ABSTRACT
Prevention of blindness due to diabetic retinopathy (DR) requires effective screening strategies, for which eye care providers need to know the magnitude of the burden and the risk factors pertinent in their geographical location. It is estimated that around 72 million of the global adult population (around 8.2%) has diabetes and about one‑fifth of all adults with diabetes lives in the South‑East Asia. In India, around 65 million people have diabetes. As the global prevalence of diabetes increases, so will the number of people with diabetes‑related complications, such as DR; nearly one‑third of them are likely to develop this complication. This article reviews the present status of diabetes and DR in India, the current situation of DR services and the projections on the load of morbidity associated with retinopathy. The article compiles the Indian studies elucidating the risk factors for DR.
ABSTRACT
Aim: The aim was to assess the foveal slope configuration in subjects with type 2 diabetes in a population‑based study. Materials and Methods: A subset of 668 subjects from Sankara Nethralaya Diabetic Retinopathy (DR) Epidemiology and Molecular Genetics Study II, a population‑based study, were included in the current study. All the subjects underwent comprehensive ophthalmic evaluation including spectral domain optical coherence tomography. Foveal thickness was assessed in five central early treatment DR study quadrants from the three‑dimensional scan and foveal slope was calculated in all the four quadrants. Results: Subjects with sight‑threatening DR (STDR) had significantly shallow foveal slope in inferior quadrant (STDR: 7.33 ± 6.26 vs. controls: 10.31 ± 3.44; P = 0.021) when compared to controls and in superior (STDR: 7.62 ± 5.81 vs. no DR: 9.11 ± 2.82; P = 0.033), inferior (STDR: 7.33 ± 6.26 vs. no DR: 8.81 ± 2.81; P = 0.048), and temporal quadrants (STDR: 6.69 ± 5.70 vs. no DR: 7.97 ± 2.33; P = 0.030) when compared to subjects with no DR. Foveal slope was significantly shallow among the older age groups in subjects with no DR (P < 0.001) and non‑STDR (P = 0.027). Average foveal slope in the diabetic subjects was independently and significantly correlated with increase in age (r = −0.241; P < 0.001) and central subfield thickness (r = −0.542; P < 0.001). Conclusion: Changes in foveal slope were seen with increasing age; however, in diabetes these segmental slope changes can be seen in late DR (STDR).
ABSTRACT
Aims: To establish the retinal sensitivity values in healthy Indians using microperimeter. Materials and Methods: In this prospective study, 144 healthy volunteers were included. All the participants underwent a comprehensive ophthalmic examination including contrast sensitivity. Microperimetry was performed in the central 20° of the macula using 76 stimulus points to assess the retinal sensitivity, and the fixation characteristics in the study population were assessed. Results: The mean age of the study sample was 43.08 ± 10.85 years (range: 25‑69). Mean retinal sensitivity was 18.26 ± 0.99 dB. Males had significantly increased retinal sensitivity (18.34 vs. 18.17 dB, P = 0.03). The linear regression analysis revealed a 0.04 dB per year age‑related decline in mean retinal sensitivity. Contrast sensitivity was significantly correlated with the mean retinal sensitivity (r = 0.432, P < 0.001). Fixation stability in the central 2° and 4° were 69% and 89%, respectively. Conclusion: Microperimeter is an ideal tool to assess the retinal sensitivity and the fixation behavior. These normative values could help in drawing a meaningful conclusion in various retinal pathologies.
ABSTRACT
Purpose: To evaluate the relationship between the morphology and retinal function of macular microhole (MMH) variants. Materials and Methods: We evaluated 12 eyes of 11 patients with defects in the IS/OS junction of photoreceptor layer with SD-OCT. All patients underwent comprehensive ophthalmic examination including spectral domain optical coherence tomography (SD-OCT) and microperimetry. Results: The mean logMAR visual acuity in the affected eye was 0.15 ± 0.17 (range 0.00–0.5). Mean horizontal diameter of the MMH was 163 ± 99 μm; the mean retinal sensitivity in the area corresponding to the MMH was 13.79 ± 4.6 dB. Negative correlation was found between the MMH diameter and the retinal sensitivity (r = -0.65, p = 0.02). Three morphological patterns of MMH variants were recognized on SD-OCT, which did not differ in retinal sensitivities. Conclusion: We described and classified the MMH variants and made an assessment on the physiological functions using microperimeter.
Subject(s)
Adult , Female , Follow-Up Studies , Humans , Macula Lutea/pathology , Male , Retinal Perforations/diagnosis , Retinal Perforations/physiopathology , Severity of Illness Index , Tomography, Optical Coherence/methods , Visual Field Tests/methods , Visual FieldsABSTRACT
A case of foveal hypoplasia associated with ocular albinism with anatomic and functional changes by various techniques using spectral domain optical coherence tomography (SD-OCT), microperimeter and confocal scanning laser ophthalmoscope is described. This case highlights the importance of microperimeter in detecting the functional abnormalities of vision and SD-OCT in identifying the retinal laminar abnormalities in foveal hypoplasia.