To compare retinal vessel caliber changes at the macula region and surrounding the optic disk after focal/grid laser treatment for diabetic macular edema.The study included 69 eyes from 46 patients treated with focal/grid laser for diabetic macular edema. Retinal photographs were taken <6 months before and 2 months and 12 months after focal/grid photocoagulation treatment. The diameters of retinal vessels around macula and the optic disk were measured separately before and after treatment. Optic disk and macular diameters were summarized into central retinal arteriolar and venular equivalent and macular retinal arteriolar and venular equivalent.Median age and duration of diabetes was 60 years and 13 years. There was a statistically significant decrease in diameter of the macular arterioles (macular retinal arteriolar equivalent 73.5 vs. 72.0 μm, P = 0.04) and venules (macular retinal venular equivalent 63.5 vs. 62.4 μm, P = 0.02) after treatment but no difference in central retinal arteriolar equivalent or central retinal venular equivalent before and after treatment. Retinal vascular calibers in control eyes did not change throughout the study.The diameters of macular vessels decreased after focal/grid laser treatment in most eyes. In contrast, vessel calibers at the optic disk did not change. Quantitative measurement of macular vessels may allow physicians to monitor the progress and success of diabetic macular edema treatment.
Neurodegeneration is an early event in the pathogenesis of diabetic retinopathy, and an association between diabetic retinopathy and Parkinson's disease has been proposed. In this nationwide register-based cohort study, we investigated the prevalence and incidence of Parkinson's disease among patients screened for diabetic retinopathy in a Danish population-based cohort. Cases (n = 173 568) above 50 years of age with diabetes included in the Danish Registry of Diabetic Retinopathy between 2013 and 2018 were matched 1:5 by gender and birth year with a control population without diabetes (n = 843 781). At index date, the prevalence of Parkinson's disease was compared between cases and controls. To assess the longitudinal relationship between diabetic retinopathy and Parkinson's disease, a multivariable Cox proportional hazard model was estimated. The prevalence of Parkinson's disease was 0.28% and 0.44% among cases and controls, respectively. While diabetic retinopathy was not associated with present (adjusted odds ratio 0.93, 95% confidence interval 0.72-1.21) or incident Parkinson's disease (adjusted hazard ratio 0.77, 95% confidence interval 0.56-1.05), cases with diabetes were in general less likely to have or to develop Parkinson's disease compared to controls without diabetes (adjusted odds ratio 0.79, 95% confidence interval 0.71-0.87 and adjusted hazard ratio 0.88, 95% confidence interval 0.78-1.00). In a national cohort of more than 1 million persons, patients with diabetes were 21% and 12% were less likely to have prevalent and develop incident Parkinson's disease, respectively, compared to an age- and gender-matched control population without diabetes. We found no indication for diabetic retinopathy as an independent risk factor for incident Parkinson's disease.
Understanding the influence of both genetics and environment on human health, especially early in life, is essential for shaping long-term health. Here, we utilize a nationwide prospective birth cohort, the Japan Environment and Children's Study (JECS), to conduct a large-scale population-based genetic study using biannual questionnaire surveys and biological and physical measurements collected from both parents and their children since the participant mothers were pregnant. Analyses of genome-wide genotyping for 80,638 child participants with parental consent and sufficient DNA from cord blood samples represent the genetic diversity of the general population in Japan. Systematic genome-wide association studies of 1,163 child health and developmental traits (including, e.g., food allergy, anthropometry measurements or ASQ-3 developmental screening) and parental environmental exposure traits (including, e.g., mercury or PFAS exposure) identify 4,985 common genomic loci (of which 1,885 loci passed the phenome-wide significant P=4.3 x 10^(-11)), of which 25% of loci represent novel associations not previously reported. Additional longitudinal GWAS of BMI using Gaussian process regression identified 66 novel dynamic genetic associations along child development. In addition, genetic correlation analysis suggested some evidence that maternal environmental exposures during pregnancy influence child traits at birth. Together with studies of environmental exposures and genetic risk factors, across time and multiple outcomes, these demonstrate the uniqueness and value of the JECS data.
Abstract Understanding the impact of a condition from the patient's perspective is important, and different types of patient-reported outcomes or instruments are available to help with this. This review article summarises the current evidence on the impact of diabetic retinopathy (DR) and its associated vision impairment on patient-reported outcomes. We have included research that has used a range of outcome measures to assess the impact of DR on generic health-related quality of life, utility, vision-functioning and vision-specific quality of life. This review also offers clarification on frequently misused psychometric terminologies to help clinicians and researchers better understand the literature associated with patient-reported outcome research. Overall, the evidence suggests that DR, particularly in its vision-threatening stages, has a substantial, negative impact on the patient. However, our understanding of the impact of DR is currently restricted due to limitations inherent in currently available patient-reported outcome measures. We conclude by discussing potential directions for future research in this area, such as item banking and computer adaptive testing.
In this study, we describe the development of a compact NIR multispectral imaging sensor for use in glare-free NIR color fundus cameras.Integrating NIR technology into a fundus camera offers significant advantages over conventional RGB imaging using visible illumination, as it enables the glare-free capture of fundus images with minimal patient discomfort.The specifications necessary for a glare-free NIR color fundus camera were evaluated on the basis of factors such as pixel pitch size, pixel array layout, and multilayer interference filter design, in accordance with the camera's intended purpose.While multilayer interference filters were deposited on a glass substrate and bonded with the sensor chip in a 7.5 μm pixel pitch in a previous study, we propose an NIR multispectral imaging sensor directly depositing the interference filters on the wafer in a narrower 4 μm pixel pitch.In addition, the fabrication process for directly depositing NIR multispectral filters on the sensor wafer was proposed.The fabricated NIR multispectral imaging sensor was analyzed against the intended design.Finally, an NIR multispectral imaging sensor was installed on a glare-free NIR color fundus camera, and it was confirmed that the resulting camera is capable of providing medically relevant and meaningful information.
In Brief Purpose: To describe the visual outcomes 2 years after photodynamic therapy in Japanese patients with age-related macular degeneration (AMD) with or without polypoidal choroidal vasculopathy (PCV) lesions. Methods: Sixty-three eyes of 63 consecutive patients with AMD or AMD + PCV who underwent photodynamic therapy were included in this study. Fluorescein and indocyanine green angiography were performed to diagnose AMD and AMD + PCV. Change in mean visual acuity and recurrence of active lesion during the follow-up period up to 2 years were assessed. Results: Patients with typical AMD maintained visual acuity for 2 years after photodynamic therapy. For patients with AMD + PCV, the visual acuity was maintained during the first year but started decreasing by 0.09 logarithm of the minimum angle of resolution units per 3 months (95% confidence intervals [CI], 0.06–0.14) after 1 year. Moreover, patients with AMD + PCV had 82% higher risk of a recurrence of active lesions for each increase in 3 months of follow-up time after 1 year; this suggested that the risk of recurrence had increased later in follow-up after 1 year. Recurrence of active PCV lesions and massive subretinal hemorrhages were the main reasons for the late worsening of visual acuity. Conclusion: The visual acuity after photodynamic therapy in AMD patients was maintained for 2 years after the initial treatment. Patients with AMD + PCV had stable visual outcome within 1 year but not after 1 year; there are risks of late recurrences and massive hemorrhages after 1 year in patients with AMD + PCV. Visual outcomes 2 years after photodynamic therapy in Japanese patients with age-related macular degeneration were described. The visual acuity after photodynamic therapy in age-related macular degeneration patients was maintained for 2 years. Patients with polypoidal choroidal vasculopathy lesions had better visual outcome within 1 year, but not after 1 year.
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