Navegando por Palavras-chave "Diabetic retinopathy"

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    Detecção da retinopatia diabética no Diabetes Mellitus Tipo 1: comparação entre a oftalmoscopia binocular indireta e a retinografia digital em um estudo populacional. Alterações na espessura da coroide em pacientes com Diabetes Mellitus Tipo 1 sem retinopatia
    (Universidade Federal de São Paulo (UNIFESP), 2016-08-31) Malerbi, Fernando Korn [UNIFESP]; Dib, Sergio Atala [UNIFESP]; http://lattes.cnpq.br/3659437526996462; http://lattes.cnpq.br/8724599579159084; Universidade Federal de São Paulo (UNIFESP)
    Article 1 Background. Diabetic retinopathy is the main cause of preventable blindness in the economically active population in western countries. Diabetic retinopathy screening is effective in preventing blindness and can be performed through various diagnostic methods. Our objective is to compare binocular indirect ophthalmoscopy (BIO) to telemedicine protocols of digital retinography for diabetic retinopathy screening in a large and heterogenous type 1 diabetes population in a developing country. Methods. Data from 1266 Type 1 Diabetes Mellitus patients from a Brazilian multicenter study were analyzed. Patients underwent BIO and digital retinography, non-mydriatic and mydriatic. Images were sent to a reading center in a telemedicine protocol. Agreement between the different methods was calculated with kappa statistic for diabetic retinopathy and maculopathy classification. Clinical outcome was either observation or referral to specialist. Results. Agreement between BIO and mydriatic retinography was substantial (kappa = 0.67 to 0.74) for diabetic retinopathy observation vs referral classification. Agreement was fair to moderate (kappa = 0.24 to 0.45) between retinography and BIO for maculopathy. Poor mydriasis was the main obstacle to image reading and classification, especially on the nonmydriatic strategy, occurring in 11.9% or right eyes and 16.9% of left eyes. Conclusion. Mydriatic retinography showed a substantial agreement to BIO for diabetic retinopathy observation vs referral classification. A significant amount of information was lost on the non-mydriatic technique because of poor mydriasis. We recommend a telemedicine-based diabetic retinopathy screening strategy with digital mydriatic retinography, preferably with 2 fields (macula- and optic disc-centered), and advise against non-mydriatic retinography in developing countries. Article 2 BACKGROUND/AIMS: To examine tomographic measurements of choroidal thickness in normoalbuminuric and albuminuric Type 1 diabetes mellitus (T1D) patients without diabetic retinopathy. METHODS: Cross-sectional study. Forty T1D patients without diabetic retinopathy were evaluated by spectral domain optical coherence tomography (SD-OCT); twenty-four agematched healthy subjects were evaluated as a control group. Patients with diabetes were classified into 2 groups: 19 patients were albuminuric and 21were normoalbuminuric. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-?m intervals up to 1000 ?m temporal and nasal to the fovea. RESULTS: Mean choroidal thickness was increased in patients with diabetes. Albuminuric diabetic patients had a thicker subfoveal choroid in comparison to normoalbuminuric diabetic patients (390?m versus 361?m), and subfoveal CT of both groups of diabetic patients was increased in comparison to the control group (323?m). Analysis of variance showed significant differences subfoveally and at the nasal points (p<0.05). CONCLUSIONS: Albuminuric T1D patients without diabetic retinopathy presented a thickened choroid. SD-OCT evaluation of the choroid revealed significant thickness changes even before diabetic retinopathy was present. An altered CT may be a surrogate for the systemic vascular changes that occur in diabetes, and albuminuria should be acknowledged as a confounding factor in the evaluation of choroidal thickness in diabetic patients.
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    Epidemiologia e diferenças regionais da retinopatia diabética em Pernambuco, Brasil
    (Conselho Brasileiro de Oftalmologia, 2008-04-01) Escarião, Paulo Henrique Gonçalves; Arantes, Tiago Eugênio Faria De [UNIFESP]; Figueiroa Filho, Natanael Cavalcanti; Urtiga, Ricardo De Deus; Florêncio, Telma Lúcia Tabosa; Arcoverde, Ana Lúcia De Andrade Lima; Fundação Altino Ventura; Hospital de Olhos de Pernambuco; Fundação Altino Ventura Projeto para Prevenção da Cegueira por Retinopatia Diabética; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To evaluate the prevalence and severity of diabetic retinopathy among patients cared for in a screening program in Pernambuco, Brazil, comparing regional differences between urban and rural zones. METHODS: The charts of 2,223 diabetic patients (1,568 females and 655 males; mean age 59.3 ± 12.0 years; mean duration of diabetes 8.1 ± 6.3 years) that took part in a screening program for diabetic retinopathy at Altino Ventura Foundation from June 2004 to June 2005 were reviewed for the presence of the disease. Patients were divided into two groups: group I, patients living in Recife and the metropolitan area; group II, patients living in the interior of Pernambuco state. RESULTS: In group I, 477 (24.2%) patients had diabetic retinophathy, while in group II, 89 (39.4%) patients (p<0.0001). The frequency of proliferative diabetic retinophathy, macular edema, vitreous hemorrhage and retinal detachment was higher in group II patients (p<0.05). CONCLUSIONS: Patients living in the interior of Pernambuco state have a higher incidence of diabetic retinophathy and the advanced forms than patients living in Recife and the metropolitan area when examined in a screening program for diabetic retinopathy at the Altino Ventura Foundation. Telemedicine and descentralization actions are recommended for improvement of screening quality in patients living in the interior of Pernambuco state.
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    Estudo da micobiota em conjuntiva sadia de diabéticos, residentes na área urbana da cidade de São Paulo - Brasil
    (Conselho Brasileiro de Oftalmologia, 2006-02-01) Andrade, Alfredo José Muniz de [UNIFESP]; Hofling-Lima, Ana Luisa [UNIFESP]; Yu, Maria Cecília Zorat [UNIFESP]; Godoy, Patricio [UNIFESP]; Gompertz, Olga Fischman [UNIFESP]; Bonfim, Sabrina de Souza [UNIFESP]; Andrade, Francisco Eudes Muniz de; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Pernambuco
    PURPOSE: To determine the mycobiota of the healthy conjunctiva in diabetic individuals, according to diabetes type, age, sex, disease time, type of treatment, and stage of diabetic retinopathy of the individuals. To identify the anemophilus mycobiota in the sampling rooms. METHODS: A cross-sectional study was carried out on 803 diabetics who reside in the urban area of São Paulo-SP/Brazil. Sabouraud's dextrose agar culture with chloramphenicol was used for primoisolation, and the key of De Hoog was used to identify filamentous fungi. RESULTS: Of the evaluated diabetics, 6.6% (53/803) presented type 1 diabetes and 93.4% (750/803) type 2. The positive cultures for fungi in the conjunctiva of diabetics was 4.2% (34/803), with 1.9% (1/53) in type 1 diabetics and 4.4% (33/740) in type 2 diabetics (p=0.720). With respect to the presence or not of isolated fungi, there was no statistically significant association regarding age (p=0.575), sex (p=0.517), disease time (p=0.633), type of treatment (p=0.422), and diabetic retinopathy stage (p=0.655) of the tested individuals. The identified fungi were all filamentous: Aspergillus spp. represented 59.5% (25/42) of isolations and 47.6% (20/42) of isolated species were Aspergillus niger. Growth of anemophilus fungi occurred in the air of the room and coincidences were observed between the isolated species from the air and those from the conjunctiva. CONCLUSIONS: Presence of mycobiota in healthy conjunctivas of diabetics was identified, with no significant association between the greater number of positive fungi isolations and the type of diabetes, age, sex, disease type, type of treatment, and stage of diabetic retinopathy. In the collection rooms, anemophilus mycobiota was identified.
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    Facoemulsificação, vitrectomia via pars plana e implante de lente intra-ocular em olhos com retinopatia diabética proliferativa
    (Conselho Brasileiro de Oftalmologia, 2004-06-01) Mattos, Armando Belfort [UNIFESP]; Bonomo, Pedro Paulo [UNIFESP]; Freitas, Lincoln Lemes [UNIFESP]; Farah, Michel Eid [UNIFESP]; Flynn Jr, Harry; Pereira, Maurício Bastos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de Miami Bascom Palmer Eye Institute
    PURPOSE: To evaluate the outcomes and the best technique for a combined phacoemulsification (PHACO), pars plana vitrectomy (PPV) and posterior chamber intraocular lens insertion (PCIOL) in one single procedure for patients with proliferative diabetic retinopathy. METHODS: We reviewed charts of 47 (53 eyes) patients with proliferative diabetic retinopathy who underwent combined phacoemulsification with posterior chamber intraocular lens implant and pars plana vitrectomy performed between January 1991 and September 1998 at the Bascom Palmer Eye Institute, eye hospital affiliated with the University of Miami. The study was done in conjunction with the Federal University of São Paulo. A total of 43 eyes from 40 patients were elected to participate in the study. RESULTS: The follow-up range was three to 60 months (mean 20 months). The age ranged from 37 to 77 years with a mean of 59. Preoperative visual acuity improved two lines or more in 26 (60.4%) eyes, remained the same in 9 (20.9%) and got worse in 8 (18.6%). In 10 (23.2%) eyes visual acuity improved to 20/40. The study showed to be statistically significant for the improvement of the final visual acuity. Recurrent vitreous hemorrhage was the most frequent postoperative complication found in 12 (27.9%) eyes and it was followed by transient anterior chamber reaction in 9 (20.9%) eyes. Intraoperative and postoperative complications related to phacoemulsification were rare. IOL capture was found in 2 (4.6%) eyes and intraocular lens subluxation in 1 (2.3%) eye. CONCLUSION: Combined phacoemulsification with posterior chamber intraocular lens implant and pars plana vitrectomy in proliferative diabetic retinopathy is a feasible procedure, well-tolerated and usually presents significant visual acuity improvement. One single procedure, to remove the cataract and to perform pars plana vitrectomy, instead of performing a second surgery that would be only to remove the cataract after the pars plana vitrectomy is safe, improves visual acuity and is also less aggressive for the patient. The potential for improving final visual acuity is limited by the severity of retinopathy.
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    The impact of metabolic parameters on clinical response to VEGF inhibitors for diabetic macular edema
    (Elsevier B.V., 2014-03-01) Matsuda, Simone [UNIFESP]; Tam, Tiffany; Singh, Rishi P.; Kaiser, Peter K.; Petkovsek, Dan; Carneiro, Glaucia [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Ehlers, Justis P.; Cleveland Clin Fdn; Universidade Federal de São Paulo (UNIFESP)
    Aims: Evaluate the role of systemic factors on the functional and anatomic outcomes of anti-VEGF therapy for diabetic macular edema (DME).Methods: A retrospective consecutive case series of 124 patients with DME treated with anti-VEGF therapy was collected. the main outcome measures were change in best corrected visual acuity (BCVA) and change central subfield macular thickness (CST) measured with spectral-domain ocular tomography coherence (SD-OCT); and their correlation with clinical findings.Results: Patients with serum hemoglobin A1c values (HbA1c) <= 7.0% had a statistically significant improvement in BCVA (20/66 to 20/43, p < 0.001), and those patients with HBA1c > 7.0% also had a significant but less robust improvement in BCVA (20/78 to 20/62, p = 0.024). CST improved significantly in both groups, but showed a larger magnitude of improvement in the group with better DM control [-140.7 microns (p < 0.001) and -83.3 microns (p < 0.001)]. Mean HBA1c levels remained relatively stable during the follow-up in both groups, but patients with improved glucose control during the study duration had a significantly lower retinal thickness than patients that had a stable or worsening HbA1c (mean final CST of 324.3 versus 390.0 mu m, respectively, p = 0.042). Other systemic parameters were not correlated with changes in OCT thickness or BCVA. There was not a significant difference related to number of intravitreal injection in the HbA1c <= 7.0% group compared to HbA1c > 7.0% group, mean of 5.48 and 6.0 intravitreal injections respectively (p = 0.362).Conclusion: This study suggests that glucose regulation can impact the response to anti-VEGF therapy in the management of DME. (C) 2014 Elsevier Inc. All rights reserved.
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    Mudanças oculares durante a gestação
    (Conselho Brasileiro de Oftalmologia, 2009-04-01) Gouveia, Enéias Bezerra; Conceição, Paulo Sergio Pereira; Morales, Maira Saad de Avila [UNIFESP]; Hospital São Joaquim da Real e Benemérita Sociedade Portuguesa de Beneficência Serviço de Oftalmologia; Universidade São Paulo Faculdade de Medicina Serviço de Ginecologia-Obstetricia; Universidade Federal de São Paulo (UNIFESP)
    Pregnancy can cause several alterations in human eye function in healthy condition as well in ocular disease; these effects on the eyes are divided into three categories: physiologic alterations, ocular diseases changes already existing before the pregnancy, and pathological alterations. The present text proposes a bibliographical revision on the theme. The authors researched PubMed (MEDLINE) and LILACS databases.
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    Novos conceitos em retinopatia diabética: dano neurológico versus dano vascular
    (Conselho Brasileiro de Oftalmologia, 2008-06-01) Serrarbassa, Pedro Durães; Dias, Alana Ferreira Gomes; Vieira, Márcio Fragoso [UNIFESP]; Universidade de São Paulo (USP); Hospital do Servidor Público Estadual de São Paulo Departamento de Oftalmologia; HSPE Departamento de Oftalmologia; Universidade Federal de São Paulo (UNIFESP)
    Diabetic retinopathy is the leading cause of irreversible legal blindness in working-age adults. The number of people worldwide at risk of developing vision loss from diabetes is predicted to double over the next 30 years. Some elements suggest that neurodegenerative changes occur beyond vascular damage. These changes include increased apoptosis, glial cell reactivity, microglial activation, and altered glutamate metabolism, and could explain some of the functional abnormalities that begin soon after the onset of diabetes, as early changes in electroretinogram. This review article will present some evidences that point out neurodegeneration as a possible initial event in diabetic retinopathy.
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    Outcomes of cataract surgery in diabetic patients: results of the PanAmerican Collaborative Retina Study Group
    (Conselho Brasileiro de Oftalmologia, 2014-12-01) Gallego-Pinazo, Roberto; Dolz-Marco, Rosa; Berrocal, Maria; Wu, Lihteh; Maia, Maurício [UNIFESP]; Serrano, Martín; Alezzandrini, Arturo; Arévalo, J. Fernando; Díaz-Llopis, Manuel; University and Polytechnic Hospital La Fe Department of Ophthalmology; University of Puerto Rico Department of Ophthalmology; Instituto de Cirugía Ocular; Universidade Federal de São Paulo (UNIFESP); Clinica Oftalmologica Centro Caracas; Arevalo-Coutinho Foundation for Research in Ophthalmology; Universidad de Buenos Aires Cátedra de Oftalmologia; The King Khaled Eye Specialist Hospital Vitreoretinal Division; Johns Hopkins University The Wilmer Eye Institute Retina Division; University of Valencia Faculty of Medicine
    Purpose:This study was designed to evaluate the visual and anatomical outcomes after cataract surgery in diabetic patients with different intraoperative therapeutic strategies.Methods:The research design comprised of a multicentric, retrospective, interventional study conducted at 6 centers in Argentina, Brazil, Costa Rica, Puerto Rico, Spain, and Venezuela. We included 138 diabetic patients with at least 6-month follow-up following phacoemulsification and intraocular lens implantation. Best-corrected visual acuity (BCVA) and central subfield thickness were collected at baseline and at 1-, 2-, 3-, and 6-month follow-up. Of these, 42 cases were not treated with any intraoperative coadjuvant medication (Group 1), 59 patients received intraoperative bevacizumab (Group 2) and 37 patients received intraoperative triamcinolone (4 mg/0.1 ml) (Group 3).Results:The mean logMAR [± standard deviation (SD)] BCVA improved from 0.82 (± 0.43) at baseline, to 0.14 (± 0.23) at 6-month follow-up (p<0.001) in Group 1; from 0.80 (± 0.48) to 0.54 (± 0.45) (p<0.001) in Group 2; and from 1.0 (± 0.40) to 0.46 (± 0.34) (p<0.001) in Group 3. The mean central subfield thickness increased from 263.57 µm (± 35.7) at baseline to 274.57 µm (± 48.7) at 6-month follow-up (p=0.088) in Group 1; from 316.02 µm (± 100.4) to 339.56 µm (± 145.3) (p=0.184) in Group 2; and from 259.18 µm (± 97.9) to 282.21 µm (± 87.24) (p=0.044) in Group 3.Conclusion:Diabetic patients may significantly benefit from cataract surgery. This study provides evidence to support the use of intravitreal triamcinolone or bevacizumab at the time of cataract surgery in cases with pre-existent diabetic macular edema or moderate-severe non-proliferative diabetic retinopathy.
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    Perfil epidemiológico e nível de conhecimento de pacientes diabéticos sobre diabetes e retinopatia diabética
    (Conselho Brasileiro de Oftalmologia, 2010-10-01) Dias, Alana Ferreira Gomes; Vieira, Márcio Fragoso [UNIFESP]; Rezende, Marcussi Palata; Oshima, Akioshi; Muller, Maria Emília Wendler; Santos, Maria Emília Xavier Dos; Serracarbassa, Pedro Duraes; Hospital do Servidor Público Estadual Francisco Morato de Oliveira; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: To assess the epidemiologic profile and level of knowledge of diabetic patients about diabetes and diabetic retinopathy (DR). METHODS: Cross-sectional study with patients seen at Retina and Vitreous sector of Hospital do Servidor Público Estadual de São Paulo. The subjetcs were assigned into two groups: diabetic patients sent for first ophthalmologic evaluation (G1) and patient already followed in the sector (G2). The patients answered a questionnaire and were submitted to ophthalmologic examination. It had been used chi-square (x²), exact of Fisher and non-parametric of Mann-Whitney tests, with level of significance of 5%. RESULTS: The total sample was composed for 357 patients (109 in G1 and 248 in G2). The majority of the patients were female, married, with incomplete basic education, age average of 63.3 years and affirmed to know what it is diabetes. However, 53.2% did not know their type of diabetes. The visual complications of diabetes are most known. Less of one third of the patients had heard of DR and 77.3% did not know if they had it. The majority of the patients had never received any explanation or lecture about diabetes or DR. Only 3.6% of the patients had participated of programs of education on diabetes. The visual acuity, in logMAR scale, was of 0.57 in OD and 0.51 in the OS. Half of the patients did not have DR. CONCLUSION: The majority of the patients have low knowledge about diabetes and its complications.
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    Regional differences in the prevalence of diabetic retinopathy: a multi center study in Brazil
    (Biomed Central Ltd, 2018) Drummond, Karla Rezende Guerra; Malerbi, Fernando Korn [UNIFESP]; Morales, Paulo Henrique [UNIFESP]; Mattos, Tessa Cerqueira Lemos; Pinheiro, Andre Araujo; Mallmann, Felipe; Perez, Ricardo Vessoni; Leal, Franz Schubert Lopes; Melo, Laura Gomes Nunes de; Gomes, Marilia Brito
    Background: Diabetic retinopathy has a significant impact in every healthcare system. Despite that fact, there are few accurate estimates in the prevalence of DR in Brazil's different geographic regions, particularly proliferative DR and diabetic macular edema. This study aims to determine the prevalence of diabetic retinopathy in Brazil's five continental regions and its determinant factors. Methods: This multi center, cross-sectional, observational study, conducted between August 2011 and December 2014, included patients with type 1 diabetes from the 5 Brazilian geographic regions (South, Southeast, North, Northeast and Midwest). During a clinical visit, a structured questionnaire was applied, blood sampling was collected and each patient underwent mydriatic binocular indirect ophthalmoscopy evaluation. Results: Data was obtained from 1644 patients, aged 30.2 +/- 12 years (56.1% female, 54.4% Caucasian), with a diabetes duration of 15.5 +/- 9.3 years. The prevalence of diabetic retinopathy was 242 (36.1%) in the Southeast, 102 (42.9%) in the South, 183 (29.9%) in the North and Northeast and 54 (41.7%) in the Midwest. Multinomial regression showed no difference in the prevalence of non-proliferative diabetic retinopathy in each geographic region, although, prevalence of proliferative diabetic retinopathy (p = 0.022), and diabetic macular edema (p = 0.003) was higher in the Midwest. Stepwise analyses reviled duration of diabetes, level of HbA1c and hypertension as independent variables. Conclusions: The prevalence of non proliferative diabetic retinopathy in patients with type 1 diabetes was no different between each geographic region of Brazil. The Midwest presented higher prevalence of proliferative diabetic retinopathy and diabetic macular edema. Duration of DM and glycemic control is of central importance to all. Hypertension is another fundamental factor to every region, at special in the South and Southeast. Glycemic control and patients in social and economic vulnerability deserves special attention in the North and Northeast of Brazil.
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    Relationship between Retinopathy Severity, Visual Impairment and Depression in Persons with Long-term Type 1 Diabetes
    (Informa Healthcare, 2012-08-01) Hirai, Flavio E. [UNIFESP]; Tielsch, James M.; Klein, Barbara E. K.; Klein, Ronald; Universidade Federal de São Paulo (UNIFESP); Johns Hopkins Univ; Univ Wisconsin
    Purpose: Our aim was to investigate the proportion of individuals with depression and its association with diabetic retinopathy and visual impairment in a cohort with 25 or more years of type 1 diabetes.Methods: This was a cross-sectional analysis at the 25-year follow-up of the population-based cohort of the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Examinations followed standardized protocols and included clinical and ophthalmic evaluations and questionnaires to assess current and past medical history, use of medications, and cigarette smoking. the Center for Epidemiologic Studies Depression Scale (CES-D) was administered to all participants. Depression was defined as use of antidepressant or CES-D score >= 16.Results: A total of 484 individuals were included in the analysis. the proportion of depression was 37.8% (95% confidence interval 33.4-42.3%). A higher proportion of individuals with depression was observed among those with more severe diabetic retinopathy and visual impairment. However these associations were not statistically significant while controlling for other factors in the multivariable analyses.Conclusions: Diabetic retinopathy severity and visual acuity in persons with long duration of type 1 diabetes were not cross-sectionally associated with depression in this cohort.
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    Ten-year change in self-rated quality of life in a type 1 diabetes population: Wisconsin Epidemiologic Study of Diabetic Retinopathy
    (Springer, 2013-08-01) Hirai, Flavio E. [UNIFESP]; Tielsch, James M.; Klein, Barbara E. K.; Klein, Ronald; Johns Hopkins Univ; Universidade Federal de São Paulo (UNIFESP); Univ Wisconsin
    To investigate a 10-year change of quality of life and associated factors in a population with type 1 diabetes.The Medical Outcome Study Short Form-36 (SF-36) was administered in participants (n = 520) at the 1995-1996 and 2005-2007 examination phases of the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). Physical (PCS) and mental (MCS) component summary scores were calculated. the associations between changes of quality of life and demographic, socioeconomic, and clinical factors were analyzed.PCS score decreased (p < 0.001) and MCS score increased (p < 0.001) after 10 years. the development of cardiovascular disease and the presence of limb amputation were associated with decrease in the PCS score. Those who were working and retired had increased MCS; those who were working and stopped had a decrease in the MCS score. Change in visual acuity and diabetic retinopathy status did not have a significant impact in health-related quality of life scores.Our findings reinforce the necessity to make every attempt to decrease complications of diabetes in individuals with long-term type 1 diabetes in order to attenuate the diminished quality of life associated with those complications such as cardiovascular disease. Change in employment status, likely due to development of these complications, was also strongly associated with poorer quality of life and suggests the benefits of preventing or decreasing complications to keep people with type 1 diabetes in the workforce.
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    Usefulness of corneal esthesiometry for screening diabetic retinopathy
    (Faculdade de Saúde Pública da Universidade de São Paulo, 2003-10-01) Alvarenga, Lênio Souza [UNIFESP]; Martins, Elisabeth Nogueira [UNIFESP]; Grottone, Gustavo Teixeira [UNIFESP]; Morales, Paulo Henrique Ávila [UNIFESP]; Paranhos Junior, Augusto [UNIFESP]; Freitas, Denise de [UNIFESP]; Scarpi, Marinho Jorge [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    OBJECTIVE: To assess the usefulness of corneal esthesiometry for screening diabetic retinopathy. METHODS: A cross-sectional study was carried out comprising 575 patients attending a diabetic retinopathy-screening program in the city of São Paulo. Corneal esthesiometry was assessed with the Cochet-Bonnet esthesiometer. The presence of diabetic retinopathy was detected with indirect fundoscopy. The validity of corneal esthesiometry in identifying diabetic retinopathy was evaluated by the Receiver Operating Characteristic (ROC) curve. RESULTS: Sensitivity and specificity analyses of the corneal esthesiometry for detecting the stages of diabetic retinopathy using different cut-offs showed values less than 80%. The best indices (72.2% sensitivity and 57.4% specificity) were obtained for the identification of patients with proliferative diabetic retinopathy. CONCLUSIONS: In the study series, corneal esthesiometry was not a good indicator of diabetic retinopathy.
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    What do Cochrane systematic reviews say about diabetic retinopathy?
    (Associacao Paulista Medicina, 2017) Mozetic, Vania [UNIFESP]; Daou, Julia Pozzetti [UNIFESP]; Martimbianco, Ana Luiza Cabrera [UNIFESP]; Riera, Rachel [UNIFESP]
    CONTEXT AND OBJECTIVE: Diabetic retinopathy is a disease caused by increased permeability of retinal vessels. Its incidence and prevalence have been increasing due to urbanization, greater life expectancy and the habits of modern life. Its onset is insidious and it may lead to blindness in 75% of individuals who have been diabetic for more than 20 years. The aim here was to evaluate the evidence from Cochrane systematic reviews on interventions relating to diabetic retinopathy. DESIGN AND SETTING: Review of systematic reviews, conducted at Cochrane Brazil. METHODS: We included Cochrane systematic reviews on interventions relating to diabetic retinopathy. Two researchers evaluated the inclusion criteria, summarized the reviews and presented the results narratively. RESULTS: Ten reviews met the inclusion criteria. They showed some evidence of benefits from: (a) photocoagulation for diabetic retinopathy