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Early-onset type 2 diabetes: A high-risk factor for proliferative diabetic retinopathy (PDR) in patients with microalbuminuria.
Lv, X, Ran, X, Chen, X, Luo, T, Hu, J, Wang, Y, Liu, Z, Zhen, Q, Liu, X, Zheng, L, et al
Medicine. 2020;(19):e20189
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Abstract
We aim to explore the relationship between early-onset diabetes and proliferative diabetic retinopathy (PDR) in type 2 diabetes mellitus (T2DM) patients with microalbuminuria.A total of 461 T2DM patients with microalbuminuria were enrolled. Subjects were defined as early-onset or late-onset based on the age at which they were diagnosed with diabetes (<40 and ≥40 years, respectively). Medical history, anthropometry, and laboratory indicators were documented. PDR was defined as the presence of any of the following changes on fundus photography: neovascularization, vitreous hemorrhage, or preretinal hemorrhage.The prevalence of PDR was 6-fold higher in patients with early-onset than late-onset T2DM [(6.1% vs 1.0%), P = .004]. Univariate correlation analysis showed that early-onset diabetes, use of oral hypoglycemic drugs, and insulin therapy were risk factors for PDR. In multivariate logistic analysis, patients with early-onset diabetes exhibited a 7.00-fold [(95% confidence interval 1.40-38.26), P = .019] higher risk of PDR than subjects with late-onset diabetes after adjusting for sex; T2DM duration; systolic blood pressure; total triglyceride; glycated hemoglobin; insulin therapy; and the use of oral hypoglycemic drugs, antihypertensive drugs, and lipid-lowering drugs.In T2DM patients with microalbuminuria, early-onset diabetes is an independent risk factor for the development of PDR.
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Automatic detection of microaneurysms in retinal fundus images.
Wu, B, Zhu, W, Shi, F, Zhu, S, Chen, X
Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society. 2017;:106-112
Abstract
Diabetic retinopathy (DR) is one of the leading causes of new cases of blindness. Early and accurate detection of microaneurysms (MAs) is important for diagnosis and grading of diabetic retinopathy. In this paper, a new method for the automatic detection of MAs in eye fundus images is proposed. The proposed method consists of four main steps: preprocessing, candidate extraction, feature extraction and classification. A total of 27 characteristic features which contain local features and profile features are extracted for KNN classifier to distinguish true MAs from spurious candidates. The proposed method has been evaluated on two public database: ROC and e-optha. The experimental result demonstrates the efficiency and effectiveness of the proposed method, and it has the potential to be used to diagnose DR clinically.
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Peripapillary retinal nerve fiber layer changes in preclinical diabetic retinopathy: a meta-analysis.
Chen, X, Nie, C, Gong, Y, Zhang, Y, Jin, X, Wei, S, Zhang, M
PloS one. 2015;(5):e0125919
Abstract
BACKGROUND Diabetic retinopathy is a microvascular neurodegenerative disorder in diabetic patients. Peripapillary retinal nerve fiber layer changes have been described in patients with preclinical diabetic retinopathy, but study results have been inconsistent. OBJECTIVE To assess changes in peripapillary retinal nerve fiber layer thickness in diabetic patients with preclinical diabetic retinopathy. METHODS A literature search was conducted through PubMed, EMBASE, Web of Science and Cochrane Library. Case-control studies on RNFL thickness in preclinical diabetic retinopathy patients and healthy controls were retrieved. A meta-analysis of weighted mean difference and a sensitivity analysis were performed using RevMan 5.2 software. RESULTS Thirteen case-control studies containing 668 diabetic patients and 556 healthy controls were selected. Peripapillary RNFL thickness was significantly reduced in patients with preclinical diabetic retinopathy compared to healthy controls in studies applying Optical Coherence Tomography (-2.88 μm, 95%CI: -4.44 to -1.32, P = 0.0003) and in studies applying Scanning Laser Polarimeter (-4.21 μm, 95%CI: -6.45 to -1.97, P = 0.0002). Reduction of RNFL thickness was significant in the superior quadrant (-3.79 μm, 95%CI: -7.08 to -0.50, P = 0.02), the inferior quadrant (-2.99 μm, 95%CI: -5.44 to -0.54, P = 0.02) and the nasal quadrant (-2.88 μm, 95%CI: -4.93 to -0.82, P = 0.006), but was not significant in the temporal quadrant (-1.22 μm, 95%CI: -3.21 to 0.76, P = 0.23), in diabetic patients. CONCLUSION Peripapillary RNFL thickness was significantly decreased in preclinical diabetic retinopathy patients compared to healthy control. Neurodegenerative changes due to preclinical diabetic retinopathy need more attention.