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This article presents a database containing 757 color fundus images acquired at the Department of Ophthalmology of the Hospital de Clínicas, Facultad de Ciencias Médicas (FCM), Universidad Nacional de Asunción (UNA), Paraguay. Firstly, the retinal images were acquired with a clinical procedure presented in this paper. The acquisition of the retinographies was made through the Visucam 500 camera of the Zeiss brand. Next, two expert ophthalmologists have classified the dataset. These data can help physicians and researchers in the detection of cases of Non-Proliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR), in their different stages. The dataset generated will be useful for ophthalmologists and researchers to work on automatic detection algorithms for Diabetic Retinopathy (DR).
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AIM: To assess if the included vascular endothelial growth factor (VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mellitus (T2DM). METHODS: A case-control study was conducted in adult individuals with T2DM associated to proliferative retinopathy or non-proliferative retinopathy from Oct. 2014 to Jun. 2015 from the Retina Department of the Asociation to Prevent Blindness in Mexico. The selected patients were adults with a diagnosis of T2DM ≥5y. All subjects had a comprehensive ocular examination and the classification of the retinopathy severity was made considering the Early Treatment Diabetic Retinopathy Study (ETDRS) standardization protocols. Genomic DNA was extracted from whole fresh blood. All samples were genotyped by qPCR for selected VEGF polymorphisms. Hardy-Weinberg equilibrium was calculated by comparing Chi-square values between the expected and the observed values for genotype counts. RESULTS: In total 142 individuals were enrolled, 71 individuals with T2DM and associated proliferative retinopathy and 71 individuals with non-proliferative retinopathy. One-sided Fisher's exact test was performed for rs3025021 [OR (95% CI)=0.44(0.08-2.2); P=0.25] and rs2010963 [OR (95% CI)=0.63(0.25-1.6); P=0.23]. The minor allelic frequencies obtained were 26% for rs3025021, 10% for rs3025035 and 61% for rs2010963. The pairwise linkage disequilibrium between the three SNP was assessed, and was as follows: rs3025021 vs rs3025035: D'=1.0, r2=0.1043, P≤0.0001; rs3025021 vs rs2010963: D'=0.442, r2=0.0446, P=0.149; rs3025035 vs rs2010963: D'=0.505, r2=0.0214, P=0.142. CONCLUSION: This is the first analysis involving VEGF polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that different populations have different associations for the same polymorphisms.
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Diabetic retinopathy (DR) is a common chronic complication of diabetes and remains the leading cause of blindness in working-aged people. Hyperglycemia increases glucose flux through the polyol pathway, in which aldose reductase converts glucose into intracellular sorbitol, which is subsequently converted to fructose by sorbitol dehydrogenase (SDH). The accelerated polyol pathway triggers a cascade of events leading to retinal vascular endothelial dysfunction and the eventual development of DR. Polymorphisms in the gene encoding aldose reductase have been consistently associated with DR. However, only two studies have analyzed the relationship between polymorphisms in the gene encoding SDH (SORD) and DR. In this case-control study, we investigated whether the -888G > C polymorphism (rs3759890) in the SORD gene is associated with the presence or severity of DR in 446 Caucasian-Brazilians with type 2 diabetes (241 subjects with and 205 subjects without DR). The -888G > C polymorphism was also examined in 105 healthy Caucasian blood donors, and the genotyping of this polymorphism was carried out by real-time PCR. The genotype and allele frequencies of the -888G > C polymorphism in patients with type 2 diabetes were similar to those of blood donors (G allele frequency = 0.16 in both groups of subjects). Similarly, the genotype and allele frequencies in patients with DR or the proliferative form of DR were similar to those of patients without this complication (P > 0.05 for all comparisons). Thus, our findings suggest that the -888G > C polymorphism in the SORD gene is not involved in the pathogenesis of DR in type 2 diabetes.
Assuntos
Diabetes Mellitus Tipo 2/genética , Retinopatia Diabética/genética , L-Iditol 2-Desidrogenase/genética , Polimorfismo de Nucleotídeo Único , População Branca/genética , Adulto , Aldeído Redutase/genética , Brasil , Estudos de Casos e Controles , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Sorbitol/metabolismoRESUMO
Objetivo: Describir el comportamiento clínico-epidemiológico de la retinopatía diabética en el municipio Marianao, en el periodo de agosto - noviembre de 2007. Métodos: Se realizó un estudio descriptivo, de corte transversal. El universo estuvo constituido por los 7 693 diabéticos dispensarizados en el municipio Marianao. Se realizó interrogatorio y examen oftalmológico a los 150 pacientes incluidos en la muestra. Además se tomó fotografía de fondo, angiografía fluoresceínica y tomografía de coherencia óptica a aquellos que lo precisaban. Resultados: La prevalencia de retinopatía diabética fue de un 16,0 %. Se encontró con más frecuencia entre los 55 a 64 años de edad (20,0 %), con predominio en los diabéticos tipo 1 (28,6 %). Se evidenció un incremento de la retinopatía diabética con el aumento del tiempo de duración de la diabetes. Se observó tendencia a las formas menos severas y se encontró mayor severidad en ojos de pacientes con 21 años o más de evolución. El 4,7 % de los pacientes presentaban edema macular diabético y el 4,0 % ceguera legal. La retinopatía diabética y la catarata constituyeron las causas más frecuentes de ceguera, 1,3 % respectivamente. Conclusión: La prevalencia de retinopatía diabética y ceguera por esta enfermedad, mostró cifras inferiores a las recogidas en estudios previos. Con el aumento del tiempo de evolución de la diabetes mellitus se observó una mayor severidad de la retinopatía diabética y el edema macular diabético.
Objective: To describe the clinical and epidemiological behavior of diabetic retinopathy in Marianao municipality in the period of August to November, 2007 Methods: A single-phase, descriptive and cross-sectional study of 7693 diabetic adults was carried out from August 2007 to November 2007 in Marianao municipality. The sample of 150 adults with diabetes was questioned and examined from the ophthalmological viewpoint. Additionally, funduscopy, fluorescein angiography and optical coherence tomography were performed on those patients who required so. Results: Diabetic retinopathy prevalence was 16,0 % and it was more frequent in patients aged from 55 to 64 years (20,0 %) and in patients suffering from diabetes type 1 (28,6 %). The length of time suffering from diabetes mellitus had an impact on the increased diabetic retinopathy. There was a tendency toward less severe forms of the disease, although more severity was found in patients who had had this disease for 21 years or more. About 4,7 % and 4 % of the patients presented macular diabetic edema and legal blindness respectively. Diabetic retinopathy and cataract were the most frequent causes of blindness (1,3 % both). Conclusions: The prevalence of diabetic retinopathy and blindness caused by this illness showed figures lower than those collected in previous studies. The longer the time of evolution of diabetes, the more severe forms of diabetic retinopathy and diabetic macular edema found.
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The fractal dimension has been employed as a useful parameter in the diagnosis of retinal disease. Avakian et al. (Curr Eye Res 2002; 24: 274-280), comparing the vascular pattern of normal patients with mild to moderate non-proliferative diabetic retinopathy (NPDR), found a significant difference between them only in the macular region. This significant difference in the box-counting fractal dimension of the macular region between normal and mild NPDR patients has been proposed as a method of precocious diagnosis of NPDR. The aim of the present study was to determine if fractal dimensions can really be used as a parameter for the early diagnosis of NPDR. Box-counting and information fractal dimensions were used to parameterize the vascular pattern of the human retina. The two methods were applied to the whole retina and to nine anatomical regions of the retina in 5 individuals with mild NPDR and in 28 diabetic but opthalmically normal individuals (controls), with age between 31 and 86 years. All images of retina were obtained from the Digital Retinal Images for Vessel Extraction (DRIVE) database. The results showed that the fractal dimension parameter was not sensitive enough to be of use for an early diagnosis of NPDR.