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

Sixty-six cases of advanced proliferative diabetic retinopathy were treated by external diathermy. The eyes had extensive fibrovascular proliferations growing into the vitreous. All had some blood, recent and old, in the vitreous. The vitreous was extremely degenerated and retracted. All the patients had inadequate diabetic control. More than half were hypertensive, with reasonable medical control, while a few had some degree of renal failure, with lower limb oedema. None of the cases were suitable for photocoagulation. Thirty-two control eyes were followed up together with the treated eyes for one to eight years. Of 53 eyes of patients with maturity onset diabetes 28 improved, 12 remained unchanged, and 13 deteriorated. Only two eyes developed neovascular glaucoma, while eight of 13 eyes of patients with juvenile diabetes improved. Of the control eyes, one regressed spontaneously, six remained unchanged, and 25 deteriorated. Of these 25 eyes eight developed traction detachment, 10 suffered relentless attacks of vitreous haemorrhage, and seven developed neovascular glaucoma. External diathermy appears to be a logical approach to cases which could not be treated by either photocoagulation or vitrectomy.
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PMID:External diathermy treatment of proliferative diabetic retinopathy with vitreous haemorrhage. 394 6

A 22-year-old man developed typical insulin-dependent diabetes mellitus. At the time of diagnosis no signs of diabetic retinopathy were found by an experienced ophthalmologist, but florid proliferative diabetic retinopathy was observed only seven months later. Despite treatment with laser and vitrectomy the eye lesions progressed to total blindness within 30 months after the diagnosis of diabetes.
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PMID:Severe proliferative retinopathy in a young man with diabetes of very short duration. 402 12

Recurrent vitreous hemorrhage associated with proliferative retinopathy can occur in eyes that do not satisfactorily respond to argon laser pantretinal photocoagulation. To evaluate the effect of relatively low-risk surgical intervention, we performed peripheral retinal cryopexy on 24 eyes of 23 diabetic patients with proliferative diabetic retinopathy and vitreous hemorrhage. In most cases, cryopexy followed complete or nearly complete panretinal photocoagulation which did not prevent subsequent vitreous hemorrhage. Existing vitreous hemorrhage cleared postoperatively in 23 of 24 eyes. The best corrected visual acuity improved in 15 eyes, remained unchanged in five, and worsened in four. Four postoperative anterior segment complications resolved completely within a short time. One patient, a 68-year-old woman who had had diabetes for 18 years, postoperatively had a macular hole in one eye and macular edema with tractional retinal detachment in the other.
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PMID:Anterior retinal cryotherapy in diabetic vitreous hemorrhage. 403 33

A 61-yr-old man presented with the nephrotic syndrome and normal oral glucose tolerance. Renal biopsy showed the nodular (Kimmelstiel-Wilson) and diffuse glomerulosclerosis lesions characteristic of diabetes. Direct ophthalmoscopy and fluorescein angiography demonstrated a picture of advanced proliferative diabetic retinopathy. The patient had no history of diabetes mellitus and upon testing had normal glucose values in response to an oral glucose tolerance test. Insulin response to an intravenous glucose tolerance test was abnormally low. It is concluded that the nodular glomerulosclerosis lesions and proliferative retinopathy, thought to be specific for diabetes mellitus, may present in the absence of either overt clinical diabetes or impaired glucose tolerance.
Diabetes Care
PMID:Diabetic nephropathy and proliferative retinopathy with normal glucose tolerance. 404 6

Early vitrectomy was carried out in 22 eyes with proliferative diabetic retinopathy and evidence of partial vitreous detachment in 17 patients with insulin-dependent diabetes. All the eyes had undergone panretinal laser photocoagulation, and all had a visual acuity of 6/12 or better, but 13 had had a vitreous hemorrhage. After a mean follow-up period of 29 months 19 of the eyes had retained the same visual acuity, 18 had been free of renewed vitreous hemorrhage for 6 months, there had been no macular retinal detachments and all the anterior segments were normal. The three instances of persistent visual loss were due to recurrent vitreous hemorrhage.
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PMID:"Early" vitrectomy for vasoproliferative retinopathy in patients with insulin-dependent diabetes mellitus. 618 59

The potential complications of cataract surgery in the general population are well known. In addition, cataract extraction in the patient with diabetes mellitus is associated with other potential complications common to this disease: neovascular glaucoma and acceleration of proliferative diabetic retinopathy with or without vitreous hemorrhage. We analyzed the records of 154 patients with diabetes mellitus who had undergone standard intracapsular cataract extraction in one eye only with the other eye serving as the unoperated control eye. We were able to determine the status of the diabetic retinopathy before the operation and to note the development of vitreous hemorrhage and rubeosis iridis/neovascular glaucoma after the operation. If either event occurred within six weeks of the surgery, it was considered to be a complication of the cataract extraction. Intracapsular cataract extraction in this diabetic population, without regard of the preoperative status of the retinopathy, was associated with a statistically significant incidence of postoperative rubeosis iridis/neovascular glaucoma (7.8% vs 0%). In patients with preoperative active proliferative diabetic retinopathy, the risk of developing postoperative rubeosis iridis/neovascular glaucoma was even higher (40% vs 0%). There was also a statistically significant incidence of vitreous hemorrhage after surgery in eyes with no diabetic retinopathy or background diabetic retinopathy (6.5% vs 0%). In patients with active proliferative diabetic retinopathy, there was an increased incidence of vitreous hemorrhage after surgery (20% vs 6.5%), but this was not statistically significant due to the small number of patients studied. Possible explanations for these findings are explored and therapeutic and prophylactic measures recommended.
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PMID:Neovascular glaucoma and vitreous hemorrhage following cataract surgery in patients with diabetes mellitus. 619 91

The effects of gliclazide on blood sugar levels and the micro-vascular system have been specified by the latest international studies of this antidiabetic agent presented at the 11th World Congress on Diabetes Mellitus. The potency of gliclazide is similar to that of the most effective reference agents. However, the mode of action of gliclazide, which induces an insulin release resembling physiologic conditions, explains why hypoglycemia is uncommon. Pharmacokinetic studies in the elderly have shown that gliclazide can be given to these more susceptible patients. Lastly, a number of trials, each of which was carried out against reference agents, have shown that gliclazide is valuable in delaying the course of non-proliferative diabetic retinopathy.
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PMID:[Hypoglycemic and microvascular properties of gliclazide: a review of the latest international studies]. 630 16

The performance of two urinary glucose tests (Clinitest and Diastix) and several color vision and lightness discrimination tests was assessed in 43 diabetic patients and 43 age-matched controls. Most of the diabetics had proliferative diabetic retinopathy, with normal or mildly reduced visual acuity. The diabetics made significantly more errors on color interpretation of the urinary test results than did controls. The extent of errors for both diabetics and controls correlated with the severity of color vision deficiency but not with lightness discrimination deficiency. The diabetics' performance of the Clinitest test and, to a lesser extent, of the Diastix test was significantly better in bright light than in dimmer light. The type of color vision deficiency among most of the diabetics was characteristic of the acquired blue-yellow defect associated with diabetes mellitus. All of the color vision tests enabled identification of patients likely to make a large number of urine-testing errors with high sensitivity and fairly high specificity.
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PMID:Urinary glucose testing inaccuracies among diabetic patients. Effect of acquired color vision deficiency caused by diabetic retinopathy. 633 31

A prospective long-term study on the predictive value of nyctometry in the development of proliferative diabetic retinopathy in insulin-dependent diabetes mellitus is in progress. Sixty-one patients participated. At a follow-up 3 years after the initial investigation, none of the patients initially showing results above the lower normal limit had developed proliferative retinopathy, whereas 6 out of 16 eyes initially displaying reduced values of nyctometry had advanced into proliferative retinopathy. It is concluded that nyctometry is valuable as an easily performed screening method in selecting those at risk of developing proliferative retinopathy within a few years.
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PMID:Nyctometry - a new screening method for selection of patients with simple diabetic retinopathy who are at risk of developing proliferative retinopathy. Results of a 3-year follow-up. 635 41

In a population-based study in southern Wisconsin, 1,370 patients given diagnoses of diabetes at age 30 years or older were examined using standard protocols to determine the prevalence and severity of diabetic retinopathy and associated risk variables. The prevalence of diabetic retinopathy varied from 28.8% in persons who had diabetes for less than five years to 77.8% in persons who had diabetes for 15 or more years. The rate of proliferative diabetic retinopathy varied from 2.0% in persons who had diabetes for less than five years to 15.5% in persons who had diabetes for 15 or more years. By using the Cox regression model, the severity of retinopathy was found to be related to longer duration of diabetes, younger age at diagnosis, higher glycosylated hemoglobin levels, higher systolic BP, use of insulin, presence of proteinuria, and small body mass.
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PMID:The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. 636 25


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