Association between the Short-term Natural History of Diabetic Macular Edema and the Vitreomacular Relationship in Type II Diabetes Mellitus

Hikichi, Taiichi; Fujio, N; Akiba, Jun; Yoshinao, Azuma; Takahashi, Masatoshi; Yoshida, Akitoshi

doi:10.1016/s0161-6420(97)30289-9

Cited by 193 publications

(82 citation statements)

References 30 publications

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“…In about 5% of cases macular edema is generated and/or sustained by traction exerted by a thickened and taut posterior hyaloid firmly attached to the internal limiting membrane [151,152]. The diagnosis is suggested by the FAG pattern, and OCT helps to identify the tractions.…”

Section: Macular Edemamentioning

confidence: 99%

Diabetic retinopathy

2002

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Abstract. Easy observation of the fundus oculi makes retinopathy the most frequently reported chronic complication of diabetes and, consequently, the one we know best in terms of epidemiology and natural history. Achieving near-normal levels of blood glucose and blood pressure provides empirical though powerful tools for clinicians to delay the onset and progression of diabetic retinopathy. Even when these measures have failed and retinopathy becomes sight-threatening, laser photocoagulation has proven remarkably effective. Nonetheless, retinopathy remains a leading cause of blindness and there is little evidence that diabetes-related visual loss is decreasing in industrialized countries. This may result from the mixed blessing of prolonged survival of patients who had become diabetic when metabolic control was pursued less fastidiously than today. Screening for sight-threatening retinopathy is the most cost-effective medical procedure known and should help optimise the use of diagnostic and therapeutic resources, but its widest deployment still meets with inertia and lack of interest within most health care systems. Improving clinical skills and technology, however, allow us to take a more optimistic look at the future, as pathogenesis-targeted forms of treatment are being developed and tested through appropriately powered clinical trials. [Diabetologia (2002[Diabetologia ( ) 45:1617[Diabetologia ( -1634

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Section: Macular Edemamentioning

confidence: 99%

Diabetic retinopathy

2002

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“…The findings first demonstrated the correlation of the vitreoretinal interface with focal and diffuse macular edema. It was reported that the persistence of diabetic macular edema was higher in patients with vitreomacular adherence than in those presenting vitreomacular separation (Hikichi et al 1997). Some authors have demonstrated that there is destabilization of the biochemical and anatomic vitreous structure in diabetic eyes due to nonenzymatic glycation of the collagen fibers (Sebag et al 1992(Sebag et al , 1994 and the abnormal vitreous fibers are related to hyperglycemia (Sebag 1993).…”

Section: Discussionmentioning

confidence: 99%

“…But few studies have investigated the factors associated with diabetic macular edema (Dodson & Gibson 1991;Klein et al 1995;Nasrallah et al 1988;Hikichi et al 1997).…”

mentioning

confidence: 99%

Diabetic macular edema, Risk factors and concomitants

Faria

Jalkh

Trempe

et al. 1999

Acta Ophthalmologica Scandinavica

115

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ABSTRACT.Purpose: To investigate the systemic and ocular factors associated with diffuse macular edema in patients with diabetic retinopathy (DR) and compare with patients with focal or no macular edema. Methods: From 160 consecutive patients with DR, we obtained medical and ocular histories, blood pressure and visual acuity. Macular edema was determined by biomicroscopy and stereoscopic fundus photography. Fluorescein angiography was used in the characterization of its leakage, and the vitreoretinal relationship was performed by preset lens biomicroscopy. Results: Among adult-onset diabetes mellitus (DM) patients, 55% had diffuse, 23.5% had focal and 21.5% had no macular edema (pΩ0.01). The risk of developing diffuse macular edema was 3.2 times greater in patients with high blood pressure (HBP) (95% confidence interval (CI), 1.5 to 6.9). Patients with cardiovascular disease (CVD) had a higher prevalence of diffuse (58.0%) than focal (26.0%) or no maculopathy (16.0%) (pΩ0.01). The odds for development of diffuse macular edema was 3.4 times greater in patients with vitreomacular adhesion (95% CI, 1.15 to 13.30) than in those with complete posterior vitreoretinal attachment or vitreoretinal separation. The odds for development of diffuse macular edema were 6.2 (95% CI, 1.83 to 21.04) and 7.7 times greater (95% CI, 3.12 to 19.12) in patients with PPDR and PDR, respectively, in comparison with those with NPDR. Conclusions: In this study, adult-onset DM, HBP, CVD, vitreomacular adhesion and advanced retinopathy were associated with increased risk of development of diffuse diabetic macular edema.

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“…22 It is also more common in patients with more severe DR and can, for example, limit visual improvement in eyes with successfully managed proliferative disease. 23 The ETDRS showed a clear benefit of focal laser photocoagulation, although the study did not distinguish between the clinical entities of focal and diffuse leakage. It is likely that much of the treatment effect was due to resolution of leakage in the former group.…”

Section: How Should We Treat Macular Oedema?mentioning

confidence: 79%

Progressive changes in diabetics and their management

Aylward

2005

Eye

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The prevalence of diabetic retinopathy is increasing worldwide due to an increasing number, and prolonged survival, of diabetic patients. Many effective treatments for different types and stages of retinopathy exist. However, there is patchy delivery of care, inconsistent screening, and unresolved questions about several management questions. This article discusses the current state of knowledge about therapeutics in diabetic retinopathy, and highlights areas where further studies and evidence base is required.

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Association between the Short-term Natural History of Diabetic Macular Edema and the Vitreomacular Relationship in Type II Diabetes Mellitus

Cited by 193 publications

References 30 publications

Diabetic retinopathy

Diabetic retinopathy

Diabetic macular edema, Risk factors and concomitants

Progressive changes in diabetics and their management

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