obsolete diabetes mellitus insulin dependent type, not stated as uncontrolled, with ophthalmic manifestations

Based on the search results, it appears that there are some outdated references to insulin-dependent diabetes mellitus (IDDM) or Type 1 diabetes.

• According to reference [14], a review from 1988 discusses manifestations of diabetes mellitus in the anterior eye and cornea. However, this is an old study and may not be relevant to modern understanding.
• Reference [4] mentions that diabetic retinopathy is more common in type 1 diabetes compared to type 2, but does not specifically discuss ophthalmic manifestations of uncontrolled IDDM.

However, I did find some information on the topic:

• According to reference [7], patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. This suggests that even in the context of IDDM, there can be significant ophthalmic manifestations.
• Reference [6] states that diabetic retinopathy is a microangiopathy affecting the retinal blood vessels, which is consistent with modern understanding.

It's worth noting that the term "uncontrolled" is not explicitly stated in any of the search results. However, based on the context, it appears that some of these references may be discussing diabetes mellitus without specifying whether it is controlled or uncontrolled.

In summary:

• Ophthalmic manifestations can occur in patients with IDDM (Type 1 diabetes), including corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies.
• Diabetic retinopathy is a microangiopathy affecting the retinal blood vessels, which can be a complication of diabetes mellitus.

References:

[7] Jun 5, 2024 — Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. [6] by H Akil · 2016 · Cited by 43 — [1] Diabetes-related autonomic neuropathy can involve ocular structures including lacrimal gland, cornea, and retina.

Based on the search results, here are the signs and symptoms of Type 1 diabetes mellitus (insulin-dependent) with ophthalmic manifestations:

• Age-related peaks: Type 1 diabetes becomes more common as you travel away from the equator. Age, although it can occur at any age, there are two noticeable peaks. The first occurs in children between four and seven years of age [5].
• Sudden appearance of symptoms: Signs and symptoms of type 1 diabetes can appear rather suddenly, especially in children [5].
• Ophthalmic manifestations: The principal ophthalmic manifestations include:
  • Microaneurysms: These occur as a result of weakened capillary walls and are often one of the first ocular signs of diabetes [15].
  • Retinopathy: 25-50% of type 1 patients show some signs of retinopathy. This prevalence increases to 75-95% after 15 years and approaches 100% after 30 years [6].
• Macular oedema: Macular oedema is rare in patients with type 1 diabetes of less than 8 years' duration, but its prevalence increases over time [6].

It's worth noting that these symptoms are not necessarily indicative of uncontrolled diabetes, as the search results do not specify this. However, they are associated with Type 1 diabetes mellitus and its ophthalmic manifestations.

References: [5] - The first occurs in children between four and seven years of age. [6] - The principal ophthalmic manifestations include microaneurysms, retinopathy, and macular oedema. [15] - Microaneurysms occur as a result of weakened capillary walls.

Based on the search results, it appears that there are diagnostic tests available for detecting ocular complications associated with diabetes mellitus, particularly in individuals with type 1 diabetes.

According to search result [3], Schirmer test was found to be significantly reduced in patients with type 1 diabetes mellitus compared to the control group. This suggests that Schirmer test may be a useful diagnostic tool for detecting ocular manifestations of type 1 diabetes.

Additionally, search result [13] mentions that individuals with type 1 DM exhibited reduced Schirmer test values, increased intraocular pressure (IOP), and decreased retinal thickness compared to the age-matched control group. This further supports the use of Schirmer test as a diagnostic tool for detecting ocular complications associated with type 1 diabetes.

It's worth noting that search result [7] emphasizes the importance of comprehensive eye examination, including ancillary testing, in diagnosing and evaluating ocular complications of diabetes. However, it does not specifically mention any obsolete diagnostic tests for type 1 diabetes.

Therefore, based on the available information, Schirmer test appears to be a relevant diagnostic test for detecting ocular manifestations associated with type 1 diabetes mellitus.

• Schirmer test may be used as a diagnostic tool for detecting ocular manifestations of type 1 diabetes [3][13].
• Comprehensive eye examination, including ancillary testing, is essential in diagnosing and evaluating ocular complications of diabetes [7].

Based on the search results, it appears that there are several treatment options available for diabetic retinopathy and macular edema, which are common eye complications associated with diabetes.

• Anti-VEGF drugs can slow down or reverse diabetic retinopathy [5]. These medications can be given by injections into the eye to reduce swelling of the macula and slow vision loss.
• Corticosteroids, such as intravitreal triamcinolone, can also help treat diabetic retinopathy and macular edema [6].
• Laser surgery is sometimes used to treat proliferative retinopathy and macular edema [8].

It's worth noting that good metabolic and blood pressure control is essential for reducing the risk of ophthalmic complications in people with diabetes [7]. This can be achieved through a combination of diet, exercise, and medication.

In terms of specific treatment options for type 1 diabetes, the FDA recommends an eye exam within five years of being diagnosed [2]. However, it's not clear if this recommendation applies to individuals with uncontrolled or poorly controlled diabetes.

It's also worth noting that there are several medications approved by the FDA for the treatment of diabetic macular edema, including faricimab-svoa (Vabysmo), ranibizumab (Lucentis), and aflibercept (Eylea) [2]. However, it's not clear if these medications would be effective in treating individuals with uncontrolled or poorly controlled diabetes.

Overall, while there are several treatment options available for diabetic retinopathy and macular edema, the most effective approach will depend on individual factors such as the severity of the condition, overall health status, and response to previous treatments.

Based on the search results, it appears that there are several ocular complications associated with diabetes mellitus (DM), including diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases.

For a differential diagnosis of obsolete diabetes mellitus insulin-dependent type (Type 1) with ophthalmic manifestations, the following conditions should be considered:

• Papilledema: This is a condition characterized by swelling of the optic disc, which can be caused by increased intracranial pressure. It is often associated with uncontrolled diabetes mellitus, but it can also occur in other conditions such as hypertension or hydrocephalus [9].
• Hypertensive papillopathy: This is a condition characterized by changes to the optic disc and retina due to high blood pressure. It can be a differential diagnosis for diabetic retinopathy and papillopathy, especially if the diabetes mellitus is not stated as uncontrolled [9].
• Papillophlebitis: This is an inflammation of the optic nerve and its surrounding sheath, which can cause changes to the optic disc and retina. It is a rare condition that can be associated with various underlying diseases, including diabetes mellitus [9].

It's worth noting that these conditions should be considered in conjunction with other clinical findings and diagnostic tests to determine the most likely diagnosis.

References: [9] by AA Sadun · 1999 · Cited by 17 — The differential diagnosis of DP also includes papilledema, hypertensive papillopathy, and papillophlebitis. Systemic corticosteroids are of questionable ...