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

Ischemic optic neuropathy and retinal arterial occlusion are 2 forms of arterial occlusive disease affecting the eye. Reports in the literature suggest platelet hyperactivity in acute arterial occlusive diseases affecting other organ systems. Therefore, 14 patients with ischemic optic neuropathy and 17 patients with central or branch retinal artery occlusion were studied to determine whether platelets have a role in the pathogenesis of these vascular occlusive disorders. The results of the following investigations were no different in these patients compared with those in 18 control patients with non-vascular eye diseases: prothrombin times, partial thromboplastin times, plasma fibrinogen, factor V, factor VIII, platelet counts and threshold concentrations of ADP, epinephrine and collagen resulting in secondary platelet aggregation and serotonin release. In contrast, platelet coagulant activities concerned with the early stages of intrinsic coagulation were significantly increased in patients with retinal artery occlusion without hypertension or type IV hyperlipoproteinemia, but generally normal in patients with ischemic optic neuropathy and in patients with retinal artery occlusion associated with hypertension, type IV hyperlipoproteinemia, diabetes mellitus and generalized atherosclerosis. These results are consistent with a platelet contribution to retinal arterial occlusive disease in patients without other known contributing factors such as hypertension, serum lipid abnormalities, diabetes mellitus and generalized atherosclerosis and may have implications regarding prophylaxis.
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PMID:Platelet coagulant activities in arterial occlusive disease of the eye. 50 1

A 62-year-old lady with hypertension and diabetes developed bilateral, sequential ischemic optic neuropathy, progressive in the right eye. Because of a reported association between amiodarone and optic neuropathy with disc edema, the patient discontinued taking this medication; however, her visual loss continued. The differential diagnoses of bilateral ischemic optic neuropathy--including infiltrative optic neuropathy and temporal arteritis--were exhaustively investigated in this patient.
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PMID:Getting to the heart of visual loss: when cardiac medication may be dangerous to the optic nerves. 156 39

Optic atrophy can often be a result of arterial blood flow insufficiency associated with systemic vascular disease (cardiovascular disease, hypertension, or diabetes mellitus). The lack of adequate blood perfusion pressure can create conditions leading to anoxia and death of the nerve fiber layer with a resultant visual field defect. A case of a 63-year-old white male is presented with optic atrophy resulting from anterior ischemic optic neuropathy 5 years earlier. A review of the literature concerning the more common causes of ocular vascular insufficiency (i.e., anterior ischemic optic neuropathy, internal carotid disease, central retinal artery occlusion, and branch retinal artery occlusion) as well as diagnostic testing and therapeutic management is discussed.
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PMID:Vascular implications of optic atrophy. 163 40

We studied the effects of intra-arterial chemotherapy (IAC) with a new nitrosourea (hydroxyethyl-chloroethyl nitrosourea: HeCNU) on the visual system of 68 patients with malignant gliomas. The intra-arterial chemotherapy was given as a complementary treatment of glioma after surgery (19 patients), after tumor recurrence (28 patients) and as the preliminary treatment before radiotherapy (21 patients). Eleven patients (16%) suffered a visual complication after two or more courses of chemotherapy. The main visual symptoms included mild to major decrease of visual acuity and in some cases ocular pain, palpebral edema and conjunctival injection. The delay in onset of ocular symptoms from the last course of IAC varied from 1 week to 9 months. From ophthalmoscopic findings, visual field testing and fluorescein angiography, the visual symptoms presented by our patients could be related to ischemic optic neuropathy or retinal vasculopathy. None of the patients had hypertension, diabetes, cardiopathy or hematological disease. Statistical analysis failed to demonstrate a relationship between the occurrence of visual toxicity and patient age, number of courses of HeCNU, the vascular axis treated, total systemic dose or dose by carotid artery, suggesting a possible specific sensitivity of some patients to chemotherapy. The pathophysiology and the therapeutic implications of this visual toxicity are discussed.
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PMID:Visual toxicity following intra-arterial chemotherapy with hydroxyethyl-CNU in patients with malignant gliomas. A prospective study with statistical analysis. 174 75

Acute anterior ischemic optic neuropathy (AION) is a circulatory disorder of the short posterior ciliary arteries and their branches. 74 patients with AION were examined with video fluorescein angiography for disturbance of the retinal circulation. The armretina time (ART) was slightly (15%, p less than 0.01) increased in patients with AION (12.9 +/- 3.9 s) as compared to healthy persons (11.2 +/- 3.3 s). The prolonged ART was more prominent in the 26 (35.1%) diabetic patients (14.2 +/- 3.9 s). Because of the ART being only moderately prolonged and since the Doppler ultrasonography of the carotid arteries showed in only 3 patients an occlusion or a hemodynamically relevant stenosis of greater than or equal to 50%, prolonged ART may play a considerable role in the course of AION in only few patients. The retinal arteriovenous passage time (AVP) is considerably (77%, p less than 0.01) increased in AION (2.57 +/- 0.89 s) as compared to healthy persons (1.45 +/- 0.40 s). In patients with duration of symptoms less than 10 days (2.78 +/- 0.96 s) the AVP was increased (p less than 0.01) as compared to patients with duration of symptoms between 11 and 30 days (2.11 +/- 0.46 s). The comparison between the eye with AION and the not affected eye showed no difference in ART but an increase of AVP in the eye with AION. The AVP in AION patients without and with diabetes was not different. No differences in ART and in AVP were found between arteriitic and non-arteriitic patients with AION. The results indicate that the retinal microcirculation is disturbed in patients with arteriitic and non-arteriitic AION. This condition may worsen the in AION affected microcirculation of the optic nerve head through the mechanism of decreased blood flow in the retinociliary anastomoses.
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PMID:[Video fluorescein angiography studies in acute anterior ischemic optic neuropathy]. 179 83

The authors have investigated risk factors associated with the occurrence of nonarteritic anterior ischemic optic neuropathy (AION) in 83 patients and 124 eyes. 12% of the patients with nonarteritic AION had diabetes mellitus, 37.3% hypertension, 14.5% atherosclerosis, while the rest (36.2%) were classified as idiopathic. The incidence of bilateral AION was slightly less than 50%. The period in which both eyes get affected is usually 1-2 months or longer. Nonarteritic AION can occur at any age, therefore it is seen in young people as well. The role of arterial hypertension and diabetes in pathogenesis of AION is still to be determined.
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PMID:Risk factors in nonarteritic anterior ischemic optic neuropathy. 207 25

The paper is a unique pathological description of a bilateral, symmetric, anterior, temporal ischemic optic neuropathy with the morphological characteristics of cavernous optic atrophy initially described by Schnabel in glaucomatous eyes. The 80-year-old woman had suffered from cardiac insufficiency and diabetes mellitus for many years. She died from sepsis and circulatory collapse due to ischemic colitis, intestinal perforation, and peritonitis. There was widespread arteriosclerosis but no evidence of giant-cell arteritis. Cell loss was demonstrated in both retinas, the chiasm, and in the central lateral geniculate body. These represent a retrograde, descending and ascending optic atrophy, with transsynaptic degeneration in the LGB. A small craniopharyngioma was found by chance in the infundibulum. Neither clinically nor morphologically were there any signs of glaucoma.
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PMID:[Histopathology of the retina, optic fascicle and lateral geniculate body in chronic, bilateral symmetric ischemic Schnabel's cavernous optic atrophy]. 224 78

Bilateral mild diabetic retinopathy and disc swelling occurred in a young woman with type I diabetes during the second month of pregnancy. The disc edema showed the typical pattern of diabetic papillopathy (D.P.). This is a recently discovered syndrome of juvenile diabetics characterized by transient bilateral edema of the optic disc with minimal functional impairment. The features of D.P. and two different pathogenetical hypotheses, ischemic and dysmetabolic, expressed by other authors, are listed in detail. The case described showed a particular evolution, with bilateral prepapillary transitory neovascularization followed by scant glial reaction. Moreover pattern VEPs analysis showed a clearly increased latency. These findings suggest that both dysmetabolic (VEPs increased latency) and and ischemic (neovascularization) stimuli are responsible for D.P., even if differences with typical ischemic optic neuropathy are evident.
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PMID:[Diabetic papillopathy and pregnancy. Clinical contribution and pathogenetic considerations]. 241 95

Optic disc neovascularization, anterior and posterior ischemic optic neuropathy (AION and PION), diabetic papillopathy and Wolfram's syndrome are known conditions affecting the optic nerve in diabetics. Analysis of frequencies of AION in diabetes and two cases with and without background diabetic retinopathy are reported. The literature concerning the pathogenesis of diabetic papillopathy and its clinical similarity to optic disc vasculitis are briefly discussed.
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PMID:Diabetic optic neuropathies: clinical features. 245 85

The records of 293 patients admitted to Padua University Eye Clinic with diagnosis of optic neuropathy were reviewed. Age and sex distribution of different types of optic neuropathies were analyzed. 84 patients (28.7%) with a mean age of 61.9 years had anterior ischemic optic neuropathy (AION). The mean follow up of these patients was 3 years. In less than 30% of patients stabilized visual acuity of the first affected eye was better than 20/200; however, patients younger than 65 showed a significantly (p less than 0.01) better visual acuity than patients older than 64. Involvement of the second eye was found in 26 patients with AION (30.9%), of whom only five were considered idiopathic. The latency before controlateral eye involvement was significantly (p less than 0.05) shorter in patients over 64 years of age than in the younger group. Commonly known associated conditions such as giant cell arteritis (3.6%), arterial hypertension (34.5%), diabetes mellitus (10.7%), both arterial hypertension and diabetes (8.3%), migraine (7.2%) or intracapsular cataract extraction (1.2%) were considered. The frequency of a number of risk factors was found out in patients with arterial hypertension and/or diabetes and in patients with idiopathic AION. Symptoms or signs of ischemic cardiopathy and/or peripheral nonarteritic vascular disease, TIAs prior to AION onset, elevated plasma cholesterol or triglyceride levels, excessive smoking were considered. These risk factors were not found in 11.1% of diabetic patients with AION, in 37.9% of hypertensives, in 14.2% of both diabetic and hypertensive patients and in 31% of patients with idiopathic AION. Our data seem to indicate that the onset of AION may be influenced more strongly from these risk factors than aging.
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PMID:Anterior ischemic optic neuropathy and aging. 277 May 22


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