Purpose: The aims of this study were to correlate diabetic retinopathy (DR) changes with insulin-like growth factor 1 (IGF-1) levels in patients with type 1 diabetes of pubertal age group and to correlate the level of retinopathy with IGF-1 levels. Methods: This cross-sectional study was done over 2 years and involved patients with type 1 diabetes of age 8 to 25 years. Patients presenting to Ophthalmology OPD and inpatient department along with active recruitment from old pediatrics and endocrinology records were taken for the study. Fasting serum IGF-1 was calculated using enzyme-linked immunosorbent assay technique. Fasting blood sugar levels were taken. Detailed ophthalmic examination was done and DR was noted in all the patients and correlated with IGF-1 levels. Results: A total of 46 patients with type 1 diabetes were recruited into the study. The mean age of the patients was 14.33 ± 4.36 years, with a female-to-male ratio of 3:2. No relationship of IGF-1 with age of onset of diabetes ( P = 0.7) or fasting capillary blood glucose (CBG) ( P = 0.6) was found, but a significant relationship was found with duration of diabetes ( P = 0.001) and low IGF-1 levels ( P < 0.0001). Conclusions: Severity of DR in patients with type 1 diabetes is inversely related to serum IGF-1 levels. Low IGF levels are an indicator for closer follow-up and strict management of diabetes and retinopathy.

Purpose: Hallmark of Diabetic Retinopathy (DR) is blood-retinal barrier alteration. Vascular endothelial growth factor (VEGF) and inflammation are involved in the pathogenesis of DR. Anti-VEGFs and lasers are effective in treating DR but have numerous drawbacks, hence the need to develop alternative therapies that may delay the onset or progression of DR. Methods: Fifteen patients were recruited in each group; the study group was on immunosuppressants for some other coexisting disease and the control group was not on them. Each subject underwent detailed history, ophthalmic examination, and glycosylated hemoglobin (HbA1c) and renal function tests at the time of recruitment and the end of one year. Primary outcome measure was to compare the progression of DR in diabetics on immunosuppressant versus those not on it. Results: Median age in the study and control group was 57 years and 60 years, respectively ( P = 0.6). Median duration of diabetes was 11 and 12 years in the study and control group, respectively ( P = 0.7). HbA1c for the study and control group for first visit was 7.6% and 8.0%, respectively ( P = 0.26) and for second visit was 7.5% and 8.1%, respectively ( P = 0.11). Hypertensives in the study and control groups were 9 and 4, respectively ( P = 0.065); renal disease in the study and control groups was 4 and 2, respectively ( P = 0.361). The control group showed 33.3% progression of DR, and no progression was seen in the study group ( P = 0.014). Conclusion: Immunosuppressants seemed to delay the onset and progression of DR in the earlier stages.

This study aims to describe a rare case of a pair of siblings of age nine and five years who presented with optic disc abnormality and choroiditis in association with type 1 diabetes. Both the siblings were born to non-consanguineous marriage and had normal developmental history. Both were type 1 diabetic. Both were observed to have microphthalmos, microcornea, alternating esotropia and high myopia. Both had optic disc abnormalities along with macular scars. Both were treated with low vision aids. The study demonstrates the need of better screening programme to prevent such late diagnosis.

Diabetic retinopathy is a major microvascular complication of diabetes mellitus causing blindness in patients with diabetes mellitus. Lack of knowledge about diabetic retinopathy and its complications is the major cause for increasing blindness in India. The aim of the study is to evaluate the knowledge about diabetic retinopathy and its influence on attitude and practice in diabetic retinopathy among patients coming to a tertiary care centre in karnataka. Patients coming to tertiary care centre were interviewed by a single interviewer with questionnaire consisting of knowledge, attitude and practice questions prepared in English and responses noted and analysed. A pilot study was conducted in sample population before starting the study. Out of 300 patients, 173 were males (57.7%) and 127 were females (42.3%). The minimum age of males and females was 31 and 32 years respectively. Among 300 diabetic patients, 163 patients (54.3%) had no knowledge about diabetic retinopathy compared to 137 patients(45.7%) who had knowledge about diabetic retinopathy which is statistically significant with p value &#60;0.05. Males had more knowledge (68.6%) compared to females (31.4%) which is statistically significant with p value of &#60;0.05. As the educational status and socioeconomic status increased, there was statistically significant increase in knowledge. Patients with longer duration of diabetes had good knowledge which is statistically significant. Patients with more knowledge and longer duration of diabetes were found to follow a good practice in diabetic retinopathy which is statistically significant with a p value of less than 0.05. Lack of knowledge about complications and screening methods is the cause for worsening the attitude and practice in diabetic retinopathy. Patient education at primary health care and community level can provide patients with positive attitude towards treatment and follow good practice patterns to prevent blindness due to diabetic retinopathy.