Hemophthalmos in patients with diabetes mellitus

A total of 110 patients with diabetes mellitus with intraocular hemorrhages were examined using computer densitometry of ultrasonic beta-scanograms of the eyes. Indications for various treatments were determined and the outcomes of hemophthalmia predicted, depending on its topography, intensity, and volume of blood released into the vitreous. Hemorrhages were located mainly in the posterior segments of the vitreous body in diabetics with hemophthalmia. High efficiency and good prospects of using objective methods of computer analysis of beta-scanograms for evaluating the status of the vitreous and extending the diagnostic potentialities of modern ophthalmology are shown.     

糖尿病患者行白内障超声乳化术的临床观察

目的:观察表面麻醉下糖尿病患者行白内障超声乳化及人工晶状体植入的临床效果。方法:临床确诊的糖尿病患者52例63眼,在表面麻醉下经透明角膜隧道切口,行白内障超声乳化及折叠式人工晶状体植入手术。结果:所有患者均能耐受手术,未发生麻醉并发症。术后1wk矫正视力≥0.5者39眼,占62%。术后1mo矫正视力≥0.5者52眼,占82%。手术并发症主要有:角膜水肿、前房纤维素性渗出。结论:表面麻醉下糖尿病患者白内障的超声乳化手术具有并发症少,视力恢复快的特点。     

Asymmetric retinopathy in patients with diabetes mellitus

We reviewed retrospectively the records of 57 diabetic patients with asymmetric retinopathy persisting for two years or more (mean, 4.8 years) to identify intraocular risk and protective factors for the development of proliferative retinopathy. For each patient in this series, the more severely affected eye had proliferative retinopathy and the fellow eye had either background diabetic retinopathy or no retinopathy. Branch vein occlusion (P = .016) was identified as a statistically significant risk factor for proliferative retinopathy and chorioretinal scarring (P = .031) was found to be a statistically significant protective intraocular factor. In 34 patients with long-standing asymmetric retinopathy, no intraocular risk or protective factors were identified.     

Intraocular lenses in patients with diabetes mellitus

Presented are personal experiences concerning the application of artificial intraocular lenses in patients with diabetes and cataract. Operated were patients aged 50-76 years in whom implantation of an artificial lens of Alcon or Cilco was performed either to the anterior or posterior chamber. During the qualification for surgery eliminated were patients with proliferating retinopathy, with rubeosis iridis (with or without secondary glaucoma) and with juvenile diabetes. In 16 patients the obtained visual acuity was 0.8-1.0, in one female patient 0.5; in the remaining 2 persons the visual acuity amounted 0.2 and 0.3. These patients exhibited a simple exudative retinopathy with a macular oedema and after surgery they were subjected to a laser therapy. Observation of our material showed that qualifying diabetic patients for cataract extraction and taking into consideration the over mentioned contraindications one can obtain good results similar as in other patients with cataract.     

Anomaloscope matches in patients with diabetes mellitus

BACKGROUND: Functional visual deficits can occur in patients with diabetes mellitus who show no visible morphological alterations in the retina. In this study we examined the colour vision of diabetic patients using metameric matches. Patients with and without retinopathy, as well as those who had been treated with laser photocoagulation, were examined to ascertain how the functional alterations in the diabetic eye alter with disease status. METHODS: Rayleigh (red-green) and Moreland (blue-green) metameric matches were determined in a total of 51 diabetic patients (24 patients with no retinopathy, 12 patients with background retinopathy and 15 patients who had undergone laser therapy). Their results are compared to those of a control group of 25 subjects with normal colour vision. RESULTS: A deficit in blue-green colour discrimination found in patients without retinopathy becomes worse with the appearance of vascular alterations in the retina. There is also a significant shift towards green in the Rayleigh match midpoint and towards blue in the Moreland match midpoint, which is at least in part explicable by alterations in lens opacity. Patients who have undergone laser therapy show, on average, better colour discrimination than those with retinopathy, but there is a large variation in their results. CONCLUSION: The alterations in the colour vision of diabetics indicate that at least the early functional changes are occurring at an inner retinal location. Lens opacity changes also play a large role as the age of the patients increases.     

The late results of the surgical treatment of glaucoma in patients with atherosclerosis and diabetes mellitus

In order to study effectiveness of surgical treatment in patients with glaucoma in association with atherosclerosis or diabetes mellitus, remote observations (from 1 to 8 years) were carried out over 216 patients operated at different stages of the glaucomatous process: at the initial stage--104 eyes, at the advanced--87, and the far-advanced--53 eyes. Sinusotrabeculectomy in the author's modification was used: at first the external wall of the Schlemm's canal was removed, then the trabecula was destroyed by a blunt spatula, gradually letting out the chamber aqueous. The observations carried out have shown that surgical treatment of glaucoma in patients with atherosclerosis is more effective at the initial and advanced stages. In patients with glaucoma and diabetes mellitus, surgical treatment was most effective in persons with initial stage of glaucoma. It should be noted here that surgical treatment at initial stage of glaucoma allows to preserve high visual functions for a long period of time. Stabilization of the process in persons operated at the initial stage was achieved in 95-97% of cases. This gives grounds to recommend surgical treatment of glaucoma in patients with atherosclerosis and diabetes mellitus at the initial stage of the glaucomatous process. The fall of intraocular pressure is mainly connected with improvement of the aqueous outflow.     

Retinal haemodynamics in patients with early diabetes mellitus.

AIMS/BACKGROUND: The retinal circulation was investigated in a group of 19 patients with insulin dependent diabetes mellitus with less than 4 years of disease duration and no evidence of diabetic retinopathy. Results of these patients were compared with those of 16 age-matched normal controls. METHODS: Venous diameter (D) was measured from monochromatic fundus photographs. Maximum erythrocyte velocity (Vmax) was assessed by bidirectional laser Doppler velocimetry in the major retinal veins of one eye of each subject. Total volumetric blood flow rate (QT) was calculated by adding the flow rates of the major retinal veins. RESULTS: Average QT was 12% larger than normal in diabetic patients (one tailed, non-paired Student's t test, p < 0.05). A statistically significant correlation was observed between QT and disease duration (r = 0.35, p < 0.04). Patients with longer disease duration tended to have somewhat larger QT. The average retinal vascular regulatory responses to hyperoxia were not significantly different from normal in diabetic patients. In these patients, however, higher blood glucose levels were associated with decreased regulatory responses to hyperoxia. CONCLUSIONS: Patients with diabetes mellitus of relatively short duration have mildly increased QT, suggesting that increased blood flow may play an early role in the development of diabetic retinal microangiopathy.     

Posterior capsule opacificationafter phacoemulsification in patients with diabetes mellitus

Purpose:To compare posterior capsule opacification (PCO) after phacoemulsificationand implantation of heparin-surface-modified (HSM) poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) in the capsular bag in patients with diabetes mellitus with that in a control group.Setting:St. Erik's Eye Hospital, Stockholm, Sweden.Methods:This prospective study comprised 26 patients with diabetes mellitus and 26 control patients without diabetes. Those with glaucoma, exfoliation syndrome, uveitis, and pupil size smaller than 6.0 mm after dilation were excluded. All patients received the same standardized phacoemulsification procedure with implantation of an HSM PMMA IOL in the capsular bag. Posterior capsule opacification was scored 1 and 2 years after surgery by evaluating retroillumination images taken with a Scheimpflug camera (Nidek Anterior Eye Segment Analysis System) after pupil dilation with phenylephrine 10% and cyclopentolate 1%. The PCO density behind the IOL optic was graded clinically from 0 to 4 (0 = none, 1 = minimal, 2 = mild, 3 = moderate, 4 = severe) and scored using the Evaluation of Posterior Capsule Opacification medical software developing system.Results:No differences in PCO were found between the diabetic and control group Results: year after surgery. The total PCO score was significantly less in diabetic than in control eyes 2 years after surgery (P < .05, Mann-Whitney). In addition, progression of PCO from 1 year to 2 years after surgery was significantly less in diabetic groups with different stages of diabetic retinopathy than in the control group (P ≤ .05, Kruskal-Wallis analysis of variance and multiple comparisons).Conclusion:The rate of PCO after phacoemulsification was statistically significantlylower in patients with diabetes mellitus than in those without diabetes.     

糖尿病患者泪液及泪膜变化的研究进展

随着糖尿病在全球发病率的持续增加,由其引发的眼部并发症也日益受到关注.除了引起视网膜病变、白内障等常见的并发症外,糖尿病患者的眼表在结构及微环境方面也可能发生改变,进而影响泪液的成分、质量及泪膜的稳定性.本文就糖尿病患者眼表,泪液和泪膜的变化、相关检查方法以及影响因素的研究进展作一综述.     

Nyctometric studies in argon laser coagulation in patients with diabetic retinopathy

Forty-two patients (57 eyes) with diabetic retinopathy at various stages have been examined by nyctometry before and over the course of the follow-up period after argon laser coagulation of the retina. The findings evidence a marked reduction of the adaptation ability of the central retinal area even in high vision acuity in the patients with diabetic retinopathy vs. normal subjects. A stable rise of the nyctometric parameters has been observed after argon laser coagulation; these parameters characterize the function of the pigmented epithelium and of the retinal cone, and these data may be considered as an evidence of the improved trophics of these tissues, resultant from such therapy.