Comprehensive assessment of ocular parameters for identifying diagnostic indicators of diabetic peripheral neuropathy.

PURPOSE: To explore variations in systemic and ocular parameters among patients with diabetes, both with and without diabetic peripheral neuropathy (DPN) and to identify sensitive indicators for DPN diagnosis. METHODS: Ninty-five patients with type 2 diabetes mellitus (T2DM) were involved in this cross-sectional study, including 49 without DPN and 46 with DPN. Ocular parameters were obtained using optical coherence tomography angiography (OCTA) and corneal confocal microscopy (CCM). RESULT: Patients with DPN presented with significantly higher HbA1c (p < 0.05) and glycated albumin (GA, p < 0.01) levels, increased prevalence of diabetic retinopathy (DR, p < 0.05), and lower serum albumin (ALB, p < 0.01) and red blood cell (RBC, p < 0.05) levels. Ocular assessments revealed reduced corneal nerve fiber length (CNFL, p < 0.001) and enlarged foveal avascular zone (FAZ) area (p < 0.05) in DPN group. Logistic regression analysis indicated a significant association of presence of DR, RBC, GA, ALB, CNFL and DPN (p < 0.05, respectively). In the binary logistic regression for DPN risk, all three models including the presence of DR and CNFL exhibited the area under the curve (AUC) exceeding 0.8. CONCLUSION: The study establishes a strong correlation between ocular parameters and DPN, highlighting CCM's role in early diagnosis. Combining systemic and ocular indicators improves DPN risk assessment and early management.

Alterations of outer retinal reflectivity in diabetic patients without clinically detectable retinopathy.

PURPOSE: This study aimed to investigate alterations of outer retinal reflectivity on spectral-domain optical coherence tomography (OCT) in diabetic patients without clinically detectable retinopathy (NDR). METHODS: In this retrospective study, 64 NDR patients and 71 controls were included. Relative reflectivity (RR) of the ellipsoid zone (EZ), photoreceptor outer segment (OS) and inner segment (IS), and outer nuclear layer (ONL) at the foveola and at 500 µm, 1000 µm, and 2000 µm nasal (N), temporal (T), superior (S), and inferior (I) to the foveola was measured by cross-line OCT and ImageJ. Retinal vessel densities (VD) in fovea, parafovea, and perifovea areas were detected by OCT angiography (OCTA). RESULTS: EZ RR in most retinal locations was significantly lower in NDR eyes compared to controls (all P < 0.05), except the foveola. Compared with controls, NDR eyes also displayed lower RR at N2000, T2000, S1000, and I1000 of OS, at S500 and I500 of IS, and at I500 of ONL (all P < 0.05). Negative correlations could be observed between retinal RR and diabetes duration, HbA1c, and best-corrected visual acuity (BCVA) (r = - 0.303 to - 0.452). Compared to controls, EZ, OS, and IS RR of the NDR eyes showed lower correlation coefficients with whole image SCP and DCP VD of parafovea and perifovea regions. CONCLUSION: Outer retinal reflectivity, along with the coefficients between retinal reflectivity and VD, is reduced in NDR patients and is correlated with diabetes duration, HbA1c, and BCVA. The reduction of outer retinal reflectivity may be a potential biomarker of early retinal alterations in diabetic patients.

Design of a high counting efficiency sensor for 1.0 cubic feet per minute laser particle counter.

Based on the theory of Mie scattering, an optical sensor for a 1.0 cubic feet per minute laser particle counter is developed in this paper. First, an illumination optical path relying on aspherical lens and cylindrical lens for laser shaping was designed, and a narrow optical spot with the illumination in the vertical direction of the photosensitive area approximately distributed as a flat top was obtained. Second, the scattering light path was designed by using the theory of Mie scattering and geometric optics method. Then, the structure of the sampling air path was designed with reference to the principle of Laval nozzle, and the particle flow trajectory was verified by simulation using the fluid dynamics software Ansys Fluent. Finally, the performance of the optical sensor was measured with polystyrene latex (PSL) particles, and the results showed that the counting efficiency of the 0.3 µm particle size channel met the requirement of 50% ± 20% and the 0.5 µm particle size channel met the requirement of 100% ± 10%, which complied with the ISO 21501-4 standard.

Multimodal imaging analysis for the impact of retinal peripheral lesions on central neurovascular structure and retinal function in type 2 diabetes with diabetic retinopathy.

OBJECTIVES: To explore the possible role of peripheral lesions (PLs) detected by ultrawide field (UWF) imaging system on central neurovascular structure and retinal function. METHODS: Ninety-seven diabetic patients were included in this cross-sectional study using UWF pseudocolour colour imaging with Optos Daytona (Optos, PLC). UWF images were graded as with predominantly peripheral lesions (PPLs) and without PPL. Macular neurovascular alterations and retinal function were measured by optical coherence tomography angiography (OCTA) and RETeval device, respectively. Central microcirculation and retinal function were compared between eyes with and without PPL. RESULTS: The study evaluated 186 eyes (97 patients; 43 females (44.3%)), including 92 eyes without PPL and 94 eyes with PPL. Central retinal vessel density was comparable between eyes with and without PPL. Delayed implicit time and decreased pupil area ratio were found in the PPL group compared with eyes without PPL, and this difference remained unchanged after adjusting for systemic factors (all p＜0.01). CONCLUSIONS: Our study suggests that retinal function is worse in diabetic eyes with PPL. These findings challenged the conventional ETDRS protocols which ignored peripheral retina in determining DR severity. Furthermore, combining UWF imaging with RETeval system to detect more retinal abnormalities may be helpful in DR management.

Sunglasses in the Eye Associated With Chronic Rhegmatogenous Retinal Detachment.

This case report describes a patient aged 27 years who presented with retinal cystoid abnormalities resulting from chronic rhegmatogenous retinal detachment that gave the appearance of sunglasses in the eye.

Diabetic Retinopathy May Be a Predictor of Stroke in Patients With Diabetes Mellitus.

Background: It is unclear whether diabetic retinopathy (DR) can be a predictor of stroke. In this research context, the objective of our study was to investigate whether there is a significant association between DR and stroke in diabetic patients by meta-analysis. Methods: After a systematic search of studies in electronic databases, we screened all studies reporting the risk of DR status and stroke incidence and calculated their odds ratios (ORs) and hazard ratios (HRs). The effects of type of diabetes and severity of DR were also considered for subgroup analysis. Results: We included 19 studies involving 45 495 patients. A pooled HR = 1.62 (1.28-2.06) were found for the risk of DR and stroke in diabetic patients. In a subgroup analysis performed on the type of diabetes, the results showed a significant association between stroke incidence and DR status in patients with type 2 diabetes (T2D) (OR: 1.78; 95% CI, 1.53-2.08), but this association was not conclusive in type 1 diabetes (T1D) (OR: 1.77; 95% CI, 0.48-6.61). The results of the subgroup analysis with diabetes severity showed that both mild and moderate nonproliferative diabetic retinopathy (NPDR) status and severe NPDR and worse status significantly increased the risk of stroke with HRs of 2.01 (1.45-2.78) and 2.27 (1.52-3.39), respectively. Conclusion: DR status in diabetic patients is associated with an increased risk of stroke. This correlation was robust in patients with T2D, but uncertain in T1D. Based on this result, we have perhaps found the new factor for stroke management, so we analyzed the necessity and advantages of considering DR as a factor for stroke screening and risk management in our studies.

Clinical Relevance of Body Fluid Volume Status in Diabetic Patients With Macular Edema.

Objective: To investigate body fluid status in diabetic macular edema (DME) patients and the extent to which it is affected by renal function. Methods: One hundred and thirty-two eyes from 132 patients with diabetes mellitus (DM) were prospectively collected in this cross-sectional, observational study. Thirty-five were DM patients without diabetic retinopathy (DR), 31 were DR patients without DME, and 66 were DME patients. The fluid status of each participant was quantified with extracellular water-to-total body water ratio (ECW/TBW) using a body composition monitor. Central subfield thickness (CST) and macular volume (MV) were obtained using optical coherence tomography (OCT). Urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and albumin was obtained using serum and urine laboratory data. Results: ECW/TBW was significantly increased in DME patients (39.2 ± 0.9, %) compared to DM (38.1 ± 0.7, %, P = 0.003) and DR patients without DME (38.7 ± 0.9, %, P < 0.001). In multilinear regression, fluid overload was positively related to DME and UACR (DME vs. DM: ß = 2.418, P < 0.001; DME vs. DR: ß = 1.641, P = 0.001; UACR, per 102, ß = 1.017, P = 0.01). In the binary logistic regression for DME risk, the area under the receiver operating characteristic curve (AUROC) increased significantly by adding ECW/TBW along with UACR and age (AUC: 0.826 vs. 0.768). Conclusion: DME patients had elevated body fluid volume independent of kidney functions. The assessment of extracellular fluid status may help in the management of DME.

Fluorescein Leakage and Optical Coherence Tomography Angiography Features of Microaneurysms in Diabetic Retinopathy.

RESULTS: Thirty-six, fifty-two, and seventy-nine MAs showed no, mild, and severe leakage on FA, respectively. Most MAs (61.7%) were centered in the inner nuclear layer. Cystoid spaces were observed adjacent to 60 (35.9%) MAs. MAs with severe leakage had a statistically higher flow proportion compared to MAs with no or mild leakage (both P < 0.001). Only 112 MAs (67.1%) were visualized in the OCTA en face images, while 165 MAs (98.8%) could be visualized in the OCT en face images. The location of MAs did not associate significantly with FA leakage status. The presence of nearby cystoid spaces and higher flow proportion by OCT B-scan with flow overlay correlated significantly with FA leakage status. CONCLUSION: The flow proportion of MAs observed on OCT B-scans with flow overlay might be a potential biomarker to identify leaking MAs. A combination of OCT B-scan, OCT en face, and OCTA en face images increased the detection rate of diabetic MAs in a noninvasive way.

MiR-761 inhibits colorectal cancer cell proliferation and invasion through targeting HDAC1.

Colorectal cancer (CRC) is one of the most common cancer diagnoses. Histone deacetylase (HDAC) overactivity in CRC could promote cancer progression. HDAC1, a member of the HDAC family, is found aberrantly expressed in CRC, but it remains unclear whether the expression of HDAC1 can be regulated by microRNA. In the present study, we confirmed the overexpression status of HDAC1 in CRC tissues and cell lines, and its overexpression could promote CRC cell proliferation and invasion in vitro. We saw that HDAC1 was a direct target gene of miR-761 in CRC by bioinformatic and luciferase reporter analyses. HDAC1 expression could be regulated and was negatively correlated with miR-761 in CRC. We also indicated that the expression of miR-761 was abnormally downregulated in CRC. Transfection with a miR-761 mimic impeded the growth and invasion of CRC cells. In addition, we showed that ectopic expression of miR-761 mitigated HDAC1 stimulation of CRC cell proliferation and invasion. Our results demonstrate that miR-761 represents a potential strategy against CRC.