Ultra-Widefield and Early Treatment Diabetic Retinopathy Study 7-Field Grading of Diabetic Retinopathy.

Importance: High concordance in diabetic retinopathy (DR) outcomes between 7-field (7F) and ultra-widefield (UWF) images would allow for combining longitudinal assessments based on the 2 modalities both in clinical studies and clinical care.

Objective: To compare 7F and UWF imaging with regard to DR severity and the associations of DR severity with risk factors, such as hemoglobin A1c, age, diabetes duration, and sex.

Design, Setting, And Participants: This cross-sectional study describes the outcomes of the randomized clinical Diabetes Control and Complications Trial (DCCT) and its subsequent observational study, the Epidemiology of Diabetes Interventions and Complications (EDIC) study.

Leveraging Delaware's Public Health Resources to Mitigate Spread of Communicable Diseases in Congregate Settings.

While resources available to public health entities increased during the COVID-19 pandemic, the need to focus mitigation efforts on Delaware's most vulnerable citizens was evident. The higher risk of community-spread and complications resulting from COVID-19 associated with individuals residing in congregate settings such as homeless shelters and encampments prompted the Delaware Division of Public Health to leverage existing and new resources to provide technical assistance, education and to build valuable partnerships with community-based homeless service providers to reduce the public health threat to those experiencing homelessness.

Retinopathy During the First 5 Years of Type 1 Diabetes and Subsequent Risk of Advanced Retinopathy.

Objective: To determine whether individuals with type 1 diabetes (T1D) who develop any retinopathy at any time prior to 5 years of diabetes duration have an increased subsequent risk for further progression of retinopathy or onset of proliferative diabetic retinopathy (PDR), clinically significant macular edema (CSME), diabetes-related retinal photocoagulation, or anti-vascular endothelial growth factor injections. Additionally, to determine the influence of HbA1c and other risk factors in these individuals.

Research Design And Methods: Diabetic retinopathy (DR) was assessed longitudinally using standardized stereoscopic seven-field fundus photography at time intervals of 6 months to 4 years.

Refractive Error and Retinopathy Outcomes in Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study.

Purpose: To determine the relationship between refractive error and diabetic retinopathy (DR).

Design: Clinical trial.

Participants: Type I diabetes individuals with serial refractive error and DR stage measurements over 30 years in the Diabetes Control and Complications Trial (DCCT) and Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study.

Plate-Adherent Nanosubstrate for Improved ELISA of Small Molecules: A Proof of Concept Study.

Enzyme-linked immunosorbent assay (ELISA) is a widely used technique for detecting and quantifying target analytes in clinical and research laboratories. One of the main drawbacks of ELISA is the involvement of multiple washing steps that desorbs the capture antigen/antibody off the polystyrene plate, thereby producing inconsistent and erroneous data. To overcome the problem of desorption, we hypothesized that gelatin nanoparticles (GelNP) could serve as a "plate-adherent" substrate to irreversibly adhere the capture antigen/antibody of interest.

Diabetic Retinopathy Screening Using a Gold Nanoparticle-Based Paper Strip Assay for the At-Home Detection of the Urinary Biomarker 8-Hydroxy-2'-Deoxyguanosine.

Purpose: We sought to assess a smartphone-based, gold nanoparticle-based colorimetric lateral flow immunoassay paper sensor for quantifying urine 8-hydroxy-2'-deoxyguanosine (8-OHdG) as a biomarker for diabetic retinopathy (DR) screening.

Methods: Paper strips incorporate gold nanoparticle-8-OHdG antibody conjugates that produce color changes that are proportional to urine 8-OHdG and that are discernible on a smartphone camera photograph. Paper strip accuracy, precision, and stability studies were performed with 8-OHdG solutions of varying concentrations.

NOD-like Receptors in the Eye: Uncovering Its Role in Diabetic Retinopathy.

Diabetic retinopathy (DR) is an ocular complication of diabetes mellitus (DM). International Diabetic Federations (IDF) estimates up to 629 million people with DM by the year 2045 worldwide. Nearly 50% of DM patients will show evidence of diabetic-related eye problems.

Correlation between systemic S100A8 and S100A9 levels and severity of diabetic retinopathy in patients with type 2 diabetes mellitus.

Aims: S100A8 and S100A9 are myeloid-related damage-associated molecular patterns (DAMPs) primarily involved in the modulation of innate immune response to cellular injury. This study evaluated the correlation between circulating concentrations of S100A8 and S100A9 proteins with the severity of diabetic retinopathy (DR) in patients with type 2 diabetes (T2DM).

Methods: T2DM patients with HbA1c levels >7%, fasting blood glucose >126 mg/dl and history of diabetes were included in this study.

Screening eye exams in youth with type 1 diabetes under 18 years of age: Once may be enough?

Case series and registry data suggest that diabetic retinopathy requiring treatment is rare in youth with type 1 diabetes (T1D) prior to 18 years of age. We evaluated this question in the standardized clinical trial setting by retrospectively reviewing diabetic retinopathy examinations from participants in the Diabetes Control and Complications Trial (DCCT) who were 13 to <18 years of age at randomization. Standardized stereoscopic 7-field fundus photographs were obtained every 6 months during DCCT (1983-1993).

Characterization of a functionally active primary microglial cell culture from the pig retina.

Retinal inflammation is an integral component of many retinal diseases including diabetic retinopathy (DR), age-related macular degeneration (AMD) and retinopathy of prematurity (ROP). Inflammation is commonly initiated and perpetuated by myeloid-derived immune cells. In the retina, microglial cells are resident macrophages with myeloid origins, which acts as the first responders involved in the innate immune system.

Risk Factors for Retinopathy in Type 1 Diabetes: The DCCT/EDIC Study.

Objective: The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy reduced the development and progression of retinopathy in type 1 diabetes (T1D) compared with conventional therapy. The Epidemiology of Diabetes Interventions and Complications (EDIC) study observational follow-up showed persistent benefits. In addition to glycemia, we now examine other potential retinopathy risk factors (modifiable and nonmodifiable) over more than 30 years of follow-up in DCCT/EDIC.

Young Ossabaw Pigs Fed a Western Diet Exhibit Early Signs of Diabetic Retinopathy.

Purpose: Recent clinical data suggest an increasing prevalence of obesity and type 2 diabetes in adolescents, placing them at high risk of developing diabetic retinopathy during adult working years. The present study was designed to characterize the early retinal and microvascular alterations in young Ossabaw pigs fed a Western diet, described as a model of metabolic syndrome genetically predisposed to type 2 diabetes.

Methods: Four-month-old Ossabaw miniature pigs were divided into two groups, lean and diet-induced obesity.

Frequency of Evidence-Based Screening for Retinopathy in Type 1 Diabetes.

Background: In patients who have had type 1 diabetes for 5 years, current recommendations regarding screening for diabetic retinopathy include annual dilated retinal examinations to detect proliferative retinopathy or clinically significant macular edema, both of which require timely intervention to preserve vision. During 30 years of the Diabetes Control and Complications Trial (DCCT) and its longitudinal follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study, retinal photography was performed at intervals of 6 months to 4 years.

Methods: We used retinal photographs from the DCCT/EDIC study to develop a rational screening frequency for retinopathy.

Vitrectomy as a Risk Factor for Complicated Cataract Surgery.

A retrospective review of 98 cases of complicated cataract surgery and/or delayed intraocular lens (IOL) dislocation examined the relationship between vitrectomy and cataract surgery complications. Nine (9.2%) of the 98 patients had a history of vitrectomy, before or after cataract surgery, and each had complicated cataract surgery.

Effect of intensive diabetes therapy on the progression of diabetic retinopathy in patients with type 1 diabetes: 18 years of follow-up in the DCCT/EDIC.

The Diabetes Control and Complications Trial (DCCT) demonstrated that a mean of 6.5 years of intensive therapy aimed at near-normal glucose levels reduced the risk of development and progression of retinopathy by as much as 76% compared with conventional therapy. The Epidemiology of Diabetes Interventions and Complications study (EDIC) observational follow-up showed that the risk of further progression of retinopathy 4 years after the DCCT ended was also greatly reduced in the former intensive group, despite nearly equivalent levels of HbA1c, a phenomenon termed metabolic memory.

Eye on statins: A comprehensive review.

Over the last 25 years, statins have demonstrated their safety from an ophthalmologic standpoint. Studies relating statin to cataract formation are insufficient to alter the usual and customary prescription of statins. If there is an association between statins and cataracts, it is weak and clinically insignificant.

Surgical management of rhegmatogenous retinal detachment: a meta-analysis of randomized controlled trials.

Purpose: To examine possible differences in clinical outcomes between pars plana vitrectomy (PPV) and scleral buckling (SB) for uncomplicated rhegmatogenous retinal detachment (RRD).

Design: Meta-analysis.

Participants: Adult patients with uncomplicated RRD from previously reported randomized controlled trials of PPV and SB.

Comparison of digital and film grading of diabetic retinopathy severity in the diabetes control and complications trial/epidemiology of diabetes interventions and complications study.

Objective: To compare diabetic retinopathy (DR) severity as evaluated by digital and film images in a long-term multicenter study, as the obsolescence of film forced the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study (DCCT/EDIC) to transition to digital after 25 years.

Methods: At 20 clinics from 2007 through 2009, 310 participants with type 1 diabetes with a broad range of DR were imaged, per the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol, with both film and digital cameras. Severity of DR was assessed centrally from film and tonally standardized digital cameras.

Long-term renal outcomes of patients with type 1 diabetes mellitus and microalbuminuria: an analysis of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications cohort.

Background: Microalbuminuria is a common diagnosis in the clinical care of patients with type 1 diabetes mellitus. Long-term outcomes after the development of microalbuminuria are variable.

Methods: We quantified the incidence of and risk factors for long-term renal outcomes after the development of microalbuminuria in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study.

Effect of prior intensive therapy in type 1 diabetes on 10-year progression of retinopathy in the DCCT/EDIC: comparison of adults and adolescents.

Objective: The aim of this study was to examine differences between adolescents and adults in persistence of the benefits of intensive therapy 10 years after completion of the Diabetes Control and Complications Trial (DCCT).

Research Design And Methods: During the Epidemiology of Diabetes Interventions and Complications (EDIC) study, progression of retinopathy from DCCT closeout to EDIC year 10 was evaluated in 1,055 adults and 156 adolescents.

Results: During 10 years of follow-up, HbA(1c) (A1C) was similar between original intensive (INT) and conventional (CON) groups and between former adolescents and adults.

Bacterial endophthalmitis following 25-gauge transconjunctival sutureless vitrectomy.

Purpose: To report a case of endophthalmitis following 25-gauge transconjunctival sutureless vitrectomy.

Design: Observational case report.

Methods: An 87-year-old male who underwent sutureless 25-gauge vitrectomy developed unilateral endophthalmitis.

Funduscopic and angiographic appearance in the neuronal ceroid lipofuscinoses.

Purpose: To characterize the retinal features of neuronal ceroid lipofuscinoses (NCLs) and to determine if retinal abnormalities are detectable in carriers of these autosomal recessively inherited diseases.

Methods: Carriers of the NCLs and their affected children underwent ophthalmic examination including color fundus photography in all patients and fluorescein angiography in selected patients. Twenty-nine patients with NCL were examined and photographed: 3 with infantile form, 2 with late-infantile form, and 24 with juvenile form.

Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial.

Objective: To examine the persistence of the original treatment effects 10 years after the Diabetes Control and Complications Trial (DCCT) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. In the DCCT, intensive therapy aimed at near-normal glycemia reduced the risk of microvascular complications of type 1 diabetes mellitus compared with conventional therapy.

Methods: Retinopathy was evaluated by fundus photography in 1211 subjects at EDIC year 10.

Intravitreal triamcinolone acetonide concentration after subtenon injection.

Purpose: To determine concentration of intravitreal triamcinolone after subtenon injection.

Design: Prospective series of vitrectomy candidates and laboratory investigation.

Methods: Twenty eyes of 20 patients received subtenon injections of triamcinolone acetonide, 40 mg, before vitrectomy surgery.