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Diabetes Mellitus (DM) is a chronic condition that affects the blood glucose metabolism of various organs and tissues throughout the body. It can result in microvascular disorders such as coronary heart disease and cerebral hemorrhage. One significant complication is retinopathy, which, in severe cases, can lead to blindness. Early screening and detection are crucial as the disease process is irreversible. In this study, we developed a model for early screening of Diabetes Retinopathy (DR) using color fundus photography images. Our approach involved employing CLAHE, grayscale image transformation methods, and transfer learning to improve diagnostic efficiency when working with limited data. The APTOS 2019 dataset, consisting of3662 retinal images, was used in this research. Four different preprocessing methods were applied to the retinal images, including removing the black edge, resizing, and normalization (Method I), adding contrast constrained adaptive histogram equalization (CLAHE) to Method I (Method II), adding grayscale transformation to Method I (Method III), and adding CLAHE and grayscale transformations to Method I (Method IV). Data augmentation techniques such as random brightness and contrast transformations, flipping, image cropping, and mix-up algorithms were utilized for data enhancement. The ResNet50 and InceptionV3 models based on convolutional neural networks were employed to build the model for learning retinal images under three scenarios: (1) learning from scratch, (2) transfer learning with fixed weights and training only the fully connected layer, and (3) transfer learning with loaded weights, followed by fine-tuning of the entire network based on the input data. The classification performance of the models was evaluated using metrics such as AUC, accuracy, F1 score, precision, and recall. For the ResNet50 model, the accuracy rates for learning from scratch, fixed weight, and fine-tuning weight were 75.41%, 54.64%, and 81.97%, respectively. When using the InceptionV3 model, the accuracy rates were 76.50%, 10.38%, and 83.61%, respectively. Fine-tuning was conducted on data II, III, and IV using the InceptionV3 model, resulting in accuracies of 81.42%, 80.87%, and 83.61%, respectively. Comparisons between models using the same data and training methods revealed that models employing the InceptionV3 structure achieved higher accuracy than those using ResNet50 (83.61% vs. 81.97%). The results indicate that the InceptionV3-based CNN, coupled with transfer learning and appropriate data pre-processing methods, exhibited superior performance in accurately detecting diabetic retinopathy, as measured by accuracy, AUC, F1 score, and other evaluation metrics. This research holds significant value in enabling efficient early diagnosis of DR lesions and conducting an intelligent and efficient graded diagnosis of the DR progression, thereby providing the groundwork for timely intervention. [ABSTRACT FROM AUTHOR]

The damage of the diabetic visual pathway is one of the main causes of blindness in diabetic patients. Visual pathways include anatomic parts from the retina to the occipital lobe. This study investigated the involvement of ferroptosis, a planned cell death brought on by the buildup of free iron in cells, in the impairment of visual pathways in diabetes mellitus. Streptozotocin (STZ) was used to construct a diabetic rat model. Pathological and ultrastructural changes of the occipital lobe, retina, and optic nerve were observed by Hematoxylin–Eosin (HE) staining and transmission electron microscopy (TEM). The expressions of Neuronal nuclei (NeuN), Glial fibrillary acidic protein (GFAP), and Glutathione Peroxidase 4 (GPX4) in the occipital lobe and retina were detected by immunofluorescence, and Western Blotting was used to identify the NeuN GFAP and GPX4 expressions in the occipital lobe. Iron content in the occipital lobe and retina was detected by Iron Assay Kit. The success rate of the diabetic rat model was 93.3%. In the diabetic group, the cells of the occipital lobe and retina were arranged disorderly, and the boundaries were unclear. The membrane of the occipital lobe, retina, and optic nerve was broken, some vacuoles were observed, mitochondrial morphology was changed, swelling was observed, and the mitochondrial ridge disappeared. There was a large increase in GFAP expression and iron concentration and a significant decrease in the expression of NeuN, and GPX4 in the retina and occipital lobe. Ferroptosis plays an important role in visual pathway damage in diabetes, and GPX4 regulates this process. [ABSTRACT FROM AUTHOR]

Abstract Diabetes retinopathy (DR) is a critical clinical disease with that causes irreversible visual damage in adults, and may even lead to permanent blindness in serious cases. Early identification and treatment of DR is critical. Our aim was to train and externally validate a prediction nomogram for early prediction of DR. 2381 patients with type 2 diabetes mellitus (T2DM) were retrospective study from the First Affiliated Hospital of Xinjiang Medical University in Xinjiang, China, hospitalised between Jan 1, 2019 and Jun 30, 2022. 962 patients with T2DM from the Suzhou BenQ Hospital in Jiangsu, China hospitalised between Jul 1, 2020 to Jun 30, 2022 were considered for external validation. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression was performed to identify independent predictors and establish a nomogram to predict the occurrence of DR. The performance of the nomogram was evaluated using a receiver operating characteristic curve (ROC), a calibration curve, and decision curve analysis (DCA). Neutrophil, 25-hydroxyvitamin D3 [25(OH)D3], Duration of T2DM, hemoglobin A1c (HbA1c), and Apolipoprotein A1 (ApoA1) were used to establish a nomogram model for predicting the risk of DR. In the development and external validation groups, the areas under the curve of the nomogram constructed from the above five factors were 0.834 (95%CI 0.820–0.849) and 0.851 (95%CI 0.829–0.874), respectively. The nomogram demonstrated excellent performance in the calibration curve and DCA. This research has developed and externally verified that the nomograph model shows a good predictive ability in assessing DR risk in people with type 2 diabetes. The application of this model will help clinicians to intervene early, thus effectively reducing the incidence rate and mortality of DR in the future, and has far-reaching significance in improving the long-term health prognosis of diabetes patients.

AIM: To analyze the related factors influencing the progression of diabetes retinopathy(DR).METHODS: This study retrospectively collected the patients with nonproliferative diabetes retinopathy(NPDR)and followed up at the same time. A total of 77 patients in the cohort who progressed from NPDR to proliferative diabetes retinopathy(PDR)were taken as the disease progression group, while 115 NPDR patients who did not progress to PDR were selected as the observation group for a nested case-control study, comparing the general information and laboratory indicators of NPDR and PDR groups, taking general data and laboratory indicators as independent variables and PDR as outcome variables; Finally, diagnostic tests were conducted to evaluate the independent influencing factors of DR progression.RESULTS: PDR group was younger than patients in the NPDR group(P=0.001), and the course of diabetes was longer(P=0.01); Glycated hemoglobin(HbA1c; P=0.001), blood urea nitrogen(BUN; P=0.003), erythrocyte sedimentation rate(ESR; P

Abstract Objective To investigate the utility of point of care screening of diabetic retinopathy (DR) and the impact of a telemedicine program to overcome current challenges. Methods This was a retrospective study on people with type 2 diabetes mellitus (T2DM) who were screened for DR using the single-field non-mydriatic fundus photography at the point of care during routine follow-up visits at endocrinology clinic. Retinal images were uploaded and sent to a retina specialist for review. Reports indicating retinopathy status and the need for direct retinal examination were transmitted back to the endocrinology clinic. All patients were informed about DR status and, if needed, referred to the retina specialist for direct retinal examination. Results Of the 1159 individuals screened for DR, 417 persons (35.98%) were screen-positive and referred to the retina specialist for direct retinal examination. A total of 121 individuals (29.01%) underwent direct retinal examination by the specialist. Diabetes macular edema (DME) was detected in 12.1%. In addition, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) were detected in 53.4% and 2.6% of the patients, respectively. Conclusion Integrating DR screening program at the point of care at the secondary care services improves the rate of DR screening as well as detection of sight threatening retinopathy and provides the opportunity for timely intervention in order to prevent advanced retinopathy in people with T2DM.

Objective: To investigate the utility of point of care screening of diabetic retinopathy (DR) and the impact of a telemedicine program to overcome current challenges. Methods: This was a retrospective study on people with type 2 diabetes mellitus (T2DM) who were screened for DR using the single-field non-mydriatic fundus photography at the point of care during routine follow-up visits at endocrinology clinic. Retinal images were uploaded and sent to a retina specialist for review. Reports indicating retinopathy status and the need for direct retinal examination were transmitted back to the endocrinology clinic. All patients were informed about DR status and, if needed, referred to the retina specialist for direct retinal examination. Results: Of the 1159 individuals screened for DR, 417 persons (35.98%) were screen-positive and referred to the retina specialist for direct retinal examination. A total of 121 individuals (29.01%) underwent direct retinal examination by the specialist. Diabetes macular edema (DME) was detected in 12.1%. In addition, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) were detected in 53.4% and 2.6% of the patients, respectively. Conclusion: Integrating DR screening program at the point of care at the secondary care services improves the rate of DR screening as well as detection of sight threatening retinopathy and provides the opportunity for timely intervention in order to prevent advanced retinopathy in people with T2DM. [ABSTRACT FROM AUTHOR]

Objective: Diabetes retinopathy (DR) is one of the top listed world health issues. Screening is usually advised for diabetic cases on a routine basis. However, there is only partial access to ophthalmologists in all parts of the world. Irisin is a myokine that is being investigated for this reason. Our study aims to assess the role of irisin in detecting DR. Methods and materials: In a cross-sectional study, 140 diabetes cases, including 70 patients with diabetic retinopathy and 70 patients free from diabetic retinopathy, were enrolled. Demographic and anthropometric data were gathered, and the patients underwent physical examination. Also, microalbuminuria and serum irisin levels were assessed in both groups. The results were compared between the two study groups. Results: Among the enrolled cases, 55 (39.28%) were men, and 85 (60.72%) were women. The disease duration (p = 0.016) and the serum level of HBA1c (p = 0.014) were significantly higher in the diabetic retinopathy group compared to the group free from diabetic retinopathy. Moreover, irisin was significantly higher in the patients free from diabetic retinopathy (p = 0.007). Conclusion: Irisin may have value in screening diabetic retinopathy; however, further studies are needed for this proposal. [ABSTRACT FROM AUTHOR]

Abstract Background Bilateral retinal detachment and choroidal detachment in a patient are rare occurrences. The presence of bilateral diabetic retinopathy (DR) in such a case is even rarer and complicates the condition. Case presentation In this study, we document a case of unconventional VKH. Manifestations in this patient included intense peripheral retinal detachment and choroidal detachment, along with vitreous opacities akin to cotton wool spots, concurrent with DR. The diagnosis was considered as probable VKH with DR. Treatment according to VKH protocols, including high-dose corticosteroids, yielded positive results. Conclusions VKH can co-occurrence with DR. VKH manifestations vary, and early, aggressive, and long-term treatment is essential. The complexity of treatment increases with concurrent DR, necessitating the use of immunosuppressants.

Diabetes retinopathy (DR) is a common microvascular complication of diabetes, and it is the main cause of global vision loss. The current observational research results show that the causal relationship between Vitamin D and DR is still controversial. Therefore, we conducted a Mendelian randomization study to determine the potential causal relationship between serum 25-hydroxyvitamin D 25(OH)D and DR. In this study, we selected aggregated data on serum 25(OH)D levels (GWAS ID: ebi-a-GCST90000615) and DR (GWAS ID: finn-b-DM_RETINOPATHY) from a large-scale GWAS database. Then use MR analysis to evaluate the possible causal relationship between them. We mainly use inverse variance weighted (IVW), supplemented by MR Egger and weighted median methods. Sensitivity analysis is also used to ensure the stability of the results, such as Cochran's Q-test, MR-PRESSO, MR-Egger interception test, and retention method. The MR analysis results showed that there was no significant causal relationship between 25(OH)D and DR (OR = 1.0128, 95%CI=(0.9593,1.0693), P = 0.6447); Similarly, there was no significant causal relationship between DR and serum 25 (OH) D levels (OR = 0.9900, 95% CI=(0.9758,1.0045), P = 0.1771). Our study found no significant causal relationship between serum 25(OH)D levels and DR, and vice versa. A larger sample size randomized controlled trial is needed to further reveal its potential causal relationship. • The current observational research results show that the causal relationship between Vitamin D and DR is still controversial. • MR analysis is considered less susceptible to various biases caused by confounding and reverse causality common. • Our study found no significant causal relationship between serum 25(OH)D levels and DR, and vice versa. [ABSTRACT FROM AUTHOR]

Objective To explore the application value of artificial intelligence (AI) based retinal microvascular analysis in the diagnosis of diabetes retinopathy (DR), diabetes nephropathy (DN) and other diabetes complications. Methods From January to December 2022, 305 subjects from the Health Medicine Department and Endocrine Department of the Eastern Theater Command General Hospital of PLA were divided into healthy control group (n = 119), diabetes without DR group (n = 100), and diabetes with DR group (n = 86) according to the condition of diabetes and its complications. The group of diabetes with DR was further divided into the group without DN (n = 50) and the group with DN (n = 36). Clinical data, laboratory test indicators, and fundus photography results of all the subjects were collected. Independent sample t-test, Kruskal Wallis H-test, and logistic regression analysis were used for data analysis. Results There were statistically significant differences in FBG, 2hPBG, HbA1c, central retinal artery equivalent (CRAE), and retinal arteriovenous ratio (AVR) among the three groups (all P < 0.05). In patients with diabetes complicated with DR, there were statistically significant differences in the history of diabetes, total number of bleeding, total area of exudation, maximum area of exudation and total number of exudation between non-DN group and DN group (all P < 0.05). There was correlation between retinal microvascular indicators and diabetic retinopathy. When the total area of retinal hemorrhage, total area of exudation, and maximum area of exudation increased, the risk of diabetic retinopathy increased. Conclusion AI-based retinal microvascular analysis has value in providing prompt indication and assisting with the diagnosis of complications in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Bilateral retinal detachment and choroidal detachment in a patient are rare occurrences. The presence of bilateral diabetic retinopathy (DR) in such a case is even rarer and complicates the condition. Case presentation: In this study, we document a case of unconventional VKH. Manifestations in this patient included intense peripheral retinal detachment and choroidal detachment, along with vitreous opacities akin to cotton wool spots, concurrent with DR. The diagnosis was considered as probable VKH with DR. Treatment according to VKH protocols, including high-dose corticosteroids, yielded positive results. Conclusions: VKH can co-occurrence with DR. VKH manifestations vary, and early, aggressive, and long-term treatment is essential. The complexity of treatment increases with concurrent DR, necessitating the use of immunosuppressants. [ABSTRACT FROM AUTHOR]

AIM: To explore the key genes related to immunity and immune cell infiltration levels in diabetes retinopathy(DR)using bioinformatics.METHODS: Differential expression genes(DEGs)were obtained by “limma” R from Gene Expression Omnibus(GEO)data from September to October 2022, Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)were analyzed, and the infiltration of immune cell types in each sample was calculated based on CIBERSORT algorithm. Weighted gene co-expression network analysis(WGCNA)was used to screen for DEGs in immune-related gene modules. The protein-protein interaction(PPI)network was established by STRING online database and Cytoscape, and the hub genes were screened by MCODE and cytoHubba plug-ins.RESULTS: The results showed that 1 426 up-regulated and 206 down-regulated differential genes were screened, where 7 immune cell types, including B cell naive, Plasma cells, CD4+T cells, T cells regulatory(Tregs), Macrophages M0, Macrophages M1 and Neutrophils were significantly overexpressed(P

Jiewei Yu,1 Lingling Ke,1 Jingjing Zhou,2 Chunyan Ding,1 Hui Yang,1 Dongbiao Yan,3 Chengbi Yu3 1Department of Ophthalmology, Jiujiang Hospital of Traditional Chinese Medicine, Jiujiang, Jiangxi, 332000, People’s Republic of China; 2Image Center, Jiujiang Hospital of Traditional Chinese Medicine, Jiujiang, Jiangxi, 332000, People’s Republic of China; 3Department of Endocrinology, Jiujiang Hospital of Traditional Chinese Medicine, Jiujiang, Jiangxi, 332000, People’s Republic of ChinaCorrespondence: Chengbi Yu, Department of Endocrinology, Jiujiang Hospital of Traditional Chinese Medicine, No. 555 Dehua Road, Lianxi District, Jiujiang, Jiangxi, 332000, People’s Republic of China, Tel +86 792-8188311, Email yuchengbi@126.comBackground: Diabetes retinopathy (DR) is a chronic, progressive, and potentially harmful retinal disease associated with persistent hyperglycemia. Autophagy is a lysosome-dependent degradation pathway that widely exists in eukaryotic cells, which has recently been demonstrated to participate in the DR development. Stachydrine (STA) is a water-soluble alkaloid extracted from Leonurus heterophyllus. This study aimed to explore the effects of STA on the autophagy in DR progression in vivo and in vitro.Methods: High glucose-treated human retinal microvascular endothelial cells (HRMECs) and STA-treated rats were used to establish DR model. The reactive oxygen species (ROS) and inflammatory factor levels (TNF-α, IL-1β, and IL-6) were determined using corresponding kits. Additionally, the cell growth was analyzed using CCK-8 and EdU assays. Besides, LC3BII, p62, p-AMPKα, AMPKα, and SIRT1 protein levels were measured using Western blot. The LC3BII and SIRT1 expressions were also determined using immunofluorescence.Results: The results showed that STZ decreased the ROS and inflammatory factor levels in the HG-treated HRMECs. Besides, after STA treatment, the beclin-1, LC3BII, p-AMPKα, and SIRT1 levels were increased, and p62 was decreased in the HG-treated HRMECs and the retinal tissue of STZ-treated rats.Conclusion: In conclusion, this study demonstrated that STA effectively relieved the inflammation and promoted the autophagy in DR progression in vivo and in vitro through activating the AMPK/SIRT1 signaling pathway.Keywords: diabetes retinopathy, stachydrine, autophagy, AMPK/SIRT1

AIM: To compare the changes of optic disc parameters, peripapillary retinal nerve fibers layer(pRNFL)thickness and macular ganglion cell layer(mGCL)thickness among patients with early diabetes retinopathy and healthy controls by Cirrus HD-optical coherence tomography(OCT).METHODS: In this cross-sectional comparative study, 45 non-diabetic retinopathy(NDR), 52 mild nonproliferative diabetic retinopathy(NPDR), 55 moderate NPDR with type 2 diabetes mellitus(T2DM)and 64 age-matched healthy controls were included. The fasting blood glucose(FBG), duration of diabetes, glycosylated hemoglobin(HbA1c)and past history of the patients were collected in detail. Optic disc parameters(i.e., binocular RNFL thickness symmetry percentage, rim area, optic disc area, cup-to-disc ratio, cup volume), pRNFL thickness and mGCL thickness were measured by Cirrus HD-OCT. The comparison of different groups was performed by one-way analysis of variance.RESULTS: Compared with the control group, the binocular RNFL thickness symmetry percentage and rim area were significantly decreased, while the average C/D and vertical C/D were significantly increased in the NDR group, mild NPDR group and moderate NPDR group(all P

AIM: To explore the relationship between the changes of serum circFTO and microRNA-141-3p(miR-141-3p)levels and the different disease stages of diabetes retinopathy.METHODS: A total of 198 patients with type 2 diabetes admitted to our hospital from October 2019 to November 2022 were collected as the study subjects, the patients were grouped into non diabetes retinopathy(NDR)group(70 cases), non proliferative diabetes retinopathy(NPDR)group(66 cases)and proliferative diabetes retinopathy(PDR)group(62 cases)according to different stages; meantime, 67 volunteers with normal physical examination results were collected as the control group. The levels of serum circFTO and miR-141-3p were detected by real-time fluorescent quantitative PCR(qRT-PCR); Pearson correlation analysis was used to examine the correlation between the serum circFTO, miR-141-3p and various indicators in patients with diabetes retinopathy; multivariate Logistic regression analysis was applied to explore the influencing factors of diabetes retinopathy.RESULTS: CircFTO, systolic blood pressure(SBP), and diastolic blood pressure(DBP)in PDR group were higher than those in control group, NDR group and NPDR group, while miR-141-3p and high-density lipoprotein cholesterol(HDL-C)were lower than those in control group, NDR group and NPDR group(P

Retinal fibrosis was a key characteristic of diabetes retinopathy (DR). Apelin was found to be a candidate for tissue fibrosis. Nevertheless, the role of Apelin in the Müller cells in DR remains unclear. This study identified the function and mechanism of Apelin in Müller cells and the fibrosis of retinal tissue. Western blot was carried out to detect the Apelin, GFAP, Collagen I, α-SMA, JAK2 and STAT3 protein levels. Masson staining was performed to display the histopathological changes in retinal tissue of diabetic mellitus (DM) rats. The immunofluorescence staining was conducted to evaluate the Apelin levels in the retinal tissue. The levels of GFAP, Collagen I and α-SMA in the retinal tissue of DM rats was visualised by the immunohistochemistry staining. The results showed that Apelin, GFAP, Collagen I andα-SMA expression was prominently elevated in the retinal tissue of DM rats and high glucose (HG)-exposed Müller cells. The results of Masson staining showed that the epiretinal fibrotic membrane was observed in DM rats. Apelin knockdown declined the GFAP, Collagen I andα-SMA levels. Besides, the protein levels of p-JAK2 and p-STAT3 were elevated in the HG-treated Müller cells, while Apelin knockdown declined them. FLLL32 treatment neutralised the role of Apelin. In conclusion, Apelin facilitated the fibrogenic activity of Müller cells through activating the JAK2/STAT3 signalling pathway, and thus inducing the retinal fibrosis in DR.

Diabetes is a chronic disease that affects people all over the world and raises the glucose level in the blood as a result of a lack of insulin. Diabetic Retinopathy causes retinal eye disease, which impairs vision and eventually results in blindness. The two classifications of Diabetic Retinopathy based on retinal indicators are Non-Proliferative and Proliferative Diabetic Retinopathy. The Diabetic Retinopathy diagnosis is a time-consuming process for professionals. But the use of handcrafted features limits this method's performance. To identify Diabetic Retinopathy at an early stage, we propose an Egret Swarm optimized hybrid Mask Region-Based Convolutional Neural Network-Bidirectional Gated Recurrent Unit approach which identifies the interdependencies between different Diabetic Retinopathy stages. Initially, the input samples are preprocessed using data augmentation and partitioned into training and testing data. The parameter of the Hybrid Mask Region-Based Convolutional Neural Network-Bidirectional Gated Recurrent Unit model is optimized through the Egret Swarm Optimization algorithm to minimize the loss of the classifier. Here, Egret Swarm optimized hybrid Hybrid Mask Region-Based Convolutional Neural Network-Bidirectional Gated Recurrent Unit architecture is utilized to classify various Diabetic Retinopathy stages. This paper uses three large baseline datasets: Idrid, APTOS 2019 blindness detection, and Zenodo dataset. The simulation results demonstrated that the proposed technique achieved improved precision, recall, and F-measure scores which are nearly equal to 99.1%, 98.9%, and 99%. [ABSTRACT FROM AUTHOR]

Diabetes causes DR. Diabetes duration influences retinopathy development. The retinal vein weakening may have no side effects or a little eyesight impairment at initially. Blindness may occur. DR intervention and treatment need early clinical indications. Thus, frequent eye examinations must guide patients to a doctor for a full eye inspection and therapy to avoid irreversible vision loss. This work develops a machine learning-based optical image-based data classification method for diabetic retinopathy identification. OCT analyses the retinal picture and the ensemble pulse coupled filtering and green histogram channel equalization-based adaptive filtering segment this picture for blood vessel characterization. CenterResnet-50 classifies images for color fundus detection. Classification accuracy, sensitivity, specificity, AUC, and ROC curves were examined for various optical retina pictures. The proposed method has 98% classification accuracy, 67% sensitivity, 73% specificity, and 63% AUC. [ABSTRACT FROM AUTHOR]

RUNT related transcription factor 1 (RUNX1) is an important DNA binding transcription factor, which plays a pleiotropic role in determining the direction of cell lineage differentiation, vascular development, hematopoiesis and tumorigenesis. It has also been found that RUNX1 can regulate the proliferation and migration of retinal vascular endothelial cells, and play a special and selective role in pathological and physiological neovascularization, and potentially participate in the occurrence and development of various fundus diseases. This article summarizes the biological characteristics, molecular structure of RUNX1 and its research progress in several major fundus diseases, in order to provide a new thinking basis for the pathogenesis and potential therapeutic value of RUNX1 in these fundus diseases. [ABSTRACT FROM AUTHOR]

AIM: To investigate the expression and correlation of C1q/tumor necrosis factor related protein 9(CTRP9)levels in the serum of patients with different stages of diabetic retinopathy(DR)and diabetic macular edema(DME).METHODS: A total of 135 patients with type 2 diabetes who were admitted to Gansu Provincial Hospital from April 2021 to April 2022 were selected as the experimental group. According to the results of non-mydriatic fundus photography, they were divided into non-DR(NDR)group(n=45), non-proliferative DR(NPDR)group(n=45), proliferative DR(PDR)group(n=45); according to the results of optical coherence tomography, DR patients were divided into DME group(n=51), non-DME group(n=39). In addition, other 45 healthy subjects who matched the age and sex of the experimental group were selected as normal control group. The clinical data and biochemical index test results of subjects in each group were recorded and compared, the correlation between serum CTRP9 level and other biochemical indexes was analyzed, and the risk factors affecting the occurrence of DR and DME were explored.RESULTS: There were significant differences in serum CTRP9 levels among subjects in normal control group, NDR group, NPDR group and PDR group(P NDR group > NPDR group > PDR group. There was significant difference in serum CTRP9 level between DME group and non-DME group(P DME group. Spearman rank correlation analysis showed that the level of serum CTRP9 in DR patients was negatively correlated with the course of diabetes(rs=-0.251, P

Jie Yang, Wencui Ding, Haiying Wang, Yanan Shi Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of ChinaCorrespondence: Jie Yang, Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, 061000, People’s Republic of China, Email yj3027185@126.comObjective: Normal thyroid hormone (TH) levels and their relation to microvascular complications in patients with type 2 diabetes mellitus (T2DM) have been studied. However, the relationship between TH sensitivity and diabetic retinopathy (DR) remains unclear. Thus, this study aimed to investigate the relationship between TH sensitivity and the risk of DR in euthyroid T2DM patients.Methods: This retrospective study analyzed 422 T2DM patients and calculated their sensitivity to TH indices. Multivariable logistic regression, generalized additive model, and subgroup analysis were performed to examine the association between sensitivity to TH indices and DR risk.Results: After adjusting for covariates, the binary logistic regression model showed no statistically significant association between the sensitivity of TH indices and the risk of DR in euthyroid T2DM patients. However, a non-linear relationship was found between sensitivity to TH indices (thyroid-stimulating hormone index, thyroid feedback quantile index [TFQI]) and the risk of DR in the crude model; TFQI and DR in the adjusted model. The inflection point of the TFQI was 0.23. The effect size (odds ratio) on the left and right of the inflection point were 3.19 (95% confidence interval [CI]: 1.24 to 8.17 p=0.02) and 0.11 (95% CI: 0.01, 0.93 p=0.04), respectively. Moreover, this relationship was maintained by men stratified by sex. In euthyroid patients with T2DM, an approximate inverted U-shaped relationship and a threshold effect were demonstrated between TH index sensitivity and DR risk with sex differences. This study provided an in-depth understanding of the relationship between thyroid function and DR, which has important clinical implications for risk stratification and individual prediction.Keywords: thyroid hormone sensitivity, diabetes retinopathy, non-linear relationship, sex differences

Background: Diabetic retinopathy (DR) screening using colour retinal photographs is cost-effective and time-efficient. In real-world clinical settings, DR severity is frequently graded by individuals of different expertise levels. We aim to determine the agreement in DR severity grading between human graders of varying expertise and an automated deep learning DR screening software (ADLS). Methods: Using the International Clinical DR Disease Severity Scale, two hundred macula-centred fundus photographs were graded by retinal specialists, ophthalmology residents, family medicine physicians, medical students, and the ADLS. Based on referral urgency, referral grading was divided into no referral, non-urgent referral, and urgent referral to an ophthalmologist. Inter-observer and intra-group variations were analysed using Gwet's agreement coefficient, and the performance of ADLS was evaluated using sensitivity and specificity. Results: The agreement coefficient for inter-observer and intra-group variability ranged from fair to very good, and moderate to good, respectively. The ADLS showed a high area under curve of 0.879, 0.714, and 0.836 for non-referable DR, non-urgent referable DR, and urgent referable DR, respectively, with varying sensitivity and specificity values. Conclusion: Inter-observer and intra-group agreements among human graders vary widely, but ADLS is a reliable and reasonably sensitive tool for mass screening to detect referable DR and urgent referable DR. [ABSTRACT FROM AUTHOR]

Diabetes retinopathy(DR)may continue to develop even if blood sugar is well controlled, which indicates that previous hyperglycemia will lead to long-term harmful vascular dysfunction, and this phenomenon is defined as “metabolic memory” of diabetes retinopathy. Because the onset of DR is insidious, clinical symptomatic treatment is mainly used. Effective means of early diagnosis, accurate treatment and prognosis are lacking and new diagnosis and treatment ideas need to be developed urgently. In recent years, many new studies have shown that epigenetic modification is involved in the pathogenesis of DR “metabolic memory” in DNA methylation, histone post-translational modification and microRNA(microRNAs,miRNAs)regulation, which provides a direction and strategy for the exploration of DR molecular mechanism. In this review, we discussed the role of epigenetic modification in the pathogenesis of DR and analyzed the challenges and prospects of its application in the treatment of DR, with a view to provide a reference for early diagnosis and treatment of DR in the future.

Diabetes retinopathy (DR) is a common complication associated with diabetes. This study aimed to investigate ameliorative effect of black raspberry anthocyanins (BRAs) on DR and underlying inhibition mechanism of protein tyrosine phosphatase 1B (PTP1B)-endoplasmic reticulum stress (ERS) with retinal pigment epithelial cells apoptosis exposed to high glucose and tunicamycin and DR rats induced by STZ and high-fat and high-sugar diet. The results showed that TG and TC levels were markedly decreased, and disarrangement of retinas was markedly improved after BRA administration. Moreover, after pre-incubation with BRAs, morphological changes and mitochondrial membrane potential were significantly improved, whereas the apoptosis rates, activities of PTP1B and Caspase-1, and reactive oxygen species levels were significantly decreased. Finally, BRAs exhibited an efficient combination with GRP78, and they significantly suppressed protein expression of axis PTP1B-ERS. The results offer a basis for mastering ameliorated DR with BRAs and further first enhanced the mechanism of inhibiting axis PTP1B-ERS.

Objective To explore the relationship between microvascular complications and subclinical carotid atherosclerosis in patients with type 1 diabetes mellitus (T1DM). Methods A total of 582 hospitalized T1DM patients from the Department of Endocrinology and Metabolism of Peking University People′s Hospital from January 2019 to December 2021 were screened consecutively, and 314 subjects who met the inclusion criteria were enrolled. The clinical data and laboratory results of the subjects were collected, including age, sex, diabetes duration, smoking history, height, weight, waist circumference, blood pressure, glycated hemoglobin A1c (HbA1c ), and lipid profile. Body mass index (BMI) was calculated. All the subjects underwent photography to determine diabetes retinopathy. Urinary albumin to creatinine ratio and estimated glomerular filtration rate (eGFR) were taken out to define the diagnosis of diabetes nephropathy. Vibration sensation, 10 g nylon silk test, ankle reflex, temperature sensation and acupuncture pain sensation were used to determine the diagnosis of diabetes peripheral neuropathy. Carotid plaques were determined by carotid ultrasound, the patients were divided into group with carotid plaque and group without carotid plaque according to the presence or absence of carotid plaque. Chi‐square test, t test or Mann‐Whitney U test were used to compare the differences between groups, and logistic analysis was used to evaluate the relationship between microvascular complications and carotid plaques. Results The average age of the subjects was (50±11) years, and the average duration of diabetes was (10±9) years. Among them, 162 were male (51.6%), and the average BMI was (23.1±3.3) kg/m², with and average HbA1c of (9.4±2.1)%. One hundred and seventy‐one (54.5%) had carotid plaques. Compared with the group without carotid plaques (143 cases), the group with carotid plaques had older age, longer duration of disease, higher waist circumference and systolic blood pressure, higher triglyceride levels, urinary microalbumin and creatinine ratios, and lower eGFR levels. Meanwhile, smoking, diabetes retinopathy and diabetes neuropathy were more common in the group with carotid plaques (P<0.05). The results of multivariate logistic regression analysis showed that age (OR=1.13, P=0.001), smoking (OR=2.93, P=0.006), eGFR (OR=0.94, P= 0.015), and diabetes neuropathy (OR=1.84, P=0.049) were associated with carotid plaques. Conclusion Diabetes nephropathy and diabetes peripheral neuropathy are associated with the risk of cardiovascular complications in T1DM patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the association of diabetic retinopathy (DR) with TyG index and TyG-related parameters among the United States population. Methods: This cross-sectional study is conducted in adults with diabetes mellitus based on the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. Multivariate logistic regression, restricted cubic spline, trend test, receiver operating characteristic curve and subgroup analysis are adopted to uncover the association of DR with TyG index and TyG-related parameter levels in diabetics. Results: An aggregate of 888 eligible participants with diabetes is included, involving 263 (29.6%) patients with DR. The participants are stratified according to the quartile of TyG index and TyG-related parameters (Q1–Q4). Following the adjustments of the confounding factors, a multivariate logistic regression analysis finds that TyG-BMI, TyG index and Q4-TyG index are significant risk factors for DR. The restricted cubic spline shows that TyG index and the DR risk of diabetes patients are proved to be U-shaped related (p for nonlinearity = 0.001). Conclusions: The triglyceride-glucose index has a U-shaped correlation with the risk of diabetic retinopathy, which has potential predictive value. [ABSTRACT FROM AUTHOR]

Semaglutide is a glucagon-like peptide 1 receptor agonist (GLP-1 RA) molecule approved for the treatment of both type 2 diabetes (T2D) and obesity. Semaglutide has a greater impact on glycated haemoglobin (HbA1c) reduction, compared to other GLP-1 RAs, and is the first molecule of this class available in oral formulation for T2D therapy, representing a useful option for subjects and physicians less prone to start an injective drug. Interestingly, due to its remarkable effects on weight reduction, higher than other GLP-1 RAs and very close to bariatric surgery, semaglutide is designated to change the approach to obesity therapy also in the subject not affected by diabetes. In addition to these favorable features, semaglutide, similarly to other GLP-1 RAs, offers beneficial effects on cardio-vascular (CV), renal, and liver protection, making this molecule an advantageous choice in the therapeutic management of “diabesity” (coexistence of both diabetes and obesity) and its co-morbidity.

BackgroundDiabetes is rapidly becoming a major cause of blindness among Kenyans, with the prevalence of any form of diabetes retinopathy (DR) ranging from 36% to 41%. Globally DR leads as a cause of vision loss in working age adults. In Kenya, specialized examinations are only available at national and some county referral hospitals through retina specialists, ophthalmologists or trained technicians. Thus, low coverage of retinal assessment and inadequate access to this service. An innovative DR fundus camera screening service run by ophthalmic nurses (ONs), ophthalmic clinical officers (OCOs) and county ophthalmologists was established since 2018.ObjectivesThe purpose of this study was to investigate the diagnostic accuracy of DR digital retinal camera screening by ONs, OCOs and county ophthalmologist against that of a retina specialist measured by sensitivity and specificity as the primary outcomes.MethodsCross sectional study conducted at 2 referral hospitals in Kenya. Using a Canon CR-2AF digital retinal camera patients with diabetes had a standard single shot of 45 degree view of the retina captured as image in each eye. This was graded for DR using the International Clinical Diabetic Retinopathy (ICDR) severity scale. All photos taken by the first graders (ON/OCO) were later assessed by the county hospital ophthalmologist who was blinded to their readings. The third grader (retina specialist) similarly was blinded to the readings of the first and second graders and assessed all the images from the 2 hospitals also using ICDR.ResultsA total of 308 patients with diabetes (median age 58 IQR 56-60, 53% female) were enrolled in the study. Sensitivity to identify any DR was (81.3%, 80.6%, and 81.54% for the OCO, ON and county ophthalmologist respectively). The corresponding specificities were 92.7%, 92.8% and 92.59%. Analysis of diagnostic accuracy of non-sight threatening DR against sight threatening DR revealed lower sensitivity for the three cadre groups although specificity remained high.ConclusionsIn this study, ON and OCO with basic training in DR screening and photo grading performed screening of DR with high specificity. However, the sensitivity to detect sight threatening DR was generally low by all the cadres which may leave severe forms of DR undetected.

Retinal fibrosis was a key characteristic of diabetes retinopathy (DR). Apelin was found to be a candidate for tissue fibrosis. Nevertheless, the role of Apelin in the Müller cells in DR remains unclear. This study identified the function and mechanism of Apelin in Müller cells and the fibrosis of retinal tissue. Western blot was carried out to detect the Apelin, GFAP, Collagen I, α-SMA, JAK2 and STAT3 protein levels. Masson staining was performed to display the histopathological changes in retinal tissue of diabetic mellitus (DM) rats. The immunofluorescence staining was conducted to evaluate the Apelin levels in the retinal tissue. The levels of GFAP, Collagen I and α-SMA in the retinal tissue of DM rats was visualised by the immunohistochemistry staining. The results showed that Apelin, GFAP, Collagen I andα-SMA expression was prominently elevated in the retinal tissue of DM rats and high glucose (HG)-exposed Müller cells. The results of Masson staining showed that the epiretinal fibrotic membrane was observed in DM rats. Apelin knockdown declined the GFAP, Collagen I andα-SMA levels. Besides, the protein levels of p-JAK2 and p-STAT3 were elevated in the HG-treated Müller cells, while Apelin knockdown declined them. FLLL32 treatment neutralised the role of Apelin. In conclusion, Apelin facilitated the fibrogenic activity of Müller cells through activating the JAK2/STAT3 signalling pathway, and thus inducing the retinal fibrosis in DR. [ABSTRACT FROM AUTHOR]

Background: A novel, rare OTUD3 c.863G>A (rs78466831) in humans has been reported associated with diabetes, but the prevalence and clinical characteristics of T2DM patients with rs78466831 have not been reported before. Objective: To investigate the prevalence and clinical characteristics of T2DM patients with rs78466831 and provide a basis for clinical diagnosis and treatment. Methods: OTUD3 gene rs78466831 SNP was detected by Sanger sequencing in all the collected specimens of laboratory-confirmed T2DM patients and healthy people. Clinical characteristics indexes inconsisting of fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG) and a body mass index (BMI), T2DM-associated chronic complications (myocardial infarction, cerebrovascular disease, retinopathy, arterial plaque, peripheral neuropathy and nephropathy) were obtained from the clinical laboratory information systems and electronic medical record system. Clinical characteristic indicators were compared between the wild-type and variant (rs78466831) patients with T2DM. Results: The prevalence of rs78466831 in the T2DM patients group was significantly higher than the healthy control in our academic center. The general characteristic indicators were not significantly different between the wild-type and rs78466831 patients with T2DM, except the family history of diabetes. Clinical laboratory indicators including HbA1c, FBG, OGTT, TC, HDL-C, LDL-C and CP had no significant difference between the two groups. The therapeutic drug and target achievement rates were not significantly different between the two groups. The incidence of diabetic retinopathy in the variant group was significantly higher than the wild-type group. Conclusions: The OTUD3 gene rs78466831 was associated with T2DM and may be a biological risk factor of diabetes retinopathy. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the effect of hexuemingmu tablet combined with whole retina laser photocoagulation (PRP) on visual acuity, hemorheology and choroidal thickness in patients with diabetes retinopathy (DR). Methods: 60 patients with DR who received treatment in Anhui No.2 Provincial People's Hospital from March 2018 to December 2019 were selected, and they were randomly numbered by computer and divided into control group (odd, n=30) and study group (even, n=30) in odd-even order. On the basis of conventional hypoglycemic treatment for the two groups, the control group received PRP treatment. The patients in the study group received hexuemingmu tablet combined with PRP treatment. The total clinical response rate of the two groups was compared, and the changes of visual acuity, hemorheology and choroid thickness were observed before and after treatment. Results: The total clinical effective rate in the study group was higher than that in the control group (P<0.05). After treatment, naked eye vision, visual field and visual acuity were increased in two groups, and the degree of increase in the study group was greater than that in the control group (P<0.05). After treatment, plasma viscosity (PV), erythrocyte aggregation index (AI), whole blood high shear viscosity (NBH), whole blood low shear viscosity (NBL) and erythrocyte sedimentation rate (ESR) decreased in two groups, and the decrease degree in the study group was greater than that in the control group (P<0.05). After treatment, the inferior choroid thickness (SFCT), inferior choroid thickness (ICT), superior choroid thickness (SCT), nasal choroid thickness (NCT) and temporal choroid thickness (TCT) in the macular fovea decreased in two groups, and the decrease degree in the study group was greater than that in the control group (P<0.05). There were no obvious adverse reactions in two groups. Conclusion: Hexuemingmu tablet combined with PRP can effectively improve the visual acuity,hemorheology and choroidal thickness of patients with DR, and the curative effect is safe and reliable. [ABSTRACT FROM AUTHOR]

Pericytes play important roles in retinal vascular mature and homeostasis. Their dysfunction is apathological manifestation in diabetes retinopathy. Circular RNAs have emerged as a class of regulatory RNA tran‐scripts and are involved in the regulation of several physiological and pathological processes. In this study, diabe‐tes-related stresses led to increased expression of circ_0001186 in pericytes but had no effects on the expression ofcirc_0001186 in endothelial cells. In vitro studies showed that circ_0001186 knockdown reduced high glucose-in‐duced pericyte injury, contributed to the proliferation of pericytes and the recruitment of pericytes to endothelialcells. In vivo studies showed that conditional knockdown of circ_0001186 in pericytes decreased diabetes-inducedpericyte loss, suppressed retinal vascular leak and inflammatory response. Mechanistically, knockdown of circ_0001186 could activate PDGF-PI3K-Akt signaling and protect pericytes against high glucose-induced injury. Thisstudy revealed a novel mechanism of retinal vascular dysfunction. Targeting of pericyte-expressed circ_0001186provides a novel insight into the treatment of diabetes retinopathy.

Objectives: Ischemia modified albumin (IMA) may aid in the early detection and management of diabetic retinopathy (DR). In this study, we examined the relationship between IMA and DR, and the effect of intravitreal anti-vascular endothelial growth factor (anti-VEGF) on IMA levels in patients with DR. Methods: This Quasi-experimental study was conducted from March-December 2018 at a Al-Ibrahim Eye Hospital in Karachi, Pakistan. Adult patients (age = 18 year) with Type-2 diabetes mellitus (T2DM) presenting to the Diabetic Clinic were categorized as control (Group-A n=30: DM without DR) or case (Group-B n=59: DM with DR). Patients in Group-B received an intravitreal injection of bevacizumab (anti-VEGF). Visual acuity, retinoscopy and serum IMA were recorded at baseline and at a 30-day follow-up for both groups. Results: A significant drop in IMA levels was seen one month after bevacizumab (IMA baseline: 1590.82±121.22 and follow up: 940.8±91.26; p<0.01) in Group-B subjects. Visual acuity (VA) of patient in Group-B also improved one month after bevacizumab injection in both eyes (p<0.001). Whereas, the IMA levels in Group-A showed an upward rising trend after one month (baseline 448.80±22.4ng/ml and follow up 522.21±33.15 ng/ml; p>0.05) indicating disease progression. Conclusion: Ischemia modified albumin may be used as an effective and novel screening biomarker for assessing oxidative stress associated with DR, and to quantify response to and prognosis after intravitreal bevacizumab injection for DR. [ABSTRACT FROM AUTHOR]

Aims: Diabetes retinopathy (DR) is associated with retinal microvascular system injury induced by high glucose (HG). This study aims to explore the role and mechanism of long non-coding RNA THRIL in regulating cell proliferation and migration of human retina microvascular endothelial cells (hRMECs) under HG condition. Method: The gene and protein expression were detetced by RT-PCR and western blot, respectively. Cell proliferation and migration of hRMECs were examined using MTT assay and Transwell assay, respectively. The interaction between miR-125b-5p and THRIL or autophagy-related gene 4D (ATG4D) was analyzed using luciferase activity assay. Results: THRIL expression was induced by HG in hRMECs. THRIL overexpression enhanced the proliferation and migration of hRMECs induced by HG, whereas THRIL silencing yielded the opposite results. Furthermore, THRIL overexpression induced autophagy activation, and inhibition of autophagy by 3-methyladenine abrogated the promotory effects of THRIL overexpression on cell proliferation and migration of hRMECs. Mechanismly, THRIL inhibited miR-125b-5p to upregulate the expression of ATG4D (an important autophagy-related gene), thereby promoting autophagy. Moreover, miR-125b-5p overexpression or ATG4D silencing alone abolished the promoting effects of THRIL overexpression on HG-induced autophagy, proliferation and migration of hRMECs. Conclusions: THRIL promotes HG-induced cell proliferation and migration of hRMECs through activation of autophagy via the miR-125b-5p/ATG4D axis. THRIL may serve as a potential therapeutic target for DR. [ABSTRACT FROM AUTHOR]

Litong Yao,1,2,* Yifan Zhong,3,* Lingzi He,1,* Yan Wang,4,* Jingyang Wu,3 Jin Geng,3 Yun Zhou,3 Jiahua Zhang,3 Jun Chen,3 Zhongyan Shan,5 Weiping Teng,5 Yingying Xu,2 Lei Chen,3 Lei Liu3 1China Medical University, Shenyang 110001, People’s Republic of China; 2Department of Breast Surgery, The First Hospital of China Medical University, Shenyang 110001, People’s Republic of China; 3Department of Ophthalmology, The First Hospital of China Medical University, Shenyang 110001, People’s Republic of China; 4Department of Radiology, General Hospital of Liaohe Oil Field, Panjin 124010, People’s Republic of China; 5Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang 110001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lei Chen; Lei Liu Email leichen51@hotmail.com; liuleijiao@163.comBackground: To investigate the association between serum carbohydrate antigen 125 (CA125) and the presence as well as severity of diabetes retinopathy (DR) in Chinese adult patients with type 2 diabetes.Methods: A hospital-based cross-sectional study was conducted from February 2012 to November 2018. DR was assessed using Early Treatment Diabetic Retinopathy Study criteria. Vision-threatening DR (VTDR) was diagnosed if subjects had severe non-proliferative DR (NPDR), proliferative DR (PDR), or clinically significant macular edema (CSME). Multivariate logistic regression models were applied to explore the associations.Results: Among the 2696 participants, the overall prevalence of DR was 25.1%, of which the prevalence of mild NPDR, moderate NPDR, and VTDR was 10.8%, 4.5%, and 9.9%, respectively. Serum CA125 level was significantly higher in participants with DR and increased with the severity of DR (P = 0.013). After accounting for age, gender, smoking, drinking, duration of diabetes, anti-diabetic agents use, systolic blood pressure, pulse pressure, weight, hemoglobin A1c and fasting plasma glucose levels, CA125 level was significantly associated with subjects in any-severity DR (odds ratio [OR] 1.006 [95% confidence interval CI: 1.002– 1.010], P = 0.006) and VTDR (1.008 [1.003– 1.013], P = 0.001). When CA125 was treated as categorized variables, the prevalence of VTDR might increase as improving CA125 quartiles (P value for trend = 0.017).Conclusion: In this study, serum CA125 level was associated with the presence and severity of DR in Chinese patients with type 2 diabetes. Further prospective studies should be warranted to validate the feasible role of CA125 as well as other biomarkers.Keywords: type 2 diabetes, diabetes retinopathy, tumor biomarker, CA125, association

For type 2 diabetes patients, the first eye examination should be initiated once a diagnosis of diabetes is confirmed, as for type 1 diabetes, the timing being extended to 5 years after the onset of diabetes. Keywords: Diabetes retinopathy; Epidemiology; Risk factors; Screening; Treatment EN Diabetes retinopathy Epidemiology Risk factors Screening Treatment 1322 1325 4 08/12/21 20210801 NES 210801 Despite progress in the treatment of diabetic macular edema and diabetic retinopathy, the rate of lower fundus examination due to limitations of medical resources delays the diagnosis and treatment of diabetic retinopathy. Diabetes retinopathy, Epidemiology, Risk factors, Screening, Treatment. [Extracted from the article]

Purpose: To evaluate the effect of propylene glycol mannate sulfate (PGMS) on retinopathy in non-proliferative diabetic patients., Methods: Eighty patients (111 eyes) with non-proliferative diabetic retinopathy were selected and retrospectively analyzed. Patients were divided into a control group (40 cases, 56 eyes) and an experimental group (40 cases, 55 eyes) using a random number table method. The control group continued had routine blood glucose management, while the experimental group received PGMS 100 mg additionally TID for 60 days. Changes in visual acuity, fundus conditions including hemorrhage points and exudation in each quadrant, and non-perfusion area were revealed through fundus angiography before and after the treatment period., Results: After PGMS treatment, the experimental group demonstrated significant improvements compared to the control group in terms of eyesight improvement ( P =0.002), the macular edema and macular retinal thickness ( P =0.008). The total clinical efficacy rate of the experimental group was 67.86%, which was higher than 38.18% of the control group ( P =0.032). Notably, there was a significant reduction in macular hemorrhage and hard extrusion., Conclusion: Oral administration of PGMS is an effective treatment for non-proliferative diabetic retinopathy., Competing Interests: None., (AJTR Copyright © 2024.)

AIM: To analyze the difference of macular retinal thickness between diabetic patients without apparent visual loss and normal subjects.METHODS: Totally 40 cases(79 eyes)with type 2 diabetes without significant decrease of visual acuity(best corrected visual acuity, BCVA ≥0.8)in our hospital from April, 2018 to June, 2019 were enrolled as observation group and 64 cases(119 eyes)normal persons were enrolled as control group. The average retinal thickness in nine areas of macula, central retinal thickness(CRT), average retinal thickness(ART)and total volume(TV)of all patients were determined by optical coherence tomography(OCT), and the difference of average retinal thickness in nine areas of macula, CRT, ART and TV among them were compared.RESULTS: The CRT, ART and TV(193.99±14.58μm, 291.07±12.24μm, 8.22±0.35mm3)in the observation group were significantly higher than those in the control group(187.38±12.24μm, 280.54±8.71μm, 7.92±0.25mm3), and the average retinal thickness in nine areas of macula in the observation group was significantly higher than that in the control group(PCONCLUSION: Compared with normal persons, macular retinal thickness and TV are significantly thickened in early stage of type 2 diabetes.

AIM: To observe the changes of chemokine macrophage inflammatory protein(MIP-1α)and MIP-1β in peripheral blood of patients with diabetic retinopathy and to analyze its clinical significance. METHODS: The patients with diabetic retinopathy(DM group), monproli fertive diabetic retinopathy(NPDR group)and proliferative diabetic retinopathy(PDR group)were selected in Foshan Fifth People's Hospital and the Fourth People's Hospital of Nanhai District, Foshan. There were 50 patients were treated in each group, and 50 healthy persons(control group)were selected for the same period. The differences in the levels of chemokine MIP-1 alpha, MIP-1 beta, blood glucose and cytokines in peripheral blood of patients with different groups were observed. The correlation between the levels of chemokine MIP-1α and MIP-1β of peripheral blood in patients with diabetic retinopathy and the level of blood glucose and cytokines was analyzed by Pearson correlation analysis. RESULTS: The levels of MIP-1α, MIP-1β and mean blood glucose(MBG)in the DM group were higher than those in the control group(t=6.306, 2.954, 3.617; Pt=27.216, 7.778, 3.214; Pt=6.620, 3.461, 3.378; Pt=10.260, 12.611, 4.108; PCONCLUSION: The levels of MIP-1α and MIP-1β in patients with PDR are relatively high, and are positively correlated with blood glucose and cytokines levels.

Abstract Objective Data regarding diabetes retinopathy and associated factors are currently lacking in Ethiopia. The study aims to determine the incidence and determinants of time to diabetes retinopathy among diabetes mellitus patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Results The incidence of diabetes retinopathy is a rapidly growing burden of disease in Ethiopia. The incidence rate of diabetes retinopathy was 2.65 (95% CI 2. 54, 4.05) per 1000 person-years observation. Moreover, 70 (18.57%, 95% CI 14.63, 22.5) DM patients developed diabetes retinopathy. The median time was 74.07 months (with IQR 53.60, 89.88). Male sex (AHR = 1.94, 95% CI = 1.10, 3.39), type 2 DM (AHR = 4.01, 95% CI = 1.34, 12.00), creatinine (AHR = 2.59, 95% CI = 1.91, 3.52), borderline triglyceride (AHR = 2.87, 95% CI 1.33, 6.21) and high triglyceride levels (AHR = 2.59, 95% CI = 1.31, 4.97) were positively correlated factors to diabetes retinopathy occurrence. Multisectoral, population-based approaches are needed to reduce type 2 DM complications.

Objective: We tried to find the relationship between statin and diabetes retinopathy (DR) in patients with type 2 diabetes mellitus (T2DM). Methods: We searched the databases of PubMed, EMBASE, and the Cochrane Library for eligible studies reporting on the relationships between statin use and DR, from inception to September 25, 2020. The terms searched including Diabetes Mellitus, Type 2, Hydroxymethylglutaryl-CoA Reductase Inhibitors, and Diabetic Retinopathy. We expressed the results as the odds ratios (ORs) with 95% confidence intervals (CIs) which were calculated using a random-effects model. Results: A total of 6 eligible studies, including 43 826 patients, were included in the meta-analysis. The meta-analysis showed that statin was not associated with elevated risk of DR [OR = 0.96 (95% CI: 0.80-1.16), P =.68]. Similarly, no differences were found between statin and placebo in participants ≥500 [OR = 0.98 (95% CI: 0.80-1.21)] or participants <500 [OR = 0.90 (95% CI: 0.49-1.66)]. Further, we conducted a meta-analysis to study the effect of statin therapy on DR in people with type 2 diabetes according to age and found that statin use was associated with a decreased risk of DR in patients with type 2 diabetes 40 years of age or older [OR = 0.87 (95% CI: 0.82-0.92)]. Conclusion: Our meta-analysis revealed that statin was not associated with elevated risk of DR in patients with T2DM. Moreover, statin use was associated with a lower incidence of DR in patients with type 2 diabetes 40 years of age or older. [ABSTRACT FROM AUTHOR]