Various models for diabetic retinopathy screening that can be applied to India

Rajalakshmi, Ramachandran; Prathiba, Vijayaraghavan; Rani, Padmaja Kumari; Mohan, Viswanathan

doi:10.4103/ijo.ijo_1145_21

Cited by 9 publications

(6 citation statements)

References 40 publications

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“…[ 19 ] Other national DR screening programs have proven and validated the positive impact of early screening and treatment. [ 16 20 ] In conclusion, TRD eyes are at a significant risk of blindness; heightening awareness of this risk among patients and caregivers will significantly benefit early identification of at-risk eyes. The early detection and treatment of proliferative retinopathy in diabetes and sickle-cell disease, including campaigns on trauma prevention, will significantly reduce the burden of blindness due to TRD.…”

Section: Discussionmentioning

confidence: 99%

Tractional retinal detachment: Prevalence and causes in nigerians

Okonkwo,

Nkanga,

Agweye

et al. 2023

J West Afr Coll Surg

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Aim: To determine the causes of tractional retinal detachment (TRD) in Nigerians. Materials and Methods: A prospective, multicentre study evaluating eyes diagnosed to have TRD. History, clinical examination (including visual acuity, intraocular pressure measurement, anterior segment examination and dilated fundoscopy) and systemic evaluation (including previous diagnosis of diabetes, hypertension, sickle-cell disease and others) were performed in TRD eyes out of a cohort of retinal detachment eyes. Results: The prevalence of TRD of the 237 patients diagnosed with RD within a one-year study period was 25.7% (61 patients). Eighty eyes were diagnosed with TRD. Thirty-eight eyes of nineteen patients (31%) were bilateral, and 42 (69%) were unilateral. There were 38 male patients (62.3%) and 23 female patients (37.7%). The mean age was 52.3 ± 12.7 years (11–69 years). 88.5% of all TRD patients had an associated systemic disease, diabetes being the most common disease in 88.8% of them. Proliferative diabetic retinopathy was the most common cause of TRD (77.5%) and the most common cause of bilateral TRD. Both trauma and proliferative sickle-cell retinopathy occurred in 3.8% of the eyes. 68.8% of TRD eyes were blind at the presentation. However, the causes of TRD did not show any significant association with blindness ( P = 0.819). Conclusion: Proliferative diabetic retinopathy poses a significant threat to vision, being the most common cause of TRD. Early detection and treatment of proliferative retinopathy in diabetes and sickle-cell disease, and trauma prevention will significantly reduce the burden of blindness due to TRD.

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Section: Discussionmentioning

confidence: 99%

Tractional retinal detachment: Prevalence and causes in nigerians

Okonkwo,

Nkanga,

Agweye

et al. 2023

J West Afr Coll Surg

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“…Optos Daytona Plus (Optos, Dunfermline, United Kingdom) is a non-contact confocal scanning laser ophthalmoscope (SLO) camera (Fig. 1B ) that uses red (633 nm) and green (532 nm) lasers for retinal colour images (pseudocolor) and provides 200° FOV of the retina through an undilated pupil using an ellipsoid mirror and virtual point technology [ 2 , 3 ].…”

Section: Methodsmentioning

confidence: 99%

“…The gold standard for grading of DR in major international studies/ randomised clinical trials has been based on the ETDRS (Early Treatment of Diabetic Retinopathy Study) standard seven-field 30° retinal colour photography that captures DR lesions in the central third of the retina [ 1 ]. Nonmydriatic fundus cameras that are used for DR screening cover the central 40–45° of the posterior pole of the retina [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…UWF photography is getting considered as the gold standard for DR screening in some of the developed counties like the United States [ 7 ]. However, it is an expensive modality for screening DR for regular screening especially for low-and middle-income countries (LMIC) like India [ 2 ]. Smartphone-based fundus cameras that are portable and easy to handle in remote places are popular as cost-effective DR screening options [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Wide-field imaging with smartphone based fundus camera: grading of severity of diabetic retinopathy and locating peripheral lesions in diabetic retinopathy

Rajalakshmi,

Mohammed,

Vengatesan

et al. 2024

Eye

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Aim To assess the performance of smartphone based wide-field retinal imaging (WFI) versus ultra-wide-field imaging (UWFI) for assessment of sight-threatening diabetic retinopathy (STDR) as well as locating predominantly peripheral lesions (PPL) of DR. Methods Individuals with type 2 diabetes with varying grades of DR underwent nonmydriatic UWFI with Daytona Plus camera followed by mydriatic WFI with smartphone-based Vistaro camera at a tertiary care diabetes centre in South India in 2021–22. Grading of DR as well as identification of PPL (DR lesions beyond the posterior pole) in the retinal images of both cameras was performed by senior retina specialists. STDR was defined by the presence of severe non-proliferative DR, proliferative DR or diabetic macular oedema (DME). The sensitivity and specificity of smartphone based WFI for detection of PPL and STDR was assessed. Agreement between the graders for both cameras was compared. Results Retinal imaging was carried out in 318 eyes of 160 individuals (mean age 54.7 ± 9 years; mean duration of diabetes 16.6 ± 7.9 years). The sensitivity and specificity for detection of STDR by Vistaro camera was 92.7% (95% CI 80.1–98.5) and 96.6% (95% CI 91.5–99.1) respectively and 95.1% (95% CI 83.5–99.4) and 95.7% (95% CI 90.3–98.6) by Daytona Plus respectively. PPL were detected in 89 (27.9%) eyes by WFI by Vistaro camera and in 160 (50.3%) eyes by UWFI. However, this did not translate to any significant difference in the grading of STDR between the two imaging systems. In both devices, PPL were most common in supero-temporal quadrant (34%). The prevalence of PPL increased with increasing severity of DR with both cameras (p < 0.001). The kappa comparison between the 2 graders for varying grades of severity of DR was 0.802 (p < 0.001) for Vistaro and 0.753 (p < 0.001) for Daytona Plus camera. Conclusion Mydriatic smartphone-based widefield imaging has high sensitivity and specificity for detecting STDR and can be used to screen for peripheral retinal lesions beyond the posterior pole in individuals with diabetes.

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“…Most patients are in the late stage of DR when they see a doctor, and the damage to retina is often difficult to reverse [5]. At present, fundus photography is mainly used to screen DR clinically [6,7]. However, its wide application is limited by high cost, complicated practical procedures, and poor patient compliance, which makes some DR patients unable to get a timely diagnosis, and then affects the prognosis of patients.…”

Section: Introductionmentioning

confidence: 99%

MiR-99a-5p Inhibits the Proliferation and Migration of Human Retinal Microvascular Endothelial Cells by Targeting NOX4

Yu¹,

Zhang

Wang

et al. 2023

Horm Metab Res

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Diabetic retinopathy is one of the common microvascular complications of diabetes, and it is the main cause of vision loss among working-age people. This study interpreted the roles of miR-99a-5p in DR patients and human retinal microvascular endothelial cell (hRMECs) injury induced by high glucose. The expression of miR-99a-5p was detected in patients with NDR, NPDR, and PDR. The indictive impacts of miR-99a-5p were tested by the ROC curve, and the link between miR-99a-5p and clinical information was verified by the Pearson test. HG was used to instruct cell models. The CCK-8 and transwell methods were performed to detect the proliferative and migrated cells. The targeted relationship was explained by luciferase activity. The content of miR-99a-5p was gradually lessened in NPDR and PDR patients. MiR-99a-5p might differentiate DR patients from NDR patients and PDR patients from NPDR patients. The interconnection between miR-99a-5p and clinical factors was endorsed in all DR patients. Overexpression of miR-99a-5p assuaged the abnormality of cell migration and proliferation of hRMECs triggered by HG. NOX4 was a downstream signaling component of miR-99a-5p. In conclusion, MiR-99a-5p protected hRMECs against HG damage, and the miR-99a-5p might be a novel target for diagnosis of DR.

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Various models for diabetic retinopathy screening that can be applied to India

Cited by 9 publications

References 40 publications

Tractional retinal detachment: Prevalence and causes in nigerians

Tractional retinal detachment: Prevalence and causes in nigerians

Wide-field imaging with smartphone based fundus camera: grading of severity of diabetic retinopathy and locating peripheral lesions in diabetic retinopathy

MiR-99a-5p Inhibits the Proliferation and Migration of Human Retinal Microvascular Endothelial Cells by Targeting NOX4

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