Eye disorders other than diabetic retinopathy in patients with diabetes.

Aim: While diabetic retinopathy is the most specific complication of chronic hyperglycaemia, numerous other ocular conditions also can involve the eyes of people with diabetes. Cataract, glaucoma, age-related macular degeneration, retinal vascular occlusion, and acute ischaemic optic neuropathy combine to impair vision in people with diabetes, especially when they are old. This report provides a critical analysis and an overview of the current knowledge of the main ocular disorders (excluding diabetic retinopathy) and their association in patients with diabetes.

RAPID MACULAR CAPILLARY LOSS IN PATIENTS WITH UNCONTROLLED TYPE 1 DIABETES.

Purpose: To analyze the evolution of macular vessel density (VD) over 1 year, during early worsening of diabetic retinopathy, in patients with uncontrolled Type 1 diabetes (T1D).

Methods: Retrospective study of 12 eyes of 9 patients with T1D with early worsening of diabetic retinopathy imaged with optical coherence tomography angiography. The following data were collected at the time of pan retinal photocoagulation initiation and after 6 and 12 months: vessel density within three retinal plexuses-superficial vascular plexus, intermediate capillary plexus, and deep capillary plexus; foveal avascular zone area, acircularity index, and flow density (FD)-300; central macular thickness; and HbA1c levels.

Early worsening of diabetic retinopathy after rapid improvement of blood glucose control in patients with diabetes.

Aim: To review the frequency, importance of and risk factors for "early worsening of diabetic retinopathy" (EWDR) after rapid improvement of blood glucose in patients with diabetes.

Methods: This was a systematic review of key references (PubMed 1980-2016) and the current international recommendations for the above-mentioned topics.

Results: EWDR has been described during intensive treatment (IT) in patients with uncontrolled type 1 or 2 diabetes, and after pancreas transplantation or bariatric surgery.

Influence of pulse pressure and spontaneous variations of macular thickness in patients with diabetic macular oedema.

Purpose: To study spontaneous variations of central macular thickness (CMT) and its relation to blood pressure (BP) in patients with diabetic macular oedema (DME).

Methods: 23 diabetic patients presenting with DME with a CMT ≥ 260 μm on optical coherence tomography (OCT-3, Carl Zeiss Meditec, CA) were followed every 2 weeks for 3 months. At baseline, ambulatory 24H-BP monitoring (ABPM) was performed, as well as five CMT measurements (9 am, 12 am, 3 pm, 6 pm and 9 am the day after).

Dextrose infusion and glucose disorders in people without diabetes hospitalized in general wards.

We measured fasting plasma glucose (FPG) on a single day in all persons without diabetes history admitted in general wards (N=1922). After age and length of stay adjustment, dextrose infusion was associated with a 3-fold increase (p<0.001) of hospital-related hyperglycemia (FPG ≥ 7 mmol/l), highlighting the need to interpret glucose disorders cautiously.

High prevalence of diabetes mellitus and hospital-related hyperglycaemia in French general wards.

Aim: The study evaluated the in-hospital prevalence of diabetes and hospital-related hyperglycaemia in a variety of French general wards.

Methods: The multicentre cross-sectional study involving nine French hospitals measured venous fasting plasma glucose (FPG) on a single day in patients hospitalized in adult medical and surgical short-term wards. Diabetes status and length of stay were recorded.

High prevalence of undiagnosed diabetes and high risk for diabetes using HbA1c criteria in middle-aged patients undergoing cataract surgery.

Aim: This study assessed the prevalence of undiagnosed diabetes and a high risk for diabetes using glycated haemoglobin (HbA(1c)) values in middle-aged patients undergoing cataract surgery.

Methods: The study comprised 137 consecutive patients, aged 40 to 65 years, with no known diabetes undergoing cataract surgery at a French national eye centre. Fasting glucose, obesity parameters, and vascular and ocular cataract risk factors were recorded.

[Insulin therapy among inpatients].

To identify patients with known diabetes or hospital-related hyperglycemia. To establish blood glucose targets according to patient's clinical state. To draw up protocols by using basal, bolus (nutritional/prandial), and supplemental insulin and not "sliding scale insulin".

[The magnifying mirror to enable patients with diabetes to self-examine their feet].

The treatment of foot wounds is a real public health issue for patients with diabetes. A specific educational tool has been developed for foot self-examination: the magnifying mirror. Its use, during nurse consultations and in the patient's home, actively contributes to foot wound prevention messages and actions.

Hypoglycaemia is associated with the absence of a decrease in diurnal macular thickness in patients with diabetic macular oedema.

Aim: Spontaneous diurnal variations measured by optical coherence tomography (OCT) have been reported in diabetic macular oedema (DME) together with a daytime decrease in central macular thickness (CMT). For this reason, this study aimed to investigate the influence of acute glucose and blood pressure changes on daytime variations in CMT in patients with DME.

Methods: In this prospective observational study of type 1 (n=4) and type 2 (n=18) diabetic patients with DME, OCT scans, capillary blood glucose, and systolic and diastolic blood pressure measurements were performed at 9 a.

[Acute total cataract in a 17-year-old woman].

Diabetes is a metabolic disease that has multiple consequences on the eye, particularly the retina but also the lens. However, in diabetic patients, the development of an acute decrease in vision is rarely caused by a cataract and diabetic lens opacities usually appear progressively several years after the diagnosis of diabetes. We present here the case of a young patient who had just been diagnosed with diabetes two months before and who developed an acute total cataract, responsible for a rapid decrease in vision.

[Systemic tolerance of corticosteroid therapy in ophthalmology depending on the route of administration].

Corticosteroids have been a major therapeutic improvement, particularly in ophthalmology. Depending on the different therapeutic modalities used, the ophthalmologist will mainly encounter a risk of short-term adverse effects (intravenous administration, high doses, etc.) or a risk of long-term side effects (related to the cumulative dose received).

Endogenous erythroid colony formation in patients with retinal vein occlusion.

Purpose: The pathophysiology and causes of retinal vein occlusion (RVO) remain largely unknown. Latent forms of myeloproliferative disorders, which are diagnosed by the presence of in vitro endogenous erythroid colony (EEC) formation, are a well-known cause of intraabdominal vein thrombosis. The suspected diagnosis of a latent myeloproliferative disorder in a patient with RVO, based on the presence of EEC formation, led us to evaluate the association between latent myeloproliferative disorders and RVO.

Hyperglycemia after repeated periocular dexamethasone injections in patients with diabetes.

Purpose: To assess the hyperglycemic effect of 3 consecutive daily periocular steroid injections in patients with diabetes.

Design: Retrospective observational study in a national eye center.

Participants: Twenty-five hospitalized patients with type 2 diabetes who received a subconjunctival (n = 11) or a peribulbar injection (n = 14) with 4 mg dexamethasone disodium phosphate once a day for 3 consecutive days for ocular conditions.

Short-term tolerance of pulse methylprednisolone therapy in patients with diabetes mellitus.

Purpose: To assess the short-term tolerance of pulse methylprednisolone in patients with diabetes.

Design: Retrospective study in a national eye center.

Participants: Eighty patients with type 2 diabetes, half of them also treated for hypertension, who received 3-day pulse methylprednisolone between January 1999 and December 2002 for eye disorders and were monitored according to a written protocol.