Ординатура / Офтальмология / Английские материалы / Eye Essentials Diabetes and the Eye_Steele, Steel_2008

Meglitinides, 46

Metaformin, 44

Micro pulse diode laser, 160 Micro-thrombus formation, 66 Microalbuminuria, 48 Microaneurysms, 76, 86–87, 109 Microangiopathic changes, in diabetic

retinopathy, 61–62 Minor stroke, 187

Mixed maculopathy, 84, 105 Modified grid patterns, in laser

treatment, 111 Molteno valves, 194

Muscle, effects of insulin on, 27 Myelinated nerve fibers, 198–199 Myelinated nerves, 199 Myocardial infarction, 13

Myopia, 92

N

NAD+, 66

NADPH, 65

National Screening Committee (NSC), 74

Neovascular glaucoma (NVG), 95, 194 Neovascularization, 68–70 Nephropathy, 54

Nerve palsies, 184–186 Neuro-ophthalmological

manifestations, 183–186 Neurogenic orthostatic hypotension,

209 Neuropathy, 13

Neuropeptide Y (NPY), 24 Neurotrophic ulcers, 181

New vessels at the disc (NVD), 184 New vessels elsewhere (NVE), 89–90,

121, 128

New vessels on optic disc, 119 Newborns of diabetic mothers, 199 Night vision, impaired, 132 Nocturia, 12

Nocturnal supine hypertension, 210 Non-arteritic ischaemic optic

neuropathy (NAION), 184

O

Obesity. See also Weight gain increasing age and, 43 type 2 diabetes and, 36, 49 in UK population, 43

Obstructive sleep apnea (OSA), 214–216

Octreotide, 155

Ocular ischaemic syndrome, 95, 189 Ocular motility defects, 186

Ocular motor disorders, 184–186 Ocular surface disorders, 181–183 Optic disc neovascularization (NVD),

88–89, 91

Optical coherence tomography (OCT), 114, 182

Oral therapy, in type 2 diabetes, 42–45 Orbital syndrome, 187

Orlistat, 49

Oxygen, hyperbaric, 158

P

Painful light sensivity, 113 Pan-retinal photocoagulation (PRP),

88–89, 101. See also Laser treatment

cataract surgery and, 179 complications of, 129–133 diagrammatic representation of, 122 indications for, 117–118

laser distribution and, 125–126 pain during laser treatment,

124–125

review after, 128–129

treatment technique for, 121–124

Papillopathy, 183–184

228Para central scotomata, 115 Paracetamol, 125

Pathogenesis, of type 1 diabetes, 19 Patterns in laser treatment

focal, 109–111 grid, 111

for maculopathy, 109–111 modified grid, 111

Pegvisomant, 155

Peri-foveal avascular zone (FAZ) microaneurysms, 177

Peripheral abnormalities, in diabetic retinopathy, 95

Peripheral autonomic neuropathy, 209 Peripheral vascular disease, 13 Photocoagulation. See Retinal

photocoagulation Photophobic patients, 113 Physical activity, 42

Pigment endothelium-derived factor (PEDF) inducers, 154

Pilocarpine, 186

PKC inhibitors, 153–154 Plasminogen activator, 66 Platelet function, 66 Polyol pathway, 65–66 Polyuria, 12

Population screening classification, diabetic retinopathy, 74–75

Posterior capsular opacity, 172 Posterior vitreous detachment (PVD),

92–93, 197 Pre-clinical retinopathy, 76

Pre-macular haemorrhage, 144 Pre-proliferative diabetic retinopathy

(PDR), 82–83 Pre-retinal haemorrhage, 90–91 Pregnancy, 213–214

Prevalence in United Kingdom, 2 Primary open angle glaucoma (POAG),

180

Progressive renal impairment, 114 Proliferative diabetic retinopathy

(PDR), 88–92

laser treatment of, 117–133 retinal ischaemia and, 69

surgical management for, 138–145 vitrectomy surgery and, 138–145

Prostacyclin (PGl2), 66 Protein kinase C, 66, 69, 152

Protein metabolism, insulin deficiency and, 21

Proteinuria, 210–211 Pupillary abnormalities, 131 Pupillary disorders, 186 Pupillary hypersensitivity, 186 Pyridine nucleotides, 65

R

Reactive oxygen species (ROS) production, 156

Redox cycling, 65 Referable maculopathy, 85 Regimes, insulin, 32

Relative afferent pupil defect (RAPD), 177

Renal impairment, progressive, 114 Repaglinide, 46

Retinal artery occlusion (central and branch), 193–194

Retinal capillary structure, 60–61 Retinal detachment, 140, 143 Retinal emboli, 192–193

Retinal ischaemia, 126 Retinal leukostasis, 63, 67–68

Retinal photocoagulation. See also Laser treatment

argon laser, 101–102 diode laser, 102–103

general principles of, 100–101 instrumentation, 102–104

Retinal pigment epithelium (RPE), 100–101

Retinal tears, 149

Retinal thickening, macular area, 113 Retinal vascular events, 189–190 Retinal vein occlusion, 190

Retinal veins, dilated, 76

Retinitis pigmentosa (RP), 93, 133

Type 2 diabetes, 36–49 (Continued)

230clinical presentation of, 13–15 dietary modification and, 40–42 dyslipidaemia and, 48 environmental factors and, 36–37 genetic factors and, 36

glucose homeostasis and, 37–40 glucosidase inhibitors and, 46 hypertension and, 48

insulin resistance and, 37

insulin secretagogues and, 45–46 insulin treatment in, 47–48 lifestyle changes and, 40–42 management of, 40–49 meglitinides and, 46

metafomin and, 44 natural history of, 40 obesity and, 49

oral therapy introduction and, 42–45 pathogenesis of, 36–37

physical activity and, 42 risk factors for, 3 smoking cessation and, 42 sulphonylureas and, 45–46

thiazolinediones and, 44–45

U

United Kingdom Prospective Diabetes

Study (UKPDS), 13, 73, 204–209

Unresponsive diabetic maculopathy, 114–115

Unusual findings, 200

US Diabetes Control and Complications Trial (DCCT), 204–205

Uveitis, 172

V

Vascular endothelial growth factor (VEGF), 68–70, 152, 165

Vasoactive intestinal peptide (VIP), 24 Venous changes, in pre-proliferative

diabetic retinopathy, 82–83

Vessel wall staining, 109

Viewing systems, in vitrectomy surgery, 136–137

Vision blurring, 12, 13

Visual loss, 106, 118. See also Blindness

Visual prognosis, following vitrectomy, 150

Vitamin C, 65

Vitamin E, 65

Vitrectomy surgery, 134–150 accessory instruments, 136 aims of, 145

anaesthesia and, 137 complications and, 146–150 indications for in proliferative DR,

138–145

infusion cannula in, 135 instrumentation, 135–137 intraocular illumination and, 136 new approaches, 161–162 setup for, 138

surgical technique, 145–148 viewing systems, 136–137 visual prognosis after, 150 vitrectomy probe, 135

Vitreous cutters, 141

Vitreous haemorrhage, 91, 131, 139, 149, 174–175

Vitreous traction, 114

W

Weight gain, 33. See also Obesity Weight loss, 12

Weiss ring, 197 White scatter, 170

Wisconsin Epidemiologic Study of Diabetic Retinopathy, 204, 207, 211–212

World Health Organization (WHO) diagnostic criteria

diabetes mellitus, 8 impaired fasting glucose, 9

impaired glucose tolerance, 9