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Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: la Retinopatía Diabética es una de las complicaciones de los pacientes diabéticos con potencial para generar trastornos visuales y la ceguera del paciente si no controla adecuadamente. Objetivo: describir los efectos de la Retinopatía Diabética sobre la salud ocular. Métodos: Se realizó una revisión bibliográfica sistemática, descriptiva, limitada a los idiomas de inglés y español. Se realizó una búsqueda de información actualizada en bases de datos electrónicos como: Scielo, Elsevier, PubMed, Biblioteca virtual de la salud, Google Académico. Desarrollo: la detección temprana y el riguroso control de los niveles de glucosa en la sangre es de vital importancia para evitar o retrasar la manifestación de la Retinopatía Diabética son factores de gran relevancia. La incorporación de evaluaciones periódicas, como la oftalmoscopia y la tomografía de coherencia óptica, desempeña un papel esencial en la identificación de los cambios retinianos incipientes. Además, las opciones terapéuticas han progresado, incluyendo tratamientos con láser y fármacos intravítreos, los cuales pueden detener o reducir la progresión de la enfermedad en algunos casos. Conclusiones: se categoriza en dos formas primordiales: no proliferativa y proliferativa. La primera se caracteriza por el debilitamiento de los vasos sanguíneos retinianos y la acumulación de líquido en el tejido de la retina. Contrariamente, la variedad proliferativa involucra el desarrollo anormal de nuevos vasos sanguíneos delicados en la retina, con el potencial de generar hemorragias y desprendimiento de la retina, lo que resulta en pérdida de la capacidad visual.

Background: Diabetes is a metabolic disease highly prevalent in our country that ends in disabling complications such as diabetic retinopathy and macular edema. As a high-impact socioeconomic issue, it is important to look for an early diagnostic test that also allows us to introduce a telemedicine service for the population with little access to specialized health services. Objective: To describe the performance in discrimination of macular edema of a feature detection algorithm on retinal fundus images from diabetic patients. Material and methods: We use a database of 266 retinal fundus images of diabetic patients and were classified in Macular Edema or Without Macular Edema by ophthalmologists’ assessment and we test if the algorithm was capable of establish the presence or not of macular edema. Results: We made 3 tests in which the standards of sensitivity, specificity and efficiency of the algorithm were increasing according to the amount of retinal fundus images in the training phase, reaching specificity values of 100%, sensitivity 84% and efficiency 91.30%. Conclusions: Our study lays the foundation of a reliable screening method due to its high specificity value and allows not only a binary reply in the presence or not of macular edema but the clinical and topographic classification favoring the onset of treatment. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introdução: Apesar da integridade morfológica e funcional do endotélio corneano, essencial para a transparência corneana, ser afetada com a Diabetes Mellitus (DM) a sua relação com severidade de retinopatia diabética e presença de edema macular diabético não é clara. Objetivos: Avaliar as características morfológicas do endotélio corneano em doentes com Diabetes Mellitus Tipo 2 (DMT2) com diferentes perfis de resposta terapêutica ao edema macular diabético (EMD). Métodos: Com uma abordagem transversal, 24 participantes com DMT2 foram divididos em 2 grupos (sem EMD e com EMD). Posteriormente, o grupo com EMD foi subdividido de acordo o tipo de resposta terapêutica (respondedor e persistente). Parâmetros obtidos através da microscopia especular (densidade de células endoteliais, coeficiente de variação, hexagonalidade e espessura central da córnea) e da tomografia de coerência ótica (espessura mínima da fóvea, espessura no 1mm central, a espessura da camada de células ganglionares macular, e a espessura da camada de fibras nervosas peripapilar) foram analisados e comparados nos diferentes grupos. Resultados: Não foram encontradas alterações significativas do endotélio corneano entre os grupos com e sem EMD (p>0,05). No entanto, foram encontradas diferenças na densidade de células endoteliais (p=0,04) nos participantes com diferentes EMD persistente (1900,3 ± 270,1) comparativamente ao EMD respondedor (2307,9 ± 121,2) e grupo de controlo (2191,7 ± 165,5). Conclusão: Os diferentes parâmetros do endotélio corneano não mostraram diferenças entre participantes com e sem EMD. No entanto, o tipo de resposta terapêutica ao EMD parece estar associada à diminuição da densidade de células endoteliais.

RESUMO Objetivo: Avaliar a acurácia de médicos generalistas em reconhecer a retinopatia diabética por meio da retinografia colorida, com um curso de capacitação com duração de 2 horas, comparando a capacidade de rastrear e classificar a retinopatia diabética em relação ao exame presencial com oftalmologista. Métodos: No primeiro braço do estudo, de 142 pacientes diabéticos incluídos, avaliaram-se 274 olhos, em que esses pacientes foram examinados com oftalmoscópio binocular indireto e classificados quanto ao grau da retinopatia diabética. No segundo braço do estudo, 14 médicos não especialistas em oftalmologia receberam um treinamento de 2 horas para o diagnóstico de retinopatia diabética com a retinografia colorida e se aferiu a acurácia desses profissionais em rastrear a retinopatia diabética antes e depois do curso de capacitação, utilizando as retinografias obtidas na primeira frente do estudo. Resultados: Verificou-se aumento significativo da sensibilidade (82% para 99%) e da especificidade (44% para 83%) na detecção da retinopatia diabética pelos médicos generalistas, com o curso de capacitação. Conclusão: O médico generalista capacitado pode avaliar a retinopatia diabética por meio da retinografia colorida, sendo o programa de rastreamento dessa complicação do diabetes uma proposta viável e benéfica ao país.

Background: diabetic retinopathy and diabetic kidney disease are highly feared microvascular complications. In our province, there are insufficient studies that address the possible association between these comorbidities. Objective: to characterize clinical and epidemiological variables in patients with diabetic retinopathy and altered values of microalbuminuria, treated at the ophthalmological center of Las Tunas, from October 2020 to May 2023. Methods: a descriptive, cross-sectional study was performed in a universe of 138 patients with diabetic retinopathy who attended the retinal consultation in the place and during the time period defined in the objective. The sample consisted of 67 patients older than 18 years, with values of microalbuminuria in the range of 30-300 mg/L. The variables evaluated were: type of diabetic retinopathy, age, sex, personal and family history of disease, time of evolution of diabetes, visual acuity, classification of diabetes according to alterations in the retina, microalbuminuria value. The data were analyzed according to descriptive statistics. Results: females predominated (64.2 %), ages 60-79 years (50.7 %) and patients with more than 10 years of diabetes evolution (53.7 %). The most frequent personal pathological history was arterial hypertension (43.3 %). 41.8 % of the eyes had a better corrected visual acuity of 0.6-0.4. Microalbuminuria values were more frequent between 60-90 in cases of non-proliferous diabetic retinopathy and 100-300 in those diagnosed with proliferative diabetic retinopathy. Conclusions: characteristics of patients with diabetic retinopathy and elevated levels of microalbuminuria were described.

Introducción: Se reconoce la asociación entre los factores de riesgo aterogénico y las alteraciones microvasculares de la retina, pero no hay consenso sobre si estas afectaciones en la retina preceden o son una respuesta fisiopatológica a dichos factores. Objetivo: Determinar si la presencia de los factores de riesgo aterogénico predice las alteraciones vasculares retinianas, a través del fondo de ojo y la retinografía. Métodos: Estudio trasversal en 55 sujetos mayores de 19 años de edad, de cualquier sexo, sin opacidades en los medios transparentes del ojo. Se estudiaron las variables edad, sexo, dislipidemia, hábito de fumar, consumo de alcohol, hipertensión arterial, diabetes mellitus tipo 2, presión arterial sistólica y diastólica, índice de masa corporal, colesterol, glicemia, triglicéridos, creatinina, lipoproteínas de alta densidad, urea, eritrosedimentación y conteo leucocitario. Resultados: El 65,45 % presentó alteraciones en el fondo de ojo: Aumento del brillo arteriolar (53,03 %) y disminución del calibre arteriolar generalizado (52,24 %). La retinografía mostró daño en el 58,18 %: Rectificación de los cruces arteriovenosos (65,71 %), tortuosidad venosa (28,21 %) y cruces arteriovenosos con aplastamiento (85,71 %). El aumento del colesterol sérico (p= 0,003) se asoció con la presión arterial sistólica (p= 0,037) en el fondo de ojo, y con el antecedente de hipertensión arterial (p= 0,023) en la retinografía. Conclusiones: El colesterol sérico, las cifras elevadas de tensión arterial sistólica y antecedentes de hipertensión arterial son los factores de riesgo que mejor predicen el daño vascular retinal.

RESUMO Objetivo: Obter imagens de fundoscopia por meio de equipamento portátil e de baixo custo e, usando inteligência artificial, avaliar a presença de retinopatia diabética. Métodos: Por meio de um smartphone acoplado a um dispositivo com lente de 20D, foram obtidas imagens de fundo de olhos de pacientes diabéticos; usando a inteligência artificial, a presença de retinopatia diabética foi classificada por algoritmo binário. Resultados: Foram avaliadas 97 imagens da fundoscopia ocular (45 normais e 52 com retinopatia diabética). Com auxílio da inteligência artificial, houve acurácia diagnóstica em torno de 70 a 100% na classificação da presença de retinopatia diabética. Conclusão: A abordagem usando dispositivo portátil de baixo custo apresentou eficácia satisfatória na triagem de pacientes diabéticos com ou sem retinopatia diabética, sendo útil para locais sem condições de infraestrutura.

OCT-A is an exam that allows visualization of the retinal and choroidal vascularization as well as the three-dimensional visualization of the vascular plexuses at different depths, providing functional information about the blood flow in the vessels, and areas of non-perfusion or neovascularization. The foveal avascular zone corresponds to an area deprived of capillaries in the foveolar region that can be detected and measured using OCT-A. When performing the exam, it is possible to choose between two methods with different resolution and acquisition times, so it is important to assess whether the measurements are comparable between methods. The objective of this study was to see if there are differences in the measurement of the foveal avascular zone between two different OCT-A scanning protocols. The conducted study was a case-control cross-sectional study. The sample consisted of 26 participants with diabetes mellitus. The instrument used was the SD-OCT HRA+OCT SPECTRALIS Heidelberg Engineering. The patient assessment consisted of collecting 10° x 10° high-resolution and 20° x 20° high-speed OCT-A scans. These were manually measured by two observers, who each took two measurements of the foveal avascular zone of each scan (high-speed and high-resolution) in each complex (superficial and deep). Statistical analysis was performed using the SPSS program. There were no statistically significant differences between the different measurements, and it can be stated that the evaluation of the two protocols is repeatable and reproducible, with good agreement between the methods. However, the use of both retinal plexuses together to evaluate the foveal avascular zone may be more appropriate. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study presents an automated method for localizing IHs (Intraretinal hemorrhages) by using the Single Shot Detector (SSD) scheme based on the MobileNet-V1 network. Diabetic retinopathy (DR) is a disease resulting from complications of diabetes and is the leading cause of blindness due to damage of retinal vessels. IHs are DR lesions that, if detected early, the patient can receive a timely treatment to avoid blindness. The proposed system is assessed by using the MESSIDOR database. The results show a detection accuracy of 70%, indicating that 70% of IH-positive test retinal image is detected correctly. The localization accuracy is 58.6%, showing that 58.6% of IH lesions of all test images are localized correctly. In conclusion, automated detection can effectively assist general doctors in determining RD severity. [ABSTRACT FROM AUTHOR]

O OCT-A é um exame que permite a visualização da vascularização da retina e da coroide, assim como a visualização tridimensional dos plexos vasculares em diferentes profundidades, fornecendo informação funcional sobre o fluxo sanguíneo nos vasos, zonas de não perfusão ou neovascularização. A zona avascular da fóvea (FAZ) corresponde a uma zona desprovida de capilares na região foveolar e pode ser detetada e medida com recurso ao OCT-A. Ao realizar o exame é possível optar por dois métodos com diferente resolução e tempo de aquisição, pelo que é importante avaliar se as medições efetuadas são comparáveis entre os dois métodos. O objetivo do estudo foi verificar se existem diferenças na medição da área avascular da fóvea entre dois protocolos diferentes de aquisição de OCT-A. O estudo realizado foi um estudo caso-controlo transversal. A amostra foi composta por 26 participantes com diabetes mellitus. O instrumento utilizado foi o SD-OCT HRA+OCT SPECTRALIS Heidelberg Engineering. A avaliação dos participantes foi constituída pela recolha de mapas de OCT-A de 10º x 10º (HR) e 20º x 20º (HS). Os mapas foram medidos manualmente por dois observadores, sendo que cada um fez duas medições da zona avascular da fóvea de cada mapa (HS e HR) em cada plexo (superficial e profundo). Com recurso ao programa SPSS efetuou-se a análise estatística das amostras. Não se verificaram diferenças estatisticamente significativas entre as diferentes medições, podendo-se assim afirmar que a avaliação com os dois protocolos é repetível e reprodutível, existindo uma boa concordância entre os métodos. No entanto, a utilização de ambos os plexos retinianos em conjunto para avaliação da área avascular da fóvea poderá ser mais adequada.

Background: Diabetic retinopathy is a progressive disfunction of blood vessels of the retina secondary to chronic hyperglycemia. There are several treatments, out of which panretinal photocoagulation (PRP) stands out. Objective: To compare the level of pain in patients undergoing PRP with different impulse. Material and methods: Comparative, cross-sectional study that compared the level of pain in patients undergoing PRP with a 50-millisecond pulse (group A) versus conventional 200 milliseconds pulse (group B). Mann-Whitney U test was used. Results: There were 26 patients, 12 (46.16%) female and 14 (53.84%) males. The median age was 58.73 ± 7.31 (40-75) years. 40 eyes were studied, 18 (45%) right and 22 (55%) left. The mean level of glycated hemoglobin was 8.15 ± 1.08 (6.5-12) %. The mean laser power was 297 ± 53.61 (200-380) and 214.5 ± 41.73 (170-320) milliwatts; the mean fluence was 18.85 ± 5.28 (12-28) J/cm² and 65.9 ± 12.87 (52-98) J/cm²; the mean level of pain was 3.1 ± 1.33 (1-5) and 7.5 ± 1.23 (6-10) points for group A and B, respectively, and there was statistically significant difference (p ≥ 0.001) in the level of pain. There were no complications in any group. Conclusion: The application of retinal 50-millisecond pulse PRP causes less pain and side effects than 200-millisecond pulse PRP. [ABSTRACT FROM AUTHOR]

Introduction – Diabetes mellitus (DM), with macro and microvascular complications, has direct and indirect consequences in the population’s life but also on the health system in Cape Verde. This study intends to characterize for the first time the ocular complications of DM in diabetic patients monitored in the Ophthalmology Service of Hospital Dr. Batista de Sousa during the last five years. Methods – This retrospective cross-sectional study assessed the clinical records of diabetic patients monitored in the ophthalmology service in São Vicente from 2015 to 2020. From the initial 57 clinical records consulted, and in accordance with the inclusion criteria and exclusion, 22 clinical files were included (44 eyes). Results – Diabetic retinopathy (100%) and diabetic macular edema (45.45%) were the most frequent alterations in the studied sample. Additionally, different ocular alterations were described, such as cataracts (72.27%), ptosis (4.54%), pterygium (13.63%), pinguecula (2.27%), conjunctival hyperemia (6.81%), neovascularization of iris (4.54%) and glaucoma (4.54%). Discussion/Conclusion – These findings are important to develop a first local impact assessment of DM on eye health and simultaneously provide tools to improve local health policies. This characterization has been useful to document not only the different DM ocular consequences but allow to clarify potential priority actions. [ABSTRACT FROM AUTHOR]

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Diabetic retinopathy (DR) is a primarily asymptomatic microvascular complication. Even though it is preventable, it is the first cause of irreversible blindness among working-age adults. Due to recent meta-analysis results, dyslipidemia is an inconclusive risk factor; therefore, the importance of accomplishing our study in the Peruvian population. Objective: Evaluate the relationship between dyslipidemia and DR in type II diabetic patients of the Ophthalmology area from the Edgardo Rebagliati Martins National Hospital in Lima-Peru, from 2018 to 2020. Methods: Case-control study, 219 cases and 219 controls were included. Diabetic patients will be classified based on the presence or absence of DR lesions on the ocular fundus determined by the specialist. Lipids parameters (triglyceride, LDL, HDL, total cholesterol) and other variables were recollected and analyzed in STATA 14. Multivariate logistic regression was used to obtain a crude and adjusted Odds Ratio. Results: Dyslipidemia (OR 2.7, p=0.03), elevated triglycerides (OR 1.0044, p=0.03), and low HDL cholesterol (OR 2.16, p=0.03) were significantly associated with DR. Conclusion: Dyslipidemia is an independent risk factor for DR in type II diabetic patients. This result emphasizes the importance of evaluating a lipid panel in diabetic patients. [ABSTRACT FROM AUTHOR]

Introdução – A diabetes mellitus (DM) e suas complicações macro e microvasculares implicam consequências diretas e indiretas na vida da população mas também para o sistema de saúde de Cabo Verde. Este trabalho pretende caracterizar pela primeira vez as complicações oculares da DM nos utentes diabéticos monitorizados no Serviço de Oftalmologia do Hospital Dr. Batista de Sousa nos últimos cinco anos. Método – Trata-se de um estudo transversal retrospetivo através da consulta das fichas clínicas dos utentes diabéticos monitorizados no Serviço de Oftalmologia em São Vicente, no período de 2015 a 2020. Das 57 fichas clínicas inicialmente consultadas, e de acordo com os critérios de inclusão e exclusão, foram incluídas 22 fichas clínicas, perfazendo um total de 44 olhos. Resultados – A retinopatia diabética (100%) e o edema macular diabético (45,45%) foram as alterações mais frequentes na amostra estudada. Adicionalmente foram descritas diferentes alterações oculares, como catarata (72,27%), ptose (4,54%), pterígio (13,63%), pinguécula (2,27%), hiperemia conjuntival (6,81%), neovascularização de íris (4,54%) e glaucoma (4,54%). Discussão/Conclusão – Estes achados são importantes para desenvolver uma primeira caracterização local do impacto da DM na saúde ocular e simultaneamente fornecer ferramentas para melhoria das políticas de saúde local. A caracterização foi útil para documentar não apenas o impacto ocular da diabetes mellitus, mas também clarificar potenciais ações prioritárias.

Introduction: diabetes mellitus leads to many associated complications, including diabetic neuropathy and diabetic angiopathy, both with a high incidence in the onset diabetic foot and including also the diabetic retinopathy disease cause of blindness. Objective: determine if there is any correlation between the onset diabetes foot and whether or not diabetic retinopathy present in patients treated at the Hospital Provincial, María Eugenia Neto, Zaire, Republic of Angola, from September 2020 to September 2020. Method: a descriptive study was carried out in 181 patients treated in the diabetic foot department of the aforementioned hospital; variables described were as follow: age, sex, associated chronic diseases, presence or absence of diabetic retinopathy, lower limb ulcers, limb amputation and years with diabetes. Bivariate correlation tests were performed, and the Pearson´s correlation coefficient was analyzed. Results: the average age was 59.3 years, the age group over 70 years (28.2%) and the female sex (57.5%) predominated. The 41.8% of patients presented previous amputations and 40.1% had ulcers. The 65.19% of patients had irregular treatment patterns, statistically strong and significant correlation between diabetic foot and diabetic retinopathy. Conclusions: there is evidence of a strong and significant relationship between patients with diabetic foot, who may suffer from a certain degree of diabetic retinopathy, more frequent in females after their sixth decade of life that cause a longer evolution of his disease.

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Small fibers diabetic peripheral neuropathy (DPN-sf) are diagnosed by biomedical vasomotor tests whose foundation is altered skin thermoregulation. Objectives: To estimate the prevalence and factors associated with DPN-sf using thermographic imaging (TI). Methods: An observational, cross-sectional, analytical study was performed in a specialized unit in the primary care setting, in which patients with type 2 diabetes mellitus were assessed by peripheral neurological tests such as tactile and vibratory sensitivity for the diagnosis of large fibers peripheral neuropathy (DPN-lf) and passive thermoregulation by TI for DPN-sf. The latter was performed on the sole using a thermographic camera in the outpatient clinic, evaluating 5 plantar thermographic measurements per subject. Then, the association between diabetics with and without DPN-sf was analyzed concerning gender, age, time of diabetic disease, type of diabetic treatment, hypertension, retinopathy, nephropathy, low carbohydrate diet, physical activity, pain symptom, and BMI. Results: 304 patients with type 2 diabetes mellitus were studied, mean age of 65.07±11.39 years, mostly male, finding DPN-lf in 14.8 %, DPN-sf in 27.3 %, and both NPD in 34.9%. The association of DPN-sf was only with the factor of the presence of retinopathy (a=0.02, C= 0.18). Conclusions: We found a high prevalence of DPN-sf using thermographic imaging that was associated with the presence of retinopathy [ABSTRACT FROM AUTHOR]

Diabetic retinopathy (RD) is a complication caused by diabetes. This can cause blindness, becoming a worldwide threat due to the affectation of people at an early age and linked to the labor field. The role of medicine in the diagnosis of this disease is associated to the analysis of pathologies (micro aneurysms, hemorrhages and exudates) presented in fundus images. This task is tedious, time-consuming for medical personnel and it makes delays in diagnosis because of the high demand of RD patients. From the engineering of CAD system designs (Computer-Aided Design) an automated method is proposed for the identification of reference characteristics such as the optical disc, the fovea and the blood vessels. This article presents a methodology for the detection and segmentation of the optical disc and blood vessels. first, a preprocessing stage based on the algorithms of contrast-adaptive histogram equalization (CLAHE) and dynamic diffuse histogram equalization that preserve brightness (BPDFHE) is proposed aiming of improving the fundus image and highlighting the blood vessels for later removal. Next, it is proposed the methodology of segmentation of blood vessels through neural networks that a posteriori, it is going to contribute information for the correct segmentation of the optical disc, which is located through iterative opening and closing morphological operations, demonstrating that it is invariability against pathological lesions of the exudates that coincide in color information with the ocular structure of interest. Once the optic disc is located, the blood vessels inside are removed by inpainting algorithm (Functional Mumford-Shah), which replaces the presence of the blood vessels with statistical information of color discrimination of the optical disc. Finally, the Graph Cut algorithm is implemented for the segmentation of the optical disc. [ABSTRACT FROM AUTHOR]

Currently the “pandemic” of diabetes mellitus is noted. The incidence and prevalence of diabetes and diabetic retinopathy, the most common microvascular complications of diabetes, are exponentially growing due to increased life expectancy in many parts of the world. The increasing number of people suffering from diabetic retinopathy not only highlights medical issues, but also an economic burden, representing a medical and social challenge. It is extremely important to identify a disease as soon as possible and successfully treat it. Technological progress results in developing Artificial Intelligence systems capable of detecting diabetic retinopathy. Current screening will be cost effectively based on the use of advanced digital technologies, in particular teleretinal screening systems. At present, we may consider teleophthalmology and Artificial Intelligence with automatic analysis of fundus photos as a Millennium-minded impactful tool for increasing discoverability and manageability of diabetic retinopathy, especially in filling the gap of inaccessibility to hard-to-reach areas, which enforces highly professionally effective time- and cost-saving care everywhere to provide the best possible care for the patients. [ABSTRACT FROM AUTHOR]

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Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de la ALAD is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: las complicaciones microvasculares más frecuentes de la diabetes involucran, principalmente, a la retina y al riñón. Se ha reconocido una estrecha relación entre la retinopatía diabética y la microalbuminuria. Objetivo: determinar el comportamiento de la microalbuminuria en pacientes con diabetes tipo 2 y retinopatía diabética. Métodos: estudio observacional, descriptivo, de corte transversal en pacientes con diabetes tipo 2 y retinopatía diabética en el Hospital “Arnaldo Milián Castro” en el período de tiempo comprendido entre los años 2018 y 2019. Resultados: las mujeres mayores de 60 años fueron las más afectadas con retinopatía diabética (43,2%). La retinopatía diabética proliferativa (47,7%) prevaleció en los pacientes con más de 10 años de evolución. En el 38,6% de los pacientes estudiados se registraron valores de microalbuminuria elevada. El 32,4% de los pacientes con microalbuminuria elevada tenía una retinopatía diabética proliferativa con mal control metabólico. El número de pacientes con retinopatía diabética proliferativa, hipertensión arterial asociada y microalbuminuria elevada fue menor al que se esperaba. Conclusiones: poco más de un tercio de los pacientes con diabetes y algún grado de severidad de retinopatía diabética presentan microalbuminuria elevada. Más de la mitad de los pacientes con valores elevados de microalbuminuria tienen un mal control metabólico, de estos la mayoría con retinopatía diabética proliferativa. El número de pacientes con retinopatía diabética proliferativa, hipertensión arterial asociada y microalbuminuria elevada fue menor al que se esperaba hallar en esta serie.

RESUMEN Introducción: La retinopatía diabética es la principal causa de ceguera en personas diabéticas de 20 a 64 años de edad, e incrementa su aparición frente a un mal control de la enfermedad, que se expresa con valores altos de hemoglobina glucosilada (HbA1C). Objetivo: Establecer la relación entre los niveles de hemoglobina glucosilada y la presencia de retinopatía en los pacientes con diabetes mellitus tipo 2. Métodos: Se llevó a cabo un estudio descriptivo, prospectivo y transversal, en el que se obtuvieron, mediante ficha de observación, datos sociodemográficos, de evaluación oftalmológica y niveles de HbA1C, de los pacientes atendidos en consulta externa del Hospital General “Isidro Ayora” de la ciudad de Loja, Ecuador, en el período febrero-junio de 2018. Se aplicaron medidas de frecuencia y asociación para el análisis estadístico. Resultados: Se incluyeron 160 pacientes: 108 mujeres y 52 hombres, todos de raza mestiza. Se identificó retinopatía en 26,8 % (N = 43) de los pacientes, de quienes 41 % (N = 18) tenía más de 65 años de edad. La media de HbA1C en pacientes sin retinopatía fue de 7,4 %, y en aquellos con retinopatía de 9,8 %. Un mayor porcentaje de pacientes con valores de HbA1C de 7 % o más presentaron retinopatía diabética, en comparación con aquellos de HbA1C menores a 7 % (p < 0,0001), la retinopatía no proliferativa moderada fue el principal diagnóstico realizado. Conclusiones: El mal control glucémico en las personas con diabetes mellitus tipo 2 se asocia con mayor probabilidad de aparición de lesiones retinianas.

RESUMEN Introducción: La retinopatía diabética puede prevenirse con el óptimo control de la diabetes mellitus; sin embargo, la constante llegada de pacientes con diagnóstico de retinopatía diabética avanzada a los centros oftalmológicos apunta a la insuficiente prevención primaria de esta enfermedad. Objetivo: Proponer herramientas prácticas vinculadas a los principales factores de riesgo que pueden ser controlados o modificados en pacientes diabéticos para lograr una prevención primaria de la retinopatía diabética más efectiva. Métodos: Se consultaron artículos referentes a la prevención de la retinopatía diabética en la atención primaria de salud durante los meses de noviembre-diciembre de 2020 y enero de 2021; publicados en diversas revistas e indexados en las bases de datos PubMed, SciELO, Medscape; otros textos afines, páginas web y blogs del año 2010 en adelante. Las sintaxis empleadas fueron retinopatía diabética, prevalencia y prevención de retinopatía diabética, prevención primaria, complicaciones oculares de la diabetes mellitus y factores de riesgo de la retinopatía diabética. Conclusiones: La adición de nuevas estrategias al control o modificación de los principales factores de riesgo en los pacientes diabéticos constituye una alternativa para perfeccionar la prevención primaria de la retinopatía diabética.

Background and Objective: Age-related macular degeneration (AMD) and diabetic retinopathy (DR) are highly prevalent., Objective: To explore perceptions of patients with AMD or DR about the impact of the disease and treatment on their daily living activities., Materials and Methods: Semi-structured interviews with a questionnaire developed from validated patient reported outcomes questionnaires. The questionnaire consisted of 19 questions about the disease and 9 about the treatment. The questions (items) were answered on a scale from 1 to 9. In addition, the patient interviewed was invited to make free comments on each question. Nine patients with AMD and 9 with DR were interviewed by videoconference or telephone call. A quantitative analysis of the responses and a qualitative analysis of the comments were carried out., Results: The most relevant item for patients with AMD or DR is "Recognize people when they are nearby", and "Read text in normal size font in a newspaper or book", followed, in patients with AMD, by "Do things what you would like" and, in patients with DR, "Feeling frustrated by the vision problems." Regarding the treatment, the most relevant aspects for both groups is that the treatment works and receiving appropriate information before and after the treatment. The qualitative comments were focused to the disease, the treatment, and to the role of doctors and the health system., Conclusion: Quantitative responses and free comments can be useful to improve the care of patients with AMD or DR by physicians and the health system., (Copyright © 2024 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.)

Introdução: A retinopatia diabética é uma complicação do diabetes mellitus com grande impacto na saúde, mas seu diagnóstico por oftalmoscopia e a instituição do tratamento precoce comprovadamente reduzem a progressão para a perda visual. No território adscrito pela Unidade de Atenção Primária à Saúde (UAPS) onde realizou-se o presente estudo a equipe médica percebeu uma quantidade significativa de pessoas que não realizam fundo de olho periodicamente. Objetivo: Avaliar a taxa de pessoas adequadamente rastreadas quanto à retinopatia entre os diabéticos tipo 2 dessa localidade rural. Métodos: Este estudo consiste em um relato de experiência da realização de uma auditoria clínica para avaliar a taxa de rastreio de retinopatia entre diabéticos tipo 2 de uma UAPS. Para isso foi gerada uma planilha com os pacientes diabéticos de forma eletrônica pelo prontuário e-SUS, com posterior leitura de prontuário dos últimos dois anos em busca de menção à realização de oftalmoscopia. Resultados: O relatório gerou 3.736 cadastros ativos, dos quais 181 eram diabéticos. Destes, 156 foram selecionados para análise por serem comprovadamente diabéticos tipo 2. A taxa de rastreio nos últimos dois anos foi de 13,4%. Em 61,9% dos casos, a realização de fundoscopia foi realizada na própria UAPS. Conclusão: A auditoria clínica foi uma ferramenta útil para confirmar e delimitar a suspeita de baixa taxa de rastreio de retinopatia diabética. A realização de fundoscopia pelo médico de família e comunidade com treinamento foi uma estratégia que permitiu elevar essa porcentagem.

Introducción: La retinopatía hipertensiva y retinopatía diabética constituyen un problema de salud pública porque generan discapacidad visual evitable, sin embargo, se desconoce la prevalencia actual, sus factores asociados en la región y su situación en el marco de las Rutas de Atención Integral en Salud (RIAS) para la hipertensión y la diabetes que tienen establecida la remisión a oftalmología como seguimiento de daño a órgano blanco. Objetivo: Describir las características y comorbilidades de la retinopatía Hipertensiva y Diabética, en pacientes que consultaron a oftalmología en el Quindío durante el año 2018. Métodos: Se realizó un estudio descriptivo de corte transversal, con base en las historias de pacientes que consultaron a una institución especializada del Quindío durante el año 2018. Se describieron variables en promedio, desviación estándar e intervalos de confianza, se hizo un análisis comparativo por sexo, se realizaron análisis de varianza y Chi cuadrado. Resultados: La prevalencia de retinopatía diabética fue de 1,65% y de retinopatía hipertensiva del 0,22%. El 62,06% presentó retinopatía diabética no proliferativa (RDNP) y el 37,93% retinopatía diabética proliferativa (RDP). Conclusiones: Se identifica más retinopatía diabética y la retinopatía hipertensiva casi no se diagnostica. Y el número de pacientes que consultan por enfermedades del ojo ha venido en aumento durante los últimos 3 años en un centro especializado de la ciudad de Armenia.

Diabetic retinopathy (RD) is a complication caused by diabetes. This can cause blindness, becoming a worldwide threat due to the affectation of people at an early age and linked to the labor field. The role of medicine in the diagnosis of this disease is associated to the analysis of pathologies (micro aneurysms, hemorrhages and exudates) presented in fundus images. This task is tedious, time-consuming for medical personnel and it makes delays in diagnosis because of the high demand of RD patients. From the engineering of CAD system designs (Computer-Aided Design) an automated method is proposed for the identification of reference characteristics such as the optical disc, the fovea and the blood vessels. This article presents a methodology for the detection and segmentation of the optical disc and blood vessels. first, a preprocessing stage based on the algorithms of contrast-adaptive histogram equalization (CLAHE) and dynamic diffuse histogram equalization that preserve brightness (BPDFHE) is proposed aiming of improving the fundus image and highlighting the blood vessels for later removal. Next, it is proposed the methodology of segmentation of blood vessels through neural networks that a posteriori, it is going to contribute information for the correct segmentation of the optical disc, which is located through iterative opening and closing morphological operations, demonstrating that it is invariability against pathological lesions of the exudates that coincide in color information with the ocular structure of interest.Once the optic disc is located, the blood vessels inside are removed by inpainting algorithm (Functional Mumford-Shah), which replaces the presence of the blood vessels with statistical information of color discrimination of the optical disc. Finally, the Graph Cut algorithm is implemented for the segmentation of the optical disc. [ABSTRACT FROM AUTHOR]

Introduction: Hypertensive retinopathy and diabetic retinopathy constitute a public health problem because they generate avoidable visual impairment, however, the current prevalence, its associated factors in the region and its situation within the framework of the Comprehensive Health Care Routes are unknown (RIAS) for hypertension and diabetes that have established referral to ophthalmology as a follow-up of target organ damage. Objective: To describe the characteristics and comorbidities of Hypertensive and Diabetic retinopathy, in patients who consulted ophthalmology in Quindío during 2018. Methods: A descriptive cross-sectional study was carried out, based on the histories of patients who consulted a specialized institution in Quindío during 2018. Variables were described in mean, standard deviation and confidence intervals, a comparative analysis was made by sex, analysis of variance and Chi square were performed. Results: The prevalence of diabetic retinopathy was 1.65% and of hypertensive retinopathy 0.22%. 62.06% had non-proliferative diabetic retinopathy (NPDR) and 37.93% had proliferative diabetic retinopathy (PDR). Conclusions: More diabetic retinopathy is identified and hypertensive retinopathy is almost undiagnosed. And the number of patients who consult for eye diseases has been increasing during the last 3 years in a specialized center in the city of Armenia. [ABSTRACT FROM AUTHOR]

Copyright of Revista de la Facultad de Medicina Humana is the property of Instituto de Investigaciones en Ciencias Biomedicas de la Universidad Ricardo Palma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Diante do aumento da expectativa de vida e das mudanças de hábitos e estilo de vida modernos, patologias vasculares da retina, como retinopatia hipertensiva e diabética, destacam-se como importantes causas de comprometimento visual. A hipertensão arterial pode causar diretamente lesões na retina, coroide e nervo óptico, além de predispor à ocorrência de outras patologias vasculares, tais como oclusões venosas da retina, e ao agravamento de patologias como a retinopatia diabética. O diabetes mellitus pode levar a múltiplas complicações oftalmológicas, sendo a retinopatia a mais prevalente e figurando como a principal causa de cegueira na população economicamente ativa. Nesse cenário, tanto o médico generalista quanto especialistas diversos devem estar atentos ao risco de comprometimento oftalmológico e realizar manejo adequado da patologia de base, reconhecimento precoce de alterações oculares e encaminhamento oportuno para serviços especializados, de modo a evitar um comprometimento visual, econômico e social frequentemente associado a estas patologias.

RESUMO Objetivo Avaliar o impacto da triagem de retinopatia diabética de paciente diabéticos realizada com retinografia colorida. Métodos Estudo retrospectivo, de caráter descritivo, avaliando laudos de retinografias realizadas desde a implementação do protocolo da triagem de retinopatia diabética de paciente diabéticos acompanhados no Ambulatório de Endocrinologia de um hospital terciário do Sistema Único de Saúde, de maio de 2018 até maio de 2020. Resultados Realizaram retinografia 727 pacientes diabéticos, que tinham entre 14 e 91 anos, sendo a maioria com 60 anos ou mais (53,2%), do sexo feminino (68%) e brancos (87,6%). Não apresentavam retinopatia diabética 467 (64,2%) pacientes, 125 (17,2%) tinham retinopatia diabética não proliferativa, 37 (5,1%) retinopatia diabética não proliferativa grave e/ou suspeita de edema macular, 65 (8,9%) retinopatia diabética proliferativa, 21 (2,9%) suspeita de outras patologias, e as imagens de 12 (1,7%) pacientes eram insatisfatórias. Foram considerados de alto risco (aqueles com retinopatia diabética não proliferativa grave e/ou edema macular, retinopatia diabética proliferativa ou imagem insatisfatória) 114 (15,68%) pacientes. Conclusão O rastreio de retinopatia diabética com retinografia colorida possibilitou a detecção de pacientes diabéticos de alto risco que necessitavam atendimento com brevidade, permitindo o acesso deles à consulta oftalmológica e diminuindo a morbidade da doença relacionada ao tratamento tardio. Os demais foram encaminhados à Atenção Primária para regulamentação, por meio do Sistema de Regulação.

O edema macular diabético é uma das principais causas de baixa visual no mundo e a indicação mais frequente de injeções intravítreas no Hospital de Clínicas de Porto Alegre. O tratamento com injeção intra-vítrea de medicamentos anti-vascular endothelial growth factor, incluindo o bevacizumabe revolucionou o desfecho visual destes pacientes às custas de múltiplas aplicações mensais. Assim como em outros centros, discrepâncias entre condutas da equipe assistencial e dificuldades logísticas acabam comprometendo a efetividade do tratamento. Portanto, desenvolvemos um protocolo de tratamento para a doença embasado na literatura, estabelecendo critérios de inclusão, exclusão, regime de tratamento e seguimento do paciente. Com isto, esperamos otimizar a efetividade e assistência do paciente com edema macular diabético.

Copyright of Revista de Salud Pública is the property of Universidad Nacional de Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)