DIABETIC RETINOPATHY IN PATIENTS OF TYPE2 DIABETES MELLITUS WITH DIABETIC NEPHROPATHY

Dr. Debabrata Das, Dr. Somedeb Gupta

Abstract


To evaluate severity of diabetic retinopathy in patients of type 2 diabetes mellitus with diabetic nephropathy. This was a cross sectional study of 159
eyes of 80 patients aged above 40 years, diagnosed to have Type 2 DM with diabetic nephropathy. All the patients were investigated for
albuminuria. The retinopathy was evaluated according to the Early Treatment Diabetes Retinopathy Study (ETDRS) classification into nonproliferative
diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). Diabetic macular edema was characterized as clinically
significant macular edema (CSME) and non-CSME. The severity of retinopathy was correlated with nephropathy. In this study, mean age of the
patients were 58.26± 6.43 years and male to female ratio 1.96:1. Out of 80 diabetic patients, 22(27.5%) patients had microalbuminuria and 58 (72.5
%) had macroalbuminuria. In this study, 67 (83.7%) patients had diabetic retinopathy, out of which 14 (20.9%) patients had mild NPDR, 20
(29.9%) had moderate NPDR, 16 (23.9%) had severe NPDR, 5(7.4%) had very severe NPDR and 12 (17.9%) had PDR. In 22 patients with
microalbuminuria 6 (27.3%) had mild NPDR, 4 (5.0%) had moderate NPDR and none had maculopathy. In 58 patients with macroalbuminuria, 8
(13.8%) had mild NPDR, 16 (27.6%) had moderate NPDR, 16 (27.6%) severe NPDR, 5 (8.6%) has very severe NPDR, 4(6.9%) had early PDR and
8(13.8%) had high-risk PDR, 14 (24.1%) had CSME and 4 (6.9%) had non-CSME. In our study, diabetic nephropathy patients with
macroalbuminuria had more severe type of DR than patients with microalbuminuria.


Full Text:

PDF

References


Pandey SK, Sharma V. World diabetes day 2018: Battling the Emerging Epidemic of Diabetic Retinopathy. Indian J Ophthalmol 2018;66:1652-3

Wirta O, Pasternack A, Mustonen J, Laippala P, Lähde Y: Retinopathy isindependently related to microalbuminuria in type 2 diabetes mellitus.Clin Nephrol 1999, 51:329-33

Unnikrishnan RI, Rema M, Pradeepa R, Deepa M, Shanthirani CS, Deepa R,Mohan V: Prevalence and risk factors of diabetic nephropathy in an urban South Indian population: the Chennai Urban Rural Epidemiology Study (CURES 45). Diabetes Care 2007, 30:2019-2024.

Prevalence of small vessel and large vessel disease in diabetic patients from 14 centers. The World Health Organization Multinational Study of Vascular Disease in Diabetics. Diabetes Drafting Group. Diabetologia 1985, 28:615-640.

Sobngwi E, Mbanya JC, Moukouri EN, Ngu KB: Microalbuminuria and retinopathy in a diabetic population of Cameroon. Diabetes Res Clin Pract 1999, 44:191-196

Kaiser, N.; Sasson, S.; Feener, E.P.; Boukobza-Vardi, N.; Higashi, S.; Moller, D.E.; Davidheiser, S.;Przybylski, R.J.; King, G.L. Differential regulation of glucose transport and transporters by glucose in vascular endothelial and smooth muscle cells. Diabetes 1993, 42, 80–89.

Mizutani, M.; Kern, T.S.; Lorenzi, M. Accelerated death of retinal microvascular cells in human and experimental diabetic retinopathy. J. Clin Investig. 1996, 97, 2883–2890.

Cavalieri GC, Lima MC, Nazario NO, Lima GC. Risk factors for diabetic retinopathy: a case–control study. Int J Retina Vitreous, 2016; 2: 21.

Bello NA, Pfeffer MA, Skali H, McGill JB, Rossert J, Olson KA et al. .Retinopathy and clinical outcomes in patients with type 2 diabetes mellitus, chronic kidney disease, and anemia.BMJ Open Diabetes Res Care, 2014 ;2 (1): e000011.

Lee WJ, Sobrin L, Kang MH, Seong M, Kim YJ, Yi JH, Miller JW, Cho HY. Ischemic diabetic retinopathy as a possible prognostic factor for chronic kidney disease progression. Eye 2014 ; 28 (9): 1119-25.

Singh SK,Bhere A,Singh MK.Diabetic retinopathy and microalbuminuria in lean type 2 diabetes mellitus.J Asso Physicians India.2001;49:439-41


Refbacks

  • There are currently no refbacks.