Prevalence of visual impairment and associated risk factors in subjects with type II diabetes mellitus: Sankara Nethralaya diabetic retinopathy epidemiology and molecular genetics study (SN-DREAMS, report 16)
Rani P.K.,8 College Road |
Raman R.,8 College Road |
Kulothungan V.,18 College Road |
Sharma T.,8 College Road
Middle East African Journal of Ophthalmology | Year: 2012
Purpose: To report the prevalence of visual impairment (VI) and the associated risk factors in type II diabetic subjects. Materials and Methods: The study included type II diabetes mellitus subjects who were enrolled from a cross-sectional study. Participants underwent biochemical testing and comprehensive ocular examination including stereo fundus photography. The VI was defined based on the World Health Organization criteria. Results: The prevalence of VI was 4% in the cohort. The risk factors associated with the presence of VI included a female gender, age greater than 60 years, low socio-economic status, hypertension, microalbuminuria, macroalbuminuria, neuropathy, use of insulin and alcohol. Various ocular risk factors are nuclear sclerosis, subjects who have undergone cataract surgery, myopia and sight-threatening diabetic retinopathy (STDR). After adjusting for the factors using stepwise logistic regression analysis, hypertension, use of alcohol, post-cataract surgery and myopia were not risk factors. Stepwise logistic regression analysis indicated that VI was higher among subjects older than 60 years (odds ratio (OR): 4.95 [2.67-9.15]) and those who belonged to a low socio-economic status (OR: 2.91 [1.24-6.85]). The systemic risk factors for VI included microalbuminuria (OR: 2.91 [1.59-5.33]), macroalbuminuria (OR: 4.65 [1.57-13.77]) and presence of neuropathy (OR: 1.97 [1.09-3.59]) among subjects. Subjects with nuclear sclerosis (OR: 36.82 [11.12-112.36]) and presence of STDR (OR: 4.17 [1.54-11.29]) were at a higher risk of VI. Cataract was the most common cause of VI in the cohort. Conclusion: Visual impairment, among type II diabetic subjects (4%), is a major public health problem that needs to be addressed. Cataract is the most common reversible cause of vision impairment in this population.
Nachiappan K.,18 College Road |
Krishnan T.,18 College Road |
Madhavan J.,Vision Research Foundation
Indian Journal of Ophthalmology | Year: 2012
We report a rare case of Bietti's crystalline dystrophy presenting with choroidal neovascular membrane (CNVM) which was treated with three injections of intravitreal ranibizumab. The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.
Raman R.,18 College Road |
Gella L.,18 College Road |
Gella L.,Birla Institute of Technology and Science |
Srinivasan S.,18 College Road |
And 2 more authors.
Indian Journal of Ophthalmology | Year: 2016
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. © 2016 Indian Journal of Ophthalmology | Published by Wolters Kluwer - Medknow.
Rishi P.,18 College Road |
Rishi E.,18 College Road |
Gupta A.,18 College Road |
Swaminathan M.,Sankara Nethralya Orbis Paediatric Ophthalmology Learning and Training Center |
Chhablani J.,18 College Road
Journal of AAPOS | Year: 2013
Purpose: To report the clinical profile, etiologies, treatment modalities, and outcomes for vitreous hemorrhage in patients <18 years of age in India. Methods: The medical records of patients presenting with vitreous hemorrhage between January 2000 and January 2010 were retrospectively reviewed. Results: A total of 261 eyes of 246 patients (201 males) were included. Of these patients, 231 (94%) were unilateral. Trauma was the leading cause of injury in 179 eyes (68.5%); blunt trauma was more common than penetrating trauma in both males (64.7%) and females (57.7%). Wooden sticks were the most common cause of trauma (20.7%). Spontaneous causes accounted for 82 (31.5%) eyes, including 33 eyes (40%) with Eales disease, and 16 eyes (19.7%) with sequelae of retinopathy of prematurity. Trauma was most common cause of vitreous hemorrhage in all age groups, except in children <4 years of age, in whom spontaneous hemorrhage predominated. Overall, the most common management was surgery, performed in 173 (66.2%) eyes; 63 (24.1%) eyes were observed. Male sex, age >8 years, unilateral presentation, surgical treatment (P < 0.001), and blunt trauma (P = 0.047) were associated with severe visual loss. Mean follow-up was 636.5 ± 802.0 days overall, 597.0 ± 749.0 days for eyes observed and 638.8 ± 802.6 days for eyes that underwent surgery. Conclusions: Posttraumatic vitreous hemorrhage comprises almost two-thirds of children and adolescents presenting with vitreous hemorrhage. Blunt trauma is more common than penetrating trauma. Male sex, age >8 years, unilateral presentation, and surgical treatment were all significantly associated with severe visual loss. © 2013 by the American Association for Pediatric Ophthalmology and Strabismus.
Pal S.S.,18 College Road |
Gella L.,18 College Road |
Sharma T.,18 College Road |
Raman R.,18 College Road
Indian Journal of Ophthalmology | Year: 2011
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.
Rewri P.,18 College Road |
Rewri P.,Radhaswamy Eye Hospital |
Kakkar M.,Radhaswamy Eye Hospital
Indian Journal of Ophthalmology | Year: 2014
Background: Studies done on the prevalence of glaucoma have reported a high proportion of undiagnosed patients. Late diagnosis is related to increased risk of glaucoma associated with visual disability. Lack of awareness and non-availability of appropriate screening procedures are among the major reasons for non-diagnosis or late diagnosis of glaucoma. The present study has been undertaken to evaluate the level of awareness about glaucoma among the North Indian rural population. Materials and Methods: A group-administered, questionnaire-based survey, involving 5000 rural residents (aged 20 and above) was conducted through random sampling. The questionnaire was structured to evaluate the level of awareness and knowledge about glaucoma and the effect of gender, education status, and glaucoma diagnosis was also studied. The source of awareness about glaucoma was also questioned. Results: Of the 5000 individuals enrolled for the survey, responses from 4927 (98.5%; 95% Confidence Interval (CI): 98.2 - 98.9) participants, including 3104 males (63%; 95% CI: 61.7 - 64.3) and 1823 females (37%; 95% CI: 35.7 - 38.3) were evaluated. A total of 409 (~8.3%; 95% CI: 7.6 - 9.14) respondents were aware about glaucoma and only 93 (1.89%; 95% CI: 1.55 - 2.31) were qualified as having knowledge about glaucoma as per the set questionnaire. Education was the only variable significantly correlated (P value < 0.001) with the awareness and knowledge of glaucoma out of the parameters included in this study. Close acquaintance with a glaucoma patient was the most common source of information. Conclusions: There is a lack of awareness about glaucoma among the rural residents of North India. The study findings stress the need to spread awareness about glaucoma for prevention of glaucoma-related blindness. © 2005 - Indian Journal of Ophthalmology.
Raman R.,18 College Road |
Srinivasan S.,18 College Road |
Roy R.,18 College Road
Expert Review of Ophthalmology | Year: 2015
Diabetic retinopathy (DR) is a major cause of acquired blindness but is asymptomatic in its early stages. Therefore, there is an urgent need to establish a nation-wide efficient screening strategy for early detection, accurate diagnosis and timely treatment of vision threatening DR. © 2015 Taylor and Francis.
Sawant S.D.,18 College Road |
Biswas J.,18 College Road
Ocular Immunology and Inflammation | Year: 2010
Purpose: To report a case of fungal scleritis associated with exudative retinal detachment. Design: A rare case report. Methods: Nonresolving fungal scleritis mimicking noninfective scleritis was treated with systemic and topical antifungals and low topical steroids after diagnosis was established on scleral scraping. Even after complete resolution of scleritis, exudative retinal detachment persisted. Results: The patient was advised of a possible need to undergo vitreo retinal surgery if exudative retinal detachment persisted for more than a month after complete resolution of the scleritis component. Conclusion: Infective scleritis must be ruled out in cases of longstanding scleritis not responding to immunosuppressives. © 2010 Informa Healthcare USA, Inc.
Ahmed A.S.,18 College Road |
Biswas J.,18 College Road
Taiwan Journal of Ophthalmology | Year: 2013
This article aims to review the current literature to identify the various laboratory and investigative modalities that can be used to aid in the diagnosis of patients with uveitis. Although laboratory tests such as erythrocyte sedimentation rate, serum angiotensin-converting enzyme levels, and human leukocyte antigen typing among others have limited utility in the diagnosis of uveitis, they provide supportive evidence. Results of serological tests such as enzyme-linked immunosorbent assay have proven to be of significant importance in diagnosing diseases such as toxoplasmosis, and the use of ocular samples such as aqueous and vitreous has greatly increased the diagnostic reliability. Imaging techniques play a major role in the diagnosis of posterior uveitis. Fundus fluorescein angiography, indocyanine green angiography and lately, autofluorescence and optical coherence tomography provide information about the diagnosis of uveitis disorders and are also useful for monitoring progression, complications, and response to treatment. The use of ultrasonography and ultrasound biomicroscopy provides useful information in eyes with chronic uveitis where complications such as retinal detachment and cyclitic membranes are suspected and hazy media precludes a thorough clinical examination. Radiological investigations such as computerized tomography aid in the diagnosis and management of systemic disorders such as tuberculosis or sarcoidosis. © 2013.
PubMed | 18 College Road
Type: Journal Article | Journal: Diabetes research and clinical practice | Year: 2011
To evaluate the role of glycosylated hemoglobin (HbA1c) on the occurrence of sight-threatening diabetic retinopathy (STDR) in urban Chennai, Tamil Nadu, India.A total of 5999 individuals were enumerated from the Chennai metropolis. Of these, 1414 subjects with diabetes were included for data analysis in the study. STDR or non-STDR groups were classified based on the fundus photographs. HbA1c was measured (Bio-Rad DiaSTAT HbA1c Reagent Kit) by the liquid chromatography technique.A statistically significant difference (p < 0.05) was noted in the duration of diabetes, gender, body mass index, HbA1c, micro- and macro-albuminuria between both non-STDR and STDR groups as compared to the no-diabetic retinopathy (DR) group. On multivariate analysis, HbA1c (non-STDR: odds ratio OR = 1.23; 95% confidence interval CI = 1.15-1.32; p < 0.0001; STDR: OR = 1.31 95% CI = 1.14-1.52; p < 0.0001) was found to be significantly associated with non-STDR and STDR when compared with the no-DR group. The Receiver Operating Characteristic analysis showed that the cut-off value of 8.0 had 75.6% sensitivity and 58.2% specificity with 64.9% maximum area under the curve.HbA1c value >8.0% was significantly related with STDR. In a screening programme, the cut-off value of HbA1c >8.0% provided a maximum yield of STDR.