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The Prevalence and Risk Factors for Diabetic Retinopathy in Shiraz, Southern Iran
摘要： Globally, diabetic retinopathy (DR) is one of the leading causes of blindness, that diminishes quality of life. This study aimed to describe the prevalence of DR, and its associated risk factors. This cross-sectional study was carried out among 478 diabetic patients in a referral center in Fars province, Iran. The mean±standard deviation age of the participants was 56.64±12.45 years old and DR prevalence was 32.8%. In multivariable analysis, lower education levels (adjusted odds ratio [aOR], 0.43; 95% confidence interval [CI], 0.24 to 0.76), being overweight (aOR, 1.70; 95% CI, 1.02 to 2.83) or obese (aOR, 1.88; 95% CI, 1.09 to 3.26), diabetes duration of 10 to 20 years (aOR, 2.35; 95% CI, 1.48 to 3.73) and over 20 years (aOR, 5.63; 95% CI, 2.97 to 10.68), receiving insulin (aOR, 1.99; 95% CI, 1.27 to 3.10), and having chronic diseases (aOR, 1.71; 95% CI, 1.02 to 2.85) were significantly associated with DR. In conclusion, longer diabetes duration and obesity or having chronic diseases are strongly associated with DR suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy in Iran.
关键词： Diabetic retinopathy,Prevalence,Diabetes,Diabetes duration,Risk factors,Insulin
更新于2025-09-23 15:22:29
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P1774Effect of early pitavastatin therapy on coronary fibrous-cap thickness assessed by optical coherence tomography in patients with acute coronary syndrome: the ESCORT study
摘要： Coronary artery disease in young adults is rare, but it is in an increasing trend. However, the risk factors are largely unknown. Previous studies have shown that hyperuricemia is associated with coronary artery disease, but the relationship in young adults is unknown. In this article, we hope to explore the effect of hyperuricemia on coronary artery disease in young adults less than 35 years old. In this retrospective study,we consecutively included young adults (aged 18–35 years old) undergoing coronary angiography in our institution from January 2005 to December 2015. Patients with coronary angiography showed that luminal diameter stenosis≥50% in any of the major epicardial coronary arteries were considered as CAD. The severity of CAD was assessed by gensini score. We tested for interactions between uric acid (hyperuricemia or normouricemia) and other traditional risk factors on the coronary artery disease. The interaction effect on the presence of CAD in young adults was analyzed with multi-variate logistic regression analyses. The relationship between hyperuricemia and CAD in young adults was analyzed with multi-variate regression. 1203 patients (1129 male and 74 female) were included in this study. 790 of young adults were confirmed as having coronary artery disease. The hyperuricemia was present in 35.41% of patients. The multivariate analysis identified hyperuricemia was not independent for the presence of CAD. We furtherly found that the interaction between hyperuricemia and smoking achieved statistical significance for the present of CAD (p=0.0109).In non-smokers, hyperuricemia was an independent risk factor for the presence of CAD (odds ratio [OR]=1.85, 95% confidence interval [CI]=1.06–3.21, P=0.0293). Multivariate analysis identified hyperuricemia was an independent risk factor for the severity of CAD in young adults (odds ratio [OR]=8.45, 95% confidence interval [CI]=1.18–15.71, p=0.0231). In young adults (≤35 years old), hyperuricemia is significantly associated with the presence of CAD in non-smokers. Hyperuricemia has strong correlation with the severity of coronary artery disease in young adults (≤35 years old).
关键词： Coronary artery disease,risk factors,hyperuricemia,smoking,young adults
更新于2025-09-23 15:21:21
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Evaluating the Risk Factors of Post Inflammatory Hyperpigmentation Complications with Nd-YAG Laser Toning Using LASSO-Based Algorithm
摘要： The neodymium-doped yttrium aluminum garnet (Nd-YAG) laser is used for removal of pigmented skin patches and rejuvenation of skin. However, complications such as hyperpigmentation, hypopigmentation, and petechiae can occur after frequent treatments. Therefore, identifying the risk factors for such complications is important. The development of a multivariable logistic regression model with least absolute shrinkage and selection operator (LASSO) is needed to provide valid predictions about the incidence of post inflammatory hyperpigmentation complication probability (PIHCP) among patients treated with Nd-YAG laser toning. A total of 125 female patients undergoing laser toning therapy between January 2014 and January 2016 were examined for post-inflammatory hyperpigmentation (PIH) complications. Factor analysis was performed using 15 potential predictive risk factors of PIH determined by a physician. The LASSO algorithm with cross-validation was used to select the optimal number of predictive risk factors from the potential factors for a multivariate logistic regression PIH complication model. The optimal number of predictive risk factors for the model was five: immediate endpoints of laser (IEL), α-hydroxy acid (AHA) peels, Fitzpatrick skin phototype (FSPT), acne, and melasma. The area under the receiver operating characteristic curve (AUC) was 0.79 (95% CI, 0.70–0.88) in the optimal model. The overall performance of the LASSO-based PIHCP model was satisfactory based on the AUC, Omnibus, Nagelkerke R2, and Hosmer–Lemeshow tests. This predictive risk factor model is useful to further optimize laser toning treatment related to PIH. The LASSO-based PIHCP model could be useful for decision-making.
关键词： LASSO,laser toning,PIHCP,risk factors,post inflammatory hyperpigmentation
更新于2025-09-23 15:21:01
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Extrusion of Femtosecond Laser-Implanted Intrastromal Corneal Ring Segments in Keratoconic Eyes: Prevalence, Risk Factors, and Clinical Outcomes
摘要： Purpose. To evaluate the prevalence, possible risk factors, and clinical results of femtosecond laser implanted intrastromal corneal ring segment (ICRS) extrusion in keratoconic eyes. Patients and Methods. This is a retrospective observational study evaluating 333 eyes of 269 patients who were subjected to femtosecond laser-implanted Keraring ICRS in the Sohag Refractive Center, Sohag, Egypt, from January 2014 to January 2019. The study included eyes with channels created by a femtosecond laser (60 kHz IntraLase femtosecond system; Advanced Medical Optics, Santa Ana, California, USA) with implantation of Keraring intrastromal corneal ring segments (Mediphacos, Belo Horizonte, Brazil). Patient data and causes of Keraring extrusions were identi?ed as being those rings that migrated or showed melting of the cornea with no other reason which required segment removal. Results. Seven eyes were found to ?t the criteria of ring extrusion (2.1%) out of the 333 eyes which had Keraring implantation. All extruded rings were from patients with keratoconus grade 3, with eccentric cones, and with femtosecond creation of the tunnel. Four eyes belonging to 3 patients (57.1%) had a history of vernal Keratoconjunctivitis, yet they did not show signs of activity at the time of implantation. They reported excessive rubbing just before they presented with conjunctival hyperemia and foreign body sensation. Five eyes (71.4%) showed chronic sun exposure. The mean minimal corneal thickness was 401.85 μm (range 384–420 μm), while the mean maximum keratometry was 61 D (range 55.18–68.96 D). Most of the extruded rings had large arcs. Six eyes had crosslinking (CXL) at the same session of the Keraring implantation. The simultaneous CXL treatment is considered as a possible signi?cant risk factor for ring extrusion. Conclusion. ICRS is an e?ective reversible option for patients with keratoconus who are intolerant to hard contact lenses, yet the choice of cases and ring segments is mandatory for satisfactory results. Moreover, meticulous history taking and examination reduces the incidence of complications including extrusion.
关键词： clinical outcomes,risk factors,keratoconus,femtosecond laser,extrusion,intrastromal corneal ring segment
更新于2025-09-23 15:19:57
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Identification of Factors Associated with Postoperative Urosepsis after Ureteroscopy with Holmium: Yttrium-Aluminum-Garnet Laser Lithotripsy
摘要： Objective: To report the incidence and risk factors of urosepsis after ureteroscopic lithotripsy (URSL). Patients and Methods: We retrospectively reviewed 1,421 patients who underwent URSL for ureteral calculi between July 2015 and June 2018 at our department to identify factors predicting postoperative urosepsis. Demographic characteristics, clinical data, operative information, and complications were compared, and risk factors of postoperative urosepsis were identified and analyzed. Results: Of the 1,421 patients treated with URSL using holmium: yttrium-aluminum-garnet laser, 12 (0.8%) developed a urosepsis after operation. The positive preoperative multidrug resistance (MDR) urine culture and operative duration were statistically different between those who did and did not develop a urosepsis (4.61 vs. 25%, p = 0.017; 70 vs. 62 min, p < 0.001). However, patient age, sex, body mass index, diabetes mellitus, history of urolithiasis, positive preoperative urine cultures, stone size and location, degree of hydronephrosis, and prior stent placement were similar in 2 groups. Multivariate analysis revealed that positive preoperative MDR urine culture and long operation duration significantly increased the risk of postoperative urosepsis (OR 5.090, 95% CI 1.312–19.751, p = 0.019; OR 1.034, 95% CI 1.004–1.063; p = 0.024). Matched-pair analysis demonstrated that positive preoperative MDR urine culture and operation duration were significantly associated with postoperative urosepsis (OR 15.77, 95% CI 1.033–240.7, p = 0.047; OR 1.087, 95% CI 1.011–1.169, p = 0.025). Conclusions: Patients with positive preoperative MDR urine culture or long operation duration had a higher risk of developing urosepsis after URSL. When treating patients who present with positive preoperative MDR urine culture or long operation duration, urologists should be vigilant and aware of the potential risk of urosepsis.
关键词： Ureteroscopy,Urosepsis,Lithotripsy,Complication,Risk factors
更新于2025-09-16 10:30:52
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RATES AND RISK FACTORS FOR RECURRENCE OF RETINOPATHY OF PREMATURITY AFTER LASER OR INTRAVITREAL ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR MONOTHERAPY
摘要： To determine the rates and risk factors of recurrent retinopathy of prematurity (ROP) treated by laser photocoagulation, intravitreal bevacizumab (IVB) monotherapy, or intravitreal ranibizumab (IVR) monotherapy. In this retrospective cohort study, consecutive infants with Type 1 ROP who received laser, IVB, or IVR treatments were followed for at least 75 weeks of postmenstrual age. Data analysis was performed between March 2010 and February 2017 in Chang Gung Memorial Hospital, Linkou, Taiwan. A total of 176 infants (340 eyes) were included in this study. The mean follow-up was 197.3 ± 110 weeks. All of the baseline demographic and ROP characteristics among the laser, IVB, and IVR groups were similar. The overall recurrence rate after treatment was 44 of 340 eyes (12.9%). The IVB group had a recurrence rate of 10.0%, followed by the laser group (18.0%) and the IVR group (20.8%); however, these rates were not signi?cantly different (P = 0.0528). Compared with the laser group, the IVB and IVR groups exhibited recurrence at later ages (43.4 ± 3.5 weeks for the IVB group, 42.3 ± 2.0 weeks for the IVR group, and 39.5 ± 2.8 weeks for the laser group; P = 0.0058). The mean interval of recurrence from initial treatment in the laser group was 3.6 ± 1.4 weeks compared with 8.8 ± 3.9 weeks and 8.3 ± 1.6 weeks in the IVB and IVR groups, respectively (P = 0.0001). Overall, the independent risk factors of recurrence included an early postmenstrual age at initial treatment (P = 0.0160), Zone I (P = 0.0007), low Apgar score (P = 0.0297), and multiple births (P = 0.0285). There was no signi?cant difference in progression to retinal detachment among the three groups (laser: 3/61, 4.9%; IVB: 2/231, 0.9%;and IVR: 1/48, 2.1%; P = 0.2701). Laser, IVR, and IVB are effective for Type 1 ROP. Retinopathy of prematurity recurrence requiring re-treatment was encountered as late as 50 weeks of postmenstrual age after IVB or IVR but earlier after laser. Longer follow-up for infants treated with anti–vascular endothelial growth factor is needed, especially in patients with signi?cant risk factors such as an early postmenstrual age at initial treatment, Zone I ROP, low Apgar score, and multiple births.
关键词： ranibizumab,risk factors,bevacizumab,rates,laser,anti-VEGF,recurrent retinopathy of prematurity
更新于2025-09-12 10:27:22
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Risk factors for early flap misalignment following microkeratome-assisted laser in situ keratomileusis: A retrospective large database analysis
摘要： Purpose: To determine factors associated with early flap misalignment following microkeratome-assisted laser in situ keratomileusis. Materials and Methods: This retrospective study included the right eyes of consecutive patients who underwent laser in situ keratomileusis procedure between 2005 and 2016 at Care-Vision Laser Centers, Tel-Aviv, Israel. Patients were divided into two groups according to whether or not they subsequently developed early flap misalignment. Results: A total of 14,582 eyes (mean age of patients: 32.4 ± 10.3 years) were included. Post-laser in situ keratomileusis early flap misalignment developed in 158 eyes (1.1%). Misalignment was more frequent during the spring (32.3% vs 22.8%, p = 0.003) and in a higher operating room temperature (23.34 ± 1.06 vs 22.98 ± 1.26, p < 0.001). In addition, in the misalignment group, there was a higher rate with the of use of the a Moria M2 microkeratome (rather than sub-Bowman’s keratomileusis microkeratome) head (55.2% vs 40.5%, respectively, p < 0.001). In a multivariable analysis adjusted for surgeon and year of surgery, high operating room temperature (odds ratio = 1.22, p = 0.006), treatment zone of 9.0 mm (as opposed to smaller treatment zones, odds ratio = 1.54, p = 0.04), and springtime (odds ratio = 1.58, p = 0.02) were associated with flap misalignment. There was a significant difference in misalignment rates between surgeons (p = 0.02). Conclusion: This study found that larger treatment zones, higher operating room temperature, operating during the spring, and the use of Moria M2 microkeratome were associated with increased flap misalignment rates. The association with operating room temperature and seasonal variation is of interest and merits further research.
关键词： microstriae,macrostriae,laser in situ keratomileusis,Flap misalignment,flap risk factors
更新于2025-09-12 10:27:22
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Patients with Advanced Diabetic Retinopathy’s Understanding of Diabetes Mellitus and Their Diabetic Eye Disease: A survey of 100 patients currently undergoing treatment for Diabetic Retinopathy in a Large Retinal Practice
摘要： Objective: To better understand what patients with advanced diabetic retinopathy understand about their DED and treatment, control of their diabetes, and risk factors for disease progression, and to assess which areas clinicians may want to target for education to increase patient understanding. Methods: 100 consecutive patients with at least 5 previous visits to a retinal clinic were surveyed to better understand patients’ understanding of diabetes mellitus (DM), diabetic eye disease (DED), and the treatments they were receiving for DM and their DED. Demographic information (age, gender, educational status, ethnicity, language, duration and treatments for DM) was collected, along with information about treatments and understanding of risk and modifiable factors about DM. Data was verified against the chart. Results: 100 surveys were completed; 97% of patients said they “understand DM”. 61% of patients were 60 years or older, and half of the patients had done some post-secondary educational training. The ethnic breakdown included 27% Caucasian and 38% Hispanic. Fasting blood glucose (FBG) was known in 89% of patients and when asked the range of FBG: 6% did not know; 17% had FBG as >160 mg/dl; and 35% had a FBG of <130 mg/dl. Regarding controlling their DM, 74% of patients did not identify exercise and 33% did not identify dietary habit as important in control. 95% identified blood pressure (BP) as important to monitor. 39% were unable to identify their current BP range, 31% identified their systolic BP as ≥ 130mmHg, and 7% described it as usually >150mmHg. Patients were asked to identify DM related ocular complications: 23% said bleeding; 7% said diabetic macular edema; and 73% said blindness or visual loss. As patient age increased, the ability to correctly identifying current treatments, and knowledge of hemoglobin A1C (HbA1C), decreased. Ability to correctly identify HbA1C increased with increasing education. Conclusions: This survey shows patient misunderstanding in how DM is treated, risk factors for DM, and how monitoring should be done. Emphasis is likely needed in diet modification and exercise for control of DM. Patients may be at risk for poor understanding of DM care/treatment (particularly those with lower educational achievement, or more elderly). Additional resources may need to be developed for sub-sets of patients.
关键词： Diabetic eye disease,Patient understanding,Diabetes mellitus,Risk factors,Diabetic retinopathy,Hemoglobin A1C
更新于2025-09-09 09:28:46