Vision Science and Eye

Biography

Biography: Nilufer Koyluoglu

Abstract

Over 382 million people in the World have diabetes, 46% of globally diabetes population is undiagnosed. Up to 50% of diabetes is detected with a clinical complication. Diabetic population will increase 54% while the number of ophthalmologists will increase by 2%. Will present activities address the magnitude of the issues that are coming up? This massive problem requires a high level solution. Advanced glycation end products (AGEs) are proteins that become glycated as a result of exposure to sugars. The HbA1C test is currently one of the best ways to check diabetes is under control. These glucose molecules are still “sticky,” with the same affinity for protein, including collagen within the lens. The non-enzymatic, chemical bonding between glucose and lens proteins forms irreversible glyco-protein aggregates. AGEs accumuate in these proteins over a persons lifetime. Lens autoluorescence may have a clinical utility is suggested by its physiological basis, which is the accumulation of AGEs, a heterogenous family of yellow-brown and fluorescent proteins that have been modified by glycation.

MATHERIAL AND METHOD

Studies of the autoflurescence of the human crytalline lens have established that lens autofluorescence intensity increases with the age of the subject and that lens autofluorescence is further increased in patients with diabetes mellitus.The transparency of the ocular media (cornea, aqueous and lens) provides a unique opportunity to shine an excitatory light source on fluorescent AGEs within the human lens and correlate that fluorescence with the degree of AGE deposition.The only technology available in the U.S. cleared by the U.S. Food and Drug Administration (FDA) for the non-invasive measurement of lens autofluorescence is the CLEARPATH DS-120™, manufactured by Freedom Meditech, Inc. (San Diego, CA). 

RESULTS

The CLEARPATH DS-120™ accurately measures a person’s lenticular fluorescence and reports if the result is at normal, high, or low limits versus age-adjusted normative data. Thus, since the glycation process in the lens has been reported to be irreversible, one can think of lens autofluorescence as a tool to obtain information about a person’s glucose excursions over a lifetime. On the other side, lens autofluorescence measurement can identify patients with lens fluorescence lower than expected as under the green line. Thus fluorescein ratio provides information on the mobility of the person, the calories they get / the calories burned and
it should be investigated by further studies whether it will be an athletic performance indicator such as an athlete's pulse.

CONCLUSION

The clinical data indicated that the fluorescence ratio could provide better discrimination between individuals with and without diabetes than fluorescence intensity.If we think of fasting blood sugar and postprandial blood sugar as photograph, HbA1c as fragman, fluorescein ratio can be considered as whole film of life until cataract operation and
it should be considered as a metabolic credit note of the person. Noninvasive measurements of lens autofluorescence may have clinical utility for general health beyond the diabetes and its complication.