Asymmetric Diabetic Retinopathy Progression in Patients With Axial Anisometropia

Kim, Dong Yoon; Song, Ji Ho; Kim, Yoon Jeon; Lee, Joo Yong; Kim, June-Gone; Yoon, Young Hee; Joe, Soo Geun

doi:10.1097/iae.0000000000002109

Cited by 13 publications

(6 citation statements)

References 28 publications

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“…Long AL may be protective against the development of DR. He et al (2017) conducted an epidemiological investigation and found that type 2 diabetic patients with long AL had a low risk of developing DR. Man et al (2012) stated that long AL is protective for mild, moderate, and severe DR. The mechanism of the protective effect of long AL and myopia on the development and progression of DR remains unknown, and the possible reasons are as follows: (1) Patients with longer AL have reduced retinal blood flow, slower blood velocity, and reduced vessel wall pressure, thus limiting the occurrence and progression of DR ( Lim et al, 2011 ; Kim et al, 2018 ). (2) Disruption of retinal and choroidal blood vessels occurs earlier in patients with high myopia, and the drop in retinal blood perfusion prevents the formation of an abnormal hyperperfusion state that induces DR, thus reducing the risk of developing DR ( Benavente-Pérez et al, 2010 ; Kim et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Analysis of independent risk factors for progression of different degrees of diabetic retinopathy as well as non-diabetic retinopathy among type 2 diabetic patients

Tong

Liu

et al. 2023

Front. Neurosci.

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PurposeTo study the independent risk factors for development of different degrees of diabetic retinopathy (DR) as well as non-DR (NDR) among type 2 diabetic patients.MethodsThis cross-sectional study included 218 patients with type 2 diabetes between January 2022 and June 2022. All the patients were divided into two groups: the DR group and the NDR group. The DR group was subdivided into the mild, moderate and severe non-proliferative DR (NPDR) group and the proliferative DR (PDR) group. Data recorded for all patients included age, gender, duration of diabetes, blood pressure, glycated hemoglobin (HbA1c), fasting blood glucose (FBG), blood lipids, best corrected visual acuity (BCVA), intraocular pressure (IOP), axial length (AL), anterior chamber depth (ACD), and renal function. Logistic regression methods were used to analyze the risk factors for DR.ResultsThe prevalence of DR in type 2 diabetes was 28.44%. The duration of diabetes, age, mean arterial pressure (MAP), HbA1c, FBG, urinary albumin/creatinine ratio (UACR), BCVA, AL, and ACD were significantly different between the DR and the NDR groups (p < 0.05). Multivariate logistic regression analysis identified age, FBG, UACR, and AL as the independent risk factors for DR (OR = 0.843, 2.376, 1.049, 0.005; p = 0.034, 0.014, 0.016, p < 0.001).ConclusionYoung age, short AL, higher levels of FBG and UACR were the independent risk factors for the progression of DR in type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Analysis of independent risk factors for progression of different degrees of diabetic retinopathy as well as non-diabetic retinopathy among type 2 diabetic patients

Tong

Liu

et al. 2023

Front. Neurosci.

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“…Recently, Kim et al performed a retrospective study of DM patients with axial anisometropia with different axis and found that eyes with a longer axial axis had significantly lower DR lesions than those with a shorter axial axis. 25 …”

Section: Discussionmentioning

confidence: 99%

The Association of Axial Length with Macular Microvascular Changes in Chinese Diabetic Retinopathy Patients

Zhang¹,

Yang²,

Xu³

et al. 2022

IJGM

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Objective To use optical coherence tomography angiography (OCTA) to compare macular blood flow density, subfoveal choroidal thickness (SFCT) and outer retina thickness (ORT) in non-proliferative diabetic retinopathy (NPDR) patients with different axial length (AL). Methods Total 42 patients with NPDR with different eye axis were divided into three groups: group A: 22 mm≤AL<24 mm; group B: 24 mm≤AL<26 mm; group C: AL≥26 mm. Superficial capillary plexus (SCP) in the macular area, vascular length density (VLD) and vascular perfusion density (VPD) in the foveal region, the parafoveal region, the perifoveal region and whole macular region were analyzed. The correlations among axial length, macular microvascular density, SFCT and outer retinal thickness (ORT) were analyzed. Results Compared with group A and B, VLD and VPD in group C were significantly lower except the foveal region, and VLD and VPD were negatively correlated with AL. The difference in SFCT among group A, B and C was significant, and SFCT was negatively correlated with AL. Compared with group A, parafoveal ORT in group C was significantly lower than that in group A, and parafoveal ORT was negatively correlated with AL. Conclusion In NPDR patients with different AL, macular microvascular density, SFCT, and parafoveal ORT decreased with the increase of AL.

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“…[ 57 ] With >1-mm axial length difference between the two eyes, the prevalence of PDR was 61.7% in shorter eyes and 23.5% in longer ones while being significantly lower in eyes with a subfoveal choroidal thickness of <250 μm. [ 66 ] However, subfoveal choroidal thickness is not related to the prevalence and stage of DR when the axial length is >24.5 mm. [ 57 ]…”

Section: Associated Modifying Factorsmentioning

confidence: 99%

Asymmetric diabetic retinopathy

Azad

Sinha

Nishant

2021

Indian Journal of Ophthalmology

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Increasing prevalence of diabetes mellitus warrants recognition of factors related to asymmetric diabetic retinopathy (DR). This thematic synthesis based on an iterative literature review conducted in Medline and Google Scholar pertaining to diabetes with coexistent asymmetry of retinopathy included 45 original articles, 21 case reports and series, and 18 review articles from 1965 to 2020. Asymmetric DR is defined as proliferative DR (PDR) in one eye and nonproliferative, preproliferative, background, or no DR in the other eye lasting for at least 2 years. It is observed in 5%–10% of patients with PDR. Associated factors can be divided into (i) vascular: carotid obstructive disease, ocular ischemic syndrome, and retinal vascular diseases; (ii) Inflammatory: uveitis, endophthalmitis, and Fuchs’ heterochromic cyclitis; (iii) degenerative: posterior vitreous detachment, high myopia and anisometropia, uveal coloboma, retinal detachment, retinitis pigmentosa, and chorioretinal atrophy and scarring; (iv) cataract surgery and vitrectomy; and (v) miscellaneous: elevated intraocular pressure, glaucoma, amblyopia, retinal detachment, and optic atrophy. The gamut of diagnostic modalities for asymmetric DR includes thorough ocular examination, slit-lamp biomicroscopy, fundus photography, fundus fluorescein angiography, optical coherence tomography, and newer modalities such as ultra-widefield fluorescein angiography and optical coherence tomography angiography, along with a complete systemic evaluation and carotid Doppler studies. The differential diagnosis includes other causes of retinal neovascularization that may present in an asymmetric manner, such as sickle cell retinopathy, retinal vein occlusions, and featureless retina. This review discusses in detail the aforementioned considerations and draws a comprehensive picture of asymmetric DR in order to sensitize ophthalmologists to this important condition.

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Asymmetric Diabetic Retinopathy Progression in Patients With Axial Anisometropia

Abstract: In patients with axial anisometropia, the longer eye had a lower degree of DR progression than the shorter eye. This result showed that elongation of the axial length had a protective effect against the progression of DR without individual confounding factors.

Cited by 13 publications

References 28 publications

Analysis of independent risk factors for progression of different degrees of diabetic retinopathy as well as non-diabetic retinopathy among type 2 diabetic patients

Analysis of independent risk factors for progression of different degrees of diabetic retinopathy as well as non-diabetic retinopathy among type 2 diabetic patients

The Association of Axial Length with Macular Microvascular Changes in Chinese Diabetic Retinopathy Patients

Asymmetric diabetic retinopathy

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