1
|
Lin Z, Wen L, Li D, Moonasar N, Zhai G, Wang Y, Wang FH, Liang YB. Refractive Error in a Chinese Population with Type 2 Diabetes: A Report from the Fushun Diabetic Retinopathy Cohort Study. Ophthalmic Epidemiol 2023; 30:38-45. [PMID: 35188061 DOI: 10.1080/09286586.2022.2031228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the prevalence and risk factors for refractive errors in a northeastern Chinese population with type 2 diabetes. METHODS Subjects (age ≥30 years) from a community-based study, the Fushun Diabetic Retinopathy Cohort Study, were enrolled. All subjects underwent comprehensive ocular examinations, including autorefraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) of the right eye <-0.5 diopter (D), <-5.0D, and >0.5D, respectively. Astigmatism was defined as cylinder <-0.5D in a minus cylinder prescription. Anisometropia was defined as a difference of SE >1.0D between two eyes. RESULTS A total of 1929 participants (790 males, 41.0%) were enrolled. The age and gender standardized prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia were 43.1% (95% confidence interval [CI]: 40.9%-45.3%), 8.5% (95% CI: 7.3%-9.8%), 21.5% (95% CI: 19.7%-23.4%), 61.0% (95% CI: 58.9%-63.2%), and 17.2% (95% CI: 15.5%-18.9%), respectively. Advancing age was associated with a higher frequency of hyperopia, astigmatism, and anisometropia, as opposed to a lower frequency of myopia. Female (adjusted odds ratio [aOR], 1.27; 95% CI, 1.02-1.57) participants, higher intraocular pressure (aOR, 1.03; 95% CI, 1.00-1.07), and lenticular opacity (aOR, 1.53; 95% CI, 1.20-1.94) were also found to be associated with myopia. Long duration of diabetes (>15 years) was found to be a significant factor for astigmatism (aOR, 1.62; 95% CI, 1.15-2.27) and anisometropia (aOR, 1.87; 95% CI, 1.29-2.71). CONCLUSION Nearly two-thirds of participants with type 2 diabetes had a refractive error. Age is a common factor with different types of refractive errors.
Collapse
Affiliation(s)
- Zhong Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | | | - Gang Zhai
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| |
Collapse
|
2
|
Lee S, Lee HJ, Lee KG, Kim J. Obesity and high myopia in children and adolescents: Korea National Health and Nutrition Examination Survey. PLoS One 2022; 17:e0265317. [PMID: 35333875 PMCID: PMC8956184 DOI: 10.1371/journal.pone.0265317] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 03/01/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The prevalence of both obesity and myopia are increasing in Korean children and adolescents. The purpose of this study is to examine the impact of obesity on the prevalence of myopia in Korean children and adolescents. Methods This study used the data of a nationally representative cross-sectional survey, the Korea National Health and Nutrition Examination Survey (KNHANES) VII conducted from 2016 to 2018. Of the 1237 children and adolescents aged 5–18 years who participated in the KNHANES VII and underwent ophthalmologic examinations for the survey, 1114 were selected for review, excluding those whose data on refractive error, family history of myopia, or waist circumference were missing. Body mass index (BMI) was classified into four groups: underweight (< 5th percentile), normal weight (≥ 5th percentile, < 85th percentile), overweight (≥ 85th percentile, < 95th percentile), and obese (≥ 95th percentile). Myopia was defined by the level of refractive error ≤ -0.5 diopters (D) and classified as mild (≤ -0.5 D, > -3.0 D), moderate (≤ -3.0 D, > -6.0 D), or high (≤ -6.0 D) myopia. The relationship between BMI and myopia was analyzed using complex sample logistic regression. Age and family history were corrected followed by an analysis of the odds ratios. Results Compared to those with normal weights (controls), being underweight, overweight, or obese showed no significant odds of developing mild and moderate myopia. Conversely, when compared with that of controls, the odds ratio of developing high myopia in the underweight, overweight, and obese groups was 0.77 (95% CI, 0.22–2.65), 1.37 (95% CI, 0.51–3.66), and 3.77 (95% CI, 1.98–7.16), respectively. Furthermore, in a separate analysis by sex and BMI, the odds ratio of developing high myopia was 2.84 (95% CI, 1.10–7.35) in boys with obesity and 4.23 (95% CI,1.19–15.09) and 5.04 (95% CI,1.77–14.34) in overweight and obese girls, respectively. Conclusions An association exists between obesity in childhood and adolescence and high myopia. Being overweight in girls was also found to be associated with high myopia. Thus, efforts to maintain a healthy weight during childhood and adolescence are of great importance.
Collapse
Affiliation(s)
- Sami Lee
- Department of Family Medicine, Chungnam National University Sejong Hospital, Sejong, Republic of Korea
| | - Haeng-Jin Lee
- Research Institute of Clinical Medicine of Jeonbuk National Univeristy-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
- Department of Ophthalmology, Jeonbuk National University College of Medicine, Jeonju, Republic of Korea
- * E-mail:
| | | | - Jihan Kim
- Department of Family Medicine, Sejong Trinium Woman’s Hospital, Sejong, Republic of Korea
- Department of Family Medicine, Research institute for Medical Science, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| |
Collapse
|
3
|
Seven E, Yıldız S, Tekin S, Altaş AS, Özer MD, Batur M, Üçler R, Yaşar T. Effect of Insulin Therapy on Ocular Biometric Parameters in Diabetic Patients. J Ocul Pharmacol Ther 2019; 36:102-108. [PMID: 31644372 DOI: 10.1089/jop.2019.0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To evaluate effects of insulin on ocular parameters in patients with type 2 diabetes mellitus who start insulin therapy. Methods: In this prospective study, ocular biometric parameters were obtained using optical biometer (Lenstar LS900®; Haag-Streit AG) and refraction test (ARK-510A Auto refracto-keratometer; Nidek Co. Ltd, Aichi, Japan) before and at 3 months after initiating insulin therapy. In addition, patients' fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C), and blood lipid levels were measured at the same time points. Pretreatment and post-treatment results were compared. In addition, associations between ocular parameters with initial dose and type of insulin treatment regimen, HbA1C, and FBG levels were evaluated. Results: The patients' mean age was 51.2 ± 12.9 (18-73) years. Post-treatment HbA1C and FBG levels (8.5% ± 2.5% and 188.1 ± 111.2 mg/dL, respectively) were significantly lower than pretreatment values (12% ± 1.4% and 325.3 ± 95.7 mg/dL, respectively; P < 0.001 for both). There was a significant positive correlation between the change in HbA1C and the change in lens thickness (P = 0.03), and a significant negative correlation between the change in FBG and the change in the spherical equivalent refraction (P = 0.045). Insulin dose and treatment regimen type were not significantly correlated with ocular parameters (P > 0.05). Conclusion: HbA1C-lowering glycemic effect of insulin was correlated with a small decrease in lens thickness. Long-term, randomized controlled trials including larger patient numbers are needed to shed light on the long-term effects of insulin use and glycemic control on ocular parameters.
Collapse
Affiliation(s)
- Erbil Seven
- Department of Ophthalmology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Saliha Yıldız
- Department of Endocrinology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Serek Tekin
- Department of Ophthalmology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Ahmet Serkan Altaş
- Department of Ophthalmology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Muhammet Derda Özer
- Department of Ophthalmology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Muhammed Batur
- Department of Ophthalmology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Rıfkı Üçler
- Department of Endocrinology, Faculty of Medicine, Van Yüzüncü Yil University, Van, Turkey
| | - Tekin Yaşar
- Department of Ophthalmology, Beyoglu Eye and Research Hospital, Istanbul, Turkey
| |
Collapse
|
4
|
Sun G, Hao R, Zhang L, Shi X, Hei K, Dong L, Wei F, Jiang A, Li B, Li X, Ke Y. The effect of hemodialysis on ocular changes in patients with the end-stage renal disease. Ren Fail 2019; 41:629-635. [PMID: 31269848 PMCID: PMC6609354 DOI: 10.1080/0886022x.2019.1635494] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Numerous metabolic parameters can be changed during hemodialysis in the end-stage renal disease (ESRD) caused by systemic diseases, such as diabetes mellitus, hypertension. Some ocular parameters also can be variable due to the changes after hemodialysis. This study evaluates the effects of ocular parameters, including best-corrected visual acuity (BCVA), intraocular pressure (IOP), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), retinal arteriolar caliber (RAC), retinal venular calibre (RVC), in ESRD patients following hemodialysis. Materials and methods: Two-hundred and two ESRD patients were recruited resulting in 404 eyes evaluations. All patients underwent hemodialysis in the Dialysis Unit of the Second Hospital of Tianjin Medical University. BCVA, CMT, IOP, SFCT, RAC and RVC were evaluated before and after hemodialysis. Systemic parameters were collected such as age, body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), duration of hemodialysis, body weight changes, high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), very low density lipoprotein cholesterol (VLDLC), glycosylated hemoglobin (HbA1c). Results: The causes of ESRD patients included chronic glomerulonephritis (n = 65), diabetes mellitus (n = 60), hypertensive nephrosclerosis (n = 37), and other causes (n = 40). In our study, BCVA (p = .817), CMT (p = .252) and IOP (p = .978) did not significantly change after hemodialysis. SFCT significantly decreased from 254.29 ± 69.36 μm to 235.54 ± 659.90 μm (p = .002) following hemodialysis. SFCT changes were significantly correlated with SBP (p = .042) and body weight changes (p = .044). The RAC and RVC were dilated significantly (p = .033, p = .007). RVC changes were correlated with baseline DBP (p = .003), HDLC (p = .009), LDLC (p = .004) and changes in DBP (p = .037) and body weight (p = .001). Conclusion: Hemodialysis can affect various ocular parameters including SFCT, RAC and RVC, which changed significantly following hemodialysis. Whereas BCVA, IOP and CMT did not change after hemodialysis in ESRD patients. The systemic compensatory mechanisms of the changes in SBP, DBP, body weight following hemodialysis need further study.
Collapse
Affiliation(s)
- Guijiang Sun
- a Department of Kidney Disease and Blood Purification Treatment , Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University , Tianjin , China
| | - Rui Hao
- b Tianjin Eye Hospital, Tianjin Key Laboratory of Ophthalmology and Vision Science , Nankai University Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University , Tianjin , China
| | - Longli Zhang
- c Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute , Tianjin , China
| | - Xueying Shi
- c Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute , Tianjin , China
| | - Kaiwen Hei
- c Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute , Tianjin , China
| | - Lijie Dong
- c Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute , Tianjin , China
| | - Fang Wei
- a Department of Kidney Disease and Blood Purification Treatment , Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University , Tianjin , China
| | - Aili Jiang
- a Department of Kidney Disease and Blood Purification Treatment , Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University , Tianjin , China
| | - Bo Li
- a Department of Kidney Disease and Blood Purification Treatment , Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University , Tianjin , China
| | - Xiaorong Li
- c Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute , Tianjin , China
| | - Yifeng Ke
- c Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute , Tianjin , China
| |
Collapse
|
5
|
Lim JH, Kim CZ, Lee SUK, Lee SJ. The Effects of Long-term Hemodialysis on Visual Acuity and Central Macular Thickness in Diabetic Retinopathy Patients. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.11.1064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jun Hyun Lim
- Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea
| | - Chang Zoo Kim
- Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea
| | - Seung UK Lee
- Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea
| | - Sang Joon Lee
- Department of Ophthalmology, Kosin University College of Medicine, Busan, Korea
| |
Collapse
|
6
|
Kaštelan S, Gverović-Antunica A, Pelčić G, Gotovac M, Marković I, Kasun B. Refractive Changes Associated with Diabetes Mellitus. Semin Ophthalmol 2018; 33:838-845. [PMID: 30199309 DOI: 10.1080/08820538.2018.1519582] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND METHODS Diabetes mellitus is the most prevalent endocrinedisease in developed countries. In people with diabetes in addition to visionloss caused by diabetic retinopathy transient visual disturbances may occurfrequently caused by refractive changes. These changes in refraction are associated with variations in blood glucose levelsbut the underlying mechanism is still not fully understood. A systematic reviewwith a comprehensive literature search was performed in order to clarify the underlyingmechanisms regarding the connection of glycaemic control and refractive shift. RESULTS Some studies have shown that increasedblood sugar leads to a myopic shift whilst others demonstrated that this changeis in a hyperopic direction. Changes in visual acuity in patients with diabetescould be an indicator of inadequate metabolic control or even the first sign ofdiabetes mellitus. CONCLUSION This reviewgives a brief overview of current research regarding potential mechanisms ofglycemic control influence on refractive error. The aim isto emphasizethe importance ofunderstanding the relationship ofblood glucose concentration and refractive changes as one of thecommon but overlooked diabetic complications.
Collapse
Affiliation(s)
- Snježana Kaštelan
- a Department of Ophthalmology , University Hospital Dubrava , Zagreb , Croatia
| | | | - Goran Pelčić
- c Department of Ophthalmology , School of Medicine, University of Rijeka , Rijeka , Croatia
| | - Marta Gotovac
- d Department of Ophthalmology , General Hospital Požega , Požega , Croatia
| | - Irena Marković
- e Clinical Department of Ophthalmology , Split University Hospital Center , Split , Croatia
| | - Boris Kasun
- f Department of Physical Medicine and Rehabilitation , Special Hospital for Medical Rehabilitation Stubičke Toplice , Stubičke Toplice , Croatia
| |
Collapse
|
7
|
Khan A, Petropoulos IN, Ponirakis G, Malik RA. Visual complications in diabetes mellitus: beyond retinopathy. Diabet Med 2017; 34:478-484. [PMID: 27917530 DOI: 10.1111/dme.13296] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/28/2022]
Abstract
Diabetic retinopathy is the most common cause of vision loss in people with diabetes mellitus; however, other causes of visual impairment/loss include other retinal and non-retinal visual problems, including glaucoma, age-related macular degeneration, non-arteritic anterior ischaemic optic neuropathy and cataracts. Additionally, when a person with diabetes complains of visual disturbance despite a visual acuity of 6/6, abnormalities in refraction, contrast sensitivity, straylight and amplitude of accommodation should be considered. We review and highlight these visual problems for physicians who manage people with diabetes to ensure timely referral and treatment to limit visual disability, which can have a significant impact on daily living, especially for those participating in sports and driving.
Collapse
Affiliation(s)
- A Khan
- Weill Cornell Medicine-Qatar, Doha, Qatar
| | | | | | - R A Malik
- Weill Cornell Medicine-Qatar, Doha, Qatar
| |
Collapse
|
8
|
Galvis V, López-Jaramillo P, Tello A, Castellanos-Castellanos YA, Camacho PA, Cohen DD, Gómez-Arbeláez D, Merayo-Lloves J. Is myopia another clinical manifestation of insulin resistance? Med Hypotheses 2016; 90:32-40. [PMID: 27063082 DOI: 10.1016/j.mehy.2016.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 02/08/2016] [Indexed: 12/28/2022]
Abstract
Myopia is a multifactorial visual refraction disease, in which the light rays from distant objects are focused in front of retina, causing blurry vision. Myopic eyes are characterized by an increased corneal curvature and/or ocular axial length. The prevalence of myopia has increased in recent decades, a trend that cannot be attributed exclusively to genetic factors. Low and middle income countries have a higher burden of refractive error, which we propose could be a consequence of a shorter exposure time to a westernized lifestyle, a phenomenon that may also explain the rapid increase in cardiometabolic diseases, such as diabetes, among those populations. We suggest that interactions between genetic, epigenetic and a rapidly changing environment are also involved in myopia onset and progression. Furthermore, we discuss several possible mechanisms by which insulin resistance may promote abnormal ocular growth and myopia to support the hypothesis that insulin resistance and hyperinsulinemia are involved in its pathogenesis, providing a link between trends in myopia and those of cardiometabolic diseases. There is evidence that insulin have direct ocular growth promoting effects as well an indirect effect via the induction of insulin-like growth factors leading to decreases insulin-like growth factor-binding protein, also implicated in ocular growth.
Collapse
Affiliation(s)
- Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia; Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia
| | - Patricio López-Jaramillo
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia; Instituto MASIRA, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia.
| | - Alejandro Tello
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia; Departamento de Cirugía, Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Santander, Colombia
| | | | - Paul Anthony Camacho
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia
| | - Daniel Dylan Cohen
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia; Instituto MASIRA, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - Diego Gómez-Arbeláez
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Spain
| |
Collapse
|
9
|
Abstract
PURPOSE To determine the effects of diabetic retinopathy (DR), increased foveal thickness (FT), and adaptive optics (AO) on wavefront aberrations and Shack-Hartmann (SH) image quality. METHODS Shack-Hartmann aberrometry and wavefront error correction were performed with a bench-top AO retinal imaging system in 10 healthy control and 19 DR subjects. Spectral domain optical coherence tomography was performed and central FT was measured. Based on the FT data in the control group, subjects in the DR group were categorized into two subgroups: those with normal FT and those with increased FT. Shack-Hartmann image quality was assessed based on spot areas, and high-order (HO) root mean square (RMS) and total RMS were calculated. RESULTS There was a significant effect of DR on HO and total RMS (p = 0.01), and RMS decreased significantly after AO correction (p < 0.001). Shack-Hartmann spot area was significantly affected by DR (p < 0.001), but it did not change after AO correction (p = 0.6). High-order RMS, total RMS, and SH spot area were higher in DR subjects both before and after AO correction. In DR subgroups, HO and total RMS decreased significantly after AO correction (p < 0.001), whereas the effect of increased FT on HO and total RMS was not significant (p ≥ 0.7). There were no significant effects of increased FT and AO on SH spot area (p = 0.9). CONCLUSIONS Diabetic retinopathy subjects had higher wavefront aberrations and less compact SH spots, likely attributable to pathological changes in the ocular optics. Wavefront aberrations were significantly reduced by AO, although AO performance was suboptimal in DR subjects as compared with control subjects.
Collapse
|
10
|
Chelala E, Dirani A, Fadlallah A, Slim E, Abdelmassih Y, Fakhoury H, Baz P, Bejjani R. Effect of hemodialysis on visual acuity, intraocular pressure, and macular thickness in patients with chronic kidney disease. Clin Ophthalmol 2015; 9:109-14. [PMID: 25657575 PMCID: PMC4295916 DOI: 10.2147/opth.s74481] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effects of hemodialysis (HD) on visual acuity, intraocular pressure (IOP), and central foveal thickness (CFT) in patients with chronic kidney disease. MATERIALS AND METHODS Forty-nine eyes from 49 chronic kidney-disease patients were analyzed. Causes of chronic kidney disease included diabetes mellitus (n=9 patients), hypertensive nephrosclerosis (n=15 patients), and other causes (n=25 patients). All patients underwent HD in the Dialysis Unit of Hôtel-Dieu de France Hospital. Best-corrected visual acuity, CFT, and IOP were evaluated before and after HD. CFT was measured with spectral domain optical coherence tomography, and IOP was measured with Goldmann applanation tonometry. RESULTS Neither decimal best-corrected visual acuity (pre-HD 0.71±0.32, post-HD 0.72±0.31; P=0.877) nor CFT (pre-HD 251.39±39.29, post-HD 253.09±39.26; P=0.272) significantly changed after HD. However, mean IOP significantly decreased from 13.99±2.48 before HD to 12.65±2.41 mmHg after HD (P=0.001). IOP change was significantly correlated with serum albumin levels (P=0.008) and weight changes (P=0.047). CONCLUSION HD can affect various ocular parameters. This is particularly true of IOP, which decreases significantly following HD.
Collapse
Affiliation(s)
- Elias Chelala
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Ali Dirani
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Ali Fadlallah
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Elise Slim
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Youssef Abdelmassih
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | | | - Patrick Baz
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - Riad Bejjani
- Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
- Hôtel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| |
Collapse
|
11
|
Mehta VV, Hull CC, Lawrenson JG. The effect of varying glucose levels on the ex vivo crystalline lens: implications for hyperglycaemia-induced refractive changes. Ophthalmic Physiol Opt 2014; 35:52-9. [PMID: 25424300 DOI: 10.1111/opo.12176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 10/28/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE Refractive changes in diabetic eyes have long been reported but with equivocal results. The lens has been a more recent focus as the source of any change but it is possible that multiple sources of variation have made it difficult to demonstrate a systematic change clinically. The aim of this study was therefore to use a bovine lens model to investigate the optical changes in hyperglycaemia and when lenses are returned to normal glucose levels as would occur following commencement of treatment. METHOD Bovine eyes were obtained and their lenses excised under sterile conditions before placing them in culture medium within an incubator using standard tissue culture techniques. In the first experiment, lenses were transferred into culture medium containing 5 mm (n = 12), 15 mm (n = 12) and 30 mm (n = 12) glucose. Measurements were made of the change in back vertex focusing distance with equatorial lens diameter using the ScanTox(™) measurement system. From these measurements, the back vertex focal length and primary longitudinal spherical aberration were derived. In a second experiment, lenses maintained at 30 mm glucose (n = 7) were stepped down to 5 mm glucose to simulate starting diabetic therapy and measured in the same way. Changes over time were assessed with a linear regression model. RESULTS A trend towards myopia was observed with increasing hyperglycaemia, this was not statistically significant. When lenses were stepped-down from hyperglycaemia to normal physiological levels of glucose, a hyperopic shift was observed in line with published clinical studies that again failed to reach statistical significance. High variability in the measurement on longitudinal spherical aberration prevented any significant trends being measured. CONCLUSIONS Our results suggest that there are no consistent crystalline lens-induced refractive changes following exposure to hyperglycaemia for time-periods up to 5 days used in the current study. It is possible that bovine lenses are able to offset the raised osmotic pressure from high glucose levels in the short-term by a process of osmoregulation and that repeated osmotic stress or longer term exposure may be required to induce the changes in refraction that are seen clinically.
Collapse
Affiliation(s)
- Vikram V Mehta
- Centre for Applied Vision Research, City University London, London, UK
| | | | | |
Collapse
|
12
|
Abstract
PURPOSE To investigate the differences in ocular biometric and keratometric characteristics in comparison with biometric measurements using the noncontact optical low coherence reflectometer (OLCR) (Lenstar LS 900, Haag-Streit) on diabetic patients. METHODS The eyes of 170 patients were included in this study, including 81 diabetic and 89 nondiabetic subjects. Optical biometric measurements of diabetic and nondiabetic patients (between the ages of 25 and 85 years) who applied to the ophthalmology clinic were noted from March to June 2013. Detailed ophthalmologic examinations were done for every subject. Biometric measurements were done using the noncontact OLCR device. RESULTS Patient age ranged from 29 to 83 years. Subgroup analyses were done in diabetic patients according to their Hba1C levels. The minimum Hba1C value was 5.3, maximum was 12.4, and mean was 7.56 ± 1.48. The median duration of diabetes was 5 years (25th-75th percentile 3.00-11.75). Diabetic patients were found to have thicker lens and shallower anterior chamber in both eyes compared to nondiabetic control subjects. There were no statistical differences between the groups according to central corneal thickness, axial length, or keratometric values in both eyes. However, lens thicknesses were found to be thicker and anterior chamber depth values were found to be shallower in the diabetic group in both eyes. CONCLUSIONS It may useful to determine eyeglasses prescription, refractive surgery calculation, lens selection, and previous cataract surgery according to biometric measurements after the regulation of blood glucose.
Collapse
|
13
|
Golay M, Ferrini W, Tagan D. Refractory changes in hyperosmolar diabetic decompensation: when hyperglycaemia improves vision. BMJ Case Rep 2013; 2013:bcr2013009760. [PMID: 23723106 PMCID: PMC3669880 DOI: 10.1136/bcr-2013-009760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Type 2 diabetes is a frequent condition in humans with about 350 million affected people. One of the complications is blindness caused by damage of the blood vessels in retina, cataract or glaucoma. But in an acute developing hyperglycaemia, changes in sugar level in blood modify the refraction in the eye. Thus people complain of blurred vision. We present a case of a patient with hypermetropia who reported quick amelioration of his vision as hyperglycaemia developed, because of myopisation.
Collapse
Affiliation(s)
- Michel Golay
- Department of Internal Medicine, Hopital Riviera Site Samaritain, Vevey, Switzerland.
| | | | | |
Collapse
|
14
|
Huntjens B, Charman WN, Workman H, Hosking SL, O’Donnell C. Short-term stability in refractive status despite large fluctuations in glucose levels in diabetes mellitus type 1 and 2. PLoS One 2012; 7:e52947. [PMID: 23285232 PMCID: PMC3532445 DOI: 10.1371/journal.pone.0052947] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 11/26/2012] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This work investigates how short-term changes in blood glucose concentration affect the refractive components of the diabetic eye in patients with long-term Type 1 and Type 2 diabetes. METHODS Blood glucose concentration, refractive error components (mean spherical equivalent MSE, J0, J45), central corneal thickness (CCT), anterior chamber depth (ACD), crystalline lens thickness (LT), axial length (AL) and ocular aberrations were monitored at two-hourly intervals over a 12-hour period in: 20 T1DM patients (mean age ± SD) 38±14 years, baseline HbA1c 8.6±1.9%; 21 T2DM patients (mean age ± SD) 56±11 years, HbA1c 7.5±1.8%; and in 20 control subjects (mean age ± SD) 49±23 years, HbA1c 5.5±0.5%. The refractive and biometric results were compared with the corresponding changes in blood glucose concentration. RESULTS Blood glucose concentration at different times was found to vary significantly within (p<0.0005) and between groups (p<0.0005). However, the refractive error components and ocular aberrations were not found to alter significantly over the day in either the diabetic patients or the control subjects (p>0.05). Minor changes of marginal statistical or optical significance were observed in some biometric parameters. Similarly there were some marginally significant differences between the baseline biometric parameters of well-controlled and poorly-controlled diabetic subjects. CONCLUSION This work suggests that normal, short-term fluctuations (of up to about 6 mM/l on a timescale of a few hours) in the blood glucose levels of diabetics are not usually associated with acute changes in refractive error or ocular wavefront aberrations. It is therefore possible that factors other than refractive error fluctuations are sometimes responsible for the transient visual problems often reported by diabetic patients.
Collapse
Affiliation(s)
- Byki Huntjens
- Division of Optometry and Visual Science, City University London, London, United Kingdom
| | - W. Neil Charman
- Faculty of Life Sciences, The University of Manchester, London, United Kingdom
| | - Helena Workman
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
| | - Sarah L. Hosking
- Division of Optometry and Visual Science, City University London, London, United Kingdom
- Department of Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Clare O’Donnell
- Faculty of Life Sciences, The University of Manchester, London, United Kingdom
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
- Optegra Eye Sciences, Manchester, United Kingdom
| |
Collapse
|
15
|
Hsu YW, Yeh SM, Chen YY, Chen YC, Lin SL, Tseng JK. Protective effects of taurine against alloxan-induced diabetic cataracts and refraction changes in New Zealand White rabbits. Exp Eye Res 2012; 103:71-7. [PMID: 22940558 DOI: 10.1016/j.exer.2012.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Revised: 07/23/2012] [Accepted: 08/02/2012] [Indexed: 11/19/2022]
Abstract
The present study examined the protective effects of taurine on alloxan-induced diabetic cataracts and lens damage in male New Zealand White rabbits. The animals were randomly divided into three treatment groups: (1) normal control (vehicle administration); (2) diabetes (100 mg/kg alloxan administration); and (3) diabetes + taurine (1% [w/v] taurine dissolved in drinking water and alloxan administration). The results showed that alloxan-induced diabetes caused significant (p < 0.05) hyperglycemia, hyperopic refraction shifts, cataract formation and lens damage compared with the normal control group. In contrast, the administration of taurine for 24 weeks significantly ameliorated the alloxan-induced elevated levels of blood glucose, level of hyperopic refraction error shifts in the eyes and progression of diabetic cataract formation in the lens in rabbits. Moreover, histopathology showed that the taurine supplement reduced the incidence of lens lesions induced by hyperglycemia. Overall, the studies demonstrate that taurine exhibits potent protective effects against alloxan-induced diabetic cataracts and refraction changes in rabbits.
Collapse
Affiliation(s)
- Yu-Wen Hsu
- School of Optometry, Chung Shan Medical University, No. 110, Sec. 1, Jianguo N. Rd., Taichung City 402, Taiwan, ROC
| | | | | | | | | | | |
Collapse
|
16
|
Wiemer NGM, Dubbelman M, Ringens PJ, Polak BCP. Measuring the refractive properties of the diabetic eye during blurred vision and hyperglycaemia using aberrometry and Scheimpflug imaging. Acta Ophthalmol 2009; 87:176-82. [PMID: 18547279 DOI: 10.1111/j.1755-3768.2008.01212.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to measure the refraction and geometry in the diabetic eye during the presence and absence of hyperglycaemia and blurred vision, using aberrometry and Scheimpflug imaging. METHODS Aberrometry and Scheimpflug imaging were used to examine ocular refraction and higher-order aberrations, as well as the shape of the cornea and the lens, in 25 patients with diabetes mellitus. From these parameters, the equivalent refractive index of the lens was calculated. Using paired t-tests, comparisons were made between a first series of measurements (Visit 1) taken in the presence of blurred vision and hyperglycaemia (> 10.0 micromol/l), and a second series of measurements (Visit 2) taken under normal conditions. RESULTS The mean difference in blood glucose between Visits 1 and 2 was 5.9 mmol/l (standard deviation [SD] 3.1) (p < 0.0001). Both small hyperopic and myopic shifts of equivalent refractive error (ERE) were found in nine patients (mean absolute difference ERE: 0.38 D [SD 0.12]; p = 0.02). Furthermore, higher-order aberrations (root mean square [RMS] error) were slightly increased in four patients (mean difference RMS error: 0.07 microm [SD 0.02]; p = 0.04) at Visit 1, compared to Visit 2. No significant changes were observed in the shape of the cornea or lens in any of the patients. No significant correlations were found between changes in blood glucose levels and the measured parameters in diabetic eyes. CONCLUSIONS The present study suggests that subjective symptoms of blurred vision during hyperglycaemia are not necessarily caused by changes in the refractive properties of the diabetic eye.
Collapse
Affiliation(s)
- Nanouk G M Wiemer
- Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
17
|
Wiemer NGM, Eekhoff EMW, Simsek S, Heine RJ, Ringens PJ, Polak BCP, Dubbelman M. Refractive properties of the healthy human eye during acute hyperglycemia. Graefes Arch Clin Exp Ophthalmol 2008; 246:993-8. [PMID: 18389272 PMCID: PMC2413123 DOI: 10.1007/s00417-008-0810-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Revised: 02/20/2008] [Accepted: 02/26/2008] [Indexed: 11/25/2022] Open
Abstract
Purpose To measure the refractive properties of the healthy human eye during acute hyperglycemia by means of Scheimpflug imaging and Hartmann-Shack aberrometry. Methods Acute hyperglycemia was induced in five healthy subjects (two males, three females, mean age ±SD 24.8 years ± 4.6) by means of an oral glucose tolerance test (OGTT) after subcutaneous somatostatin injection. Before and every 30 minutes after the OGTT, measurements with Scheimpflug imaging and Hartmann-Shack aberrometry were performed. The main outcome measures were the thickness and shape of the lens, and the ocular refractive error and higher order aberrations. The equivalent refractive index of the lens was calculated from these parameters. Measurements at baseline and during hyperglycemia were analyzed by means of Wilcoxon signed rank sum tests. Results During hyperglycemia (mean blood glucose level at baseline: 4.0 mmol/l; mean maximal blood glucose level: 18.4 mmol/l) no changes could be found in the refractive properties within the group. In one subject, a hyperopic shift (0.4 D) was observed, together with a more convex shape of the anterior lens surface and a decrease in the equivalent refractive index of the lens. Conclusions This study shows that hyperglycemia generally does not cause changes in the refractive properties of the healthy eye. Nevertheless, in one subject a hyperopic shift accompanied by a change in shape and refractive index of the lens was measured. This finding could provide an explanation for the mechanism underlying the refractive changes that are often observed during hyperglycemia.
Collapse
Affiliation(s)
- Nanouk G M Wiemer
- Department of Ophthalmology, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| | | | | | | | | | | | | |
Collapse
|
18
|
Herse P. Effects of hyperglycaemia on ocular development in rabbit: refraction and biometric changes. Ophthalmic Physiol Opt 2005; 25:97-104. [PMID: 15713201 DOI: 10.1111/j.1475-1313.2004.00262.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To determine the effect of acute and chronic hyperglycaemia on the refraction and development of the rabbit eye. METHODS Ocular dimensions of five alloxan-induced hyperglycaemic and six control rabbits were measured over 9 weeks using A scan biometry. Refraction was measured using retinoscopy. The animals were 10 weeks of age at the start of the experiment. RESULTS The acute onset of hyperglycaemia was associated with a fast and stable 2 D hyperopic shift in refraction. Lens thickness increased during the first 2 weeks of hyperglycaemia, returned to near normal thickness after 3-5 weeks of hyperglycaemia and then decreased in thickness in the last 4 weeks of the study. The hyperopic refraction remained unchanged during changes in lens thickness. Nine weeks of hyperglycaemia was associated with a 25% reduction in the growth of both the globe and the lens and a 17% decrease in body mass compared with the controls. CONCLUSION The hyperopic refraction change of acute hyperglycaemia is likely to be because of a change in the refractive index of the cortical fibres of the lens and is the probable source of the fluctuating refraction seen in diabetic patients. Chronic hyperglycaemia reduced the axial development of the eye and is the probable source of the chronic hyperopic refraction seen in children with Type I diabetes.
Collapse
Affiliation(s)
- Peter Herse
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW 2053, Australia.
| |
Collapse
|