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  1. Risk factors associated with diabetic retinopathy among type 2 diabetes patients at teaching hospital in Malaysia
    Abougalambou SS, Abougalambou AS
    Diabetes Metab Syndr, 2015 Apr-Jun;9(2):98-103.
    PMID: 25470640 DOI: 10.1016/j.dsx.2014.04.019
    BACKGROUND: Diabetic retinopathy (DR) is the leading cause of blindness in the United States and it is the leading cause of new cases of blindness in adults aged 20-74. It is estimated that about 20% of patients with type 2 DM have evidence of diabetic retinopathy at diagnosis with diabetes.
    OBJECTIVE: To evaluate the prevalence of DR and to determine risk factors related to diabetic retinopathy among type 2 diabetes patients attending endocrinology clinics at Hospital Universiti Sains Malaysia (HUSM).
    SUBJECTS AND METHODS: The study design was observational prospective longitudinal follow-up study, the study was conducted with sample of 1077 type 2 diabetes mellitus outpatient recruited via attended the diabetes clinics at HUSM. Diagnosis of retinopathy is based on finding the diagnostic signs of retinopathy on eye exams by fundoscopy. Logistic regression analysis was used to assess the independent variables that affect the development of retinopathy.
    RESULTS: The prevalence of retinopathy was 39.3%. It has been noticed from this study findings, that the progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance.
    CONCLUSION: DR is highly prevalent among type 2 DM. The progression of retinopathy is been influenced by five independent risk factors such as duration of diabetes, presence neuropathy, total cholesterol at second and third visit and createnine clearance. DR is a serious diabetic complication and public health strategies are required in order to reduce its risk factors and decrease its prevalence.
    KEYWORDS: Prevalence; Retinopathy; Risk factors; Type 2 diabetes mellitus
    Study site: Endocrinology clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Diabetic Retinopathy/etiology*; Diabetic Retinopathy/metabolism; Diabetic Retinopathy/epidemiology
  2. Explorative study on diabetes neuropathy among type II diabetic patients in Universiti Sains Malaysia Hospital
    Abougalambou SS, Abougalambou AS
    Diabetes Metab Syndr, 2012 Jul-Sep;6(3):167-72.
    PMID: 23158982 DOI: 10.1016/j.dsx.2012.09.002
    OBJECTIVE: The aim of this study was to determine risk factors and prevalence of diabetic neuropathy (DN) among type II diabetic patients in Malaysian hospital setting.
    SUBJECTS AND METHODS: a observational prospective longitudinal follow up study design was selected, total no of respondents were 1077 type 2 diabetes mellitus outpatients recruited via attended the diabetes clinics at Hospital Universiti Sains Malaysia (HUSM) in Kelantan. The diagnosis of neuropathy was confirmed by nerve conduction studies. Logistic regression analysis was used to assess the independent variables that affect the development of neuropathy.
    RESULTS: The prevalence of nephropathy is 54.3%. Longitudinal logistic regression identified four predictive variables on the development and progression of diabetic neuropathy that are: duration of diabetes, retinopathy, HbA1c at second visit, and creatinine clearance third visit.
    CONCLUSION: Findings of this study show high prevalence of diabetic neuropathy. HbA1c and creatinine clearance are two modifiable risk factors for the development of diabetic neuropathy.
    Study site: Diabetes clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Diabetic Retinopathy/blood; Diabetic Retinopathy/epidemiology*; Diabetic Retinopathy/physiopathology
  3. Automated screening system for retinal health using bi-dimensional empirical mode decomposition and integrated index
    Acharya UR, Mookiah MR, Koh JE, Tan JH, Bhandary SV, Rao AK, et al.
    Comput Biol Med, 2016 08 01;75:54-62.
    PMID: 27253617 DOI: 10.1016/j.compbiomed.2016.04.015
    Posterior Segment Eye Diseases (PSED) namely Diabetic Retinopathy (DR), glaucoma and Age-related Macular Degeneration (AMD) are the prime causes of vision loss globally. Vision loss can be prevented, if these diseases are detected at an early stage. Structural abnormalities such as changes in cup-to-disc ratio, Hard Exudates (HE), drusen, Microaneurysms (MA), Cotton Wool Spots (CWS), Haemorrhages (HA), Geographic Atrophy (GA) and Choroidal Neovascularization (CNV) in PSED can be identified by manual examination of fundus images by clinicians. However, manual screening is labour-intensive, tiresome and time consuming. Hence, there is a need to automate the eye screening. In this work Bi-dimensional Empirical Mode Decomposition (BEMD) technique is used to decompose fundus images into 2D Intrinsic Mode Functions (IMFs) to capture variations in the pixels due to morphological changes. Further, various entropy namely Renyi, Fuzzy, Shannon, Vajda, Kapur and Yager and energy features are extracted from IMFs. These extracted features are ranked using Chernoff Bound and Bhattacharyya Distance (CBBD), Kullback-Leibler Divergence (KLD), Fuzzy-minimum Redundancy Maximum Relevance (FmRMR), Wilcoxon, Receiver Operating Characteristics Curve (ROC) and t-test methods. Further, these ranked features are fed to Support Vector Machine (SVM) classifier to classify normal and abnormal (DR, AMD and glaucoma) classes. The performance of the proposed eye screening system is evaluated using 800 (Normal=400 and Abnormal=400) digital fundus images and 10-fold cross validation method. Our proposed system automatically identifies normal and abnormal classes with an average accuracy of 88.63%, sensitivity of 86.25% and specificity of 91% using 17 optimal features ranked using CBBD and SVM-Radial Basis Function (RBF) classifier. Moreover, a novel Retinal Risk Index (RRI) is developed using two significant features to distinguish two classes using single number. Such a system helps to reduce eye screening time in polyclinics or community-based mass screening. They will refer the patients to main hospitals only if the diagnosis belong to the abnormal class. Hence, the main hospitals will not be unnecessarily crowded and doctors can devote their time for other urgent cases.
    Matched MeSH terms: Diabetic Retinopathy
  4. Fulltext Assessment of awareness of diabetic retinopathy among the diabetics attending the peripheral diabetic clinics in Melaka, Malaysia
    Addoor KR, Krishna RA, Bhandary SV, Khanna R, Rao LG, Lingam KD, et al.
    Med J Malaysia, 2011 Mar;66(1):48-52.
    PMID: 23765143 MyJurnal
    In view of the alarming increase in the incidence of diabetes mellitus in Malaysia, we conducted a study to assess the awareness of complications of diabetes among the diabetics attending the peripheral clinics in Melaka. The study period was from January 2007 to December 2007. 351 patients were included in the study. 79.8% were aware of the complications of diabetes mellitus and 87.2% were aware that diabetes can affect the eyes. However, only 50% of the patients underwent an ophthalmological evaluation. Although awareness was good, the motivation to undergo the assessment was poor.
    Study site: Klinik Kesihatan Peringgit, Klinik Kommunity Ayer Keroh, Melaka, Malaysia
    Matched MeSH terms: Diabetic Retinopathy*
  5. Analysis of foveal avascular zone in colour fundus images for grading of diabetic retinopathy severity
    Ahmad Fadzil M, Ngah NF, George TM, Izhar LI, Nugroho H, Adi Nugroho H
    Annu Int Conf IEEE Eng Med Biol Soc, 2010;2010:5632-5.
    PMID: 21097305 DOI: 10.1109/IEMBS.2010.5628041
    Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. At present, the classification of DR is based on the International Clinical Diabetic Retinopathy Disease Severity. In this paper, FAZ enlargement with DR progression is investigated to enable a new and an effective grading protocol DR severity in an observational clinical study. The performance of a computerised DR monitoring and grading system that digitally analyses colour fundus image to measure the enlargement of FAZ and grade DR is evaluated. The range of FAZ area is optimised to accurately determine DR severity stage and progression stages using a Gaussian Bayes classifier. The system achieves high accuracies of above 96%, sensitivities higher than 88% and specificities higher than 96%, in grading of DR severity. In particular, high sensitivity (100%), specificity (>98%) and accuracy (99%) values are obtained for No DR (normal) and Severe NPDR/PDR stages. The system performance indicates that the DR system is suitable for early detection of DR and for effective treatment of severe cases.
    Matched MeSH terms: Diabetic Retinopathy/pathology*
  6. Analysis of retinal fundus images for grading of diabetic retinopathy severity
    Ahmad Fadzil MH, Izhar LI, Nugroho H, Nugroho HA
    Med Biol Eng Comput, 2011 Jun;49(6):693-700.
    PMID: 21271293 DOI: 10.1007/s11517-011-0734-2
    Diabetic retinopathy (DR) is a sight threatening complication due to diabetes mellitus that affects the retina. In this article, a computerised DR grading system, which digitally analyses retinal fundus image, is used to measure foveal avascular zone. A v-fold cross-validation method is applied to the FINDeRS database to evaluate the performance of the DR system. It is shown that the system achieved sensitivity of >84%, specificity of >97% and accuracy of >95% for all DR stages. At high values of sensitivity (>95%), specificity (>97%) and accuracy (>98%) obtained for No DR and severe NPDR/PDR stages, the computerised DR grading system is suitable for early detection of DR and for effective treatment of severe cases.
    Matched MeSH terms: Diabetic Retinopathy/diagnosis*
  7. Determination of foveal avascular zone in diabetic retinopathy digital fundus images
    Ahmad Fadzil MH, Izhar LI, Nugroho HA
    Comput Biol Med, 2010 Jul;40(7):657-64.
    PMID: 20573343 DOI: 10.1016/j.compbiomed.2010.05.004
    Monitoring FAZ area enlargement enables physicians to monitor progression of the DR. At present, it is difficult to discern the FAZ area and to measure its enlargement in an objective manner using digital fundus images. A semi-automated approach for determination of FAZ using color images has been developed. Here, a binary map of retinal blood vessels is computer generated from the digital fundus image to determine vessel ends and pathologies surrounding FAZ for area analysis. The proposed method is found to achieve accuracies from 66.67% to 98.69% compared to accuracies of 18.13-95.07% obtained by manual segmentation of FAZ regions from digital fundus images.
    Matched MeSH terms: Diabetic Retinopathy/diagnosis*; Diabetic Retinopathy/pathology
  8. Vascular intersection detection in retina fundus images using a new hybrid approach
    Aibinu AM, Iqbal MI, Shafie AA, Salami MJ, Nilsson M
    Comput Biol Med, 2010 Jan;40(1):81-9.
    PMID: 20022595 DOI: 10.1016/j.compbiomed.2009.11.004
    The use of vascular intersection aberration as one of the signs when monitoring and diagnosing diabetic retinopathy from retina fundus images (FIs) has been widely reported in the literature. In this paper, a new hybrid approach called the combined cross-point number (CCN) method able to detect the vascular bifurcation and intersection points in FIs is proposed. The CCN method makes use of two vascular intersection detection techniques, namely the modified cross-point number (MCN) method and the simple cross-point number (SCN) method. Our proposed approach was tested on images obtained from two different and publicly available fundus image databases. The results show a very high precision, accuracy, sensitivity and low false rate in detecting both bifurcation and crossover points compared with both the MCN and the SCN methods.
    Matched MeSH terms: Diabetic Retinopathy/diagnosis
  9. Fulltext Automated microaneurysm detection in diabetic retinopathy using curvelet transform
    Ali Shah SA, Laude A, Faye I, Tang TB
    J Biomed Opt, 2016 Oct;21(10):101404.
    PMID: 26868326 DOI: 10.1117/1.JBO.21.10.101404
    Microaneurysms (MAs) are known to be the early signs of diabetic retinopathy (DR). An automated MA detection system based on curvelet transform is proposed for color fundus image analysis. Candidates of MA were extracted in two parallel steps. In step one, blood vessels were removed from preprocessed green band image and preliminary MA candidates were selected by local thresholding technique. In step two, based on statistical features, the image background was estimated. The results from the two steps allowed us to identify preliminary MA candidates which were also present in the image foreground. A collection set of features was fed to a rule-based classifier to divide the candidates into MAs and non-MAs. The proposed system was tested with Retinopathy Online Challenge database. The automated system detected 162 MAs out of 336, thus achieved a sensitivity of 48.21% with 65 false positives per image. Counting MA is a means to measure the progression of DR. Hence, the proposed system may be deployed to monitor the progression of DR at early stage in population studies.
    Matched MeSH terms: Diabetic Retinopathy/complications*; Diabetic Retinopathy/pathology
  10. Fulltext Comparison of dry eye parameters between diabetics and non-diabetics in district of Kuantan, Pahang
    Aljarousha M, Badarudin NE, Che Azemin MZ
    Malays J Med Sci, 2016 May;23(3):72-7.
    PMID: 27418872 MyJurnal
    INTRODUCTION: Diabetes may affect the human body's systems and organs, including the eye. Diabetic retinopathy is the 5th leading cause of blindness globally. Diabetic subjects demonstrated dry eye symptoms that were also supported by the low values of the clinical tests.
    PURPOSE: This study aimed to compare the dry eye symptoms and signs between diabetics and non-diabetics and tear functions between diabetic subjects with and without dry eye.
    METHODS: This retrospective study was based on the observation of 643 medical files. Using a convenience sampling method, 88 subjects were found to report diabetes mellitus. The information extracted from the files included: date of first examination, age at first visit, gender, past ocular history, systemic disease, symptoms of dry eye disease and details of clinical diagnostic signs. Non-contact lens wearers were excluded. A group of 88, age and gender matched, control subjects were included for this comparison study.
    RESULTS: The percentage of dry eye symptoms was higher in diabetic subjects (15.9%) compared with non-diabetic subjects (13.6%; p<0.001). The percentage of dry eye symptoms was also higher in diabetics with dry eye (63%) than in diabetics without dry eye (36.9%; p<0.001). Tear break up time was significantly different between diabetics and non-diabetics (p<0.001) and between diabetics with and without dry eye (p=0.046). The corneal staining was significantly different between diabetic subjects with and without dry eye (p=0.028).
    CONCLUSION: Dry eye symptoms were significantly associated with diabetics. Tear break up time was significantly shorter in diabetics with dry eye compared to diabetics without dry eye.
    KEYWORDS: Diabetes mellitus; cornea; dry eye syndromes; signs and symptoms; tears
    Study site: Klinik Kesihatan Jalan Hospital, Kuantan, Malaysia
    Matched MeSH terms: Diabetic Retinopathy
  11. Total Protein Concentration and Tumor Necrosis Factor α in Tears of Nonproliferative Diabetic Retinopathy
    Amil-Bangsa NH, Mohd-Ali B, Ishak B, Abdul-Aziz CNN, Ngah NF, Hashim H, et al.
    Optom Vis Sci, 2019 12;96(12):934-939.
    PMID: 31834153 DOI: 10.1097/OPX.0000000000001456
    SIGNIFICANCE: Total protein concentration (TPC) and tumor necrosis factor α (TNF-α) concentration in tears are correlated with severity of retinopathy. However, minimal data are available in the literature for investigating tear TPC and TNF-α concentrations in Asian individuals with different severity of nonproliferative diabetic retinopathy (NPDR).

    PURPOSE: This study evaluated differences of TPC and TNF-α concentrations in tears at different severity of NPDR among participants with diabetes in comparison with normal participants.

    METHODS: A total of 75 participants were categorized based on Early Treatment for Diabetic Retinopathy Study scale, with 15 participants representing each group, namely, normal, diabetes without retinopathy, mild NPDR, moderate NPDR, and severe NPDR. All participants were screened using McMonnies questionnaire. Refraction was conducted subjectively. Visual acuity was measured using a LogMAR chart. Twenty-five microliters of basal tears was collected using glass capillary tubes. Total protein concentration and TNF-α concentrations were determined using Bradford assay and enzyme-linked immunosorbent assay, respectively.

    RESULTS: Mean ± SD age of participants (n = 75) was 57.88 ± 4.71 years, and participants scored equally in McMonnies questionnaire (P = .90). Mean visual acuity was significantly different in severe NPDR (P = .003). Mean tear TPC was significantly lower, and mean tear TNF-α concentration was significantly higher in moderate and severe NPDR (P < .001). Mean ± SD tear TPC and TNF-α concentrations for normal were 7.10 ± 1.53 and 1.39 ± 0.24 pg/mL; for diabetes without retinopathy, 6.37 ± 1.65 and 1.53 ± 0.27 pg/mL; for mild NPDR, 6.32 ± 2.05 and 1.60 ± 0.21 pg/mL; for moderate NPDR, 3.88 ± 1.38 and 1.99 ± 0.05 pg/mL; and for severe NPDR, 3.64 ± 1.26 and 2.21 ± 0.04 pg/mL, respectively. Tear TPC and TNF-α concentrations were significantly correlated (r = -0.50, P < .0001). Visual acuity was significantly correlated with tear TPC (r = -0.236, P = .04) and TNF-α concentrations (r = 0.432, P < .0001).

    CONCLUSIONS: This cross-sectional study identified differences in tear TPC and TNF-α concentrations with increasing severity of NPDR.

    Matched MeSH terms: Diabetic Retinopathy/classification; Diabetic Retinopathy/metabolism*
  12. Intravenous fluconazole for bilateral endogenous Candida endophthalmitis
    Annamalai T, Fong KC, Choo MM
    J Ocul Pharmacol Ther, 2011 Feb;27(1):105-7.
    PMID: 21235384 DOI: 10.1089/jop.2010.0117
    To report a case of bilateral endogenous candida endophthalmitis treated with intravenous fluconazole.
    Matched MeSH terms: Diabetic Retinopathy/complications
  13. Fulltext Prevalence of falls and its associated factors among elderly diabetes in a tertiary center, Malaysia
    Azidah AK, Hasniza H, Zunaina E
    Curr Gerontol Geriatr Res, 2012;2012:539073.
    PMID: 22693496 DOI: 10.1155/2012/539073
    The purpose of this study is to determine the prevalence of falls and its associated factors among elderly diabetes type 2 patients attending a tertiary center in Malaysia. We conducted a cross-sectional study among 288 elderly diabetes type 2. The data collected includes data on sociodemographic, diabetes history, comorbid diseases, drug use, and activity of daily living (Barthel's index). The patient also was examined physically, and balance and gait assessment was carried out. Prevalence of falls among elderly diabetes was 18.8%. Female gender (OR: 2.54, P < 0.05), age group more than 75 (OR: 2.97, P < 0.05), retinopathy (OR: 2.19, P < 0.05), and orthostatic hypotension (OR: 2.87, P < 0.05) were associated with higher risk for falls. High balance and gait score was associated with reduced risk of fall in elderly diabetes (OR: 0.89, P < 0.05). In conclusion, the factors that are associated with higher risk for falls among elderly diabetes were female sex, age group more than 75, presence of retinopathy, and orthostatic hypotension. Those who had higher balance and gait score were found to be less likely to fall compared with those with lower score.
    Study site: Hospital Universiti Sains Malaysia, Kelantan, Malaysia
    Questionnaires, Scales, Device: Tinetti Balance and Gait Assessment; 5.07 Semmes- Weinstein monofilament; Barthel’s index
    Study site: Diabetic clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Diabetic Retinopathy
  14. The association of waist circumference and microvascular complications in diabetic patients in an Asian population. [Abstract]
    Azmi S, Feisul MI, Abdat A, Goh A, Abdul Aziz SH
    Value Health, 2015 Nov;18(7):A597.
    PMID: 26533354 DOI: 10.1016/j.jval.2015.09.2042
    Conference abstract:
    Objectives: The aim of the study was to explore the association of waist circumference with microvascular complications in Malaysian patients with type 2 diabetes.
    Methods: We utilised data of type 2 diabetes patients followed up in Malaysian public sector primary care clinics contained in the National Diabetes Registry in the year 2012. Variables of interest were the presence of microvascular complications, namely nephropathy and retinopathy. Multiple logistic regression was used to explore the association between presence of microvascular complications and waist circumference, which was adjusted for age, sex, duration of diabetes, systolic blood pressure, insulin use, total cholesterol and HbA1c.
    Results: A total of 114,719 patients with type 2 diabetes were included in the study. The mean age of patients was 59.8 years (SD: 11.2) with mean duration of diabetes of 6.8 years (SD: 5.1). Male
    patients comprised 39.9% of the sample population and 83.5% of the patients were overweight with BMI ≥ 23 kg/m2. Nephropathy and retinopathy was present in 9.1% and 7.9% of patients respectively. The mean waist circumference was 94.1 cm (SD: 11.8) for males and 90.8 cm (SD: 11.8) for females; while 78.4% of the patients had waist circumference above the cut off (≥ 90 cm for men and ≥ 80 cm for women). Larger waist circumference was found to be significantly associated with nephropathy (adj. OR 1.005; p-value< 0.001; 95% CI: 1.003–1.008) after adjusting for confounding factors. However, waist circumference was not significantly associated with retinopathy (adj. OR 0.998; p= 0.209; 95% CI: 0.996–1.001).
    Conclusions: Analysis showed that patients with higher waist circumference were more likely to have nephropathy than patients with lower waist circumference. The analysis also showed that waist circumference was not associated with retinopathy in the study population.
    Matched MeSH terms: Diabetic Retinopathy
  15. Fulltext A new blood vessel extraction technique using edge enhancement and object classification
    Badsha S, Reza AW, Tan KG, Dimyati K
    J Digit Imaging, 2013 Dec;26(6):1107-15.
    PMID: 23515843 DOI: 10.1007/s10278-013-9585-8
    Diabetic retinopathy (DR) is increasing progressively pushing the demand of automatic extraction and classification of severity of diseases. Blood vessel extraction from the fundus image is a vital and challenging task. Therefore, this paper presents a new, computationally simple, and automatic method to extract the retinal blood vessel. The proposed method comprises several basic image processing techniques, namely edge enhancement by standard template, noise removal, thresholding, morphological operation, and object classification. The proposed method has been tested on a set of retinal images. The retinal images were collected from the DRIVE database and we have employed robust performance analysis to evaluate the accuracy. The results obtained from this study reveal that the proposed method offers an average accuracy of about 97 %, sensitivity of 99 %, specificity of 86 %, and predictive value of 98 %, which is superior to various well-known techniques.
    Matched MeSH terms: Diabetic Retinopathy/diagnosis*
  16. Fulltext Pneumatic retinopexy for treatment of posterior pole detachment following vitreoretinal surgery for diabetic tractional retinal detachment threatening the fovea
    Bastion ML
    BMJ Case Rep, 2012;2012.
    PMID: 22878988 DOI: 10.1136/bcr-2012-006303
    To describe the usage of 100% perfluoropropane and subsequent laser retinopexy for the repair of posterior pole retinal detachment in a previously vitrectomised patient with diabetic tractional detachment.
    Matched MeSH terms: Diabetic Retinopathy/complications; Diabetic Retinopathy/physiopathology; Diabetic Retinopathy/surgery*
  17. Fulltext Brilliant crystallisation in the anterior chamber and subretinal space following adjunctive intravitreal ranibizumab for diabetic vitrectomy
    Bastion ML, Mustapha M, Ho I
    BMJ Case Rep, 2012;2012.
    PMID: 23093508 DOI: 10.1136/bcr-2012-007260
    To report a unique case of crystallisation in the anterior chamber and subretinal space in a Malay lady following inadvertent subretinal injection of ranibizumab prior to vitrectomy for proliferative diabetic retinopathy.
    Matched MeSH terms: Diabetic Retinopathy/drug therapy*
  18. Fulltext Spontaneous resolution of vitreomacular traction syndrome in a patient with diabetes with associated thickened posterior hyaloid prior to elective parsplanar vitrectomy demonstrated on optical coherence tomography
    Bastion ML
    BMJ Case Rep, 2010;2010.
    PMID: 22791576 DOI: 10.1136/bcr.03.2010.2867
    To describe an unusual case of vitreomacular traction syndrome spontaneously resolving prior to elective pars planar vitrectomy demonstrated on optical coherence tomography.
    Matched MeSH terms: Diabetic Retinopathy/complications*
  19. Fulltext Accelerated diabetic retinopathy in pregnancy--a real and present danger
    Bastion MLC, Barkeh HJ, Muhaya M
    Med J Malaysia, 2005 Oct;60(4):502-4.
    PMID: 16570717
    A 36 year-old Malay lady with diabetes mellitus in pregnancy and poorly controlled hypertension developed rapid progression of diabetic retinopathy from no retinopathy to florid proliferative retinopathy over three months in her right eye. She had subsequent loss of vision due to vitreous haemorrhage in the peri-partum period. She had good final visual acuity with quiescent retinopathy following pars planar vitrectomy. A similar course was avoided in the left eye by timely pan retinal photocoagulation.
    Matched MeSH terms: Diabetic Retinopathy/diagnosis; Diabetic Retinopathy/physiopathology*
  20. Fulltext Retrospective review of the adjunctive use of pre- operative ranibizumab “lucentistm” in the surgical management of diabetic retinopathy in a tertiary referral hospital in Malaysia
    Bastion, M.L.C., Siti Aishah, S., Aida Zairani, M.Z., Barkeh, H.J.
    Medicine & Health, 2010;5(2):93-102.
    MyJurnal
    A retrospective case series review was conducted to determine the pre-operative role and safety of pre-operative adjunctive anti-vascular endothelial growth factor (anti- VEGF) agent ranibizumab “LUCENTISTM” in patients with diabetic retinopathy requiring vitrectomy. The study involved twenty consecutive eyes of sixteen patients (age range: 46-72 years; mean 57.5 years) which received intravitreal injection of 0.5 - 1 mg of ranibizumab 3 to 8 days (mean 4.4 days) prior to vitrectomy for diabetic retinopathy. There were no local or systemic post-injection complications. Indications for vitrectomy were retinal detachment (RD) [n=11; 3 combined tractional (TRD) - rhegmatogenous RD (RRD), 8 TRD], TRD with vitreous haemorrhage (VH) (n=3) ,VH (n=8) and vitreomacular traction syndrome (n=1). Inclusion criteria include all consecutive eyes of diabetic patients requiring vitrectomy receiving a first pre-operative injection of anti- VEGF. Pre-operative visual acuity (VA) ranged from 6/36 to light perception. All eyes had minimal to moderate intraoperative bleeding. Post-operative VH in eyes without tamponade or gas tamponade was nil (n=1), mild (n=13) or moderate (n=1). Silicone filled eyes had nil (n=1), moderate (n=3) or severe haemorrhages (n=1). Post-operative VA was unchanged (n=2) (10%), improved (n = 14) (70%) or worsened (n=4). VA was 2/60 or better (n=15) to no light perception (n=1). Two eyes achieved 6/12 or better vision (10%). Ten eyes (50%) had 6/36 or better vision. In conclusion, pre-operative intravitreal ranibizumab is safe and useful in diabetic vitrectomy and appears to help with perioperative bleeding leading to improvement in vision.
    Matched MeSH terms: Diabetic Retinopathy
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