Abstract
Aim: Estimation of the ocular status in adolescents with diabetes mellitus type 1 (DM1) treated with continuous subcutaneous insulin infusion (CSII), assessment of the development of the diabetic retinopathy (DR) and nephropathy (DN) within 10 years.
Methods: 37 patients (74 eyes) aged 16-33 years, treated with CSII were enrolled to the study. Baseline, and a 10- year follow-up evaluation included: best corrected visual acuity (BCVA), tonometry, slit lamp exam and fluorescein angiography (FLA). Additionally, spectral-domain optical coherence tomography (SD-OCT) was done in the 7th year of observation to assess the thickness of the retinal nerve fiber (RNFL) and the ganglion cellinner plexiform layers (GCL-IPL) complex thickness. Glycated haemoglobin (HbA1) and albuminuria were also analysed.
Results: During the 10-year observation period DR (non-proliferative - NPDR, proliferative - PDR, diabetic macular edema - DME) was diagnosed in 3 (8%) patients. In the DR group: BCVA was significantly lower, intraocular pressure (IOP) levels and albuminuria were higher. There were no differences in HbA1 in both groups. The thinning of RNFL was observed in both groups. Macular RNFL, GCL-IPL complex thickness assessment showed a significantly higher number of borderline results in the group with DR.
Conclusions: Diabetic patients treated with CSII are at a lower risk of developing vascular complications even with poor metabolic control. Increased albuminuria may be a predictive sign for early ocular complications, and requires intense observation. Diagnosis of RNFL and GCL-IPL decreased values is crucial prior to diabetic retinopathy development. SD-OCT is a non-invasive, easy-to-perform, relatively inexpensive procedure, and can be a useful tool to monitor neuropathy progression.
Keywords: Continuous subcutaneous insulin infusion, diabetic retinopathy, optical coherence tomography, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer.
Current Pharmaceutical Design
Title:Pilot Study of Eyesight Characteristics and Thickness of the Retinal Nerve Fiber and Ganglion Cell-inner Plexiform Layers in Adolescent Patients with Type one Diabetes Mellitus on an Insulin Pump
Volume: 24 Issue: 27
Author(s): Dorota Raczyńska*, Beata Bzoma, Katarzyna Sielachowicz, Agnieszka Brandt, Dorota Chomińska-Dorn, Krystyna Raczyńska, Leopold Glasner, Alicja Dębska-Ślizień and Małgorzata Myśliwiec
Affiliation:
- Department of Ophthalmology, Medical University of Gdansk, Gdansk,Poland
Keywords: Continuous subcutaneous insulin infusion, diabetic retinopathy, optical coherence tomography, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, inner nuclear layer.
Abstract: Aim: Estimation of the ocular status in adolescents with diabetes mellitus type 1 (DM1) treated with continuous subcutaneous insulin infusion (CSII), assessment of the development of the diabetic retinopathy (DR) and nephropathy (DN) within 10 years.
Methods: 37 patients (74 eyes) aged 16-33 years, treated with CSII were enrolled to the study. Baseline, and a 10- year follow-up evaluation included: best corrected visual acuity (BCVA), tonometry, slit lamp exam and fluorescein angiography (FLA). Additionally, spectral-domain optical coherence tomography (SD-OCT) was done in the 7th year of observation to assess the thickness of the retinal nerve fiber (RNFL) and the ganglion cellinner plexiform layers (GCL-IPL) complex thickness. Glycated haemoglobin (HbA1) and albuminuria were also analysed.
Results: During the 10-year observation period DR (non-proliferative - NPDR, proliferative - PDR, diabetic macular edema - DME) was diagnosed in 3 (8%) patients. In the DR group: BCVA was significantly lower, intraocular pressure (IOP) levels and albuminuria were higher. There were no differences in HbA1 in both groups. The thinning of RNFL was observed in both groups. Macular RNFL, GCL-IPL complex thickness assessment showed a significantly higher number of borderline results in the group with DR.
Conclusions: Diabetic patients treated with CSII are at a lower risk of developing vascular complications even with poor metabolic control. Increased albuminuria may be a predictive sign for early ocular complications, and requires intense observation. Diagnosis of RNFL and GCL-IPL decreased values is crucial prior to diabetic retinopathy development. SD-OCT is a non-invasive, easy-to-perform, relatively inexpensive procedure, and can be a useful tool to monitor neuropathy progression.
Export Options
About this article
Cite this article as:
Raczyńska Dorota *, Bzoma Beata , Sielachowicz Katarzyna , Brandt Agnieszka, Chomińska-Dorn Dorota , Raczyńska Krystyna , Glasner Leopold, Dębska-Ślizień Alicja and Myśliwiec Małgorzata , Pilot Study of Eyesight Characteristics and Thickness of the Retinal Nerve Fiber and Ganglion Cell-inner Plexiform Layers in Adolescent Patients with Type one Diabetes Mellitus on an Insulin Pump, Current Pharmaceutical Design 2018; 24 (27) . https://dx.doi.org/10.2174/1381612824666180924125516
DOI https://dx.doi.org/10.2174/1381612824666180924125516 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Plant Natural Products in Anti-Diabetic Drug Discovery
Current Organic Chemistry Effects of PPARγ Ligands on Vascular Tone
Current Molecular Pharmacology Dysregulation of Glycogen Synthase Kinase-3 in Skeletal Muscle and the Etiology of Insulin Resistance and Type 2 Diabetes
Current Diabetes Reviews Breath Analysis Using SIFT-MS to Assess Metabolic Status in Patients After Gastro-oesophageal Cancer Surgery- a Pilot Study
Current Analytical Chemistry HIV-Antigens Charged on Phosphorus Dendrimers as Tools for Tolerogenic Dendritic Cells-Based Immunotherapy
Current Medicinal Chemistry Revision on Renal Sympathetic Ablation in the Treatment of Resistant Hypertension
Current Hypertension Reviews The Prevalence and Progression of Arterial Calcification in Patients with End-Stage Renal Disease
Vascular Disease Prevention (Discontinued) Dendritic Cells: A New Player in Osteoimmunology
Current Molecular Medicine Lifestyle Modifications in the Treatment of Hypertension
Current Hypertension Reviews Recent Patents on Immunoregulatory DNA Vaccines for Autoimmune Diseases and Allograft Rejection
Recent Patents on DNA & Gene Sequences Nutritional Supplements Modulating Metabolic Syndrome Risk Factors and the Prevention of Cardiovascular Disease
Current Nutrition & Food Science Atrial Fibrillation: The Emerging Role of Inflammation and Oxidative Stress
Cardiovascular & Hematological Disorders-Drug Targets A Review on the Pharmacology and Toxicology of Steviol Glycosides Extracted from Stevia rebaudiana
Current Pharmaceutical Design Low Estimated Glomerular Filtration Rate is Associated with High Recurrence Rate and Poor Prognosis of Hemorrhage Stroke
Current Neurovascular Research Sexual Dysfunction, Cardiovascular Risk and Effects of Pharmacotherapy
Current Vascular Pharmacology Requirements and Perspectives for Integrating Metabolomics with other Omics Data
Current Metabolomics Incretin-based Therapies for Type 2 Diabetes Mellitus: Effects on Insulin Resistance
Current Diabetes Reviews Diet Control in Pregnant Women with Gestational Diabetes Mellitus
Current Women`s Health Reviews Drug Interactions with Angiotensin Receptor Blockers: Role of Human Cytochromes P450
Current Drug Metabolism Biomarkers for Risk Assessment and Prevention of Breast Cancer
Current Cancer Drug Targets