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Automated Grading of Diabetic Retinopathy with Ultra-Widefield Fluorescein Angiography and Deep Learning.

J Diabetes Res 2021 8;2021:2611250. Epub 2021 Sep 8.

Eye Center, Renmin Hospital of Wuhan University, Wuhan, China.

Purpose: The objective of this study was to establish diagnostic technology to automatically grade the severity of diabetic retinopathy (DR) according to the ischemic index and leakage index with ultra-widefield fluorescein angiography (UWFA) and the Early Treatment Diabetic Retinopathy Study (ETDRS) 7-standard field (7-SF).

Methods: This is a cross-sectional study. UWFA samples from 280 diabetic patients and 119 normal patients were used to train and test an artificial intelligence model to differentiate PDR and NPDR based on the ischemic index and leakage index with UWFA. Read More

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September 2021

Association between cystatin C and diabetic retinopathy among type 2 diabetic patients in China: a Meta-analysis.

Int J Ophthalmol 2021 18;14(9):1430-1440. Epub 2021 Sep 18.

Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.

Aim: To explore the correlation between cystatin C (Cys-C) and diabetic retinopathy (DR) in those patients with type 2 diabetes mellitus (DM) in China.

Methods: Articles were collected from China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, EMBASE, Cochrane Library, Clinical Trials.gov, and Google Scholar. Read More

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September 2021

Animal models of diabetic retinopathy.

Ann Transl Med 2021 Aug;9(15):1272

Department of Ophthalmology and Visual Sciences, State University of New York (SUNY), Upstate Medical University, Syracuse, NY, USA.

The retina is the posterior neuro-integrated layer of the eye that conducts impulses induced by light to the optic nerve for human vision. Diseases of the retina often leads to diminished vision and in some cases blindness. Diabetes mellitus (DM) is a worldwide public health issue and globally, there is an estimated 463 million people that are affected by DM and its consequences. Read More

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Screening attendance, prevalence and severity of diabetic retinopathy (DR) in a cohort of patients with diabetes mellitus secondary to chronic pancreatitis (DMsCP) in Northern Ireland.

BMJ Open Diabetes Res Care 2021 Sep;9(1)

The Belfast Pancreatic Diabetes Clinic, Belfast City Hospital Health and Social Services Trust, Belfast, UK

Introduction: This study investigated Northern Ireland Diabetic Eye Screening Programme (NIDESP) attendance and diabetic retinopathy (DR) prevalence/severity in patients with diabetes mellitus secondary to chronic pancreatitis (PwDMsCP).

Research Design And Methods: Medical/NIDESP records for all PwDMsCP attending the pancreatic diabetes clinic were analyzed in 2017 (n=78) and 2019 (n=94).

Results: Between 2017 and 2019, those without DR decreased (76% to 63%); mild non-proliferative DR (NPDR), severe NPDR and PDR were found in 30%, 2% and 5%, respectively (previously 18%, 4%, 2%); diabetic maculopathy (DMac) was present in 12% (previously 10%). Read More

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September 2021

Macular Vascular Density Analysis Using Adobe Photoshop Software In Diabetic Eyes: Optical Coherence Tomography Angiography Study.

J Ayub Med Coll Abbottabad 2021 Jul-Sep;33(3):441-446

Department of Biotechnology and Genetic Engineering, University of Agriculture, Peshawar, Pakistan.

Background: Optical Coherence Tomography Angiography (OCTA) is dye less microvascular visualizing technique. In study we binaries OCTA images of macular vessels in healthy and diabetic subjects without macular oedema using Adobe Photoshop CS3 extended version.

Methods: Prospective, single centered, observational study total of 58 eyes of 108 Diabetic Retinopathy (DR) subjects and 20 eyes of 40 normal subjects with mean age of 58. Read More

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September 2021

Alterations in choroidal vascular parameters following panretinal photocoagulation using enhanced-depth imaging optical coherence tomography in diabetic retinopathy.

Graefes Arch Clin Exp Ophthalmol 2021 Sep 1. Epub 2021 Sep 1.

Retina Service, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin square, South Karegar Street, 1336616351, Tehran, Iran.

Purpose: To investigate the alteration of choroid in patients with very severe non-proliferative diabetic retinopathy (NPDR) or early proliferative diabetic retinopathy (PDR) following panretinal photocoagulation (PRP).

Methods: Thirty-nine eyes of 21 patients with very severe non-proliferative diabetic retinopathy (NPDR) (19 eyes) and early proliferative diabetic retinopathy (PDR) (20 eyes) were recruited. Enhanced-depth imaging optical coherence tomography at baseline, 1, and 6 months after PRP was employed to measure choroidal parameters including total choroidal area (TCA) and choroidal vascular index (CVI). Read More

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September 2021

Ocular surface temperature measurement in diabetic retinopathy.

Exp Eye Res 2021 Aug 28;211:108749. Epub 2021 Aug 28.

Indira Gandhi Centre for Atomic Research, Kalpakkam, India. Electronic address:

Infrared thermography provides functional imaging by picturing the temperature pattern of the region imaged. The temperature correlates to the blood flow pattern and is used in the diagnosis of diseases like breast cancer, peripheral vascular disorders, diabetic neuropathy and fever screening. In the present study, the usage of ocular thermography for diagnosis of diabetic retinopathy is explored. Read More

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Intravitreal Anti-Vascular Endothelial Growth Factor Agents for the Treatment of Diabetic Retinopathy: A Review of the Literature.

Pharmaceutics 2021 Jul 26;13(8). Epub 2021 Jul 26.

Division of Ophthalmology, Tel-Aviv Sourasky Medical Center, Tel Aviv-Yafo 6423906, Israel.

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population. The purpose of this review is to gather the existing literature regarding the use of the approved anti-vascular endothelial growth (anti-VEGF) agents in the treatment of DR. A comprehensive literature review in PubMed engine search was performed for articles written in English language up to 1 July 2021, using the keywords "diabetic retinopathy", "ranibizumab", "aflibercept", and "anti-VEGF". Read More

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Prevention of vision-threatening complications in diabetic retinopathy: two perspectives based on results from the DRCR Retina Network Protocol W and the Regeneron-sponsored PANORAMA.

Curr Opin Ophthalmol 2021 Aug 20. Epub 2021 Aug 20.

Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Retina Division, Department of Ophthalmology, Chiang Mai University, Chiang Mai, Thailand.

Purpose Of Review: The use of intravitreous antivascular endothelial growth factor to prevent center-involved diabetic macular edema (CI-DME) with vision loss and proliferative diabetic retinopathy (PDR) has been investigated and recently reported in two randomized clinical trials. Although both trials showed substantial superiority of aflibercept at preventing the development of vision-threatening complications (VTCs) of CI-DME or PDR compared with sham at 1 or 2 years, without a concomitant benefit in visual acuity outcomes, the interpretation of the results and its application to clinical practice resulted in two disparate opinions. In this review, we discuss these two trials including their similarities and differences, other relevant studies, and considerations regarding the interpretation and the application of these results into clinical practice. Read More

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Incidence and risk factors of severe non-proliferative/proliferative diabetic retinopathy: More than a decade follow up in the Tehran Lipids and Glucose Study.

J Diabetes Investig 2021 Aug 17. Epub 2021 Aug 17.

Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Aims/introduction: To examine the incidence rate of severe non-proliferative and proliferative diabetic retinopathy (severe-NPDR/PDR) and determine its potential risk factors.

Materials And Methods: The study consisted of 1,169 participants (675 women) with type 2 diabetes mellitus, aged ≥20 years. A trained interviewer collected information about the history of pan-retinal photocoagulation as a result of diabetic retinopathy. Read More

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Subclinical Hypothyroidism in Patients with Diabetic Retinopathy: Role of Vascular Endothelial Growth Factor.

Endocr Metab Immune Disord Drug Targets 2021 Aug 9. Epub 2021 Aug 9.

Department of Internal Medicine, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

Background: Considering the vital role of vascular endothelial growth factor (VEGF) in the development of diabetic retinopathy (DR) in one hand and the frequent association between subclinical hypothyroidism (SCH) and DR on the other hand.

Objective: The present study was proposed to explore the possible role of VEGF in the relation between SCH and DR, thus we investigated the relation between SCH and VEGF levels in patients with DR.

Methods: Two hundred patients with DR were recruited in this study [100 patients with proliferative diabetic retinopathy (PDR) and 100 patients with non-proliferative diabetic retinopathy (NPDR)]. Read More

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Correlation of serum delta-like ligand-4 level with the severity of diabetic retinopathy.

BMC Endocr Disord 2021 Aug 6;21(1):157. Epub 2021 Aug 6.

Department of Endocrinology, The First Affiliated Hospital of Soochow University, No.188 Shizi Road, Suzhou, China.

Background: Diabetic retinopathy (DR) is one of the most serious microvascular complications of type 2 diabetes mellitus (T2DM). Delta-like ligand-4 (DLL4) maintains the normal physiological microenvironment of the retina. However, the relationship between the level of DLL4 and the severity of DR remains unclear. Read More

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Macrophage-Like Cell Density Is Increased in Proliferative Diabetic Retinopathy Characterized by Optical Coherence Tomography Angiography.

Invest Ophthalmol Vis Sci 2021 08;62(10)

Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States.

Purpose: To quantitatively characterize macrophage-like cells (MLCs) at the vitreoretinal interface in different severity stages of diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA).

Methods: The study included 72 eyes of 72 subjects: 18 healthy controls, 22 diabetes mellitus (DM) without DR, 17 nonproliferative DR (NPDR), and 15 proliferative DR (PDR). We obtained repeated (average, 6. Read More

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Dataset from fundus images for the study of diabetic retinopathy.

Data Brief 2021 Jun 21;36:107068. Epub 2021 Apr 21.

Computer Engineer Department, Universidad Americana, Asunción 1029, Paraguay.

This article presents a database containing 757 color fundus images acquired at the Department of Ophthalmology of the Hospital de Clínicas, Facultad de Ciencias Médicas (FCM), Universidad Nacional de Asunción (UNA), Paraguay. Firstly, the retinal images were acquired with a clinical procedure presented in this paper. The acquisition of the retinographies was made through the Visucam 500 camera of the Zeiss brand. Read More

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Serum cortisol is a biomolecular biomarker for severity of diabetic retinopathy.

Mol Vis 2021 3;27:429-437. Epub 2021 Jul 3.

Eye Institute, Saint Louis University, Saint Louis, MO.

Purpose: Cortisol and prolactin are multifunctional hormones essential for various metabolic processes in the human body. This study evaluated for the first time the association between serum cortisol and prolactin levels and severity of diabetic retinopathy (DR) and their role as biomolecular biomarkers for disease progression.

Methods: A tertiary care center-based cross-sectional study was conducted. Read More

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Pro-inflammatory cytokine profile is present in the serum of Mexican patients with different stages of diabetic retinopathy secondary to type 2 diabetes.

BMJ Open Ophthalmol 2021 30;6(1):e000717. Epub 2021 Jun 30.

Research Unit, Microbiology and Ocular Proteomics Department, Instituto de Oftalmologia Fundacion Conde de Valenciana IAP, Mexico City, Mexico.

Aim: It's been reported that pro-inflammatory cytokines are elevated in patients with diabetic retinopathy (DR); this may contribute to the pathophysiology of the disease. The aim of this study is to measure the concentration of various inflammatory cytokines from the main CD4+ T helper inflammatory responses in blood serum from Mexican patients with DR in different stages using cytometric bead array (CBA) technology and correlate them with the presence and severity of DR in order to find possible DR biomarkers that serve as diagnostic or therapeutic predictors.

Methods: 64 subjects were included in the study, 16 in the control group, 16 in the type 2 diabetes mellitus no DR (NDR) group, 16 in the non-proliferative DR (NPDR) group and 16 in the proliferative DR (PDR) group. Read More

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Ocular TGF-, Matrix Metalloproteinases, and TIMP-1 Increase with the Development and Progression of Diabetic Retinopathy in Type 2 Diabetes Mellitus.

Mediators Inflamm 2021 25;2021:9811361. Epub 2021 Jun 25.

Swiss Eye Institute, Rotkreuz and Retina Clinic, Berner Augenklinik am Lindenhofspital, 3012, Switzerland.

Diabetic retinopathy (DR) is a sight-threatening late complication of diabetes mellitus (DM). Even though its pathophysiology has not been fully elucidated, several studies suggested a role for transforming growth factor- (TGF-) , matrix metalloproteinases (MMPs), and tissue inhibitors of matrix metalloproteinase (TIMP) in the onset and progression of the disease. Consequently, the aim of this study was to analyze the concentrations of TGF-1, TGF-2, TGF-3, MMP-3, MMP-9, and TIMP-1 in patients with different stages of DR in order to identify stage-specific changes in their concentrations during the progression of the disease. Read More

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Detection of the Microvascular Changes of Diabetic Retinopathy Progression Using Optical Coherence Tomography Angiography.

Transl Vis Sci Technol 2021 06;10(7):31

Department of Ophthalmology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.

Purpose: To investigate microvascular parameters that are related to the severity of diabetic retinopathy (DR) with optical coherence tomography angiography (OCTA).

Methods: In total, 105 eyes from 105 diabetic patients were recruited in this prospective cross-sectional study, including 37 eyes with no clinical signs of DR (NoDR), 43 eyes with nonproliferative diabetic retinopathy (NPDR), and 25 eyes with proliferative diabetic retinopathy (PDR). Angiogram images from the parafoveal superficial capillary plexus (SCP), the deep capillary plexus (DCP), and the radial peripapillary capillary plexus were analyzed, and metrics were compared among groups. Read More

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Increased serum cortisol is associated with alterations in cross-sectional and topographic OCT parameters in diabetic retinopathy: a preliminary study.

Int Ophthalmol 2021 Jun 29. Epub 2021 Jun 29.

Augenklinik, Davos, Switzerland.

Purpose: Cortisol, a steroid hormone, plays an essential role in metabolic processes of diabetes mellitus. This study for the first time evaluated the association of serum cortisol with spectral domain optical coherence tomography (SD-OCT)-based cross-sectional and topographic parameters with severity of diabetic retinopathy (DR).

Methods: A tertiary care center-based preliminary study was undertaken. Read More

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Prevalence and incidence of diabetic retinopathy (DR) in the UK population of Gloucestershire.

Acta Ophthalmol 2021 Jun 28. Epub 2021 Jun 28.

Boehringer Ingelheim International GmBH, Ingelheim, Germany.

Purpose: To estimate prevalence and incidence of diabetic retinopathy (DR) in a UK region by severity between 2012 and 2016 and risk factors for progression to proliferative DR (PDR).

Methods: Electronic medical records from people with diabetes (PWD) ≥18 years seen at the Gloucestershire Diabetic Eye Screening Programme (GDESP) and the hospital eye clinic were analysed (HEC). Prevalence and incidence of DR per 100 PWD (%) by calendar year, grade and diabetes type were estimated using log-linear regression. Read More

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SCREENING FOR DIABETIC RETINOPATHY - A TWELVE-MONTH REVIEW.

Authors:
Tomaž Gračner

Acta Clin Croat 2020 Sep;59(3):424-430

1Maribor University Clinical Centre, Department of Ophthalmology, Maribor, Slovenia; 2University of Maribor, Faculty of Medicine, Maribor, Slovenia.

The purpose is to provide a twelve-month database review of screening for diabetic retinopathy (DR). A total of 1428 diabetes mellitus (DM) patients screened in 2017 were analyzed in a retrospective study. Retinal photographs were reviewed by an ophthalmologist for the presence and stage of DR, as well as for additional nondiabetic findings. Read More

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September 2020

Non-invasive Diagnosis and Prognosis Values of 3D Pseudocontinuous Arterial Spin Labeling and Optical Coherence Tomography Angiography in Proliferative Diabetic Retinopathy.

Front Med (Lausanne) 2021 4;8:682708. Epub 2021 Jun 4.

Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

3D Pseudocontinuous Arterial Spin Labeling (3D-PCASL) MRI and optical coherence tomography angiography (OCTA) have been applied to detect ocular blood flow (BF). We aim to characterize the ocular BF in diabetic retinopathy (DR) using 3D-PCASL and OCTA, to discuss the relationship between ocular and cerebral BF, and to evaluate their potential utility to assess the severity of DR. A total of 66 participants (132 eyes) were included. Read More

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Relating Retinal Vascular Oxygen Saturation and Microvasculature Morphology at Progressive Stages of Diabetic Retinopathy.

Transl Vis Sci Technol 2021 05;10(6)

Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA.

Purpose: Diabetic retinopathy (DR) is a common cause of vision loss in working age adults and presents changes in retinal vessel oxygenation and morphology. The purpose of this study was to test the hypothesis that there is an association of retinal vessel oxygen saturation with vessel density (VD) and tortuosity in DR.

Methods: Ninety-five subjects were classified in the following groups: nondiabetic control (N = 25), no DR (N = 28), mild nonproliferative DR (NPDR; N = 21), moderate to severe NPDR (N = 14), or treated proliferative DR (PDR; N = 7). Read More

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Association analysis of 374T/A (rs1800624) receptor for advanced glycation end-products (RAGE) gene polymorphism with diabetic retinopathy in Pakistani patients.

Pak J Med Sci 2021 May-Jun;37(3):733-739

Prof. Dr. Abdul Khaliq Naveed, FCPS, PhD. Department of Biochemistry, Riphah International University, Islamabad, Pakistan.

Objectives: to determine the relationship of 374T/A (rs1800624) polymorphism in the gene encoding RAGE with Type-2 diabetes mellitus (T2DM), diabetic retinopathy (DR) and serum soluble RAGE (sRAGE) level in Pakistani patients.

Methods: A case-control study, conducted from January 2017 to December 2018, involving 150 healthy controls (HC), 150 T2DM patients with no retinopathy (DNR) and 150 DR patients diagnosed by coloured fundus photography. Tetra-primer amplification refractory mutation system - polymerase chain reaction (T-ARMS-PCR) was used for genotyping. Read More

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Blood Levels of Glycated Hemoglobin, D-Dimer, and Fibrinogen in Diabetic Retinopathy.

Diabetes Metab Syndr Obes 2021 2;14:2483-2488. Epub 2021 Jun 2.

Department of Ophthalmology, Affiliated Hospital of Hebei University, Baoding, Hebei Province, 071000, People's Republic of China.

Purpose: This study aimed to describe the levels of glycated hemoglobin (HbA1c), D-dimer (D-D), and fibrinogen (FIB) in different types of diabetic retinopathy (DR).

Methods: A total of 61 patients with diabetes, who were treated in our department between November 2017 and May 2019, were selected. According to their non-mydriatic fundus photography and fundus angiography results, patients were divided into three groups, ie, the non-DR (NDR) group (n=23), the non-proliferative DR (NPDR) group (n=17), and the proliferative DR (PDR) group (n=21). Read More

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Remote screening of diabetic retinopathy using ultra-widefield retinal imaging.

Diabetes Res Clin Pract 2021 Jul 6;177:108902. Epub 2021 Jun 6.

Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8601, Japan. Electronic address:

Aims: To study the possibility of constructing a remote interpretation system for retinal images.

Methods: An ultra-widefield (UWF) retinal imaging device was installed in the internal medicine department specializing in diabetes to obtain fundus images of patients with diabetes. Remote interpretation was conducted at Nagoya City University using a cloud server. Read More

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Factors Affecting Predominantly Peripheral Lesion Identification and Grading.

Transl Vis Sci Technol 2021 06;10(7)

Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, USA.

Purpose: The purpose of this study was to determine factors affecting predominantly peripheral lesion (PPL) grading, such as qualitative versus quantitative assessment, device type, and severity of diabetic retinopathy (DR) in ultrawide field color images (UWF-CIs).

Methods: Patients with DR had UWF-CI qualitatively graded for PPL using standardized techniques and had hemorrhages/microaneurysms (H/Mas) individually annotated for quantitative PPL grading on two different ultrawide field devices.

Results: Among 791 eyes of 481 patients, 38. Read More

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Diabetic Retinopathy and Hearing Loss: Results from the Fifth Korean National Health and Nutrition Survey.

J Clin Med 2021 May 28;10(11). Epub 2021 May 28.

Department of Ophthalmology, Hanyang University College of Medicine, Seoul 04763, Korea.

We investigated the association between the severity of diabetic retinopathy (DR) and hearing loss based on vascular etiology. We used data from the Korean National Health and Nutrition Survey 2010-2012. Adults aged >40 years with diabetes were enrolled. Read More

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Increased serum concentration of netrin-1 after intravitreal bevacizumab injection: is it a compensatory mechanism to counteract drug side effects?

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

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Predictive value of the SYNTAX score for diabetic retinopathy in stable coronary artery disease patients with a concomitant type 2 diabetes mellitus.

Diabetes Res Clin Pract 2021 Jul 29;177:108875. Epub 2021 May 29.

Hatay Mustafa Kemal University, Tayfur Ata Sökmen Faculty of Medicine, Department of Cardiology, Hatay, Turkey.

Aims: Diabetic retinopathy (DR) is a serious complication of type 2 diabetes mellitus (T2DM) and is the most common cause of impaired vision for adults. DR is related to a number of risk factors. The aim of this study was to investigate the relationship between burden of coronary artery disease assessed by Syntax Score (SS) and DR in T2DM. Read More

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