ABSTRACT
Diabetes mellitus can cause diabetic retinopathy, diabetic macular edema, optic neuropathy, cataract or dysfunction of the eye muscles. The incidence of these disorders correlates with disease duration and quality of metabolic control. Regular ophthalmological examinations are needed to prevent sight-threatening advanced stages of diabetic eye diseases.
Subject(s)
Cataract , Diabetes Mellitus , Diabetic Retinopathy , Macular Edema , Humans , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/therapy , Macular Edema/diagnosis , Macular Edema/therapy , Cataract/therapy , Laser Coagulation , Diabetes Mellitus/therapyABSTRACT
Diabetes mellitus can cause diabetic retinopathy, diabetic macular edema, optic neuropathy, cataract or dysfunction of the eye muscles. The incidence of these defects correlates with disease duration and quality of metabolic control. Recommendations of the Austrian Diabetes Association for diagnosis, therapeutic procedures and requirements for adequate follow-up depending on stage of diabetic eye disease are summarized.
Subject(s)
Diabetic Retinopathy , Macular Edema , Practice Guidelines as Topic , Austria , Cataract , Cataract Extraction , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/therapy , Humans , Macular Edema/diagnosis , Macular Edema/therapy , Treatment Outcome , VitrectomySubject(s)
Choroid/drug effects , Dexamethasone/administration & dosage , Diabetic Retinopathy/drug therapy , Drug Implants , Glucocorticoids/administration & dosage , Macular Edema/drug therapy , Aged , Choroid/pathology , Diabetic Retinopathy/physiopathology , Female , Humans , Intravitreal Injections , Macular Edema/physiopathology , Male , Middle Aged , Prospective Studies , Vitreous Body/drug effectsSubject(s)
Blood Glucose/metabolism , Dexamethasone/administration & dosage , Diabetic Retinopathy/drug therapy , Hypothalamo-Hypophyseal System/physiology , Macular Edema/drug therapy , Pituitary-Adrenal System/physiology , Vascular Endothelial Growth Factor A/blood , Adrenocorticotropic Hormone/blood , Aged , Diabetic Retinopathy/physiopathology , Drug Implants , Female , Glucocorticoids/administration & dosage , Humans , Hydrocortisone/blood , Intravitreal Injections , Macular Edema/physiopathology , Male , Middle Aged , Prospective StudiesABSTRACT
[This corrects the article DOI: 10.1371/journal.pone.0154397.].
ABSTRACT
PURPOSE: High-density lipoproteins (HDL) have long been implicated in the pathogenesis of age-related macular degeneration (AMD). However, conflicting results have been reported with regard to the associations of AMD with HDL-cholesterol levels. The present study is the first to assess HDL composition and metrics of HDL function in patients with exudative AMD and control patients. METHODS: Blood samples were collected from 29 patients with exudative AMD and 26 age-matched control patients. Major HDL associated apolipoproteins were determined in apoB-depleted serum by immunoturbidimetry or ELISA, HDL-associated lipids were quantified enzymatically. To get an integrated measure of HDL quantity and quality, we assessed several metrics of HDL function, including cholesterol efflux capacity, anti-oxidative and anti-inflammatory activities using apoB-depleted serum from study participants. RESULTS: In our study, we observed that the HDL associated acute phase protein serum amyloid A (SAA) was significantly increased in AMD patients (p<0.01), whereas all other assessed apolipoproteins including ApoA-I, apoA-II, apoC-II, apoC-III and apoE as well as major HDL associated lipids were not altered. HDL efflux capacity, anti-oxidative capacity and arylesterase activity were not different in AMD patients when compared with the control group. The ability of apoB-depleted serum to inhibit monocyte NF-κB expression was significantly improved in AMD patients (mean difference (MD) -5.6, p<0.01). Moreover, lipoprotein-associated phospholipase A2 activity, a marker of vascular inflammation, was decreased in AMD subjects (MD -24.1, p<0.01). CONCLUSIONS: The investigated metrics of HDL composition and HDL function were not associated with exudative AMD in this study, despite an increased content of HDL associated SAA in AMD patients. Unexpectedly, anti-inflammatory activity of apoB-depleted serum was even increased in our study. Our data suggest that the investigated parameters of serum HDL function showed no significant association with exudative AMD. However, we cannot exclude that alterations in locally produced HDL may be part of the AMD pathogenesis.
Subject(s)
Lipoproteins, HDL/blood , Wet Macular Degeneration/blood , Aged , Animals , Anti-Inflammatory Agents/pharmacology , Antioxidants/metabolism , Aryldialkylphosphatase/metabolism , Cholesterol/metabolism , Demography , Humans , Mice , Oxidation-Reduction , Phospholipases A2/metabolism , RAW 264.7 Cells , Serum Amyloid A Protein/metabolismABSTRACT
Diabetes mellitus can cause diabetic retinopathy, diabetic macular edema, optic neuropathy, cataract or dysfunction of the eye muscles. The incidence of these defects correlates with disease duration and quality of metabolic control. Recommendations of the Austrian Diabetes Association for diagnosis, therapeutic procedures and requirements for adequate follow up depending on stage of diabetic eye disease are summarized.
Subject(s)
Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/therapy , Macular Edema/diagnostic imaging , Macular Edema/therapy , Practice Guidelines as Topic , Angiogenesis Inhibitors/administration & dosage , Austria , Dose-Response Relationship, Drug , Drug Administration Schedule , Evidence-Based Medicine , Humans , Intravitreal Injections/standards , Laser Coagulation/standards , Treatment Outcome , Vitrectomy/standardsABSTRACT
PURPOSE: The purpose of this study was to investigate the safety profile of the 23-gauge sutureless vitrectomy system in the treatment of epiretinal membranes compared with standard 20-gauge vitrectomy. METHODS: A retrospective case comparison of 20-gauge and 23-gauge vitrectomy performed in 167 and 64 eyes, respectively, by the same surgeon. Intraoperative and postoperative complications, duration of surgery, and postoperative visual acuity results were evaluated. RESULTS: Postoperative hypotony occurred significantly more often in the 23-gauge group [9.4% (n = 6) vs. 0% (n = 0), P < 0.001]. With the 23-gauge system, the incidence of retinal detachment was 1.6% (n = 1), vitreous hemorrhage was 0%, and endophthalmitis was 1.6% (n = 1). Patients with 20-gauge vitrectomy developed retinal detachments in 1.8% (n = 3), vitreous hemorrhages in 1.2% (n = 2), and endophthalmitis in 2.4% (n = 4). The mean overall duration of surgery was significantly shorter in the 23-gauge procedures with 23.1 +/- 6.5 minutes compared with 34.5 +/- 9.1 minutes in the 20-gauge procedures (P < 0.05). At postoperative Day 2, patients with 23-gauge vitrectomy regained preoperative mean best-corrected visual acuity of 20/60. Patients who had 20-gauge vitrectomy experienced a statistically significant decrease of visual acuity from 20/80 to 20/100 (P < 0.05). CONCLUSION: Twenty-three-gauge vitrectomy in epiretinal membrane surgery is comparable with 20-gauge vitrectomy and is a safe method with a low complication rate. However, the incidence of postoperative hypotony is more frequent using the 23-gauge system.