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The aim of this study was to analyze the cost and factors affecting diabetic retinopathy (DR) care in a tertiary eye care facility in South India.
In a retrospective, observational study, we evaluated the costs incurred in DR management in each stage of retinopathy from electronic medical records. find more Both medical and indirect costs (transportation and boarding) were calculated.
The study evaluated 1000 consecutive patients (2000 eyes) with DR, from January to June 2019. One-third (32%; n = 321) patients were females. The median cost per patient was INR 8,214 (IQR 2,812-29,748). Cost of care was higher in patients with sight-threatening DR (STDR) compared to non-STDR (INR 31,820 vs INR 14,356, P < 0.001). Among 57.3% (n = 573;1137 eyes) of subjects who completed treatment, there was a statistically significant reduction in visual impairment (427 to 355 eyes) and blindness (<3/60) (132 to 103 eyes) from baseline (P < 0.001). The number of follow-up visits had a negative association with travel distance and socioeconomic status (P < 0.001); the positive association was seen with DR severity (P = 0.002) and total cost (P < 0.001) on regression analysis. There was a nearly 3-fold difference in the average medical cost per eye for subjects with severe visual loss (<3/60) (INR 26,270) compared to those with good vision (≥6/12) (INR 8,510).
Treatment of DR benefits, but the cost of care increases with disease severity and visual impairment. Compliance to care was related to DR severity and treatment cost. Some of the barriers could be reduced with greater advocacy and reduced travel distance.
Treatment of DR benefits, but the cost of care increases with disease severity and visual impairment. Compliance to care was related to DR severity and treatment cost. Some of the barriers could be reduced with greater advocacy and reduced travel distance.
To assess the role of dietary factors in the development of diabetic retinopathy (DR) in diabetics.
This prospective study was carried out on patients attending the outpatient department of ophthalmology for a period of 1 year. An interview-based 24-hour diet recall was used to document average daily dietary nutrient intakes. Each patient was subjected to a comprehensive ocular examination to look for DR.
A total of 261 patients attending the outpatient department of ophthalmology were the participants for this study. The mean (±SD) age of the participants was 57.73 ± 11.29 years, and 67% were men. One hundred and six participants had DR. Univariate analysis revealed sex, duration, fish (times/week), egg (yes/no), rice lunch (yes/no), rice dinner, rice (boiled/white), and total calorie intake to be associated with DR (P < 0.05). Logistic regression multivariable analysis revealed males (OR 3.20, 95% CI 1.65-6.19), longer duration of diabetes (OR1.05,95% CI1.01-1.11), antioxidant intake (OR 3.42, 95%
Males, longer duration of diabetes, antioxidant intake, fish consumption, and consumption of rice were associated with the occurrence of DR. Participants with diabetes who consumed fish more frequently and those who were on pharmacological treatment for diabetes mellitus had a significantly lower risk of DR and frequent fish consumption could reduce the risk of DR progression.
The present study's objectives are 1) to describe a novel model of Diabetic Retinopathy Capacity Building (DRCB) for optometrists in the detection of diabetes-related retinal pathology in India and 2) to assess the outcomes of this model by comparing the ability of optometrists to detect these diseases using retinal photographs, vis-à-vis, a specialist ophthalmologist.
The DRCB model for optometrists conducted between August 2016 and August 2018 included training, certification in the screening, and referral guidelines for Diabetic Retinopathy (DR) and hospital-and community-based service delivery. Training included a 7-month long fellowship in DR and mentored participation as cofacilitators in 1-day orientation workshops on DR screening guidelines across India. The sensitivity and specificity of study optometrists in screening for DR by fundus photography were compared to a retina specialist before certification.
A total of eight optometrists successfully completed their DR fellowship in the project duration of 24 months. The sensitivity and specificity of detection of any DR were 95 and 79%, any Diabetic macular edema (DME) was 80 and 86%. The sensitivity and specificity of detection of sight threatening DR were 88 and 90% and DME was 72% and 92% respectively. Seven workshops were cofacilitated by study optometrists training 870 optometrists in DR screening guidelines across India.
The present DRCB model results advocate for an optometry coordinated DR screening in India. Lessons learnt from this model can be useful in designing community-based task sharing initiatives for optometrists in DR screening.
The present DRCB model results advocate for an optometry coordinated DR screening in India. Lessons learnt from this model can be useful in designing community-based task sharing initiatives for optometrists in DR screening.
Age-related macular degeneration (AMD) is one of the leading causes of irreversible central vision loss in the elderly population. The current study aims to find non-invasive prognostic biomarkers in the urine specimens of the AMD patients.
Peripheral blood and urine samples were collected from 23 controls and 61 AMD patients. Genomic DNA was extracted from the buffy coat of peripheral blood. Allele specific PCR was used to assay SNPs in complement factor H (CFH), complement component 3 (C3). Comparative proteomic analysis of urine samples from early AMD, choroidal neovascular membrane (CNVM), geographic atrophy (GA), and healthy controls was performed using isobaric labelling followed by mass spectrometry. Validation was performed using enzyme-linked immunosorbent assay (ELISA).
Comparative proteomic analysis of urine samples identified 751 proteins, of which 383 proteins were found to be differentially expressed in various groups of AMD patients. Gene ontology classification of differentially expressed proteins revealed the majority of them were involved in catalytic functions and binding activities.
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