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Eye Complications of Diabetes

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Abstract

Diabetic retinopathy is a well-characterized, sight-threatening, chronic, ocular disorder that eventually develops, to some degree, in nearly all patients with diabetes mellitus. With experienced ophthalmic evaluation, diabetic retinopathy can be detected in its early stages. Existing therapies are remarkably effective at preventing some types of visual loss when administered at the appropriate time in the disease process. In addition, improved systemic glycemic control is associated with a delay in onset and slowing of progression of diabetic retinopathy. Nevertheless, diabetic retinopathy is the leading cause of new cases of legal blindness, as well as of severe and moderate visual loss among Americans between the ages of 20 and 74 years.

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References

  1. Klein R, BE Klein, Moss SE: Visual impairment in diabetes. Ophthalmology 1984, 91:1–9.2.

    Google Scholar 

  2. Klein R, Klein BE, Moss SE, Cruickshanks KJ: The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long-term incidence of macular edema. Ophthalmology 1995, 102:7–16.

    CAS  Google Scholar 

  3. Javitt JC, Aiello LP, Bassi LJ, et al.: Detecting and treating retinopathy in patients with type I diabetes mellitus. Savings associated with improved implementation of current guidelines. American Academy of Ophthalmology. Ophthalmology 1991, 98:1565–1573.

    Google Scholar 

  4. Javitt JC, Aiello LP, Chiang Y, et al.: Preventive eye care in people with diabetes is cost-saving to the federal government. Implications for health-care reform. Diabetes Care 1994, 17:909–917.

    CAS  Google Scholar 

  5. Javitt JC, Aiello LP: Cost-effectiveness of detecting and treating diabetic retinopathy [see comments]. Ann Intern Med 1996, 124:164–169.

    PubMed  CAS  Google Scholar 

  6. Javitt, JC, Canner JK, Sommer A: Cost effectiveness of current approaches to the control of retinopathy in type 1 diabetics. Ophthalmology 1989, 96:255–264.

    PubMed  CAS  Google Scholar 

  7. Kahn HA, Hiller R: Blindness caused by diabetic retinopathy. Am J Ophthalmol 1974, 78:58–67.

    PubMed  CAS  Google Scholar 

  8. Palmberg PF: Diabetic retinopathy. Diabetes 1977, 26:703–709.

    PubMed  CAS  Google Scholar 

  9. The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus [see comments]. N Engl J Med 1993, 329:977–986.

    Article  Google Scholar 

  10. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial. Diabetes 1995, 44:968–983.

    Google Scholar 

  11. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. Am J Ophthalmol 2000, 129:704–705.

    Google Scholar 

  12. Lifetime benefits and costs of intensive therapy as practiced in the Diabetes control and complications trial. The Diabetes Control and Complications Trial Research Group [see comments]. JAMA 1996, 276:1409–1415; published erratum, JAMA 1997, 278:25.

    Google Scholar 

  13. Resource utilization and costs of care in the Diabetes Control and Complications Trial. Diabetes Care 1995, 18:1468–1478.

    Google Scholar 

  14. Ferris FL: How effective are treatments for diabetic retinopathy? JAMA 1993, 269:1290–1291.

    Article  PubMed  Google Scholar 

  15. Aiello LP, Gardner TW, King GL, et al.: Diabetic retinopathy: technical review. Diabetes Care 1998, 21:143–156.

    PubMed  CAS  Google Scholar 

  16. National Diabetes Data Group: Diabetes in America. Washington, DC: US Government Printing Office; 1995.

    Google Scholar 

  17. Bursell SE, Clermont AC, Kinsley BT, et al.: Retinal blood flow changes in patients with insulin-dependent diabetes mellitus and no diabetic retinopathy. Am J Physiol 1996, 270:R61–R70.

    PubMed  CAS  Google Scholar 

  18. Wilkinson CP, Ferris FL III, Klein RE, et al.: Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 2003, 110:1677–1682.

    Article  PubMed  CAS  Google Scholar 

  19. Chew EY: A simplified diabetic retinopathy scale. Ophthalmology 2003, 110:1675–1676.

    Article  PubMed  Google Scholar 

  20. Krolewski AS, Warram JH, Rand LI, et al.: Risk of proliferative ­diabetic retinopathy in juvenile-onset type 1 diabetes: a 40-yr ­follow-up study. Diabetes Care 1984, 9:443–452.

    Article  Google Scholar 

  21. Klein R, Klein BE, Moss SE, et al.: The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol 1984, 102:520–536.

    Google Scholar 

  22. Klein R, Moss SE, Klein BE, et al.: New management concepts for timely diagnosis of diabetic retinopathy treatable by photocoagulation. Diabetes Care 1987, 10:633–638.

    Article  PubMed  CAS  Google Scholar 

  23. American Academy of Pediatrics: Screening for retinopathy in the pediatric patient with type 1 diabetes mellitus. Pediatrics 1998, 101:313–314.

    Article  Google Scholar 

  24. Klein BE, Moss SE, Klein R: Effect of pregnancy on progression of diabetic retinopathy. Diabetes Care 1990, 13:34–40.

    Article  PubMed  CAS  Google Scholar 

  25. The Early Treatment Diabetic Retinopathy Study Research Group: Grading diabetic retinopathy from stereoscopic color fundus photographs: an extension of the modified Airlie House classification. ETDRS report number 10. Ophthalmology 1991, 98:786–806.

    Google Scholar 

  26. The Early Treatment Diabetic Retinopathy Study Research Group: Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology 1991, 98:766–785.

    Google Scholar 

  27. The Diabetic Retinopathy Study Research Group: Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS Report Number 8. Ophthalmology 1981, 88:583–600.

    Google Scholar 

  28. The Diabetic Retinopathy Study Research Group: Indications for photocoagulation treatment of diabetic retinopathy: Diabetic Retinopathy Study Report no. 14. Int Ophthalmol Clin 1987, 27:239–253.

    Google Scholar 

  29. The Early Treatment Diabetic Retinopathy Study Research Group: Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol 1985, 103:1796–1806.

    Google Scholar 

  30. Cavallerano J: Diabetic retinopathy. Clin Eye Vis Care 1990, 2:4–14.

    Google Scholar 

  31. Ferris F: Early photocoagulation in patients with either type 1 or type 2 diabetes. Trans Am Ophthalmol Soc 1996, 94:505–537.

    PubMed  CAS  Google Scholar 

  32. The Diabetes Control and Complications Trial Research Group: The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial. Arch Ophthalmol 1995, 113:36–51.

    Article  Google Scholar 

  33. The Diabetic Retinopathy Vitrectomy Study Research Group: Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Clinical application of results of a randomized trial: Diabetic Retinopathy Vitrectomy Study Report 4. Ophthalmology 1988, 95:1321–1334.

    Google Scholar 

  34. Aiello LP, Cahill MT, Wong JS: Systemic considerations in the management of diabetic retinopathy. Am J Ophthalmol 2001, 132:760–776.

    Article  PubMed  CAS  Google Scholar 

  35. Michaelson IC: The mode of development of the vascular system of the retina, with some observations on its significance for certain retinal diseases. Trans Ophthalmol Soc UK 1948, 68:137–180.

    Google Scholar 

  36. Aiello LP, Northrup JM, Keyt BA: Hypoxic regulation of vascular endothelial growth factor in retinal cells. Arch Ophthalmol 1995, 113:1538–1544.

    Article  PubMed  CAS  Google Scholar 

  37. Aiello LP, Avery RL, Arrigg PG, et al.: Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders [see comments]. N Engl J Med 1994, 331:1480–1487.

    Article  PubMed  CAS  Google Scholar 

  38. Aiello LP, Pierce EA, Foley ED, et al.: Suppression of retinal neovascularization in vivo by inhibition of vascular endothelial growth factor (VEGF) using soluble VEGF-receptor chimeric proteins. Proc Natl Acad Sci U S A 1995, 92:10457–10461.

    Article  PubMed  CAS  Google Scholar 

  39. Adamis AP, Shima DT, Tolentino MJ, et al.: Inhibition of vascular endothelial growth factor prevents retinal ischemia-associated iris neovascularization in a nonhuman primate. Arch Ophthalmol 1996, 114:66–71.

    Article  PubMed  CAS  Google Scholar 

  40. Robinson GS, Pierce EA, Rook SL, et al.: Oligodeoxynucleotides inhibit retinal neovascularization in a murine model of proliferative retinopathy. Proc Natl Acad Sci U S A 1996, 93:4851–4856.

    Article  PubMed  CAS  Google Scholar 

  41. Smith LE, Wesolowski E, McLellan A, et al.: Oxygen-induced retinopathy in the mouse. Invest Ophthalmol Vis Sci 1994, 35:101–111.

    PubMed  CAS  Google Scholar 

  42. Aiello LP: Vascular endothelial growth factor. 20th-century mechanisms, 21st-century therapies. Invest Ophthalmol Vis Sci 1997, 38:1647–1652.

    Google Scholar 

  43. A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology 2008,115:1447–1449.

    Google Scholar 

  44. Giuliari G: Images in clinical medicine. Intravitreal triamcinolone for diabetic macular edema. N Engl J Med 2010, 363:2351.

    CAS  Google Scholar 

  45. Clark WL, Callejo S, Rosa R, Clayman H: Atlas of Ophthalmology. New York; Springer: 2002.

    Google Scholar 

  46. Davis J, Palestine A, Mildvan D: Ophthalmic manifestations. In Atlas of Infectious Diseases. New York: Springer; 2008.

    Google Scholar 

  47. Avery RL, Pearlman J, Pieramici DJ, et al.: Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology 2006, 113:1695.e1–1695.e15.

    Google Scholar 

  48. Nguyen QD, Shah SM, Heier JS, et al.: Primary end point (six months) results of the Ranibizumab for Edema of the Macula in Diabetes (READ-2) Study. Ophthalmology 2009, 116:2175–2181.

    Article  PubMed  Google Scholar 

  49. Michaelides M, Kaines A, Hamilton RD, et al.: A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT) study 12-month data: report 2. Ophthalmology 2010, 117:1078–1086.

    Article  PubMed  Google Scholar 

  50. Diabetic Retinopathy Clinical Research Network, Elman MJ, Aiello LP, et al.: Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology 2010, 117:1064–1077.

    Google Scholar 

  51. Elman MJ, Aiello LP, Beck RW et al.: Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology 2010,117:1064–1077.

    Article  PubMed  Google Scholar 

  52. Keenan HA, Costacou T, Sun JK, et al.: Clinical factors associated with resistance to microvascular complications in diabetic patients of extreme disease duration: the 50-year medalist study. Diabetes Care 2007, 30:1995–1997.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The excellent technical and editorial assistance of Jerry D. Cavallerano, OD, PhD, is gratefully acknowledged. Portions of this chapter are adapted from Aiello et al. [15] and the American Academy of Ophthalmology, Diabetes 2000, Diabetic Retinopathy course.

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Aiello, L.P. et al. (2012). Eye Complications of Diabetes. In: Skyler, J. (eds) Atlas of Diabetes. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-1028-7_12

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  • DOI: https://doi.org/10.1007/978-1-4614-1028-7_12

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