Diabetic Retinopathy News

Congressman Asks African-Americans With Diabetes To Get an Eye Exam ASAP

SAN FRANCISCO, February 2010 — House Majority Whip James E. Clyburn, D-SC, has recorded a video to urge African-American diabetics to get an annual eye exam in February, which is Black History Month.

"Diabetes is an epidemic in the African-American community," said Rep. Clyburn. "People with diabetes are 25 times more likely to go blind, and African-Americans with diabetes are at an even higher risk — almost 50 percent more likely to develop diabetic retinopathy."

"If you have diabetes, it's critically important for you to receive an annual diabetic eye exam, because it will help detect and prevent eye disease," the congressman added.

In the United States, 3.7 million African-Americans over age 20 have diabetes, and the incidence is growing.

According to studies, African-Americans with diabetes are more likely to develop diabetic complications and experience greater disability from the complications than white Americans with diabetes. But this can be prevented with strict glucose control and annual dilated eye exams.

The video was produced in conjunction with the American Academy of Ophthalmology's EyeSmart campaign and the Stop Diabetes movement of the American Diabetes Association.

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Could Magnesium and Vitamins C and E Help Diabetics
Avoid Retinopathy?

CAMBRIDGE, U.K., February 2010 — Vitamins C and E suppress production of the growth factor VEG-F, which promotes abnormal blood vessels in the retina; and high dietary levels of magnesium are associated with lower blood pressure and blood sugar, which reduce the risk of retinopathy.

So does this mean that taking these supplements could help prevent diabetic retinopathy?

To find out, researchers at the Institute of Metabolic Science in Cambridge examined studies published from 1988 through 2008 and involving 4,094 people. The survey found that the evidence is not compelling enough to recommend supplements of vitamins C and E and magnesium to diabetics. However, the researchers said that studies should continue. For example, hospital-based studies did find that people with higher levels of vitamin C in their blood were less likely to have diabetic retinopathy, though population-based studies did not produce that finding.

The survey report appeared in the January issue of Ophthalmology.

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Too Many Calories, Too Much Sodium Increase Retinopathy
Risk Among African-Americans

NEWARK, N.J., February 2010 — In a six-year study of 469 African-American patients with type 1 diabetes, those who had the highest caloric intake at the beginning of the study were more likely to develop vision-threatening diabetic retinopathy than others.

And those who had a high intake of sodium at the beginning of the study were more likely to develop macular edema.

"These results suggest that low caloric and sodium intakes in African-American individuals with type 1 diabetes mellitus may have a beneficial effect on the progression of diabetic retinopathy and thus might be part of dietary recommendations for this population," concluded the researchers, who work at New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark, and New York University College of Dentistry. The study was reported in the January issue of Archives of Ophthalmology.

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Steroid Injections Could Slow Diabetic Retinopathy Progression

BALTIMORE, Md., February 2010 — Injecting the corticosteroid triamcinolone into the eye can slow diabetic retinopathy progression, says a study by researchers at Johns Hopkins Wilmer Eye Institute.

However, they say, this treatment should not be used until a drug is developed that can deliver the benefits of steroids without the damage they cause, including increasing the risk of glaucoma and cataracts. For now, the preferred treatment is laser photocoagulation.

The study involved 840 eyes of 693 men and women from July 2004 to May 2006. The subjects had an average age of 63 and had diabetic retinopathy with macular edema. They were randomly assigned to receive laser photocoagulation or steroid injections.

The steroid injections did not perform better than the laser regarding increasing the chance of improved vision and decreasing the chance of vision loss. The study appeared in Archives of Ophthalmology in December.

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Hemoglobin A1C Proves Strong Retinopathy Predictor; Glucose Control and Blood Pressure Lowering Show Positive Renal Outcomes

ATLANTA & SYDNEY, January 2010 — A new study finds that hemoglobin A1C levels in blood tests are a stronger indicator for diabetic retinopathy than fasting plasma glucose. The study examined 1,066 individuals over 40 years old. Thirty-six percent were diagnosed diabetics, and 11 percent had retinopathy.

The findings show that the prevalence of retinopathy increased with A1C levels of 5.5 percent or greater and fasting plasma glucose of 5.8 mmol/L or greater.

The study was conducted by the U.S. Centers for Disease Control and Prevention, the National Institute of Diabetes and Digestive and Kidney Diseases and the University of Wisconsin School of Medicine and Public Health.

A related study by the University of Sydney in Australia examined renal outcomes in patients with type 2 diabetes. It found that the combined treatment of blood pressure lowering and intensive glucose control had better outcomes than treatments used independently.

The studies were reported in the November issue of Diabetes Care.

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Pine Bark Extract Can Improve Vision in Early-Stage
Diabetic Retinopathy

HOBOKEN, N.J., December 2009 — Maybe Euell Gibbons was right about the benefits of eating pine trees. Pycnogenol, an antioxidant plant extract from the bark of the French maritime pine tree, improves microcirculation, retinal edema and visual acuity in the early stages of diabetic retinopathy, according to a study conducted at G. D'Annunzio University in Chieti and Pescara, Italy.

Twenty-four diabetic patients were given three 50 mg Pycnogenol tablets in the morning after breakfast, with 22 others receiving a placebo. The regimen lasted three months.

After two months, visual acuity improved from the baseline measure of 14/20 to 17/20 in 18 of the 24 people in the Pycnogenol group. The placebo control group showed no improvement.

Reduction of retinal swelling also occurred, possibly due to improved retinal blood circulation.

The study report appeared online in the Journal of Ocular Pharmacology and Therapeutics in November. Natural Health Science, which supported this research, is the Hoboken, N.J.-based North American distributor for Pycnogenol brand French maritime pine bark extract on behalf of Horphag Research Ltd.

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New Device Shines Light on the Eye To Detect Glucose Levels

SAN DIEGO, November 2009 — Finger-pricking may become a thing of the past for diabetics when development is completed of a device that reads glucose levels by shining light on one eye for less than a second.

The consumer-friendly device would operate like binoculars, displaying a glucose reading digitally. It is being developed by Freedom Meditech (San Diego, Calif.), which is also pursuing commercialization of a screening device for eye care professionals.

A pre-clinical study on rabbits showed a mean absolute percent error for glucose prediction of less than 13 percent, compared with an estimated 32 percent error common with the finger stick blood test.

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Nearsightedness May Reduce Risk of Diabetic Retinopathy

SINGAPORE, November 2009 — Small, inconclusive studies have suggested that nearsightedness (myopia) has a protective effect against diabetic retinopathy (DR). A recent study of 675 diabetics included an additional measurement, axial length (measurement of the front of the eye to the back).

Less risk of DR, especially severe DR, was found in people whose nearsightedness resulted from both longer axial length and deeper anterior eye chamber. This was true whether the myopia was mild or severe.

The researchers speculated that the protective effect resulted from characteristics found in myopia, such as atrophy of the retina, choroid or vitreous. Even though they cause vision problems, these conditions may reduce retinal metabolic needs and increase oxygen circulation in the back of the eye, which would lower risk of DR.

Results of this study were presented at this year's joint meeting of the American Academy of Ophthalmology and the Pan-American Association of Ophthalmology.

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Diabetics Who Receive Good Medical Care Less
Likely To Lose Vision

DURHAM, N.C., October 2009 — In a study, people with diabetes mellitus who received recommended levels of care for their disease had much lower rates of low vision or blindness from diabetic retinopathy and other diabetes-related eye diseases than did those who didn't receive the care.

"Recommended levels of care" was defined as receiving each of the following services 0.75 times per year on average: examination by a physician, examination by an ophthalmologist or optometrist, urinalysis and measurements of hemoglobin A1c level and lipid levels.

The study included 5,989 diabetes mellitus patients whom Duke University School of Medicine researchers followed for up to three years. It was reported in the journal Ophthalmology in August.

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Controlling Arginase Levels in the Blood May Help
Combat Diabetic Retinopathy

AUGUSTA, Ga., September 2009 — Researchers know that nitric oxide can reduce injury from inflammation. But high blood levels of arginase reportedly reduce nitric oxide availability, thereby allowing the damage to occur. Arginase is a liver enzyme that plays a part in digestion, converting the amino acid arginine to urea.

High levels of arginase in the blood can indicate cardiovascular disease, as well as inflammation in the kidneys and other organs. Recently scientists found that it is also an indicator of early blood vessel damage in the eyes. This knowledge is especially useful in detecting the retinal blood vessel inflammation caused by diabetes.

The scientists, from the Medical College of Georgia and Charlie Norwood Veterans Affairs Medical Center, say they would like to find new drugs that maintain arginase at healthy levels.

The study report was published in The American Journal of Pathology in August.

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Antihypertensive Drugs Slow Diabetic Eye Injury

MINNEAPOLIS & ST. PAUL, July 2009 — Recently a five-year study examined the ability of certain antihypertensive medications to slow diabetic kidney damage in people with type 1 diabetes and found that they were not effective.

So what does this have to do with the eyes? A surprise finding was that participants did show a significant slowing of the progression of diabetic eye injury, by 65 percent for one drug (enalapril) and 70 percent for the other (losaran).

Still to be determined is the age at which a diabetic person should take these kinds of drugs and for how long.

Researcher Michael Mauer, MD, of the University of Minnesota Medical School, published the results this month in New England Journal of Medicine.

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Sleep Apnea Linked to Retinopathy

OXFORD, England, June 2009 — People with type 2 diabetes who have retinopathy should also be screened for obstructive sleep apnea (OSA), says a new study.

Retina images of 118 men with type 2 diabetes revealed retinopathy in 54 percent of those who had OSA and 31 percent of those without OSA, a statistically significant finding according to researchers.

Poor glucose control and high blood pressure are related to diabetic retinopathy, but in the study OSA was more strongly linked to retinopathy than either of those two factors.

Symptoms of OSA include snoring, breathing lapses during sleep and sleepiness during the daytime. The researchers said that the OSA treatment of continuous positive airway pressure would be studied in the future as a possible way to delay the development of diabetic retinopathy.

Study results were presented at the American Thoracic Society's recent international conference.

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Implants Can Help Eyes Oxygen-Deprived From
Diabetic Retinopathy

OAK RIDGE, Tenn., April 2009 — A new surgical procedure may help retinal tissue that's oxygen-deprived due to restricted blood flow caused by diabetic retinopathy. This could slow or prevent the vision damage that results from diabetic retinopathy.

Researchers are implanting small electrodes in the eye that provide short pulses of current. This stimulates oxygen production while suppressing production of potentially harmful chlorine.

By implanting a "ground" electrode behind the ear, the surgeons can also keep constant pH in the treatment area.

The project team includes researchers from Oak Ridge National Laboratory, the University of Southern California and the University of Tennessee.

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New Imaging Technology Instantly Detects Eye Diseases

OAK RIDGE, Tenn., February 2009 — A new screening device photographs and transmits images of a person's retina to a central database, where early signs of eye diseases such as diabetic retinopathy can be detected instantly.

Researchers say the technology, developed at the Department of Energy's Oak Ridge National Laboratory (ORNL), could become a powerful screening tool for eye doctors. The device uses a central database of images to sort and instantly match new photographs with those that contain specific signs of retinal eye diseases.

"Once we've taken pictures of the eyes, we transmit that information to our database, where it is compared to thousands of images of known retinal disease states," said Ken Tobin, leader of the ORNL team that developed the technology. "From there, the computer system is able to determine whether the patient passes the screening, or it provides a follow-up plan that includes seeing an ophthalmologist."

The National Eye Institute funded the research, led on the medical side by Edward Chaum, MD, ophthalmologist and Plough Foundation professor of retinal diseases at the University of Tennessee Health Science Center.

"Right now, with 21 million diabetics in the United States, we need to be screening 400,000 patients for diabetic eye disease every week," Chaum said. "Less than half of these diabetics receive the recommended annual eye exam, which is absolutely essential to minimize serious eye complications and potential blindness."

Chaum said the automated screening tool eventually could be in widespread use worldwide, including remote and rural areas.

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Avastin Helps Cataract Patients With Diabetic Retinopathy

DHAHRAN, Saudi Arabia, February 2009 — Saudia Arabia researchers say a drug (bevacizumab) injected into the eye at the end of cataract surgery helped delay or halt progression of diabetic retinopathy (DR) in patients already diagnosed with the eye disease.

Bevacizumab is an anti-cancer drug known commercially as Avastin, often used off label to treat advanced age-related macular degeneration. The drug prevents growth of abnormal blood vessels in the retina to help prevent scarring and resulting blindness.

The Saudi Arabia study involved 68 eyes of 68 cataract patients with diabetic retinopathy. Half of patients received Avastin injections at the end of cataract surgery, while the other half did not. After six months, researchers observed significant impediment of DR progression in the Avastin group with these results:

• Only four of 35 eyes in the Avastin group had DR progression, compared with 15 of 33 eyes in the control group.
• Only two eyes had progression of diabetic maculopathy in the Avastin group, compared with 17 in the control group.

Study results appeared in the January issue of the Journal of Cataract & Refractive Surgery.

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Diabetic Eye Disease Numbers Likely To Triple by 2050

ATLANTA, January 2009 — Researchers predict that the number of Americans 40 and older with diabetic retinopathy will triple to 16 million by 2050.

The study by U.S. Centers for Disease Control and other researchers says the number of people with vision-threatening diabetic eye disease also will triple, to 3.4 million during the same time period.

Researchers say the growing number of Americans with diabetes means a greater prevalence of resulting eye diseases, including diabetic retinopathy, cataracts and glaucoma.

"Efforts to prevent diabetes and to optimally manage diabetes and its complications are needed," study authors said.

Research results were published in the December issue of Archives of Ophthalmology.

Please click here for more diabetic retinopathy news from 2008.

[Page updated February 12, 2010]