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

The apparition of diabetic retinopathy depends on the duration of the evolution of the diabetes and its control, and its type. The indications for photocoagulation are in progressive retinopathy the existence of macular edema or retinal or prepapillar neovascularisation. The pan-rtinal argon laser photocoagulation is the best technic for treatment. It leads to a global improvement whose results are presented, after 2 years follow-up.
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PMID:[Pan-retinal argon laser-photocoagulation in retinopathia diabetica. First results (author's transl)]. 30 63

This report presents an unusual case of visual impairment following cardiac arrest during general anesthesia. The presumptive etiology was macular capillary insufficiency secondary to vascular stagnation which occurred during cardiac standstill. Ophthalmic examination confirmed areas of macular edema corresponding to localized perifoveal regional infarcts. Isolated macular infarction is not a unique condition and has been reported in hemoglobulinopathies, diabetes, and other systemic diseases.
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PMID:Transient visual impairment following cardiac arrest. 30 10

Diabetic retinopathy progresses through three distinct stages. A rational approach to management is based on an understanding of the pathophysiology of each stage. Based on the results of national multicentered clinical trials of laser photocoagulation and other treatments, advances in our understanding of the pathogenesis and treatment can now make a dramatic impact on blindness in the diabetic population: Panretinal laser photocoagulation treatment can reduce the risk of vision loss from high-risk proliferative diabetic retinopathy by at least 50%. Laser photocoagulation treatment of clinically significant diabetic macular edema can reduce the risk of vision loss by more than 50%. Vitrectomy can restore useful vision to some patients with severe diabetic retinopathy and vitreous hemorrhage with or without an accompanying traction retinal detachment. Diabetes 2000 is a new project sponsored by the American Academy of Ophthalmology, the goal of which is to eliminate preventable blindness from diabetes by the year 2000. As its name implies, Diabetes 2000 will be a long-term project aimed at a specific disease--diabetic retinopathy and its complications. It will provide the latest research findings to ophthalmologists and primary care physicians as the first priority, followed by the education of patients and the general public. Recent advances and treatment guidelines for the medical and surgical treatment of diabetic eye disease will be emphasized through the continuing education of ophthalmologists, other physicians, and allied health professionals. In later phases, educational programs for diabetic persons and the public will be developed. Ultimately, improved access of diabetic patients to ophthalmologic care and a close working relationship between ophthalmologists and primary care physicians will ensure early detection of diabetic retinopathy and the timely delivery of state-of-the-art treatments.
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PMID:Current management of diabetic retinopathy. 141 52

Retinal vein occlusion is a common form of retinal vascular disease, especially in middle-aged and older individuals. The diagnosis is based on the funduscopic finding of retinal vein dilatation in association with retinal hemorrhages and cotton-wool spots. The pathology can involve the entire venous system or can be limited to a branch of the central retinal vein. Retinal vein occlusion can be distinguished clinically from diabetic retinopathy and other retinal diseases. Treatment for the acute phase of retinal vein occlusion has been disappointing. However, some late complications, such as persistent macular edema and neovascularization of the iris and retina, respond well to retinal photocoagulation. The family physician has an important role in detecting and controlling risk factors for retinal vein occlusion, including hypertension, diabetes mellitus and hyperviscosity syndromes.
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PMID:Retinal vein occlusion. 159 15

The prevalence of diabetic retinopathy was examined in people with newly discovered noninsulin-dependent diabetes mellitus (NIDDM) (n = 50) and in those with previously diagnosed diabetes (n = 395) in a population-based study of people between the ages of 43 and 86 years who lived in Beaver Dam, Wisconsin between 1988 and 1990. Retinopathy was determined from stereoscopic fundus photographs. The prevalence of any retinopathy was 10.2% in those with newly diagnosed NIDDM, none had proliferative retinopathy, and 2.0% had macular edema. These data suggest that asymptomatic people discovered to have NIDDM during epidemiologic studies may not need immediate ophthalmoscopic examination at the time of their diagnosis because they have a relatively low risk of danger of visual loss due to diabetic retinopathy at that time.
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PMID:The Beaver Dam Eye Study. Retinopathy in adults with newly discovered and previously diagnosed diabetes mellitus. 174 Nov 41

Diabetic retinopathy is the leading cause of acquired blindness among Americans of working age. The resulting economic and societal burdens are of profound magnitude. Epidemiologic and clinical trials data were used to analyze the impact of improved recruitment of patients with Type I diabetes mellitus into screening and treatment programs. The analysis predicted annual savings of $101.0 million and 47,374 person-years-sight at the currently estimated 60% screening and treatment implementation level. If all patients received appropriate eye care, the predicted savings exceed 167.0 million and 79,236 person-years-sight. Approximately two thirds of all savings result from treatment of proliferative diabetic retinopathy, while nearly one third arises from treatment of clinically significant macular edema. Additional savings of $9571 are realized with each recruitment of a newly diagnosed patient with diabetes. Initiating screening immediately upon diagnosis of diabetes, rather than the currently recommended 5-year deferral, would be cost effective if 1 additional individual in 56 were recruited. This model suggests that improved delivery of ophthalmic care to patients with diabetes would yield substantial financial and visual savings, thus making major recruitment programs such as the National Eye Institute's National Eye Health Education Program and the American Academy of Ophthalmology's Diabetes 2000, both economically and clinically effective.
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PMID:Detecting and treating retinopathy in patients with type I diabetes mellitus. Savings associated with improved implementation of current guidelines. American Academy of Ophthalmology. 196 46

Data from the Wisconsin Epidemiologic Study of Diabetic Retinopathy from persons with diabetes of older onset whose average age was 65.4 years indicate that 9.9% of the men and 13.3% of the women had some degree of visual impairment, and 1.4% of men and 1.7% of women were legally blind (with an visual acuity of 20/200 or worse in the better eye). Poorer visual acuity was strongly associated with increasing duration of diabetes, but age was also an important factor, with rates of legal blindness increasing markedly after the seventh decade of life in groups of any duration. Conditions responsible for legal blindness were diabetic retinopathy or maculopathy, cataracts, glaucoma, and macular degeneration. Incidence of blindness 4 years after the initial evaluation was related to insulin use, younger age at examination, longer duration of diabetes, and more severe retinopathy at baseline. Worsening of vision was related to higher levels of glycosylated hemoglobin and the presence of macular edema on diabetic retinopathy at baseline. These data indicate that there is a high prevalence of ocular problems among people with diabetes of older onset. The practitioner should suggest to these patients that, soon after the diagnosis of diabetes, they have an ophthalmologic evaluation to determine whether asymptomatic problems are present. This action may lead to timely intervention to prevent loss of vision in some patients.
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PMID:Ocular problems in older Americans with diabetes. 222 49

Macular edema can occur early, especially in maturity onset diabetics. These patients will usually have blurred vision. An examination (through dilated pupil) will reveal fuzziness or hard exudates in the central retina. The ETDRS proved focal laser treatment to leaking blood vessels reduces vision loss. Proliferative retinopathy occurs after 12-15 years or more of diabetes in juvenile diabetics and any time in maturity onset diabetics. Proliferative disease may be completely asymptomatic until there is a vitreous hemorrhage or retinal detachment. The DRS showed scatter laser treatment reduces severe visual loss by at least 50% in patients with proliferative disease. If proliferative disease is not treated, it almost always causes blindness. We must shout this message to all primary care physicians and diabetics. If we are successful, we can eliminate preventable blindness in Iowa's diabetics.
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PMID:Diabetic retinopathy. 225 70

Diabetic eye disease, particularly diabetic retinopathy, is the leading cause of new cases of legal blindness in people 20-74 yr of age in the United States. The prevalence and rate of diabetes in this age-group are higher in Blacks than in Whites. The rate of blindness from diabetic eye disease is also higher in Blacks than in Whites. Severe macular edema, the most frequent cause of decreased vision in diabetic retinopathy, appears to be more common in Blacks. Risk factors for developing macular edema include poorly controlled hypertension, hyperglycemia, and duration of disease. The higher prevalence of hypertension in Blacks may contribute to the increased severity of diabetic retinopathy. Further evaluation is necessary to determine the influence of race on the severity of diabetic retinopathy.
Diabetes Care 1990 Nov
PMID:Diabetic retinopathy in blacks. 226 43

As part of a population-based study of diabetes mellitus, the 4-year incidence of macular edema and its relationship to various risk factors was examined in a group of younger onset insulin-taking persons (n = 610) and older onset persons (n = 652). The presence of macular edema at the baseline and follow-up examinations was determined from gradings of stereoscopic fundus photographs. The overall incidence of macular edema in the younger onset group was 8.2% (50/610); in the group of older onset persons using insulin, 8.4% (23/273) and in the group of those not using insulin, 2.9% (11/379). The incidence of macular edema was associated with higher level of glycosylated hemoglobin, longer duration of diabetes, and more severe retinopathy at the baseline examination in both younger and older onset groups. These data provide accurate population-based estimates of incidence of macular edema, and suggest that the level of glycemia is a significant risk factor for the development of macular edema.
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PMID:The Wisconsin epidemiologic study of diabetic retinopathy. XI. The incidence of macular edema. 258 45


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