Optical coherence tomography angiography changes after subthreshold micropulse yellow laser in diabetic macular edema

Purpose: To assess changes on optical coherence tomography (OCT) angiography in diabetic macular edema (DME) treated with subthreshold micropulse yellow laser (SMPL) over a period of 6 months. Methods: Thirty-five eyes (35 consecutive patients) with treatment-naive DME prospectively underwent (at baseline, 3 and 6 months) best-corrected visual acuity, swept-source OCT angiography/OCT, and fundus autofluorescence. Following parameters were evaluated on OCT angiography in the superficial capillary plexus (SCP) and deep capillary plexus (DCP): the area of foveal avascular zone, number of microaneurysms (MA), area of cysts, and presence of capillary network alterations. Microaneurysm change was also evaluated in 15 fellow eyes, not needing treatment over 6 months. Vessel and perfusion densities were evaluated in the SCP, DCP, and choriocapillaris, with image J. Retina thickness, number of hyperreflective retinal spots, and external limiting membrane integrity were evaluated on OCT. All measurements were performed by two masked graders, independently. Results: All patients had diabetes mellitus Type 2 (mean age, 69.4 ± 10.9 years; duration of diabetes mellitus, 15.7 ± 8.7 years; and HbA1c 7.7 ± 1.2%). Mean best-corrected visual acuity at baseline was 69.7 ± 12.0 letters ETDRS, 72.7 ± 10.7 at 3 months (gain 3.1 ± 4.3, P = 0.0049) and 74.3 ± 9.5 at 6 months (gain 4.6 ± 7.2, P
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research

Related Links:

This article presents an overview on recent advances in optical non-invasive diagnostics of the peripheral hemodynamics of the upper and lower limbs in rheumatological and endocrinological profile patients. Among these are laser Doppler flowmetry (LDF), tissue reflectance oximetry (TRO), pulse oximetry (PO) and fluorescent spectroscopy (FS). The laser Doppler flowmetry method allows for investigating the blood flow in the microcirculatory bed in vivo. The method is based on probing the tissue with laser radiation and analyzing back reflected from the tissue radiation partially scattered from moving red blood cells (Bonner...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
ConclusionsOCTA findings of the ONH area may provide evidence that microvascular changes occur preceding neural impairment in early-stage DR. However, further researches are still needed to support the statement. Reduced ONH perfusion inside the optic disc may be one of the crucial biomarkers in early-stage DR detection and is a possible sensitive visual acuity predictor in early-stage DR subjects. With the ONH mode, OCTA may be a more promising tool in DR screening.
Source: Acta Diabetologica - Category: Endocrinology Source Type: research
​BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; &AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and it...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
The objective of this study was to evaluate the diagnostic value of quantitative rest and stress 13N-NH3 PET myocardial perfusion imaging (MPI) on coronary microvascular disease (CMVD),and to provide information for accurate classification of CMVD. Methods: From July 2016 to December 2017, a total of 36 patients who were suspected of CMVD (28 males, 8 females; 27-70 years) were prospectively enrolled in this study. Rest and ATP-stress MPI were acquired using 13N-NH3 PET and analyzed with Heartsee software. Rest and stress relative uptake, absolute myocardial blood flow (MBF) and coronary flow reserve (CFR) were obtained an...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Cardiovascular Clinical Science Poster Session Source Type: research
Using computed tomography myocardial perfusion imaging (CTP) to investigate resting myocardial perfusion alterations in uncomplicated type 2 diabetes mellitus (T2DM) patients without obstructive coronary artery disease (CAD). A total of 34 participants with 544 myocardial segments were included prospectively: 17 uncomplicated T2DM patients with no significant coronary artery stenosis on coronary computed tomography angiography and 17 healthy controls. Myocardial perfusion was evaluated by transmural perfusion ratio (TPR). Parameters of cardiac structure and function were measured for cardiac comprehensive assessment. Anal...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
ConclusionsIn symptomatic diabetic patients without obstructive coronary artery disease, ranolazine did not change exercise‐stimulated myocardial blood flow or CFR but did modestly improve diastolic function. Patients with more severe baseline impairment in CFR may derive more benefit from ranolazine.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT01754259.
Source: JAHA:Journal of the American Heart Association - Category: Cardiology Authors: Tags: Coronary Circulation, Diabetes, Type 2, Nuclear Cardiology and PET Original Research Source Type: research
Aims Patients with type 2 diabetes mellitus (T2DM) are known to have impaired resting myocardial energetics and impaired myocardial perfusion reserve, even in the absence of obstructive epicardial coronary artery disease (CAD). Whether or not the pre-existing energetic deficit is exacerbated by exercise, and whether the impaired myocardial perfusion causes deoxygenation and further energetic derangement during exercise stress, is uncertain. Methods and results Thirty-one T2DM patients, on oral antidiabetic therapies with a mean HBA1c of 7.4 ± 1.3%, and 17 matched controls underwent adenosine stress cardiovascular m...
Source: European Heart Journal - Category: Cardiology Authors: Tags: Obesity and metabolic syndrome Source Type: research
PurposeTo evaluate diabetic macular edema in non proliferative diabetic retinopathy (NPDR) using a wide field fluorescein angiography. MethodsIn a retrospective study, consecutive wide‐field angiographs using the Heidelberg Retina Angiograph 2 with a contact lens system Staurenghi and SD‐OCT were performed in diabetic patients with non proliferative diabetic retinopathy. ResultsA total of 71 eyes in 39 diabetic, average age was 58 years (SD 12). Most of the patients had type 2 diabetes mellitus (92%) and average duration since diabetes diagnosis was 10 years. Mean HA1c was 7.4%. Distribution of NPDR severity ...
Source: Acta Ophthalmologica - Category: Opthalmology Authors: Tags: Abstracts from the 2016 European Association for Vision and Eye Research Conference Source Type: research
Conclusion: This is the first case of acute thrombosis of the transplanted renal artery following gastric ulcer bleeding in a patient with a long-term well-functioning graft kidney.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 59-year-old woman is evaluated for continued substernal chest pain. She presented with exertional chest pain 6 months ago that occurred with minimal ambulation. She was evaluated with a stress nuclear medicine myocardial perfusion study that showed no ST-segment changes but a small area of inducible ischemia in the lateral area of the left ventricle and an ejection fraction of 45%. She was initially treated medically but has continued to have chest pain with exertion despite the addition of multiple an...
Source: Kevin, M.D. - Medical Weblog - Category: Journals (General) Authors: Tags: Conditions Heart Source Type: blogs
More News: Angiography | Diabetes | Diabetes Mellitus | Diabetes Type 2 | Endocrinology | Eyes | Opthalmology | Perfusion | Study | Vitamin A