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

In 231 subjects with Type 1 diabetes mellitus aged 17.6 +/- 4.0 years, with a diabetes duration of 8.5 +/- 4.9 years at the end of the study, the prevalence and the development of retinopathy during a period of 5 years were studied. All patients were examined between one and six times both by ophthalmoscopy and fluorescein angiography. A total of 626 fluorescein angiographies were evaluated. By the end of the study, 109 out of 231 patients (47%) had developed retinal changes, half of which were classified as minimal (less than 5 microaneurysms). Thirty-eight patients (35% of those affected) had background (n = 28) or proliferative (n = 10) retinopathy. In subjects less than 15 years of age and diabetic for less than 5 years, retinal lesions were rare. With increasing age and duration of diabetes, both the prevalence and severity of retinal changes increased markedly. Life-table analysis was used to calculate the median individual risk for the development of early retinal changes, which was 9.1 years of diabetes duration. This risk differed in sub-groups with different ages at onset of diabetes, i.e. 12.1, 8.9 and 6.6 years (p less than 0.0001), with diabetes starting below 4, between 5 and 9, and after 10 years of age respectively. After 18 years of diabetes, every patient demonstrated at least incipient structural changes. Fluorescein angiography allowed the detection of retinopathy, on average, four years earlier than with ophthalmoscopy. The median interval between the 'onset' of retinopathy, as indicated by a few microaneurysms, and background retinopathy was 5 years.
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PMID:Prevalence and development of retinopathy in children and adolescents with type 1 (insulin-dependent) diabetes mellitus. A longitudinal study. 395 93

Fluorescein angiographies of the iris and retina were performed both in normal individuals (104) and in patients suffering from hyperlipoproteinemia (48), maturity-onset diabetes (184), systemic hypertension (12) and atherosclerosis (12). While hyperpermeation of dye located at the pupillary border was seen in 7.7% of the normals, leakages occurred in 66.6% of the hyperlipoproteinemics and in 79% of the recent maturity-onset diabetics. Paraclinical examination of the normal subjects with pathologic dye transit revealed vascular risk factors in each case. Thus, fluorescein iris angiography is a suitable method of detecting vascular damage in cases of metabolic disorder as early as possible.
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PMID:[Value of iris fluorescence angiography in the early diagnosis of vascular lesions]. 406 83

We describe affinity sensors for monitoring various metabolites in blood plasma by optical means. The principle of detection is similar to that used in radioimmunoassays and is based on the competitive binding of a particular metabolite and a fluorescein-labeled analogue with receptor sites specific for the metabolite and the labeled ligand. This concept has been directed toward the development of an affinity sensor for glucose. Concanavalin A, a protein with specific binding character for glucose, was immobilized on the inside surface of a hollow dialysis fiber. Fluorescein-labeled dextran was selected as the competitive labeled ligand. The molecular weight cutoff of the dialysis fiber is low enough to completely retain the 70,000 MW dextran within the fiber lumen while glucose can freely pass through the dialysis membrane. The sensor is completed by inserting a single optical fiber in the lumen of the dialysis fiber, thus allowing measurement of the unbound FITC-dextran. Preliminary tests of the sensor indicated the feasibility of the approach. Sensitivity to glucose in the physiologic range was obtained, but further work will be required to optimize the sensitivity and response time of the sensor.
Diabetes Care
PMID:Affinity sensor: a new technique for developing implantable sensors for glucose and other metabolites. 618 10

A study was performed to determine the relationship between level of long-term antecedent diabetic control and early diabetic retinopathy changes. Fifty-eight insulin dependent diabetics aged 14 to 17 1/2 years, with duration of diabetes of at least 8 years, were studied. Glycosylated hemoglobins were assessed a mean of 8.5 times per patient, over a mean period of 3.1 years, representing 28% of the mean duration of diabetes in this patient population. Fluorescein angiography, obtained according to a standardized technique, was assessed in masked fashion for number of microaneurysms, presence of abnormal areas of capillary nonperfusion, and presence of intraretinal dye leakage. Sixty-four percent of the study population showed some evidence of retinopathy. There was a high correlation found between degree of metabolic control as measured by glycosylated hemoglobin level, and presence of early retinopathy changes as defined by angiography.
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PMID:The association between long-term diabetic control and early retinopathy. 647 13

Leakage of fluorescein to the vitreous has been reported in diabetes and systemic hypertension. We have done detailed studies in normal subjects to look for determinators of possible leakage in this population. Twenty-nine healthy males, aged 18-67 years, were studied in the morning after an overnight fast. Fluorescein 17 mg/kg body weight was injected intravenously and blood drawn 5, 10, 15, 30, 45, 75 and 120 minutes later for measurement of ultrafiltrable fluorescein. Ocular fluorophotometry was performed before, 60 and 120 min after the injection. Mean fluorescein (+/- SD) in the posterior vitreous was 8.1 (+/- 5.5), middle vitreous 4.7 (+/- 6.0) and aqueous 240 (+/- 142) ng/ml after 60 minutes. At 120 minutes, a significant increase to 12.2 (+/- 8.6), 9.4 (+/- 9.3) and 317 (+/- 139) ng/ml was found in the three regions, p less than 0.05. At 60 minutes, age related significantly to posterior and middle vitreous concentrations, Spearmans rho = 0.49 and 0.61, as well as to aqueous concentrations, rho = 0.51 (p less than 0.01). Blood pressure related only to aqueous concentrations, at 60 minutes, rho = 0.42, p less than 0.05. When the intraocular measurements were corrected for average preceding ultrafiltrable fluorescein, age remained significantly related only to vitreous readings and blood pressure to aqueous readings.
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PMID:Ocular fluorophotometry in normal subjects. 667 47

Abnormalities in ocular fluorophotometry occur in human and experimental diabetes mellitus. To determine the reversibility of these abnormalities, we studied prospectively 11 intensively treated and 25 conventionally treated insulin-dependent diabetics (IDD) preselected because of abnormal vitreous fluorophotometry. Among the 25 IDD treated conventionally with one or two insulin injections daily, hemoglobin A1C concentrations remained elevated and fluorescein concentration, 1 h after the intravenous injection of fluorescein (7 mg/kg), did not change significantly in either the anterior chamber or the posterior vitreous. Among 11 IDD treated intensively with home blood glucose monitoring and pumped subcutaneous insulin or three or more injections daily, hemoglobin A1C fell dramatically (10.4 +/- 0.7% to 7.5 +/- 0.2%) and anterior chamber fluorescein concentration decreased (73.9 +/- 7.7 to 49.5 +/- 5.3 ng/ml). Two patients with proliferative retinopathy showed no improvement in their massive vitreous fluorescein accumulation and subsequently required photocoagulation. In the nine subjects without proliferative retinopathy, vitreous fluorescein accumulation decreased in eight (10.6 +/- 0.7 to 6.5 +/- 0.5 ng/ml) and was normal in six after 1 yr. The only subject with increasing vitreous fluorescein accumulation also had concurrent worsening of background retinopathy. These studies support the hypothesis that moderate abnormalities in ocular fluorophotometry are due to reversible changes in ocular tissues, such as retinal pigment epithelium. Fluorescein leakage emanating from the advanced vascular or retinal abnormalities of proliferative retinopathy were not reversed with the degree and duration of metabolic control achieved in the present study. The long-term significance of the reversal of moderate abnormalities in fluorophotometry is not clear at the present time.
Diabetes 1982 Jan
PMID:Reversal of abnormalities in ocular fluorophotometry in insulin-dependent diabetes after five to nine months of improved metabolic control. 675 17

The blood-retinal barrier (BRB) is located at two levels, forming an outer barrier in the retinal pigment epithelium and an inner barrier in the endothelial membrane of the retinal vessels. Both these membranes have tight junctions of the 'non-leaky' type and cellular transport processes predominate. The occurrence of an alteration of the BRB in retinal disease is briefly reviewed. Fluorescein angiography findings have now been extended by the introduction of vitreous fluorophotometry. Kinetic vitreous fluorophotometry studies in diabetes and in experimental situations suggest that measurement of the coefficient of fluorescein loss from the vitreous may be the best means of evaluating the early functional changes which occur in the BRB in diabetes and their apparent reversibility.
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PMID:Blood-retinal barriers in health and disease. 694 26

Fluorescein angiography of the angle with the Goldmann gonioscopy lens was used to examine eyes of 100 Japanese patients with diabetes mellitus. Ocular tension was 21 mmHg or over in 31 of these 100 patients. Gonioscopy revealed angle neovascularisation in the eyes of 30 patients; however, fluorescein gonioangiography showed evidence of angle neovascularisation in 56 of the 100 patients. Angle neovascularsation was first seen 20.3 +/- 4.1 s after injection of fluorescein dye. Of the newly formed vessels, the branching small vessels showed more prominent leakage than the larger vessels at the root. With progression of the retinopathy, angle neovascularisation became more severe. Following panretinal photocoagulation in 26 of the patients with neovascular glaucoma, angle neovascularisation remarkably regressed in 12 and moderately regressed in 7 patients. Ocular tension became normal in 13 patients. Two of 31 patients with ocular hypertension were considered as cases of primary open-angle glaucoma as there was glaucomatous cupping, visual field defects and no evidence of newly formed vessels in the angle, as observed using fluorescein gonioangiography. Thus, fluorescein gonioangiography may be helpful in the diagnosis and clinical management of neovascular glaucoma.
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PMID:Fluorescein gonioangiography in diabetic neovascularisation. 751 5

Microvascular damage, often resulting in renal failure, is a common complication of diabetes. Transcapillary fluorescein escape rate (TCFER) as monitored by intravital microscopy has been used as an indicator of the extent of capillary damage in diabetes and to assess improvement in microvascular function after combined kidney-pancreas transplant. However, fluorescein anion binds to plasma albumin, and albumin-ligand binding may be altered in the presence of renal disease. The purpose of this study was to compare fluorescein binding by plasma from diabetics with renal failure with plasma from healthy nondiabetics. Fluorescein binding by plasma from seven type I diabetics awaiting kidney-pancreas transplant and seven healthy adults of similar age and sex was studied using ultrafiltration and dialysis. There was no significant difference in the apparent albumin binding of fluorescein at physiologically relevant fluorescein concentrations, even though the TCFER was significantly increased in the diabetics as compared with the controls. Hippurate, a ligand that accumulates in renal failure, did alter fluorescein binding in a defatted albumin solution but not sufficiently to account for the differences in TCFERs. These data indicate that impaired albumin binding of fluorescein does not contribute significantly to the TCFER in diabetics with renal failure.
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PMID:Plasma fluorescein binding and transcapillary fluorescein escape rate in renal failure associated with diabetes. 770 48

In 148 healthy volunteers and 75 older patients the physiological aqueous humor secretion was calculated during the afternoon hours (13.00 to 20.00 hours) using the anterior chamber protocol of Fluorotron Master II (Coherent, Palo Alto, USA). Fluorescein eye drops were applied topically to each eye five times, 5 h before measurements. Healthy volunteers as well as patients had no history of ocular pathology, surgery or laser treatment. Further exclusion criteria were hypertension, diabetes, local and systemic drug therapy, neoplasia, kidney or liver diseases, contact lens, ocular trauma. Mean age of volunteers was 26.5 +/- 3.8 years; mean age of patients was 65.5 +/- 10.5 years. The aqueous humor flow in healthy volunteers (mean +/- standard deviation) was 2.26 +/- 1.0 microliters/min and in the older patients 1.91 +/- 1.1 microliters/min. Correlation coefficient between right and left eyes in the younger volunteers: r = 0.8; in the older patients: r = 0.54. The Mann-Whitney-U-test revealed a significant difference comparing mean aqueous humor flow in healthy volunteers with the mean aqueous humor flow in older patients (P < 0.01). The results in our study underline that the mean aqueous secretion does decrease with age of about 2.5% per decade. However, to date we do not know whether eyes with primary open-angle glaucoma or ocular hypertension show such a decrease in aqueous humor flow with age or whether there is an autoregulation mechanism in eyes with primary open-angle glaucoma that decreases aqueous humor secretion in relation to an increase of outflow facility.
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PMID:[Physiologic aging in aqueous humor minute volume of the human eye]. 781 85


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