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      Association of pupil responses with severity of erectile dysfunction in diabetes mellitus

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          Abstract

          Purpose:

          To investigate the relation between erectile dysfunction (ED) severity and pupillary functions in patients with diabetes mellitus (DM).

          Methods:

          This prospective and observational study included 90 patients with type 2 DM and ED. Patients divided into three subgroups according to severity of ED: (i) Mild ED, (ii) Moderate ED and (iii) Severe ED groups. Thirty age-matched healthy subjects formed the control group. Main outcome measures were pupil diameter and average speed of pupil dilation. Static and dynamic pupillometry analysis was performed using the Sirius Topographer (CSO, Firenze, Italy).

          Results:

          Mean pupil diameter during static and dynamic pupillometry analysis were significantly greater in the control group than in the all study groups ( P < 0.05). Mean pupil diameter in static pupillometry analysis was significantly different in each study group and pupil was more miotic in the Severe ED group than in the both Moderate and Mild ED groups ( P < 0.05 for each). Dynamic pupillometry analysis revealed that mean pupil diameter and mean average dilation speed were significantly different in each study group throughout measurement period and the highest speed was observed in the Mild ED group and the lowest speed was observed in the severe ED group ( P < 0.005 for each).

          Conclusion:

          Our study results suggest that abnormal pupil functions due to diabetic autonomic neuropathy may indicate the associated ED in patients with DM.

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          Most cited references22

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          Physiology of penile erection and pathophysiology of erectile dysfunction.

          This article reviews the physiology of penile erection, the components of erectile function, and the pathophysiology of erectile dysfunction. The molecular and clinical under-standing of erectile function continues to gain ground at a particularly fast rate. Advances in gene discovery have aided greatly in working knowledge of smooth muscle relaxation/contraction pathways. The understanding of the nitric oxide pathway has aided not only in the molecular understanding of the tumescence but also greatly in the therapy of erectile dysfunction.
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            Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7.

            (1991)
            The Early Treatment Diabetic Retinopathy Study (ETDRS), a multicenter collaborative clinical trial supported by the National Eye Institute, was designed to assess whether argon laser photocoagulation or aspirin treatment can reduce the risk of visual loss or slow the progression of diabetic retinopathy in patients with mild-to-severe nonproliferative or early proliferative diabetic retinopathy. The 3711 patients enrolled in the ETDRS were assigned randomly to either aspirin (650 mg per day) or placebo. One eye of each patient was assigned randomly to early argon laser photocoagulation and the other to deferral of photocoagulation. Both eyes were to be examined at least every 4 months and photocoagulation was to be initiated in eyes assigned to deferral as soon as high-risk proliferative retinopathy was detected. Examination of a large number of baseline ocular and patient characteristics indicated that there were no important differences between randomized treatment groups at baseline.
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              Diabetes and sexual dysfunction: current perspectives

              Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes.
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                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Wolters Kluwer - Medknow (India )
                0301-4738
                1998-3689
                August 2019
                : 67
                : 8
                : 1314-1319
                Affiliations
                [1]Department of Ophthalmology, Medical School of Mustafa Kemal University, Hatay, Turkey
                [1 ]Department of Ophthalmology, Kars Harakani State Hospital, Kars, Turkey
                [2 ]Department of Urology, Medical School of Mustafa Kemal University, Hatay, Turkey
                Author notes
                Correspondence to: Dr. Serdar Ozates, Yenişehir Mahallesi, İsmail Aytemiz Blv. No: 55, 36200 Merkez, Kars, Turkey. E-mail: serdarozates@ 123456gmail.com
                Article
                IJO-67-1314
                10.4103/ijo.IJO_220_19
                6677051
                31332117
                85de9de2-5e43-4f44-bfea-702e57951fe8
                Copyright: © 2019 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 28 January 2019
                : 05 April 2019
                Categories
                Original Article

                Ophthalmology & Optometry
                diabetes mellitus,diabetic autonomic neuropathy,erectile dysfunction,pupillometry

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