Objective: To evaluate if the low postprandial C-peptide levels are clinically significant and would it relate to the risk of diabetic retinopathy (DR) in Iraqi patients with type 2 diabetes. Methods: Forty-one patients with diabetes (28 male, 13 female) were included, and eight non-diabetic tests were present in this study: HbAlc and 2 h. Post-prandial C-peptide levels were measured in all patients and control groups. Results: In subjects both NPDR and DMO, patients with DR showed lower levels of postprandial C-peptide and higher HbA1c percent. Regression analysis between postprandial C-peptide and DR showed that postprandial C-peptide was negatively associated with DR with odds ratio: (0.569, CI: 0.370- 0.872, p = 0.01) in Iraqi type 2 diabetes. Conclusion: Low postprandial C-peptide levels may predict NPDR and DMO in T2DM patients. Measuring the postprandial or non-fasting C peptide level offers uncomplicated and flexible testing for an outpatient or inpatient.
Diabetic macular oedema is still a significant cause of vision drop in the diabetic patient with no definitive regime for treatment. This study was on the result of effects of intravitreal injection of (2mg) triamcinolone on central macular thickness measured by OCT, visual acuity and intraocular pressure in pseudophakic eyes with diabetic macular oedema as a primary treatment line followed in six months. This study is a prospective, interventional case study series. It was on patients who received intravitreal injection of Triamcinolone in a single dose of ( 2 mg/0. 05 ml). Central macular thickness by OCT, visual acuity, and intraocular pressure was measured pre-injection and 1,3,6 months after injection. This study was performed in Iraq, Baghdad, Ibn Al-Haitham Teaching Eye Hospital from October 2014 to July 2015. Results showed 25 eyes received intravitreal injection of Triamcinolone Acetoniod with pre-injection central macular thickness 597.9+98.02 µm, visual acuity 1.096+0.61 Log MAR and intraocular pressure of 16.5+ 2.53 mmHg. After six months of follow up on central macular thickness 341.6+163.1 µm, visual acuity was 0.63 + 0.40 Log MAR and IOP was 18. 04+ 5. 63mmHg. This study suggests that intravitreal injection of Triamcinolone in a dose 2mg / 0. 05ml improves both anatomical and visual outcome in 21 eyes (84%) out of 25 pseudophakic eyes with diabetic macular oedema during first six months after injection and an increase in intraocular pressure in 2 eyes (8%). The intraocular pressure was despite the use of anti-glaucoma medications during this period.
Pterygium can cause deterioration of vision by distortion the corneal smooth surface, and so induce astigmatism usually with the rule type, which is reversible by Pterygium excision surgery. So the aim of this study to evaluate prospectively, the change in keratometeric readings and corneal refractive status after pterygium excision surgery, a case series study was carried out on117eyes of 117 patients with primary Pterygium. It was carried out over a period of 9 months from 1st, January 2018 to 30th. September 2018, for patients, were admitted to the departments of ophthalmology at Najaf city. All patients underwent preoperative assessment for visual acuity (using Snellen’s chart), anterior segment examination, and posterior segment examination using Slitlamp biomicroscopy with condensing lens, refraction and Keratometry using auto-refractometers. All data collected preoperatively then one month postoperatively. Data analysis and comparison then performed. The findings of this study was that Pterygium is more prevalent in males than females, as it found in (81%) of males and only (19%) in females, and more prevalent in young to middle-aged people between (30-45 years 59%), grade II (45%) are presented. This study also found that keratometric (K1, K2) readings in all grade are significantly reduced postoperatively, where preoperative mean K1 was (43.43D±0.67), that decreased to a postoperative mean of (42.95D±0.6). Astigmatism associated pterygium at all grades also showed significant improvement, where the total mean preoperative astigmatism was (1.04D ± 0.80), that became (0.36 D± 0.20) one month later. This improvement also applied on visual acuity, as most of the patient were had visual acuity between (6/12) to ( 6/18) that represent (50%), (37%) of our sample, which improves to (64%) with visual acuity of (6/6) one-month postoperatively. We conclude that Pterygium excision, associated with significant improvement in refraction and keratometeric readings. And we suggested for eye protection should be considered, when spend long time work outdoor, like proper polarized and UV filter sunglasses, also if possible, avoid work outdoor during sunny and hot days. Surgical excision of Pterygium in early stages will result in better visual rehabilitation.
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