Grading of diabetic retinopathy

Published on Dec 1, 2007
· DOI :10.1007/978-3-540-29542-6_19
Michael Larsen62
Estimated H-index: 62
(UCPH: University of Copenhagen),
Wael Soliman14
Estimated H-index: 14
(UCPH: University of Copenhagen)
+ 12 AuthorsJulia A. Haller60
Estimated H-index: 60
(Johns Hopkins University)
Sources
Abstract
The grading of diabetic retinopathy is based on the concept that a hierarchy of stages can be defined, where the higher the grade, the higher the risk of suffering visual loss. The grading scale reflects the natural course of the disease in its unrelenting and most devastating form. In reality, diabetic retinopathy can regress both spontaneously and after therapeutic intervention. To construct or validate a grading scale, rates of progression to visual loss or another endpoint that is meaningful to the patient must be measured. Grading scales constructed for scientific and regulatory purposes, such as the study of new interventions, are made with the purpose of achieving maximum sensitivity for change in retinopathy. Interventional trials may then result in selected grades being validated and found useful for guiding interventions such as photocoagulation for proliferative diabetic retinopathy or diabetic macular edema. The timely identification of patients who reach interventional thresholds is the purpose subserved by simpler grading scales used in clinical screening practice.
📖 Papers frequently viewed together
49 Citations
2019
6 Authors (Filippo Arcadu, ..., Marco Prunotto)
89 Citations
References488
Newest
#1Ralph A. DeFronzo (University of Texas Health Science Center at San Antonio)H-Index: 182
#2Ele Ferrannini (UniPi: University of Pisa)H-Index: 110
Last. Paul Zimmet (Alfred Hospital)H-Index: 143
view all 4 authors...
Diagnosis, Epidemiology and Aetiology of Diabetes Biochemistry and Pathophysiology of Diabetes Management of Diabetes Monitoring of Therapy Special Problems in Management Acute Disturbances of Diabetes Chronic Complications of Diabetes Diabetes and Public Health.
611 Citations
Vascular endothelial growth factor (VEGF, VEGF-A) is a major regulator of physiological and pathological angiogenesis. Several VEGF inhibitors have been approved by the FDA for the treatment of advanced cancer and neovascular age-related macular degeneration. This brief review provides a historic account of the challenges associated with the discovery of VEGF and the early steps in elucidating the role of this molecule in the regulation of angiogenesis.
1,137 CitationsSource
#1Ioannis Ladas (Athens State University)H-Index: 25
#2George Theodossiadis (Athens State University)H-Index: 30
Fifty eyes of 42 patients with background diabetic retinopathy and diffuse macular edema were included in a prospective, randomized, clinical study to determine the long-term visual results of modified grid laser photocoagulation compared with the natural course of the disease. At the end of the three annual follow-up visits there were more eyes with improved visual acuity in the treatment group and more eyes with worse visual acuity in the control group. However, statistical analysis of the dat...
20 CitationsSource
Despite the better options of controlling diabetes mellitus and although the prognosis of diabetic retinopathy has markedly improved by laser treatment and vitreoretinal surgery, diabetic retinopathy
18 CitationsSource
#1Timothy S. Kern (Case Western Reserve University)H-Index: 75
#2C. Miller (Case Western Reserve University)H-Index: 9
Last. David P. BingamanH-Index: 1
view all 9 authors...
Pharmacologic treatment of diabetic retinopathy via eyedrops could have advantages but has not been successful to date. We explored the effect of topical Nepafenac, an anti-inflammatory drug known to reach the retina when administered via eyedrops, on the development of early stages of diabetic retinopathy and on metabolic and physiologic abnormalities that contribute to the retinal disease. Streptozotocin-induced diabetic rats were assigned to three groups (0.3% Nepafenac eyedrops, vehicle eyed...
150 CitationsSource
#1Antonia M. Joussen (HHU: University of Düsseldorf)H-Index: 13
#2Anthony P. AdamisH-Index: 85
In the past few decades, our knowledge of the mechanisms underlying retinal vasoproliferation has increased greatly (see Chapters 2, 3.1, 3.2 and 3.3). While vasoproliferation was once considered to be mainly a consequence of ischemia, current evidence also supports a contribution of inflammatory mechanisms. Inflammation is also highly related to vascular leakage in diseases that are known to result in retinal and macular edema. Recently, inflammatory mechanisms have gained interest with respect...
2 CitationsSource
#1Antonia M. Joussen (HHU: University of Düsseldorf)H-Index: 13
#2Thomas W. Gardner (PSU: Pennsylvania State University)H-Index: 46
Last. Stephen J. Ryan (SC: University of Southern California)H-Index: 75
view all 1 authors...
Section I -General Concepts in the pathogenesis of retinal vascular disease: Anatomy of the retinal vasculature. - General concepts in angiogenesis and vasculogenesis. - Cellular interaction in vascular remodeling. - Hematopoietic stem cells in vascular development. - Retinal vascular development.- Retinal vascular leakage. - Inflammation as a stimulus for vascular leakage and proliferation. - Hypoxia and hypoxic signaling in retinal disease. - Genetic approach to retinal vascular disease: the r...
82 CitationsSource
#1Quan Dong Nguyen (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 58
#2S. Tatlipinar (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 6
Last. Peter A. Campochiaro (JHUSOM: Johns Hopkins University School of Medicine)H-Index: 121
view all 9 authors...
Purpose The role of vascular endothelial growth factor (VEGF) in diabetic macular edema (DME) was tested with ranibizumab, a specific antagonist of VEGF. Design A nonrandomized clinical trial. Methods Ten patients with chronic DME received intraocular injections of 0.5 mg of ranibizumab at baseline and at one, two, four, and six months. The primary outcome was change in foveal thickness between baseline and seven months, and the secondary outcome measures were changes from baseline in visual acu...
319 CitationsSource
#1Janet B. McGill (WashU: Washington University in St. Louis)H-Index: 68
#2George L. King (Harvard University)H-Index: 113
Last. David L. Hyslop (Eli Lilly and Company)H-Index: 6
view all 7 authors...
The aim of this manuscript is to report the safety profile of patients treated with ruboxistaurin mesylate (RBX; LY333531), a selective protein kinase C-β (PKC-β) inhibitor, for up to 4 years. Data from patients with diabetes (1396 RBX 32 mg/day; 1408 placebo) were combined from 11 placebo-controlled, double-masked studies. The proportion of patients who reported one or more serious adverse events was greater in the placebo group than in the RBX-treated group (23.2 versus 20.8%, respectively). T...
43 CitationsSource
#1David M. BrownH-Index: 42
#2Peter K. Kaiser (Cleveland Clinic)H-Index: 104
Last. Susan Schneider (Genentech)H-Index: 4
view all 8 authors...
Of the 423 patients enrolled, 94.3% of those given 0.3 mg of ranibizumab and 96.4% of those given 0.5 mg lost fewer than 15 letters, as compared with 64.3% of those in the verteporfin group (P<0.001 for each comparison). Visual acuity improved by 15 letters or more in 35.7% of the 0.3-mg group and 40.3% of the 0.5-mg group, as compared with 5.6% of the verteporfin group (P<0.001 for each comparison). Mean visual acuity increased by 8.5 letters in the 0.3-mg group and 11.3 letters in the 0.5-mg g...
2,730 CitationsSource
Cited By1
Newest
#1E. Nitoda (UoC: University of Crete)H-Index: 1
#2P. Kallinikos (RMIT: RMIT University)H-Index: 1
Last. Miltiadis K. TsilimbarisH-Index: 31
view all 7 authors...
Purpose/Aim: To employ corneal confocal microscopy to assess differences in the extent of corneal nerve fiber alterations between diabetic patients classed according to retinopathy status and nondiabetic patients.Materials and Methods: Two hundred seventy-eight corneas of 139 patients with type 2 diabetes mellitus and 94 corneas of 47 age-matched control participants were scanned using corneal confocal microscopy. Images of the subbasal nerve plexus were collected and analyzed for nerve fiber de...
56 CitationsSource