment in one eye. Patients with progressive diabetic retinopathy of equal intensity in both eyes were selected from a single diabetes department. The course of diabetic retinopathy was assessed by ophthalmoscopy and composite fundus photographs as well as fluorescence angiography. In the first two-year post-treatment period non-proliferative retinopathy improved in the coagulated eyes and also, albeit to a lower degree, in the control eyes. In the next three years the treated eyes showed further improvement or stabilization, whereas the control eyes showed either stabilization or deterioration of the retinopathy. The most favourable results were obtained in proliferative diabetic retinopathy, which regressed in the majority of the eyes, the other eyes remaining stable or progressing only very slightly, in contrast with the control eyes, in the great majority of which proliferative diabetic retinopathy developed or progressed.
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PMID:Photocoagulation treatment in diabetic retinopathy: a two-year pre- and five-year post-treatment study. 9 8

In a group of 709 individuals with diabetes diagnosed prior to age 50 and followed for five to thirteen years a strong inverse relationship was demonstrated between the severity of the retinopathy at the initial visit and survival. Survival in patients with no retinopathy or with microaneurysms only was little different from that of the general population (five-year rate .99, SE .01). The five-year survival rate for patients with more severe nonproliferative retinopathy, characterized by the presence of hemorrhages and/or exudates, but without new vessels or vitreous hemorrhage (B2), was .81 (SE .04), and that for patients with proliferative retinopathy (PDR) was .56 (SE .03). After adjustment for age at diagnosis of diabetes, duration of diabetes and sex, the differences in survival between these three groups were highly statistically significant. Impairment of visual acuity was also shown to be inversely related to survival. The five-year survival rate for patients with visual acuity of 20/200 or worse in each eye was .42 (SE .05). In patients with B2 retinopathy there was a weak but statistically significant trend towards decreasing survival with increasing duration of diabetes. In patients with PDR survival decreased with increasing duration up to 20 years, but then improved for patients with 20 years or more of diabetes.
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PMID:Prognosis for life in patients with diabetes: relation to severity of retinopathy. 54 24

Internal ophthalmoplegia was found in eight eyes of four patients with juvenile-onset diabetes. All eight eyes had received argon laser panretinal photocoagulation (PRP) for proliferative diabetic retinopathy. Internal ophthalmoplegia was not found in any of the 14 eyes of seven patients with juvenile diabetes who had not had photocoagulation treatment. This group included one patient in whom internal ophthalmoplegia was present after treatment. Laser injury to the short ciliary nerves, as they course anteriorly on the inner surface of the sclera, is the probable cause of internal ophthalmoplegia in these patients. To my knowledge, this complication has not been reported previously, but it appears to be a common side effect of PRP.
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PMID:Internal ophthalmoplegia after argon laser panretinal photocoagulation. 57 10

Proliferative diabetic retinopathy (PDR) is uncommon in patients younger than the age of 20 and has been rarely reported. Since 1969, 14 adolescents with severe PDR have been seen, the youngest of whom was 16 years old and the oldest, 19 years old. The shortest duration of diabetes mellitus prior to diagnosis of PDR was eight years. Ten patients had a positive family history of diabetes. Thirteen patients had suboptimal metabolic control. Ten patients had some degree of azotemia, seven were hypertensive, and six had proteinuria. Ophthalmic findings included advanced neovascular and fibrous proliferation on initial classification, and rapid progression to blindness-which was most frequently secondary to traction retinal detachment. In a small retrospective study, pituitary ablation may have offered greater preservation of vision than that observed in untreated patients.
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PMID:Severe adolescent-onset proliferative diabetic retinopathy: the effect of pituitary ablation. 67 70

Following radical hysterectomy a 65-year old patient developed massive preretinal vascular proliferation, similar in appearance to advanced proliferative diabetic retinopathy, which led to a traction detachment. Diabetes mellitus could not be established, and a thrombocyte count up to one million is discussed as a possible cause.
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PMID:[Bilateral marked fundus changes with neovascularisation and subsequent detachment in association with thrombocythaemia (author's transl)]. 95 39

Preretinal neovascularization is a well-described feature of advanced diabetic retinopathy. In this study, contrast-enhanced magnetic resonance imaging was used to examine blood-retinal barrier breakdown associated with preretinal neovascularization in three subjects with proliferative diabetic retinopathy. Using a standard imaging protocol, a varying degree of vitreous enhancement was observed in these eyes. The location and severity of enhancement, judged by visual inspection of the images, corresponded to the fluorescein angiographic and/or clinical appearance of preretinal neovascularization. This result suggests that contrast-enhanced magnetic resonance imaging may prove a reasonable approach to the identification of preretinal neovascularization in eyes with significant media opacities.
J Diabetes Complications
PMID:Preretinal neovascularization in diabetic retinopathy: a preliminary investigation using contrast-enhanced magnetic resonance imaging. 128 35

Laser panretinal photocoagulation (PRP) reduces visual loss in proliferative diabetic retinopathy but decreases peripheral retinal function. The Driver and Vehicle Licensing Centre (DVLC) states that when a patient volunteers that he or she has had photocoagulation, a questionnaire will then be sent to the patient's diabetic physician who can refer the patient for formal field testing. Of 30 patients who had PRP, 15 failed DVLC visual field regulations using the Esterman binocular field test on the Humphrey field analyser. The failures were more likely to have had treatment with a xenon laser, but there was no difference between the groups as regards age, number of burns or whether an argon or diode laser was used. The patients who failed were more likely to be hypertensive (p = 0.04). Two patients with unilateral PRP could not meet the driving regulations because of other field defects. Diabetes itself causes field defects, and therefore even with small amounts of laser, formal field testing may be necessary.
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PMID:Fields, DVLC and panretinal photocoagulation. 128 41

Since urinary guanidinoacetic acid (GAA) derives from the kidneys, its detection is suggested to be associated with renal disease. We have been making a practice of investigating renal GAA production in diabetic patients, using a citrulline/creatine loading test. We noted a marked increase in urinary GAA excretion in 1 patient. Since GAA-synthesis is hormonally regulated, we made a through investigation of endocrine function in this patient. She was a 58-year-old woman with a 15-year history of diabetes mellitus, proliferative diabetic retinopathy, and negative microalbuminuria. There was a high plasma GH level and urinary 17-KS analysis revealed an increase in the adrenal androgen-derived fractions. Based on the X-ray finding of ballooning of the sella turcica and the MRI data, empty sella syndrome was diagnosed. It was suggested that stimulated anabolic hormone release had accelerated renal nitrogen metabolism and induced aggravation of her retinopathy. The findings in this patient implied the involvement of hormones in the development of diabetic complications.
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PMID:[A diabetic patient with empty sella syndrome accompanied by stimulated guanidinoacetic acid metabolism]. 129 72

A clinical research on the diabetic retinopathy(DR) is reported. In the 662 cases of diabetes mellitus examined, the prevalence of DR was 51.3%, of which 7.6% were preproliferative and 7% proliferative. The study showed that when the disease progressed to the preproliferative and proliferative DR, laser photocoagulation could be the best treatment of choice, and panretinal photocoagulation was also quite effective in the treatment of pregnant patients with proliferative diabetic retinopathy.
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PMID:A clinical study on diabetic retinopathy. 139 43

Within the central nervous system, pericyte degeneration in diabetes mellitus occurs only in the retinal microcirculation and is not seen in the brain. This study sought to elucidate differences between bovine retinal and brain pericytes. When pairs of retinal and brain pericytes from individual calves were cultured in vitro, the morphological organisation of early post-confluent retinal pericyte cultures was consistently different from that of brain pericyte cultures. When retinal and brain pericyte cultures were grown to second passage in high or normal glucose medium supplemented with fetal calf serum, brain pericyte cultures grew significantly faster than retinal pericytes in either medium (p less than 0.0001). Brain pericytes thus appeared to grow intrinsically faster than retinal pericytes and this effect was largely independent of glucose concentration. Brain pericytes also grew faster than retinal pericytes in high glucose medium containing human diabetic or control serum (p less than 0.002). The proliferative effect of serum from diabetic patients with non-proliferative diabetic retinopathy on pericytes grown in high glucose medium was not significantly different from that of control serum. Both brain and retinal pericytes showed variation in their ability to replicate in high concentrations of glucose. The selectivity of pericyte degeneration to the retinal circulation does not appear to be due to changes in the mitogenic activity of diabetic serum for retinal pericytes, but may relate to the intrinsic relative inability of the retinal pericyte to reproliferate in response to the metabolic injury of diabetes mellitus.
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PMID:Differential growth of brain and retinal bovine pericytes. 139 76


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