AIM:To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis,treatment,and best practices of diabetic macular edema(DME).The experts'panel suggests that the tre...AIM:To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis,treatment,and best practices of diabetic macular edema(DME).The experts'panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula.The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load.METHODS:On two different occasions,a panel of 14 retinal specialists from Malaysia,together with an external expert,responded to a questionnaire on management of DME.A consensus was sought by voting after compiling,analyzing and discussion on first-phase replies on the round table discussion.A recommendation was deemed to have attained consensus when 12 out of the 14 panellists(85%)agreed with it.RESULTS:The terms target response,adequate response,nonresponse,and inadequate response were developed when the DME patients'treatment responses were first characterized.The panelists reached agreement on a number of DME treatment-related issues,including the need to classify patients prior to treatment,firstline treatment options,the right time to switch between treatment modalities,and side effects associated with steroids.From this agreement,recommendations were derived and a treatment algorithm was created.CONCLUSION:A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.展开更多
AIM:To determine the prevalence of diabetic retinopathy(DR)among diabetic patients at the primary health clinics in Selangor,Malaysia.METHODS:All diabetic patients were screened in Retinal Disease Awareness Programme(...AIM:To determine the prevalence of diabetic retinopathy(DR)among diabetic patients at the primary health clinics in Selangor,Malaysia.METHODS:All diabetic patients were screened in Retinal Disease Awareness Programme(RDAP)and those who had significant DR changes were referred to the hospital for further management.Descriptive analyses were done to determine the prevalence of DR and sociodemographic characteristics among patients with diabetic.Univariate and multivariable analysis using Logistic regression were performed to find association and predictor factors in this screening.RESULTS:A total of 3305 patients aged 40y and above were screened for DR.Ofthe patients screened,9%patients were found to have DR and other visual complication such as maculopathy(0.9%),cataract(4.8%)and glaucoma(0.4%).The mean age of patients without retinopathy was 57.82±8.470y and the mean age of patients with DR was 63.93±9.857y.About 61.5%of the patients screened were aged below 60y and 38.5%were aged 60y and above.Majority of the patients screened were women 58.5%and Malay in the age group of 50-59y,while 27%were aged 60-69y.Significant association were found between age,sex,race,visual loss and DR.CONCLUSION:Although the prevalence of DR among patients is not alarming,effective interventions need to be implemented soon to avert a large burden of visual loss from DR.展开更多
The prevalence of diabetic retinopathy(DR),and associated morbidity is high in the Asia-Pacific region.Emerging evidence suggests a potential role for fenofibrate in the prevention of progression of DR,especially in p...The prevalence of diabetic retinopathy(DR),and associated morbidity is high in the Asia-Pacific region.Emerging evidence suggests a potential role for fenofibrate in the prevention of progression of DR,especially in patients with cardiovascular risk,and pre-existing mild-to-moderate DR.Fenofibrate has also been found to reduce maculopathy,and the need for laser treatment in these patients.Considering these benefits of fenofibrate,a group of experts from the fields of endocrinology and ophthalmology convened in May 2017,to discuss on the the mechanism of action,and clinical efficacy of fenofibrate in DR.The findings from key clinical studies on fenofibrate in DR were reviewed by the experts,and consensus statements were derived to define the role of fenofibrate in the prevention and treatment of DR.The statements were rated based on the GRADE criteria.An algorithm was also developed for the screening and treatment of DR in patients with type 2 diabetes(T2D),and the place of fenofibrate was defined in the algorithm.The expert recommendations,and the algorithm provided in this review will serve as a guide to the clinicians to reconsider the adjunctive use of fenofibrate for preventing the progression of DR in selected T2D patients.展开更多
文摘AIM:To derive a Malaysia guideline and consensus as part of the Malaysia Retina Group's efforts for diagnosis,treatment,and best practices of diabetic macular edema(DME).The experts'panel suggests that the treatment algorithm to be divided into groups according to involvement the central macula.The purpose of DME therapy is to improve edema and achieve the best visual results with the least amount of treatment load.METHODS:On two different occasions,a panel of 14 retinal specialists from Malaysia,together with an external expert,responded to a questionnaire on management of DME.A consensus was sought by voting after compiling,analyzing and discussion on first-phase replies on the round table discussion.A recommendation was deemed to have attained consensus when 12 out of the 14 panellists(85%)agreed with it.RESULTS:The terms target response,adequate response,nonresponse,and inadequate response were developed when the DME patients'treatment responses were first characterized.The panelists reached agreement on a number of DME treatment-related issues,including the need to classify patients prior to treatment,firstline treatment options,the right time to switch between treatment modalities,and side effects associated with steroids.From this agreement,recommendations were derived and a treatment algorithm was created.CONCLUSION:A detail and comprehensive treatment algorithm by Malaysia Retina Group for the Malaysian population provides guidance for treatment allocation of patients with DME.
文摘AIM:To determine the prevalence of diabetic retinopathy(DR)among diabetic patients at the primary health clinics in Selangor,Malaysia.METHODS:All diabetic patients were screened in Retinal Disease Awareness Programme(RDAP)and those who had significant DR changes were referred to the hospital for further management.Descriptive analyses were done to determine the prevalence of DR and sociodemographic characteristics among patients with diabetic.Univariate and multivariable analysis using Logistic regression were performed to find association and predictor factors in this screening.RESULTS:A total of 3305 patients aged 40y and above were screened for DR.Ofthe patients screened,9%patients were found to have DR and other visual complication such as maculopathy(0.9%),cataract(4.8%)and glaucoma(0.4%).The mean age of patients without retinopathy was 57.82±8.470y and the mean age of patients with DR was 63.93±9.857y.About 61.5%of the patients screened were aged below 60y and 38.5%were aged 60y and above.Majority of the patients screened were women 58.5%and Malay in the age group of 50-59y,while 27%were aged 60-69y.Significant association were found between age,sex,race,visual loss and DR.CONCLUSION:Although the prevalence of DR among patients is not alarming,effective interventions need to be implemented soon to avert a large burden of visual loss from DR.
文摘The prevalence of diabetic retinopathy(DR),and associated morbidity is high in the Asia-Pacific region.Emerging evidence suggests a potential role for fenofibrate in the prevention of progression of DR,especially in patients with cardiovascular risk,and pre-existing mild-to-moderate DR.Fenofibrate has also been found to reduce maculopathy,and the need for laser treatment in these patients.Considering these benefits of fenofibrate,a group of experts from the fields of endocrinology and ophthalmology convened in May 2017,to discuss on the the mechanism of action,and clinical efficacy of fenofibrate in DR.The findings from key clinical studies on fenofibrate in DR were reviewed by the experts,and consensus statements were derived to define the role of fenofibrate in the prevention and treatment of DR.The statements were rated based on the GRADE criteria.An algorithm was also developed for the screening and treatment of DR in patients with type 2 diabetes(T2D),and the place of fenofibrate was defined in the algorithm.The expert recommendations,and the algorithm provided in this review will serve as a guide to the clinicians to reconsider the adjunctive use of fenofibrate for preventing the progression of DR in selected T2D patients.
