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Med Image Anal 2021 May 28;72:102118. Epub 2021 May 28.

Univ Bretagne Occidentale, Brest F-29200 France; Inserm, UMR 1101, Brest F-29200 France; Service d'Ophtalmologie, CHRU Brest, Brest F-29200 France.

In recent years, Artificial Intelligence (AI) has proven its relevance for medical decision support. However, the "black-box" nature of successful AI algorithms still holds back their wide-spread deployment. In this paper, we describe an eXplanatory Artificial Intelligence (XAI) that reaches the same level of performance as black-box AI, for the task of classifying Diabetic Retinopathy (DR) severity using Color Fundus Photography (CFP). Read More

BMC Pharmacol Toxicol 2021 Jun 13;22(1):34. Epub 2021 Jun 13.

Glenmark Pharmaceuticals Ltd, Mumbai, India.

Background: Patients with type 2 diabetes mellitus (T2DM) are characterized by an elevated glycemic index and are at a higher risk for complications such as cardiovascular disease, nephropathy, retinopathy and peripheral neuropathy. Normalization of glycemic index can be achieved by dosing combinations of metformin with other anti-diabetic drugs. The present study (Clintrials number NCT00519480) was conducted to evaluate the safety, tolerability, pharmacokinetics and pharmacodynamics of remogliflozinetabonate, an SGLT2 inhibitor, withdoses (500 mg and 750 mg BID) greater than the commercial dose (100 mg BID)in combination with metformin with minimum daily dose of 2000 mg given in two divided doses. Read More

J Inflamm Res 2021 4;14:2411-2424. Epub 2021 Jun 4.

Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China.

Background: Diabetic retinopathy (DR) is a most common microvascular complication and regarded as the leading cause of blindness in the working age population. The involvement of miR-200a in various disorders has become recognized, and the objective of this study was to identify the protective effect of miR-200a in the development of DR.

Methods: The contents of miR-200a and its potential target gene, PDZ and LIM domain protein 1 (PDLIM1), were detected in both in-vivo and in-vitro DR models. Read More

Curr Diabetes Rev 2021 Jun 8. Epub 2021 Jun 8.

Department of Medical Microbiology & Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Background: Type 2 diabetes is a part of metabolic syndrome associated with a higher risk of vascular complications. Diabetes is characterized by changes in platelet morphology, function, and platelet hyperactivity so, it's considered a prothrombotic condition. Morbidity and mortality in people with type 2 diabetes-related to micro and macrovascular complications. Read More

BMC Ophthalmol 2021 Jun 7;21(1):252. Epub 2021 Jun 7.

Department of Ophthalmology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Key Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences, Beijing, 100730, China.

Background: To describe the longitudinal changes in retinal neovascularization elsewhere (NVE) as observed on optical coherence tomography angiography (OCTA) in proliferative diabetic retinopathy (PDR) treated by panretinal photocoagulation (PRP).

Methods: Each patient included in this prospective clinical study was newly diagnosed with PDR and NVE confirmed by both fundus fluorescein angiography (FFA) and OCTA. They received four sessions of PRP using a multiwavelength laser. Read More

Eur J Ophthalmol 2021 Jun 7:11206721211020200. Epub 2021 Jun 7.

Department of Ophthalmology, Chang'an Hospital, Xi'an, Shaanxi, China.

Background: Diabetic retinopathy (DR), a common complication of diabetes mellitus, is the major cause of visual impairment and blindness. Circ_0000615 was found to be elevated in retina samples of diabetic patients. Hence, the detailed effects and molecular mechanisms of circ_0000615 in DN progression were explored. Read More

J Res Med Sci 2021 28;26. Epub 2021 Jan 28.

The National Centre for Diabetes, Endocrinology and Genetics, Amman, Jordan.

Background: Hyperglycemia over-activates glucose reduction to sorbitol by aldose reductase (ALR) leading to osmoregulation disruption and cellular damage that cause diabetic complications. We investigated the association of C106T polymorphism of gene with the severity of diabetic retinopathy (DR) in Jordanian Type 2 diabetic patients in this case-control study at the Ophthalmology clinic of the National Centre of Diabetes, Endocrinology, and Genetics.

Materials And Methods: A total of 277 subjects participated in the study (100 diabetics without retinopathy, 82 diabetics with retinopathy, and 95 controls). Read More

Br J Ophthalmol 2021 Jun 3. Epub 2021 Jun 3.

Warwick Medical School, University of Warwick, Coventry, UK.

Background/aims: Surveillance of people with previously successfully treated diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) adds pressure on ophthalmology services. This study evaluated a new surveillance pathway entailing multimodal imaging reviewed by trained ophthalmic graders and compared it with the current standard care (face-to-face evaluation by an ophthalmologist).

Methods: Cost analysis of the new ophthalmic grader pathway, compared with the standard of care, from the perspective of the UK National Health Service, based on evidence from the Effectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy study. Read More

Can J Physiol Pharmacol 2021 Jun 3. Epub 2021 Jun 3.

Huizhou Municipal Central Hospital, Huizhou, China;

Background: Diabetic retinopathy (DR) has been regarded as a sight-threatening vascular complication of diabetes mellitus (DM). Accumulating evidence has identified the involvement of long non-coding RNAs (lncRNAs) in DR pathogenesis. We aim to investigate the role and underlying mechanism of linc00174 in DR process. Read More

Ophthalmol Ther 2021 Jun 1. Epub 2021 Jun 1.

Pharmerit International, An OPEN Health Company, Berlin, Germany.

Background: The 96 weeks' assessment from the VIEW studies provided insights into the long-term efficacy of intravitreal aflibercept (IVT-AFL) in neovascular age-related macular degeneration (nAMD) and demonstrated that it was possible to maintain long-term outcomes while moving from a fixed bimonthly regimen in Year 1 to a variable dosing regimen in Year 2. The aim of this analysis was to perform a literature review and meta-analysis assessing the use of IVT-AFL and real-world outcomes in treatment-naïve patients with nAMD treated with IVT-AFL for 2 years, as per label.

Methods: A literature review and meta-analysis were performed to provide an overview of the baseline characteristics of the population, the 2-year outcomes, the associated treatment burden, and safety. Read More

Int J Environ Res Public Health 2021 May 29;18(11). Epub 2021 May 29.

Department of Ophthalmology, University Hospital of Zurich, 8091 Zurich, Switzerland.

Background: During the first COVID-19 pandemic outbreak, a new triage concept had to be implemented for patients with retinal diseases having a scheduled appointment at the medical retina clinic. In this study, we aimed to assess patients' confidence in this triage concept and patients' satisfaction regarding the received treatment during the outbreak.

Methods: This retrospective study included all patients with a diagnosed retinal disease, triaged into three priority groups based on their condition's urgency during lockdown. Read More

J Clin Med 2021 May 27;10(11). Epub 2021 May 27.

Department of Ophthalmology, Poznan City Hospital, Szwajcarska 3, 60-285 Poznan, Poland.

Background: The prevalence of diabetic retinopathy (DR) is expected to increase. This will put an increasing strain on health care resources. Recently, artificial intelligence-based, autonomous DR screening systems have been developed. Read More

Sensors (Basel) 2021 May 25;21(11). Epub 2021 May 25.

School of Informatics, Xiamen University, Xiamen 361005, China.

(1) Background: Diabetic retinopathy, one of the most serious complications of diabetes, is the primary cause of blindness in developed countries. Therefore, the prediction of diabetic retinopathy has a positive impact on its early detection and treatment. The prediction of diabetic retinopathy based on high-dimensional and small-sample-structured datasets (such as biochemical data and physical data) was the problem to be solved in this study. Read More

Diagnostics (Basel) 2021 May 11;11(5). Epub 2021 May 11.

UPMC Eye Centre, University of Pittsburgh, Pittsburgh, PA 15213, USA.

Background: To map the choroidal vascularity index and compare two eyes in patients with unilateral central serous chorioretinopathy (CSCR).

Methods: This was a retrospective, observational study performed in patients with unilateral CSCR. Choroidal thickness (CT) and Choroidal vascularity index (CVI) were measured and mapped in various zones according to the early treatment diabetic retinopathy (ETDRS) grid. Read More

J Clin Med 2021 May 15;10(10). Epub 2021 May 15.

AIBILI-Association for Innovation and Biomedical Research on Light and Image, 3000-548 Coimbra, Portugal.

Background: Analysis of retinal microaneurysm turnover (MAT) has been previously shown to contribute to the identification of eyes at risk of developing clinically significant complications associated with diabetic retinopathy (DR). We propose to further characterize MAT as a predictive biomarker of DR progression and development of vision-threatening complications.

Methods: 212 individuals with type 2 diabetes (T2D; ETDRS grades 20 and 35) were evaluated annually in a 5-year prospective, longitudinal study, by color fundus photography and optical coherence tomography. Read More

Health Technol Assess 2021 May;25(32):1-104

Warwick Medical School, University of Warwick, Coventry, UK.

Background: Owing to the increasing prevalence of diabetes, the workload related to diabetic macular oedema and proliferative diabetic retinopathy is rising, making it difficult for hospital eye services to meet demands.

Objective: The objective was to evaluate the diagnostic performance, cost-effectiveness and acceptability of a new pathway using multimodal imaging interpreted by ophthalmic graders to detect reactivation of diabetic macular oedema/proliferative diabetic retinopathy in previously treated patients.

Design: This was a prospective, case-referent, cross-sectional diagnostic study. Read More

BMC Ophthalmol 2021 May 31;21(1):243. Epub 2021 May 31.

Recep Tayyip Erdoğan University, Zihni Derin Yerleşkesi - Fener Mahallesi, 53100, Merkez/Rize, Turkey.

Background: To evaluate alterations in the serum concentrations of vascular endothelial growth factor (VEGF) and netrin-1 after intravitreal bevacizumab (BCZ) injection for the treatment of diabetic macular edema (DME).

Methods: This prospective case-control study included a total of 50 participants assigned to one of three groups, including 10 individuals with DME and non-proliferative diabetic retinopathy (NPDR), 13 with DME, and proliferative diabetic retinopathy (PDR), and 27 healthy individuals as a control group. Serum VEGF and netrin-1 concentrations were measured by enzyme-linked immunosorbent assays (ELISAs) immediately before, as well as 1 week and 1 month after, intravitreal BCZ injection. Read More

JMIR Med Inform 2021 May 31;9(5):e28868. Epub 2021 May 31.

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Background: Retinal vascular diseases, including diabetic macular edema (DME), neovascular age-related macular degeneration (nAMD), myopic choroidal neovascularization (mCNV), and branch and central retinal vein occlusion (BRVO/CRVO), are considered vision-threatening eye diseases. However, accurate diagnosis depends on multimodal imaging and the expertise of retinal ophthalmologists.

Objective: The aim of this study was to develop a deep learning model to detect treatment-requiring retinal vascular diseases using multimodal imaging. Read More

J Manag Care Spec Pharm 2021 Jun;27(6):743-752

Retina Consultants of Houston, Retina Consultants of America, and Blanton Eye Institute and Houston Methodist Hospital, Houston, TX.

Age-related macular degeneration (AMD) is a leading cause of blindness worldwide and is the most common cause of blindness in developed countries. Despite antivascular endothelial growth factor (anti-VEGF) therapy demonstrating improvements in visual and anatomical outcomes, unmet needs remain. Brolucizumab-dbll (ie, brolucizumab), a VEGF inhibitor for treatment of neovascular (wet) AMD and recently approved by the FDA for its treatment of wet AMD, attempts to mitigate treatment burden through less frequent injections. Read More

Clin Hemorheol Microcirc 2021 May 23. Epub 2021 May 23.

Moscow Regional Research and Clinical Institute ("MONIKI"), Moscow, Russian Federation.

Background: Neurogenic regulation is involved in the development of microcirculation response to local heating. We suggest that microvascular reactivity can be used to estimate the severity of diabetic polyneuropathy (DPN).

Objective: To evaluate the prospects for using the parameters of skin microvascular reactivity to determine the severity of DPN. Read More

Diabetes Metab Syndr Obes 2021 21;14:2291-2308. Epub 2021 May 21.

Department of Ophthalmology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.

Background: Diabetic retinopathy (DR) is characterized by retinal vascular endothelial cell death and vascular inflammation, which are microvascular complications of diabetes mellitus (DM). Salusin-β, a newly identified peptide, is closely associated with hypertension, atherosclerosis and diabetic cardiomyopathy. However, the exact role of salusin-β in high glucose (HG)-induced retinal capillary endothelial cell (REC) inflammation and apoptosis remains unclear. Read More

PeerJ 2021 18;9:e11316. Epub 2021 May 18.

Research Unit Protein Science and Metabolomics and Proteomics Core Facility, Helmholtz Center Munich, German Research Center for Environmental Health GmbH, Munich, Germany.

Background: The underlying pathomechanisms in diabetic retinopathy (DR) remain incompletely understood. The aim of this study was to add to the current knowledge about the particular role of retinal Mller glial cells (RMG) in the initial processes of DR.

Methods: Applying a quantitative proteomic workflow, we investigated changes of primary porcine RMG under short term high glucose treatment as well as glycolysis inhibition treatment. Read More

Clin Ophthalmol 2021 20;15:2089-2097. Epub 2021 May 20.

Department of Ophthalmology, London North West University Healthcare NHS Trust, London, UK.

Background: Diabetic macular oedema (DMO) is the leading cause of sight impairment in working age populations in developed countries. Current first line treatment for centre-involving DMO involves intravitreal anti-VEGF but treatment response can be variable. In this retrospective, real world, multi-centre cohort study, we aim to identify ocular and systemic characteristics that correlate with anatomical and functional outcomes for treatment-naive DMO patients treated with intravitreal aflibercept. Read More

Ophthalmic Surg Lasers Imaging Retina 2021 May 1;52(5):247-256. Epub 2021 May 1.

Background And Objective: To determine outcomes of eyes with diabetic macular edema (DME) and best visual acuity (BVA) of 20/25 or better in routine clinical practice.

Patients And Methods: Retrospective study of 72 patients with DME and BVA of 20/25 or better. Patients were divided by anti-vascular endothelial growth factor (VEGF) treatment regimen: early (Group A), delayed (Group B), and none (Group C). Read More

Curr Med Chem 2021 May 26. Epub 2021 May 26.

Diabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain.

Background: Ezrin, radixin, and moesin (the ERM complex) interact directly with membrane proteins regulating their attachment to actin filaments. ERM protein activation modifies cytoskeleton organization and alters the endothelial barrier function, thus favoring vascular leakage. However, little is known regarding the role of ERM proteins in diabetic retinopathy (DR). Read More

J Family Med Prim Care 2021 Feb 27;10(2):985-990. Epub 2021 Feb 27.

Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes, Buckinghamshire, UK.

Background: Lower extremity amputation (LEA) in individuals with diabetes is a serious health issue with a considerable physical and social burden. The aim of this study was to assess the prevalence and risk factors associated with LEA in diabetic foot ulcer (DFU) patients.

Materials And Methods: This was a cross-sectional health facility-based study that recruited 315 diabetes individuals with foot ulcers from the diabetes center in Khartoum, Sudan. Read More

Ophthalmic Surg Lasers Imaging Retina 2021 Apr 1;52(4):208-217. Epub 2021 Apr 1.

Background And Objective: This study assessed racial and ethnic differences in receiving anti-vascular endothelial growth factor (VEGF) intravitreal injections among commercially insured patients.

Patients And Methods: A retrospective cohort study of 104,430 patients diagnosed with wet age-related macular degeneration (AMD), diabetic retinopathy, central retinal vein occlusion (CRVO), and branch retinal vein occlusion (BRVO) in the Optum Research Database between 2011 and 2016. Main outcomes included receiving an intravitreal anti-VEGF treatment; the first type of treatment received, if any; and subsequent treatment with ranibizumab or aflibercept among patients who were first treated with bevacizumab. Read More

Ophthalmic Surg Lasers Imaging Retina 2021 Mar 1;52(3):116-122. Epub 2021 Mar 1.

Background And Objective: To quantify fractal dimension (FD) by mass-radius method in optical coherence tomography angiography (OCTA) images and characterize microvascular differences in eyes with and without diabetic retinopathy (DR).

Patients And Methods: A retrospective study was conducted using OCTA images of 3 mm × 3 mm and 6 mm × 6 mm scans for superficial and deep capillary plexuses from 49 control eyes and 58 eyes with DR.

Results: Analysis of variance showed a significant difference between the FD of control and diabetic eyes in deep plexus scans, and the 3 mm × 3 mm superficial plexus scan ( < . Read More

Implement Sci Commun 2021 May 22;2(1):54. Epub 2021 May 22.

Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

Background: Recommended annual diabetic retinopathy (DR) screening for people with diabetes has low rates in the USA, especially in underserved populations. Telemedicine DR screening (TDRS) in primary care clinics could expand access and increase adherence. Despite this potential, studies have observed high variability in TDRS rates among clinics and over time, highlighting the need for implementation supports. Read More

Caspian J Intern Med 2021 Mar;12(2):129-134

Clinical Research Development Unit of Rohani Hospital, Babol University of Medical Sciences, Babol, Iran.

Background: To the aim of this study was to evaluate the association between mean platelet volume (MPV) and diabetic retinopathy (DR).

Methods: Patients with diabetes mellitus (DM) referred to Ophthalmology Clinic of Rohani Teaching Hospital in Babol, Northern Iran were entered into this case-control study. Healthy subjects in control group included individuals without history of DM. Read More