Retinal blood flow is increased in type 1 diabetes mellitus patients with advanced stages of retinopathy.

Background: Diabetic retinopathy (DRP) is a common microvascular complication seen in patients with type 1 diabetes mellitus (T1DM). The effects of T1DM and concomitant (proliferative) DRP on retinal blood flow are currently unclear. Therefore, we measured retinal vascular blood flow in T1DM patients with and without DRP and non-diabetic controls.

Real-world evidence of suboptimal blood pressure control in patients with type 2 diabetes.

Aims: In order to eventually improve blood pressure (BP) management, the aim of this study was to identify subgroups of type 2 diabetes mellitus (T2DM) patients with distinct trajectories of SBP levels. Identifying subgroups with distinct SBP trajectories helps to better understand the course of SBP levels in T2DM patients and its associated consequences. Subgroup characteristics were determined and the prevalence of complications and mortality rates over time in the different subgroups was investigated.

Distinct HbA1c trajectories in a type 2 diabetes cohort.

Aims: The aim of this study was to identify subgroups of type 2 diabetes mellitus patients with distinct hemoglobin A1c (HbA1c) trajectories. Subgroup characteristics were determined and the prevalence of microvascular complications over time was investigated.

Study Design And Setting: Data from a cohort of 5,423 type 2 diabetes patients from a managed primary care system were used [mean follow-up 5.

Low-grade inflammation and endothelial dysfunction explain the association between retinopathy and left ventricular ejection fraction in men: an 8-year follow-up of the Hoorn Study.

Purpose: The aim of this study was to prospectively investigate the association of retinopathy with changes in left ventricular (LV) function.

Methods: Within the Hoorn Study, a population-based cohort study of diabetes in The Netherlands, retinal photography and echocardiography were performed in the year 2000 (baseline) and 2008 (follow-up). Retinopathy was graded according to the Eurodiab classification and further defined as absent or present retinopathy.

Validation of a model to estimate personalised screening frequency to monitor diabetic retinopathy.

Aims/hypothesis: Our study aimed to validate a model to determine a personalised screening frequency for diabetic retinopathy.

Methods: A model calculating a personalised screening interval for monitoring retinopathy based on patients' risk profile was validated using the data of 3,319 type 2 diabetic patients in the Diabetes Care System West-Friesland, the Netherlands. Two-field fundus photographs were graded according to the EURODIAB coding system.

Objectives of teaching direct ophthalmoscopy to medical students.

Purpose: To propose the objectives of undergraduate training in direct ophthalmoscopy (DO).

Method: Narrative review of the literature on (i) opinions about the expected proficiency from students in DO, and (ii) estimates of its diagnostic value.

Results: (i) Authorities disagree on the proficiency in DO that they expect from students.

Progression and regression: distinct developmental patterns of diabetic retinopathy in patients with type 2 diabetes treated in the diabetes care system west-friesland, the Netherlands.

Objective: To identify distinct developmental patterns of diabetic retinopathy (DR) and assess the risk factor levels of patients in these clusters.

Research Design And Methods: A cohort of 3,343 patients with type 2 diabetes mellitus (T2DM) monitored and treated in the Diabetes Care System West-Friesland, the Netherlands, was followed from 2 to 6 years. Risk factors were measured, and two-field fundus photographs were taken annually and graded according to the EURODIAB study group.

[Visual loss as a sign of hypertension].

A 26-year-old male patient had been suffering from a decreased visual acuity in both eyes for 3 weeks. This appeared to be due to malignant hypertension. The hypertension went unnoticed until papillary and macular oedema were detected during fundoscopy.

Reliability of screening methods for diabetic retinopathy.

Aim: To review studies of the reliability (reproducibility) of the commonly used methods (ophthalmoscopy and inspection of retinal images) of screening for diabetic retinopathy (DR).

Research Design And Methods: Literature search.

Results: We found six studies of the intra-examiner agreement after examining the same retinal images.

Changes in the internal structure of the human crystalline lens with diabetes mellitus type 1 and type 2.

Purpose: To investigate the effect of diabetes mellitus (DM) type 1 and type 2 on the internal structure of the lens.

Design: Observational cross-sectional study.

Participants And Controls: One hundred seven patients with DM type 1, 106 patients with DM type 2, and 75 healthy control subjects.

Measuring the refractive properties of the diabetic eye during blurred vision and hyperglycaemia using aberrometry and Scheimpflug imaging.

Purpose: This study aimed to measure the refraction and geometry in the diabetic eye during the presence and absence of hyperglycaemia and blurred vision, using aberrometry and Scheimpflug imaging.

Methods: Aberrometry and Scheimpflug imaging were used to examine ocular refraction and higher-order aberrations, as well as the shape of the cornea and the lens, in 25 patients with diabetes mellitus. From these parameters, the equivalent refractive index of the lens was calculated.

Precision and reliability of retinal thickness measurements in foveal and extrafoveal areas of healthy and diabetic eyes.

Purpose: To determine the precision and reliability of retinal thickness measurements with an optical coherence tomograph (Stratus OCT 3; Carl Zeiss Meditec, Dublin, CA) and a retinal thickness analyzer (RTA; Talia Technology Ltd., Neve-Ilan, Israel) in foveal, parafoveal, and perifoveal areas.

Methods: Three measurements of all areas were performed within 1 hour on the same day with each instrument in the eyes of healthy volunteers and diabetic patients.

The influence of diabetes mellitus type 1 and 2 on the thickness, shape, and equivalent refractive index of the human crystalline lens.

Purpose: To study the influence of diabetes mellitus (DM) types 1 and 2 on the thickness, radius of curvature, equivalent refractive index, and power of the lens.

Design: Observational cross-sectional study.

Participants And Controls: One hundred fourteen patients with DM type 1, 112 patients with DM type 2, and 75 control subjects.

Refractive properties of the healthy human eye during acute hyperglycemia.

Purpose: To measure the refractive properties of the healthy human eye during acute hyperglycemia by means of Scheimpflug imaging and Hartmann-Shack aberrometry.

Methods: Acute hyperglycemia was induced in five healthy subjects (two males, three females, mean age +/-SD 24.8 years +/- 4.

The effect of acute hyperglycemia on retinal thickness and ocular refraction in healthy subjects.

Purpose: To quantify the retinal thickness and the refractive error of the healthy human eye during hyperglycemia by means of optical coherence tomography (OCT) and Hartmann-Shack aberrometry.

Methods: Hyperglycemia was induced in five healthy subjects who were given a standard oral glucose tolerance test (OGTT) after a subcutaneous injection of somatostatin. Main outcome parameters were the central, pericentral and peripheral thickness of the fovea, measured by means of optical coherence tomography (OCT3).

The influence of chronic diabetes mellitus on the thickness and the shape of the anterior and posterior surface of the cornea.

Purpose: To determine the influence of diabetes mellitus (DM) type 1 and type 2 on the thickness, radius of curvature, power, and asphericity of the cornea.

Methods: In this observational cross-sectional study, 102 patients with DM type 1, 101 patients with DM type 2, and 69 healthy subjects were measured by means of Scheimpflug imaging to determine central corneal thickness and the radius and asphericity of the anterior and posterior corneal surfaces. Corneal power was calculated from these parameters.

Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study.

The aim of the present study was to investigate the relationship between homocysteine and homocysteine metabolism components and retinal microvascular disorders in subjects with and without Type 2 diabetes. In this population-based study of 256 participants, aged 60-85 years, we determined total plasma homocysteine, SAM (S-adenosylmethionine) and SAH (S-adenosylhomocysteine) in plasma and erythrocytes, total folate in serum and erythrocytes, 5-MTHF (5-methyltetrahydrofolate), and vitamins B12 and B6. Participants were examined ophthalmologically by means of indirect funduscopy and two-field 45 degrees fundus photography, and were graded for retinopathy and retinal sclerotic vessel abnormalities.

Are retinal microvascular abnormalities associated with large artery endothelial dysfunction and intima-media thickness? The Hoorn Study.

It has been hypothesized that microvascular dysfunction affects endothelial dysfunction of the large arteries, which may explain the relationship of microvascular disease with macrovascular disease. The aim of the present study was to investigate the relationship of retinal microvascular disorders with endothelium-dependent FMD (flow-mediated vasodilatation) and carotid IMT (intima-media thickness). A total of 256 participants, aged 60-85 years, 70 with normal glucose metabolism, 69 with impaired glucose metabolism and 109 with Type II diabetes, were included in this study.

Diabetic retinopathy is associated with mortality and cardiovascular disease incidence: the EURODIAB prospective complications study.

Objective: To study the relationship of nonproliferative and proliferative retinopathy with all-cause mortality and cardiovascular disease (CVD) incidence in type 1 diabetic patients and, additionally, the role of cardiovascular risk factors in these associations.

Research Design And Methods: This prospective study included 2,237 type 1 diabetic patients from 31 centers in 16 European countries at baseline, aged 15-60 years, who were examined for retinopathy by taking two-field 45 degrees fundus photographs, which were centrally graded. Mortality and cardiovascular morbidity follow-up was assessed 6-8 years after baseline examination according to a standardized protocol.

Risk factors for incident retinopathy in a diabetic and nondiabetic population: the Hoorn study.

Objective: To investigate the effect of glycosylated hemoglobin, age, sex, hypertension, body mass index, waist-hip ratio, serum lipid levels, and smoking on the incidence of retinopathy in persons with normal and abnormal glucose metabolism.

Methods: The incidence of retinopathy was determined in 233 individuals, aged 50 to 74 years, by ophthalmoscopy and fundus photography at baseline and after an average follow-up of 9.4 years.

Retinal thickness analysis(RTA): an objective method to assess and quantify the retinal thickness in healthy controls and in diabetics without diabetic retinopathy.

Background: Since it has been shown that photocoagulation is indicated in patients with diabetic macular edema, quantitative and objective assessment of retinal thickness is of clinical importance.

Methods: A laser slit beam was projected on the retina and scanned across a 2 x 2 mm retinal area in 200 msec. Nine type 1 and 2 diabetic patients without funduscopically and photographically visible diabetic retinopathy and 10 healthy controls were scanned with the RTA.