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Diabetic Retinopathy Pictures

Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy is damage to the retina at the back of the eye from long-term high blood sugar levels in people with diabetes. Left untreated, diabetic retinopathy can affect a person's vision and can lead to blindness. Everyone with diabetes should attend annual NHS eye screening to check for signs of damage to the retina. This is done using a special camera to take pictures of the back of the eye. The retina and diabetes Too much blood sugar can damage the blood vessels in the back of the eye, preventing the retina from receiving the appropriate amount of nutrients it needs to maintain vision. The retina is light-sensitive nerve tissue at the back of the eye. As light enters the front of the eye, the retina converts the light rays into electrical impulses that travel along the optic nerve to part of the brain called the visual cortex. The brain then combines images sent from both eyes to interpret them as a single, three-dimensional image. This allows us to perceive depth and distance. Without the retina, the eye cannot communicate with the brain, making vision impossible. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. In the early stages of diabetic retinopathy, called non-proliferative retinopathy, these blood vessels leak fluid and distort sight. In the more advanced stage of diabetic retinopathy, called proliferative retinopathy, fragile new blood vessels grow around the retina and in the vitreous humour - a clear substance that fills the eye. If left untreated, these blood vessels may bleed, clouding vision or detaching the retina. Anyone with diabetes - either type 1 or type 2 diabetes - is at risk of developing diabetic retinopathy. However, the type of diabetes a person has, how often their blood sugar fluctuates, Continue reading >>

How To Treat Diabetic Retinopathy

How To Treat Diabetic Retinopathy

Expert Reviewed Diabetic retinopathy is a disease in which the blood vessels in the retina (which is located in the back of the eye) are weakened due to an imbalance in your blood sugar. This imbalance and weakening is caused by uncontrolled diabetes and it can result in blood and other fluids leaking into the eye, resulting in difficulty with vision and even loss of vision in severe cases. In order to treat diabetic retinopathy you will need to identify the condition, consult with a physician, and then follow your physician's suggestions for treatment.[1] The sooner you detect retinopathy, the better. It can be diagnosed and treated early with annual eye exams. 1 Find out how serious your diabetic retinopathy is. There are four stages of diabetic retinopathy, with the first being the least severe and the fourth being the most severe. When you visit your optometrist, tell them that you have diabetes. They can perform a basic dilated eye exam. They may refer you to a more specialized eye doctor, an ophthalmologist, who can let you know how serious your condition is.[2] Knowing what stage you are will help you to understand the severity of your condition and what steps will need to be taken to get your condition under control. The stages are:[3] Mild nonproliferative diabetic retinopathy: At this stage there are small areas of weakness and bulging in the blood vessels. These are called microaneurysms. These microaneurysms may allow fluid to leak into the retina. Moderate nonproliferative retinopathy: At this stage the blood vessels are bulging and distorting. They may also become blocked or no longer move blood around the eye. Severe nonproliferative retinopathy: At this stage there are numerous blood vessels that have ruptured or are blocked. This causes a lack of blood Continue reading >>

Detecting Diabetic Retinopathy In Eye Images

Detecting Diabetic Retinopathy In Eye Images

The past almost four months I have been competing in a Kaggle competition about diabetic retinopathy grading based on high-resolution eye images. In this post I try to reconstruct my progression through the competition; the challenges I had, the things I tried, what worked and what didn’t. This is not meant as a complete documentation but, nevertheless, some more concrete examples can be found at the end and certainly in the code. In the end I finished fifth of the almost 700 competing teams. Update 02/08/2015: Code and models (with parameters) added. Introduction Introduction Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population of the developed world and is estimated to affect over 93 million people. (From the competition description where some more background information can be found.) The grading process consists of recognising very fine details, such as microaneurysms, to some bigger features, such as exudates, and sometimes their position relative to each other on images of the eye. (This is not an exhaustive list, you can look at, for example, the long list of criteria used in the UK to grade DR (pdf).) Some annotated examples from the literature to get an idea of what this really looks like (the medical details/terminology are not very important for the rest of this post): Example of non-proliferative diabetic retinopathy (NPDR): Thin arrows: hard exudates; Thick arrow: blot intra-retinal hemorrhage; Triangle: microaneurysm. (Click on image for source.) Now let’s look at it as someone who simply wants to try to model this problem. You have 35126 images in the training set that look like this annotated by a patient id and “left” or “right” (each patient has two images, one per eye) and divided into 5 fairly unbalanc Continue reading >>

Imaging In Diabetic Retinopathy

Imaging In Diabetic Retinopathy

Go to: Abstract While the primary method for evaluating diabetic retinopathy involves direct and indirect ophthalmoscopy, various imaging modalities are of significant utility in the screening, evaluation, diagnosis, and treatment of different presentations and manifestations of this disease. This manuscript is a review of the important imaging modalities that are used in diabetic retinopathy, including color fundus photography, fluorescein angiography, B-scan ultrasonography, and optical coherence tomography. The article will provide an overview of these different imaging techniques and how they can be most effectively used in current practice. Keywords: B-scan Ultrasonography, Color Fundus Photography, Diabetic Retinopathy, Fluorescein Angiography, Optical Coherence Tomography, Retinal Imaging Go to: INTRODUCTION While the primary method for evaluating diabetic retinopathy involves direct and indirect ophthalmoscopy, various imaging modalities are of significant utility in the screening, evaluation, diagnosis, and treatment of the different presentations of this disease. Many imaging techniques can be useful depending on the manifestation of diabetic retinopathy. Important imaging techniques to be familiar with include color fundus photography, fluorescein angiography (FA), B-scan ultrasonography, and optical coherence tomography (OCT). This manuscript is meant to provide an overview of these different imaging techniques and how they relate to the management of diabetic retinopathy. Go to: FUNDUS PHOTOGRAPHY Color fundus photography is a useful tool in the management of diabetic eye disease. Traditionally, fundus photography has been performed using film, but more recently, digital fundus photography has become widely adopted. Digital images enable easy and immediate Continue reading >>

Retinopathy

Retinopathy

Definition Retinopathy is a noninflammatory disease of the retina. There are many causes and types of retinopathy. Description The retina is the thin membrane that lines the back of the eye and contains light-sensitive cells (photoreceptors). Light enters the eye and is focused onto the retina. The photoreceptors send a message to the brain via the optic nerve. The brain then interprets the electrical message sent to it, resulting in vision. The macula is a specific area of the retina responsible for central vision. The fovea is about 1.5 mm in size and is located in the macula. The fovea is responsible for sharp vision. When looking at something, the fovea should be directed at the object. Retinopathy, or damage to the retina, has various causes. A hardening or thickening of the retinal arteries is called arteriosclerotic retinopathy. High blood pressure in the arteries of the body can damage the retinal arteries and is called hypertensive retinopathy. Diabetes damages the retinal vessels resulting in a condition called diabetic retinopathy. Sickle cell anemia also affects the blood vessels in the retina. Exposure to the sun (or looking at the sun during an eclipse) can cause damage (solar retinopathy), as well as certain drugs (for example, chloroquine, thioridazine, and large doses of tamoxifen). The arteries and veins can become blocked, resulting in a retinal artery or vein occlusion. These are just some of the causes of the various retinopathies. Retinopathies are divided into two broad categories: simple or nonproliferative retinopathies and proliferative retinopathies. The simple retinopathies include the defects identified by bulging of the vessel walls, bleeding into the eye, small clumps of dead retinal cells called cotton wool exudates, and closed vessels. T Continue reading >>

Picture Review Of Diabetic Retinopathy

Picture Review Of Diabetic Retinopathy

Unfortunately, Americans are being diagnosed with diabetes at record rates, which means that eye examinations mean a lot more than just screening for glasses. I am often asked what diabetic changes in the eye look like, so below are a few pictures of some of my most advanced diabetic changes. An eye exam is a crucial part of your diabetic care because the eye is the only part of the body where blood vessels can be seen. If you have bleeding from damaged blood vessels in your eye, there are likely changes going on throughout your body. I always send a letter to my patient's primary care doctors when they have been diagnosed with diabetes, reporting any ocular findings. If we all work together (patients, and all doctors!) we can help prevent severe damage from occurring! Diabetic retinal (internal eye) findings can be as mild as a small spot of blood, which may just require yearly examination. The three pictures below are actual patients where things have gotten a lot more advanced. This photo shows bleeding or hemorrhaging throughout the retina, but you also see exudate which is the yellow changes you see above the central vision spot (the macula). Exudate is evidence of swelling, which means that the blood vessels have been actively leaking in the area. This patient's central vision was reduced because the swelling was so close to her macula. She was seen by an ophthalmologist, who is monitoring closely for resolution. The 2 photos above are from the same patient who has even more advanced damage. At the bottom of both photographs you can see small, "squiggly" spider-web like blood vessels. I know these pictures might not appear as severe as the first, but these new blood vessels (or neovascularization) are evidence of advanced changes. These lacy and thin blood vessels Continue reading >>

Accuracy Of Digital Images For Assessing Diabetic Retinopathy

Accuracy Of Digital Images For Assessing Diabetic Retinopathy

Go to: Background To determine the accuracy of diabetic retinopathy status assessments with and without pupil dilation using digital fundus photographs acquired by a clinic staff person and interpreted remotely by ophthalmologists. Using early treatment diabetic retinopathy study (EDTRS) grading criteria, diabetic retinopathy status assessments were made by an experienced (nonphysician) retinal grader (NPG) based on seven standard field 35-mm stereoscopic slides acquired by an experienced ophthalmic photographer. These assessments were compared with those of the same eyes made by two ophthalmologists and the NPG using digital photographs acquired by a clinic staff person using a high-resolution (800 × 600) digital color camera system. Based on 35-mm slides, 38% of 244 diabetic patients had ETDRS ≥35 in at least one eye and 5% had vision-threatening diabetic retinopathy (ETDRS ≥53 or macular edema). The proportion of ungradable images was significantly greater for nonmydriatic than mydriatic assessments (30% versus 10% ungradable as determined by the NPG). For ETDRS level ≥35, specificity ranged from moderate to high (0.70 to 0.96) for the three graders, while sensitivity was poor to moderate (0.38 to 0.71), and the area under the receiver-operating characteristic curves was less than satisfactory (0.67 to 0.71). Conclusions The low sensitivity of the digital assessments indicates a significant proportion of patients in need of referral would not have been referred. These findings suggest that implementation of a simplified screening system using nonphotographer clinic staff acquiring nonmydriatic images, with interpretation by an ophthalmologist, should take place with an understanding of potential limitations. Keywords: diabetic retinopathy, screening, sensitivi Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

What is Diabetic Retinopathy? Diabetic Retinopathy is a chronic and progressive disease of the retinal microvasculature as a result of complication from Diabetes. It is a common complication and manifestation of prolonged diabetes or for those patients suffering from Diabetes for more than 10 years. Diabetic retinopathy is characterized by damage in the blood vessel of the retina or the light sensitive tissue found at the rear of the eye. It is regarded as the leading cause of blindness among people 27 to 74 years of age and is commonly associated with diabetes type 1 and type 2. Patients suffering from long-term diabetes are especially at high risk for diabetic retinopathy. In type 1 diabetes the onset of diabetic retina is mild and is usually recognized in the 7th year on the average from the onset of diabetes. Type 2 diabetes is the more common type of diabetes where the onset is rather gradual in which the retinal changes may have taken place right before the diagnosis of diabetes. Diabetes is a metabolic disease described with high levels of blood glucose as a consequence of the inability of the pancreas to produce sufficient amount of insulin in the body or as a result of dysfunction of the pancreas. This metabolic disease is divided into two main types known as diabetes mellitus type 1 and diabetes type 2. Type 1 of diabetes mellitus is also known as juvenile onset diabetes and formerly known as insulin dependent diabetes. It is an autoimmune disease where the pancreas is mistakenly being attacked by the autoimmunity itself leading the pancreas to the inability to produce insulin. Type 2 diabetes on the other hand is known as adult onset diabetes mellitus or the non-insulin dependent diabetes. This type of diabetes is characterized by an overproduction of insulin Continue reading >>

Slideshow: Diabetes Complications -- Eye Problems And Blindness

Slideshow: Diabetes Complications -- Eye Problems And Blindness

Diabetes can make you more likely to have eye problems. Your blood sugar (glucose) levels may be high because your body can't make or use insulin properly. Too much blood sugar can build up and harm your nerves and blood vessels. Damage to the blood vessels in your eyes can lead to vision loss or blindness. Anyone with diabetes is at risk, so it’s important to get yearly eye exams. Diabetes can affect your eyes in different ways. When your blood sugar is high or when you start insulin treatment, you may have blurry vision or other problems. But your eyes can be damaged even if you don’t notice any changes. Don’t wait for symptoms to arise to get your vision checked. Diabetic Retinopathy The retina senses light coming into your eye, and it sends messages to your brain about the things you see. Damage to blood vessels inside the retina from blood sugar buildup is called diabetic retinopathy. You might not notice changes at first, but over time the walls of your blood vessels may leak fluid. When you’ve had diabetes for a while, blood vessels can form scar tissue and pull the retina away from the back of your eye. This can lead to severe vision loss and even blindness. Your doctor can diagnose retinopathy during a thorough eye exam. He’ll use a special dye to find leaking blood vessels. In the early stages, diabetic retinopathy often can be treated with laser surgery called photocoagulation. The laser seals the blood vessels and stops them from leaking and growing. The procedure can't restore lost vision. Combined with follow-up care, though, it can lower your chances of blindness by as much as 90%. In the late stages of diabetic retinopathy -- if the retina has detached or a lot of blood has leaked into your eye -- your doctor may suggest vitrectomy. This surger Continue reading >>

Deep Learning For Detection Of Diabetic Eye Disease

Deep Learning For Detection Of Diabetic Eye Disease

Posted by Lily Peng MD PhD, Product Manager and Varun Gulshan PhD, Research Engineer Diabetic retinopathy (DR) is the fastest growing cause of blindness, with nearly 415 million diabetic patients at risk worldwide. If caught early, the disease can be treated; if not, it can lead to irreversible blindness. Unfortunately, medical specialists capable of detecting the disease are not available in many parts of the world where diabetes is prevalent. We believe that Machine Learning can help doctors identify patients in need, particularly among underserved populations. A few years ago, several of us began wondering if there was a way Google technologies could improve the DR screening process, specifically by taking advantage of recent advances in Machine Learning and Computer Vision. In "Development and Validation of a Deep Learning Algorithm for Detection of Diabetic Retinopathy in Retinal Fundus Photographs", published today in JAMA, we present a deep learning algorithm capable of interpreting signs of DR in retinal photographs, potentially helping doctors screen more patients in settings with limited resources. One of the most common ways to detect diabetic eye disease is to have a specialist examine pictures of the back of the eye (Figure 1) and rate them for disease presence and severity. Severity is determined by the type of lesions present (e.g. microaneurysms, hemorrhages, hard exudates, etc), which are indicative of bleeding and fluid leakage in the eye. Interpreting these photographs requires specialized training, and in many regions of the world there aren’t enough qualified graders to screen everyone who is at risk. Working closely with doctors both in India and the US, we created a development dataset of 128,000 images which were each evaluated by 3-7 ophthalmo Continue reading >>

Symptoms Of Diabetic Retinopathy:

Symptoms Of Diabetic Retinopathy:

Diabetes is a disease that affects blood vessels throughout the body, particularly vessels in the kidneys and eyes. When the blood vessels in the eyes are affected, this is called diabetic retinopathy. The retina is the thin layer that lines the back of the eye. It detects visual images and transmits them to the brain. Major blood vessels lie on the front portion of the retina. When these blood vessels are damaged due to diabetes, they may leak fluid or blood and grow scar tissue. This leakage affects the ability of the retina to detect and transmit images. During the early stages of diabetic retinopathy, reading vision is typically not affected. However, when retinopathy becomes advanced, new blood vessels grow in the retina. These new vessels are the body’s attempt to overcome and replace the vessels that have been damaged by diabetes. However, these new vessels are not normal. They may bleed and cause the vision to become hazy, occasionally resulting in a complete loss of vision. The growth of abnormal blood vessels on the iris of the eye can lead to glaucoma. Diabetic retinopathy can also cause your body to form cataracts more quickly. The new vessels also may damage the retina by forming scar tissue and pulling the retina away from its proper location. This is called a retinal detachment and can lead to blindness if left untreated. There are usually no symptoms in the early stages of diabetic retinopathy Blurry or hazy vision Floaters Difficulty reading or doing close work Double vision Causes of diabetic retinopathy: Diabetes: Everyone who has diabetes is at risk for developing diabetic retinopathy, but not everyone develops it. Changes in blood sugar levels increase the risk. Generally, diabetics don’t develop diabetic retinopathy until they’ve had diabetes Continue reading >>

Non-proliferative Diabetic Retinopathy

Non-proliferative Diabetic Retinopathy

Common Diseases NON-PROLIFERATIVE DIABETIC RETINOPATHY Fundus photo of mild diabetic retinopathy Fluorescein angiography showing microaneurisms not seen visually on previous picture What is non-proliferative diabetic retinopathy? Diabetes is a systemic condition that is characterized by the in-ability of the body to utilize sugar; either because the body does not produce enough insulin (a necessary hormone for the metabolism of sugar) or cells can no longer use insulin. If blood sugar levels are elevated for a prolonged period of time, corrosion of the blood vessels can occur. Since blood vessels within the eye are very tiny, they are highly susceptible, and can be easily damaged by high blood sugar levels. The earliest stages of diabetic retinopathy (when the blood vessels start to get damaged from high blood sugar levels) are not visible on examination. As the disease progresses, signs of diabetic retinopathy become more apparent. There are two main types of diabetic retinopathy; non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Non-proliferative diabetic retinopathy occurs in a large majority of diabetic patients (both type I and type II). Recent studies have shown that 85% of patients who have had diabetes for over 15 years show non-proliferative diabetic retinopathy changes on exam. Non-proliferative diabetic retinopathy is characterized by microaneurisms within the retina and small areas of hemorrhaging (bleeding) within the retina. Since the blood vessels have been damaged from high blood sugar levels, fluid can leak into the retina, causing edema and swelling of the retina. What are the risk factors? Diabetic retinopathy typically affects people who have had diabetes for a long period of time (15+ years). However, 35% of people who� Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

On this page: Diabetes and diabetic retinopathy • DR symptoms • Types of diabetic eye disease • Who gets diabetic retinopathy? • Minorities and diabetic eye disease • When is DR a disability? • Eye exam assistance program • Prevention • Diabetic retinopathy videos Diabetic retinopathy — vision-threatening damage to the retina of the eye caused by diabetes — is the leading cause of blindness among working-age Americans. The good news: Diabetic retinopathy often can be prevented with early detection, proper management of your diabetes and routine eye exams performed by your optometrist or ophthalmologist. According to the International Diabetes Federation (IDF), the United States has the highest rate of diabetes among 38 developed nations, with approximately 30 million Americans — roughly 11 percent of the U.S. population between the ages of 20 and 79 — having the disease. About 90 percent of Americans with diabetes have type 2 diabetes, which develops when the the body fails to produce enough insulin — a hormone secreted by the pancreas that enables dietary sugar to enter the cells of the body — or the body becomes resistant to insulin. This causes glucose (sugar) levels in the bloodstream to rise and can eventually damage the eyes, kidneys, nerves or heart, according to the American Diabetes Association (ADA). Risk factors for type 2 diabetes include obesity, an unhealthful diet and physical inactivity. Unfortunately, the prevalence of obesity and type 2 diabetes has increased significantly in the United States over the past 30 years. According to data released by the U.S. Centers for Disease Control and Prevention (CDC) in December 2015, there were 1.4 million new cases of diabetes reported in the U.S. in 2014. Though this annual number is d Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Practice Essentials Diabetes mellitus (DM) is a major medical problem throughout the world. Diabetes causes an array of long-term systemic complications that have considerable impact on the patient as well as society, as the disease typically affects individuals in their most productive years. [1] An increasing prevalence of diabetes is occurring throughout the world. [2] In addition, this increase appears to be greater in developing countries. The etiology of this increase involves changes in diet, with higher fat intake, sedentary lifestyle changes, and decreased physical activity. [3, 4] Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. The most common and potentially most blinding of these complications, however, is diabetic retinopathy, [5, 6, 7] which is, in fact, the leading cause of new blindness in persons aged 25-74 years in the United States. Approximately 700,000 persons in the United States have proliferative diabetic retinopathy, with an annual incidence of 65,000. An estimate of the prevalence of diabetic retinopathy in the United States showed a high prevalence of 28.5% among those with diabetes aged 40 years or older. [8] (See Epidemiology.) The exact mechanism by which diabetes causes retinopathy remains unclear, but several theories have been postulated to explain the typical course and history of the disease. [9, 10] See the image below. In the initial stages of diabetic retinopathy, patients are generally asymptomatic, but in more advanced stages of the disease patients may experience symptoms that include floaters, distortion, and/or blurred vision. Microaneurysms are the earliest clinical sign of diabetic retinopathy. (See Clinical Presentat Continue reading >>

Oct Angiography Provides Vivid Pictures Of Nonproliferative Diabetic Retinopathy Severity

Oct Angiography Provides Vivid Pictures Of Nonproliferative Diabetic Retinopathy Severity

Test all patients for evidence of current or prior hepatitis B virus (HBV) infection before initiating treatment with HARVONI or EPCLUSA. HBV reactivation has been reported in HCV/HBV coinfected patients who were undergoing or had completed treatment with HCV direct acting antivirals (DAAs) and were not receiving HBV antiviral therapy. Some cases have resulted in fulminant hepatitis, hepatic failure, and death. Cases have been reported in patients who are HBsAg positive, in patients with serologic evidence of resolved HBV, and also in patients receiving certain immunosuppressant or chemotherapeutic agents; the risk of HBV reactivation associated with treatment with HCV DAAs may be increased in patients taking these other agents. Monitor HCV/HBV coinfected patients for hepatitis flare or HBV reactivation during HCV treatment and post-treatment follow-up. Initiate appropriate patient management for HBV infection as clinically indicated. If HARVONI or EPCLUSA is used in combination with ribavirin (RBV), all contraindications, warnings and precautions, in particular pregnancy avoidance, and adverse reactions to RBV also apply. Refer to RBV prescribing information. Serious Symptomatic Bradycardia When Coadministered with Amiodarone: Amiodarone is not recommended for use with HARVONI or EPCLUSA due to the risk of symptomatic bradycardia, particularly in patients also taking beta blockers or with underlying cardiac comorbidities and/or with advanced liver disease. A fatal cardiac arrest was reported in a patient taking amiodarone who was coadministered a sofosbuvir containing regimen. In patients without alternative, viable treatment options, cardiac monitoring is recommended. Patients should seek immediate medical evaluation if they develop signs or symptoms of bradycardia. R Continue reading >>

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