Browsing by Subject "Diabetic retinopathy (DR)"

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    Computer-based Quantification of Acellular Capillaries to Assess Experimental Diabetic Retinopathy
    (Office of the Vice Chancellor for Research, 2016-04-08) Hemmady, Anish; Tuceryan, Mihran; Bhatwadekar, Ashay
    Diabetic retinopathy (DR) is a disease of small blood vessels in the retina. The increase in the number of acellular capillaries is used as a marker to assess the severity of DR. The traditional approach for identifying acellular capillaries is manual counting of the capillaries either directly under the microscope or using the captured images. However, these methods are cumbersome and often involve inconsistencies among researchers. The purpose of this study is to reduce discrepancies in the enumeration of acellular capillaries using computer-based image processing algorithms. The retinas of control and diabetic mice were processed using trypsin digestion. The high resolution png format images of retinal quadrants were prepared from the trypsin digested retina. The computer programming was performed using the Python language along with open source packages such as OpenCv, Python Imaging Library (PIL), NumPy (Numerical Python) and SciPy. The images initially corrected for a Gaussian Blur and a Median blur to remove noise followed by the histogram based image segmentation. After image segmentation, a binary image was generated based on a histogram analysis. The segmentation threshold for binary image was determined and the medial axis transform (MAT) algorithm was applied to the binary image. The MAT representation was used to skeletonize the blood vessels and to detect branches and branch-points in those blood vessels. As part of the MAT computation, the distances from the skeleton to the vessel boundaries are encoded. The thin capilleries, i.e., acellular capilleries, were identified using a threshold on this distance which encodes the thickness of the vessel. Finally, acellular capillaries were counted by connected component algorithm. In conclusion, we have designed an automated computer-based system to enumerate the acellular capillaries. This computer-based automated system will help to maintain consistency in retinopathy assessment and may reduce time for analysis.
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    Effect of the Pharmacist-managed Cardiovascular Risk Reduction Services (CVRRS) on the Diabetic Retinopathy Outcome Measures
    (Office of the Vice Chancellor for Research, 2016-04-08) Kaur, Palakpreet; Gonzalvo, Jasmine; Weber, Zach; Bhatwadekar, Ashay D.
    Indianapolis Diabetes mellitus is affecting many people throughout the world. Diabetic retinopathy (DR) is a long-term complication of diabetes associated with impaired vision. If left untreated DR may eventually lead to blindness. DR is caused by a damage to the small blood vessels in the retina. According to the American Academy of Ophthalmology, 5-10 % of the diabetic patients with normal retinal exams will develop DR within a year of their last retinal exam. The diabetic individuals who currently have DR are similarly susceptible to developing more severe retinopathy. Unfortunately many individuals with diabetes fail to receive education about maintaining glycemic control, medication management and recommended frequency of tests to monitor diabetic complications such as DR. Several studies have shown that the disease management services are effective in improving the quality of care for persons with diabetes. An increasing number of disease management programs utilize pharmacists to assist in the disease management of diabetic individuals. For this clinical study we evaluated the effect of pharmacistmanaged CVRRs on the development of DR in over 100 diabetic individuals. The patient records were assessed for demographics (e.g. age, sex etc.), metabolic parameters (lipid profile, HbA1c) along with number of pharmacist appointments and ophthalmology records. We observed that 95% of the patients who have had pharmacist intervention have been able to keep their retinopathy from getting worse or have improved it. Our studies suggest that there is a correlation supporting the theory that pharmacist intervention helps manage or reduce the severity of DR. Further studies can be conducted in the area to find potential ways to help decrease the severity of DR in patients with diabetes and maybe even prevent diabetic patients from developing DR.
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    Gene Therapy for Non-Hereditary Retinal Disease: Age-Related Macular Degeneration, Diabetic Retinopathy, and Beyond
    (MDPI, 2024-06-01) Rowe, Lucas W.; Ciulla, Thomas A.; Ophthalmology, School of Medicine
    Gene therapy holds promise as a transformative approach in the treatment landscape of age-related macular degeneration (AMD), diabetic retinopathy (DR), and diabetic macular edema (DME), aiming to address the challenges of frequent intravitreal anti-vascular endothelial growth factor (VEGF) injections. This manuscript reviews ongoing gene therapy clinical trials for these disorders, including ABBV-RGX-314, ixoberogene soroparvovec (ixo-vec), and 4D-150. ABBV-RGX-314 utilizes an adeno-associated virus (AAV) vector to deliver a transgene encoding a ranibizumab-like anti-VEGF antibody fragment, demonstrating promising results in Phase 1/2a and ongoing Phase 2b/3 trials. Ixo-vec employs an AAV2.7m8 capsid for intravitreal delivery of a transgene expressing aflibercept, showing encouraging outcomes in Phase 1 and ongoing Phase 2 trials. 4D-150 utilizes an evolved vector to express both aflibercept and a VEGF-C inhibitory RNAi, exhibiting positive interim results in Phase 1/2 studies. Other therapies reviewed include EXG102-031, FT-003, KH631, OLX10212, JNJ-1887, 4D-175, and OCU410. These therapies offer potential advantages of reduced treatment frequency and enhanced safety profiles, representing a paradigm shift in management towards durable and efficacious cellular-based biofactories. These advancements in gene therapy hold promise for improving outcomes in AMD and addressing the complex challenges of DME and DR, providing new avenues for the treatment of diabetic eye diseases.