Diabetic macular edema (DME) can cause blindness in diabetic patients suffering from diabetic retinopathy (DR). DM parameters controls (glycemia, arterial tension, and lipids) are the gold standard for preventing DR and DME. Although the vascular endothelial growth factor (VEGF) is known to play a role in the development of DME, the pathological processes leading to the onset of this disease are highly complex and the exact sequence in which they occur is still not completely understood. Angiogenesis and inflammation have been shown to be involved in the pathogenesis of this disease. However, it still remains to be clarified whether angiogenesis following VEGF overexpression is a cause or a consequence of inflammation. This paper provides a review of the data currently available, focusing on VEGF, angiogenesis, and inflammation. Our analysis suggests that angiogenesis and inflammation act interdependently during the development of DME. Knowledge of DME etiology seems to be important in treatments with anti-VEGF or anti-inflammatory drugs. Current diagnostic techniques do not permit us to differentiate between both etiologies. In the future, diagnosing the physiopathology of each patient with DME will help us to select the most effective drug.
PURPOSE: To investigate the correlation between the hyperreflective foci (HF) on spectral domain optical coherence tomography at the baseline and visual outcomes after intravitreal bevacizumab injections in different patterns of diabetic macular edema. METHODS: We retrospectively reviewed the medical records of 97 eyes (80 patients) with diabetic macular edema that were treated with intravitreal bevacizumab injection. The eyes were categorized into three groups by optical coherence tomographic f...
Purpose To investigate the role of baseline demographics, disease characteristics, and treatment responses to ranibizumab during RIDE/RISE in predicting long-term treatment frequency with a criteria-based pro re nata (PRN) regimen during the open-label extension (OLE). Design Pooled, retrospective, post hoc analysis from the phase III, randomized RIDE/RISE studies and subsequent OLE. Participants Five hundred patients enrolled in the OLE after completion of the 36-month RIDE/RISE studies. Method...
To assess and correlate early modifications in hyperreflective retinal spots (HRS), retinal sensitivity (RS), fixation stability, and best-corrected visual acuity (BCVA) after anti-vascular endothelial growth factor treatment in naive center-involving diabetic macular edema.Cross-sectional comparative case-control series. Twenty diabetic patients underwent 3 consecutive intravitreal anti-vascular endothelial growth factor injections in the study eye (20 fellow eyes served as control), full ophth...
Purpose To provide 2-year results comparing anti–vascular endothelial growth factor (VEGF) agents for center-involved diabetic macular edema (DME) using a standardized follow-up and retreatment regimen. Design Randomized clinical trial. Participants Six hundred sixty participants with visual acuity (VA) impairment from DME. Methods Randomization to 2.0-mg aflibercept, 1.25-mg repackaged (compounded) bevacizumab, or 0.3-mg ranibizumab intravitreous injections performed up to monthly using a proto...
#1Thomas S. Hwang(OHSU: Oregon Health & Science University)H-Index: 30
#2Simon S. Gao(OHSU: Oregon Health & Science University)H-Index: 25
Last. Yali Jia(OHSU: Oregon Health & Science University)H-Index: 43
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Importance Macular ischemia is a key feature of diabetic retinopathy (DR). Quantification of macular ischemia has potential as a biomarker for DR. Objective To assess the feasibility of automated quantification of capillary nonperfusion as a potential sign of macular ischemia using optical coherence tomography (OCT) angiography. Design, Setting, and Participants An observational study conducted in a tertiary, subspecialty, academic practice evaluated macular nonperfusion with 6 × 6-mm OCT angiog...
Purpose To evaluate visual and anatomic outcomes after intravitreal aflibercept injection (IAI) versus laser in diabetic macular edema (DME) patients with and without prior anti–vascular endothelial growth factor (VEGF) treatment for DME. Design Post hoc analysis of eyes from 2 similarly designed, phase 3 trials, VISTA and VIVID. Participants Patients (eyes) with DME with central involvement from VISTA (n = 461) and VIVID (n = 404). Methods Eyes received IAI 2 mg every 4 weeks (2q4), IAI 2 mg ev...
Last. Anita Kotwani(DU: University of Delhi)H-Index: 19
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Diabetic retinopathy, a severe sight-threatening complication of diabetes mellitus, accounts for a large number of cases of acquired, yet potentially avoidable, blindness. The principal mechanism of its pathogenesis appears to be alterations in the microvasculature of retina as the result of hyperglycemia. The elevated concentration of blood glucose is a harbinger of numerous molecular changes. These lead to various responses that result in microangiopathy. Oxidative stress, one such response, i...
Over the last decade, there has been an expansion of imaging modalities available to clinicians to diagnose and monitor the treatment and progression of diabetic retinopathy. Recently, advances in image technologies related to OCT and OCT angiography have enabled improved visualization and understanding of this disease. In this review, we will describe the use of imaging techniques such as colour fundus photography, fundus autofluorescence, fluorescein angiography, infrared reflectance imaging, ...
Last. Edoardo Midena(UNIPD: University of Padua)H-Index: 39
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Purpose Retinal glia cells (RGC) activation and release of inflammatory cytokines have been associated with development of diabetic retinopathy (DR). In this study, we evaluated by protein array the presence of aqueous humour (AH) cytokines secreted by RGC in patients with diabetes without DR and with mild DR. Methods This is a cross-sectional, case–control study. Thirty-five subjects (diabetics and controls) underwent full ophthalmic examination and AH samples collection before cataract surgery...
PURPOSE: The purpose of this study was to compare optical coherence tomography (OCT) angiography to standard fluorescein angiography (FA) in the grading of diabetic macular ischemia. METHODS: In our study, OCT angiography and traditional FA images were acquired from 24 diabetic patients. The level of diabetic macular ischemia in the superficial capillary plexus was graded with standard Early Treatment Diabetic Retinopathy Study (ETDRS) protocols and a comparison between conventional FA and OCT a...
Autophagy is the major catabolic pathway involved in removing and recycling damaged macromolecules and organelles and several evidences suggest that dysfunctions of this pathway contribute to the onset and progression of central and peripheral neurodegenerative diseases. Diabetic retinopathy (DR) is a serious complication of diabetes mellitus representing the main preventable cause of acquired blindness worldwide. DR has traditionally been considered as a microvascular disease, however this conc...
#2Wei Yen Kong(UKM: National University of Malaysia)
Last. Norshamsiah Md Din(UKM: National University of Malaysia)H-Index: 7
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To evaluate vascular endothelial growth factor (VEGF) levels in serum and urine among diabetic nephropathy (DN) patients with and without diabetic retinopathy (DR). This is a cross-sectional study involving stage 3 and 4 DN patients. A fundus examination was done to determine the DR status. VEGF levels were measured using VEGF-A ELISA kits. Serum creatinine, glycated hemoglobin (HbA1c), and urine protein creatinine index (UPCI) were analyzed per laboratory protocol. Clinical data collected inclu...
Purpose To study the association between gut microbial abundance and sight-threatening diabetic retinopathy among patients with a history of type 2 diabetes mellitus. Methods An observational case-control study was performed using a sample population of diabetics referred to a tertiary eye institute. Sample subjects were identified as cases if they were diagnosed with sight-threatening diabetic retinopathy and controls if they were not but had at least a 10-year history of diabetes. Fecal swabs ...
#1Irini Chatziralli(UoA: National and Kapodistrian University of Athens)H-Index: 21
Introduction: Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus and the leading cause of blindness in young adults. Prior to anti-vascular endothelial growth factor (anti-VEGF) agents, the treatment of DR was based on control of systemic factors and laser photocoagulation. Over the past decade, the use of anti-VEGF agents has revolutionized the treatment of DR, including diabetic macular edema (DME).Areas covered: Ranibizumab has been proven to be effec...
Diabetes-associated complications, such as retinopathy, nephropathy, cardiomyopathy, and atherosclerosis, the main consequences of long-term hyperglycemia, often lead to organ dysfunction, disability, and increased mortality. A common denominator of these complications is the myofibroblast-driven excessive deposition of extracellular matrix proteins. Although fibroblast appears to be the primary source of myofibroblasts, other cells, including endothelial cells, can generate myofibroblasts throu...
Abstract Age-related eye disorders are chronic diseases that affect millions of people worldwide. They cause visual impairment and, in some cases, irreversible blindness. Drug targeting to the retina is still a challenge due to the difficulties with drug distribution, crossing eye barriers, and reaching intraocular tissues in an effective therapeutic concentration. Although intravitreal injections can directly deliver drugs to the posterior segment of the eye, it remains an invasive technique an...
Bone morphogenetic proteins (BMPs) play an important role in bone formation and repair. Recent studies underscored their essential role in the normal development of several organs and vascular homeostasis in health and diseases. Elevated levels of BMPs have been linked to the development of cardiovascular complications of diabetes mellitus. However, their particular role in the pathogenesis of microvascular dysfunction associated with diabetic retinopathy (DR) is still under-investigated. Accumu...
Background. According to a wide range of authors, eye damage caused by diabetes mellitus accounts for 80–90 % of the total number of disorders. The development of mathematical predictive models allows for a more versatile analysis of experimental and clinical data. The purpose of the study was to develop a model for predicting the severity of diabetic retinopathy based on a review of markers of endothelial dysfunction and hypoxia. Materials and methods. We used a streptozotocin model of type 2 d...
PURPOSE To evaluate the morphological characteristics in patients with diabetic macular edema (DME), either with co-existent non-proliferative diabetic retinopathy (NPDR) or with PDR. METHODS Retrospective study includes 138 treatment naive patients with DME, either with NPDR (n = 96) or in combination with PDR (n = 42). All patients underwent best corrected visual acuity (BCVA) measurement, spectral domain-optical coherence tomography (SD-OCT) and fluorescein angiography, while demographic char...
Purpose. To evaluate efficacy and safety of intravitreal dexamethasone 0.7 mg implant in treatment-naive DME patients and to assess the utility of OCT structural biomarkers as predictors of functional response after treatment. Methods. Thirty-nine eyes of 39 diabetic patients with center involving DME were enrolled. Best-corrected visual acuity (BCVA) and SS-OCT (DRI SS-OCT Triton, Topcon, Japan) to evaluate central retinal thickness (CRT), serous retinal detachment (SRD), intraretinal cysts (IR...