Retinal Photographs (retinal + photograph)

Distribution by Scientific Domains

Selected Abstracts

Relationship between the severity of retinopathy and progression to photocoagulation in patients with Type 2 diabetes mellitus in the UKPDS (UKPDS 52)

Uk Prospective Diabetes Study (ukpds) Group
Summary Aim to establish the degree to which the severity of retinopathy determines the risk for the need for subsequent photocoagulation in those with newly diagnosed Type 2 diabetes mellitus. Methods Of 5102 patients entered into the UK Prospective Diabetes Study (UKPDS), 3709 had good quality retinal photographs that could be graded at entry. They were followed until the end of the study or until lost to follow-up, or until they received photocoagulation. Retinopathy severity was categorized as no retinopathy, microaneurysms (MA) only in one eye, MA in both eyes or more severe retinopathy features. The risk of photocoagulation was assessed in relation to severity of retinopathy at baseline, 3 and 6 years. Results Of the 3709 patients assessed at entry to the UKPDS, 2316 had no retinopathy. Of these 0.2% needed photocoagulation at 3 years, 1.1% at 6 years and 2.6% at 9 years. Those with MA in one eye only (n = 708) were similar, with 0%, 1.9% and 4.7% needing photocoagulation by 3, 6 and 9 years, respectively. Amongst those who had more retinopathy features at entry (n = 509), 15.3% required photocoagulation by 3 years, and 31.9% by 9 years. When those without retinopathy at 6 years (n = 1579) were examined 3 and 6 years later (9 and 12 years after diagnosis), 0.1% and 1.8% required photocoagulation. Those with more severe retinopathy (n = 775) needed earlier treatment, 6.6% after 3 years and 13.3% after 9 years. The commonest indication for laser therapy was maculopathy, but those with more severe retinopathy were more likely to be treated for proliferative retinopathy and to need both eyes treated. Conclusion Few type 2 diabetic patients without retinopathy progress to photocoagulation in the following 3,6 years, while patients with more severe retinopathy lesions need to be monitored closely. [source]

Increased retinopathy occurrence in type 1 diabetes patients with increased serum levels of the advanced glycation endproduct hydroimidazolone

Dag S. Fosmark
Abstract. Purpose:, We aimed to investigate associations between serum levels of the advanced glycation endproduct methylglyoxal-derived hydroimidazolone (MG-H1) and retinopathy in a sample of patients with type 1 diabetes. Methods:, We conducted a cross-sectional study in a Scandinavian ophthalmology outpatient clinic on 61 randomly selected patients with type 1 diabetes. Blood samples and retinal photographs were taken at the same visit. Serum levels of hydroimidazolone immunoreactivity were determined using an immunoassay, and levels of retinopathy were determined from seven standard field stereo photographs of each eye according to the ETDRS method. Results were compared between patients with and without retinopathy. Results:, Hydroimidazolone quartiles were significantly associated with retinopathy (p = 0.013). The most profound increase in occurrence of retinopathy was observed from the lowest to the second-lowest hydroimidazolone quartile. Adjusted for duration of diabetes using logistic regression, a significant difference in the presence of retinopathy was found when comparing the lowest quartile with the rest (p = 0.022). Conclusions:, In our patients with type 1 diabetes, serum levels of hydroimidazolone were found to be associated with retinopathy. This is in keeping with findings in a larger sample of patients with type 2 diabetes. [source]

Validity of non-mydriatic cameras for screening and follow-up in diabetic retinopathy

Purpose: To determine the validity of a non-mydriatic camera for screening and grading diabetic retinopathy (DR). To establish the number of photographs and the field width needed for a correct DR follow-up. Methods: A cross-sectional, observational study was carried out to assess the validity of the non-mydriatic Topcon TRC-NW6S retinograph. Validity proportions were calculated. Kappa analysis was made to determine the agreement with conventional fundoscopy exploration performed by indirect ophthalmoscopy and retinal biomicroscopy. One 45 single-field non-mydriatic digital photograph was taken in 82 eyes for DR screening. For DR grading, several combinations of retinal fields were photographed in 247 eyes, first without pupillary dilatation and later with mydriasis. Results: In DR screening, 88.2% sensitivity and 96.9% specificity were obtained, where 9% of the tests were invalid. In DR grading diagnosis, the kappa analysis showed close agreement (k>0.8) based on at least two 45 photographs with mydriasis. However, when attempting to detect macular edema (ME), the maximum kappa statistic obtained did not go above 0.71, showing 67% maximum sensitivity. The sensitivity for detecting derivable DR was similar to that obtained with indirect ophthalmoscopy (94-98%). Conclusions: The non-mydriatic retinograph is a valid instrument for DR screening only when taking one 45 non-mydriatic photograph per eye. However, given that the sensitivity for proliferative DR (PDR) was worse, when grading DR, we would recommend obtaining nine retinal photographs (mosaic) with mydriasis. Used in this way, the apparatus is extremely useful for detecting derivable DR cases. [source]

Angiotensin-converting enzyme inhibitors (ACEIs) and age-related maculopathy (ARM): cross-sectional findings from the Blue Mountains Eye Study

Kathy H. C. Wu
Abstract. Purpose:, To assess the relationship between the use of angiotensin-converting enzyme inhibitors (ACEIs) and prevalence of age-related maculopathy (ARM). Methods:, Eligible residents aged , 49 years were first examined in 1992,94 (Cross-section 1, n = 3654). Of these, 2335 were re-examined in 1997,99, together with an additional 1174 who became eligible after 1994 (Cross-section 2, n = 3509). Information regarding ACEI use was obtained and retinal photographs were graded using the Wisconsin ARM Grading System. Results:, In Cross-section 1, prevalence rates of late and early stage ARM were 1.3% and 4.3% among current ACEI users, and 2.0% and 4.8% among non-current users, respectively. In Cross-section 2, prevalence rates of late and early stage ARM were 2.3% and 11.3% among current ACEI users, and 1.3% and 9.3% among non-current users, respectively. After adjusting for age, sex and smoking, neither survey found any significant association between ACEI use and prevalence of either late or early ARM. Conclusions:, No significant cross-sectional associations were found between ACEI use and ARM prevalence in this population. [source]

Visual function tests, eye disease and symptoms of visual disability: a population-based assessment

Rebecca Q Ivers MPH
ABSTRACT Purpose: To examine associations between eye disease and tests of visual function with self-reported visual disability. Methods: The Blue Mountains Eye Study is a cross-sectional census-based survey of eye disease in two postcode areas in the Blue Mountains, west of Sydney, Australia. Of 4433 eligible residents, 3654 (82.4%) participated. Subjects had a detailed eye examination, including tests of visual acuity, contrast sensitivity, disability glare and visual field. Lens and retinal photographs were taken and graded according to standardized protocols for presence of cataract, early and late age-related maculopathy, glaucoma, diabetic retinopathy, retinal vein occlusion and other eye diseases. An interviewer-administered questionnaire included questions about perception of visual disability. Results: Scores on all tests of visual function significantly decreased with age (P < 0.0001). This decrease persisted for all tests except disability glare after excluding subjects with identifiable eye disease. The presence of one or more eye diseases was significantly associated with all (self-reported) measures of visual disability (trouble driving at night, difficulty recognizing a friend across the street, reading a newspaper or recognizing detail on television); mixed cataract (cortical and nuclear, or posterior subcapsular and nuclear) was associated with trouble driving at night and difficulty recognizing a friend across the street. A 10-letter (two-line) decrease in best corrected or presenting visual acuity was significantly associated with all self-reported measures of visual disability, as was a two-step decrease in contrast sensitivity. A five-point increase in points missing in the visual field was weakly but significantly associated with all self-reported measures of visual disability except trouble driving at night. Conclusions: Visual function declines with age. Impaired visual function was strongly, and eye disease relatively weakly associated with reports of visual disability. [source]