Current pattern of ophthalmologists' awareness and importance of HbA1c in managing diabetic retinopathy patients.
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ABSTRACT:
SUBMITTER: Ghoshal T
PROVIDER: S-EPMC8725069 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
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Current pattern of ophthalmologists' awareness and importance of HbA1c in managing diabetic retinopathy patients.
Ghoshal Tulika T Mondal Soumen S Chakraborty Debdulal D
Indian journal of ophthalmology 20211101 11
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Project description:BackgroundThis study aimed to evaluate and compare the utility values associated with diabetic retinopathy (DR) in a sample of Chinese patients and ophthalmologists.MethodsUtility values were evaluated by both the time trade-off (TTO) and rating scale (RS) methods for 109 eligible patients with DR and 2 experienced ophthalmologists. Patients were stratified by Snellen best-corrected visual acuity (BCVA) in the better-seeing eye. The correlations between the utility values and general vision-related health status measures were analyzed. These utility values were compared with data from two other studies.ResultsThe mean utility values elicited from the patients themselves with the TTO (0.81; SD 0.10) and RS (0.81; SD 0.11) methods were both statistically lower than the mean utility values assessed by ophthalmologists. Significant predictors of patients' TTO and RS utility values were both LogMAR BCVA in the affected eye and average weighted LogMAR BCVA. DR grade and duration of visual dysfunction were also variables that significantly predicted patients' TTO utility values. For ophthalmologists, patients' LogMAR BCVA in the affected eye and in the better eye were the variables that significantly predicted both the TTO and RS utility values. Patients' education level was also a variable that significantly predicted RS utility values. Moreover, both diabetic macular edema and employment status were significant predictors of TTO and RS utility values, whether from patients or ophthalmologists. There was no difference in mean TTO utility values compared to our American and Canadian patients.ConclusionsDR caused a substantial decrease in Chinese patients' utility values, and ophthalmologists substantially underestimated its effect on patient quality of life.
| S-EPMC4667925 | biostudies-literature
Project description:IntroductionGlobally, diabetic retinopathy (DR) is the leading cause of blindness in working-aged adults. Early detection and treatment of DR is essential for preventing sight loss. Services must be available, accessible and acceptable to patients if we are to ensure they seek such care.ObjectivesTo understand patients' knowledge and attitudes towards laser versus antivascular endothelial growth factor (VEGF) injections to treat DR in Vietnam, and to identify factors Vietnamese ophthalmologists consider when making treatment decisions.MethodsThis is a descriptive qualitative study based on semi-structured interviews with 18 patients (12 from Ho Chi Minh City and 6 from Hanoi) plus individual interviews with 24 ophthalmologists working in eye clinics in these cities. Thematic analysis was used to analyse the data.ResultsIn total, 10/24 (41.7%) ophthalmologists were female, and their median age was 41 years (range 29-69 years). The median age of patients was 56.5 years (range 28-72 years), and 7/18 (38.9%) were female. Briefly, factors that influence DR treatment decisions for ophthalmologists are medical considerations (ie, severity of disease, benefits and risks), availability (ie, treatment and resources) and patient-related factors (ie, costs and adherence). Patient's perceived barriers and facilitators to treatments were based on patient and family related factors (ie, treatment and transportation costs) and previous treatment experiences (ie, positive and negative). Recommendations by all participants included ensuring that both laser and anti-VEGF injections are widely available across the country and controlling costs for patients and the healthcare system.ConclusionsReducing DR treatment costs, optimising treatments options, and expanding the network of clinics offering treatment outside metropolitan areas were the main issues raised by participants. These findings can help inform policy changes in Vietnam and may be generalisable to other low-resource settings.
| S-EPMC9263907 | biostudies-literature
Project description:ObjectiveDiabetic retinopathy is an evident complication of diabetes on eye and contributes for significant portion of blindness worldwide. In Ethiopia, data are lacking on awareness and knowledge of diabetic retinopathy in diabetic patients. This study desired to assess knowledge of diabetic retinopathy and it is relating factors among diabetic patients attending at a General Hospital in Ethiopia.MethodsWe have interviewed 306 diabetic patients who were attending at Debre Tabor General Hospital. Binary logistic regression model was used to recognize associated factors to good knowledge of diabetic retinopathy. Adjusted odds ratio was used to show the power of association. A p-value of less than 0.05 was set to determine its statistical significance.ResultThe diabetic patients had a median age of 45 (range = 30) years. From the total diabetic patients, 242 (79.10%) knew that diabetes could affect the eye and 81 (26.50%) were aware of diabetic retinopathy. From those who were informed of diabetic retinopathy, 32 (39.50%) (95% confidence interval = 27.90-51.20) had good knowledge of diabetic retinopathy. High educational status (adjusted odds ratio = 4.08, 95% confidence interval = 1.00-16.50) and non-government employee (adjusted odds ratio = 0.19, 95% confidence interval = 0.05-0.70) were significantly associated with good knowledge of diabetic retinopathy. Physicians and eye doctors were the most frequent source of information for the awareness of diabetic retinopathy.ConclusionFrom the total diabetic patients recruited in the study, 39.5% of them obtained information about diabetic retinopathy and the overall knowledge was poor among them. Knowledge of diabetes can affect the eye and it causes blindness was good among majority of the participants. Higher educational status and being a non-government employee were determined to be important predisposing factors of good knowledge. It is also better to involve diabetic educators and counselors in educating diabetic patients on the serious complication of diabetes on eye.
| S-EPMC8649097 | biostudies-literature
Project description:We aimed to estimate the supply of ophthalmologists in relation to the global and regional burden of vision-threatening diabetic retinopathy (VTDR). Diabetes mellitus (DM) population data from seven world regions were obtained from the International Diabetes Federation Atlas 2017. A systematic review was performed to include population-, community-based studies that reported country-specific VTDR prevalence. Random effect meta-analysis was then performed to estimate global and regional VTDR prevalence. VTDR prevalence estimates coupled with DM population data were then used to estimate the number of VTDR cases. Global and regional number of ophthalmologists were derived from the International Council of Ophthalmology Report 2015. Fifty studies (17 from Western Pacific [WP], nine North America and Caribbean [NAC], nine Middle East and North Africa [MENA], five Europe, eight South East Asia [SEA], one South and Central America [SACA] and one from Africa) were included. Global VTDR prevalence was 7.26% (95% CI, 6.18-8.32%). Regional VTDR prevalence was 14.35% in Africa, 11.21% in MENA, 10.00% in NAC, 6.32% in Europe, 6.22% in WP, 5.83% in SACA and 2.97% in SEA. Globally, there were 7.16 ophthalmologists per 1000 VTDR patients. Europe had the highest ophthalmologist per 1000 VTDR patient ratio at 18.03 followed by SACA (17.41), while NAC, MENA and Africa had the lowest at 4.90, 4.81 and 0.91 respectively. Across regions, the ophthalmologist densities ranged from 0.91 to 18.03 per 1000 VTDR patients, with NAC, MENA and Africa having less than 5 ophthalmologists per 1000 patients. These findings will aid global and regional policy planning and healthcare resource allocation for VTDR management.
| S-EPMC7314752 | biostudies-literature
Project description:Diabetic retinopathy (DR) is a most severe microvascular complication which, if left unchecked, can be sight-threatening. With the global prevalence of diabetes being relentlessly projected to rise to 438 million subjects by 2030, DR will undoubtedly pose a major public health concern. Efforts to unravel the human genetics of DR have been undertaken using the candidate gene and linkage approaches, while GWAS efforts are still lacking. Aside from evidence for a few genes including aldose reductase and vascular endothelial growth factor, the genetics of DR remain poorly elucidated. Nevertheless, the promise of impactful scientific discoveries may be realized if concerted and collaborative efforts are mounted to identify the genes for DR. Harnessing new genetic technologies and resources such as the upcoming 1000 Genomes Project will help advance this field of research, and potentially lead to a rich harvest of insights into the biological mechanisms underlying this debilitating complication.
| S-EPMC2913807 | biostudies-literature
Project description:ObjectiveTo compare general ophthalmologists, retina specialists, and the EyeArt Artificial Intelligence (AI) system to the clinical reference standard for detecting more than mild diabetic retinopathy (mtmDR).DesignProspective, pivotal, multicenter trial conducted from April 2017 to May 2018.ParticipantsParticipants were aged ≥ 18 years who had diabetes mellitus and underwent dilated ophthalmoscopy. A total of 521 of 893 participants met these criteria and completed the study protocol.TestingParticipants underwent 2-field fundus photography (macula centered, disc centered) for the EyeArt system, dilated ophthalmoscopy, and 4-widefield stereoscopic dilated fundus photography for reference standard grading.Main outcome measuresFor mtmDR detection, sensitivity and specificity of EyeArt gradings of 2-field, fundus photographs and ophthalmoscopy grading versus a rigorous clinical reference standard comprising Reading Center grading of 4-widefield stereoscopic dilated fundus photographs using the ETDRS severity scale. The AI system provided automatic eye-level results regarding mtmDR.ResultsOverall, 521 participants (999 eyes) at 10 centers underwent dilated ophthalmoscopy: 406 by nonretina and 115 by retina specialists. Reading Center graded 207 positive and 792 eyes negative for mtmDR. Of these 999 eyes, 26 eyes were ungradable by the EyeArt system, leaving 973 eyes with both EyeArt and Reading Center gradings. Retina specialists correctly identified 22 of 37 eyes as positive (sensitivity 59.5%) and 182 of 184 eyes as negative (specificity 98.9%) for mtmDR versus the EyeArt AI system that identified 36 of 37 as positive (sensitivity 97%) and 162 of 184 eyes as negative (specificity of 88%) for mtmDR. General ophthalmologists correctly identified 35 of 170 eyes as positive (sensitivity 20.6%) and 607 of 608 eyes as negative (specificity 99.8%) for mtmDR compared with the EyeArt AI system that identified 164 of 170 as positive (sensitivity 96.5%) and 525 of 608 eyes as negative (specificity 86%) for mtmDR.ConclusionsThe AI system had a higher sensitivity for detecting mtmDR than either general ophthalmologists or retina specialists compared with the clinical reference standard. It can potentially serve as a low-cost point-of-care diabetic retinopathy detection tool and help address the diabetic eye screening burden.
| S-EPMC9636573 | biostudies-literature
Project description:We identified lncRNA expression profiles in vitreous samples between proliferative diabetic retinopathy (PDR) patients and idiopathic macular hole (IMH) patients, and between PDR patients who had received preoperative anti-vascular endothelial growth factor (anti-VEGF) therapy and PDR patients who had received surgery alone. There had been the systemic expression differences in vitreous at the microarray level from PDR patients and IMH patients, and from PDR patients after anti-VEGF treatment and untreated PDR patients.
2022-07-15 | GSE191210 | GEO
Project description:There is emerging evidence which indicates the essential role of genetic factors in the development of diabetic retinopathy (DR). In this regard it should be highlighted that genetic factors account for 25-50% of the risk of developing DR. Therefore, the use of genetic analysis to identify those diabetic patients most prone to developing DR might be useful in designing a more individualized treatment. In this regard, there are three main research strategies: candidate gene studies, linkage studies and Genome-Wide Association Studies (GWAS). In the candidate gene approach, several genes encoding proteins closely related to DR development have been analyzed. The linkage studies analyze shared alleles among family members with DR under the assumption that these predispose to a more aggressive development of DR. Finally, Genome-Wide Association Studies (GWAS) are a new tool involving a massive evaluation of single nucleotide polymorphisms (SNP) in large samples. In this review the available information using these three methodologies is critically analyzed. A genetic approach in order to identify new candidates in the pathogenesis of DR would permit us to design more targeted therapeutic strategies in order to decrease this devastating complication of diabetes. Basic researchers, ophthalmologists, diabetologists and geneticists should work together in order to gain new insights into this issue.
| S-EPMC3763680 | biostudies-literature
Project description:BACKGROUND:Diabetic retinopathy refers to vascular disease of the retina that affects patients who have been diagnosed with type II diabetes mellitus. Information about DR must be spread the population, especially diabetic patients. Tools for DR screening are available and easy to access. No similar study was carried out in Tabuk to assess awareness of DR among type II diabetic patients up to our knowledge. AIM:To assess awareness of diabetic retinopathy among type II diabetic patients. METHODS:A cross-sectional study carried out in Tabuk city at King Salman Armed Forced Hospital-Primary Health Care Centers among type II diabetic patients attending at the period of study (n = 382) to assess their awareness about diabetic retinopathy. RESULTS:Out of 382 diabetics patients, (41.4%) had DM less than 5 years, (34.8%) had DM more than 10 years, and (23.8%) had DM between 5-10 years, (30.1%) had university degree, (42.4%) considered having low income, (57.6%) were screened for DR in the past year, (18.1%) of participant think that Seeing optometrist is enough for DR diagnosis. The total knowledge score about DR with a mean ± SD of 6.4 ± 1.5, indicating poor knowledge level, where 180 (47.1%) had poor knowledge, 106 (27.7%) had moderate knowledge, and 96 (25.2%) had good knowledge. CONCLUSION:Almost the Awareness of Type II Diabetic Patients Attending at king Salman Armed Forced Hospital-Primary Health Care centre regarding Diabetic Retinopathy needs to be improved.
| S-EPMC7061365 | biostudies-literature
Project description:Medical nutrition therapy is an important part of the management of type 1 diabetes mellitus (T1DM). Proper adherence to a healthy diet may have a favorable impact on diabetes management and its diabetic complications. Our aim was to assess differences in food and nutrient intake of type 1 diabetic patients with and without diabetic retinopathy (DR). This was a two-center, cross-sectional study in patients with T1DM, with and without DR. Subjects were recruited from the outpatient clinic of the two participating centers. A validated food frequency questionnaire was administered. A total of 103 T1DM patients with DR and 140 T1DM patient without DR were recruited. Subjects with DR showed a lower intake of total fat (p = 0.036) than that of their non-DR counterparts. DR was associated with increasing age (p = 0.004), hypertension (p < 0.001), and diabetes duration (p < 0.001), however there was a negative association with high educational level (p = 0.018). The multivariate-adjusted analysis showed that the intake of complex carbohydrates was positively related to the presence of DR (p = 0.031). In contrast, the intakes of total fat (p = 0.009), monounsaturated fatty acids (MUFAs) (p = 0.012), oleic acid (p = 0.012), and vitamin E (p = 0.006) were associated with the absence of DR. As conclusions, the intake of total MUFAs, oleic acid, and vitamin E is associated with a lower frequency of DR in patients with T1DM. These results suggest a potential protective effect of these lipid components for DR.
| S-EPMC6165451 | biostudies-literature