Determinants of Diabetic Retinopathy in Southwest Ethiopia: A facility-based case-control study

Garoma, Dugasa; Merga, Hailu; Hiko, Desta

doi:10.21203/rs.3.rs-16187/v2

Cited by 1 publication

(1 citation statement)

References 15 publications

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“…An Ethiopian study of 311 patients with diabetes found that patients over the age of 60 were five times more likely to develop DR than those under 60, patients with poor adherence were three times more likely to develop DR than those who were adherent, and those with poor glycemic control were nine times more likely to develop DR than those with good glycemic control. 77 A study examining the adherence within the Atherosclerosis Risk in Communities Study, average participant age 75.4, found that 2119 participants, or about 40%, reported intermediate to poor compliance with their medication; of these participants, 75% of them said their non-adherence was due to poor memory. 78 Although these results look daunting, there were some positive takeaways from the study.…”

Section: Challenges For the Aging Populationmentioning

confidence: 99%

Diabetic Retinopathy in the Aging Population: A Perspective of Pathogenesis and Treatment

Leley¹,

Ciulla²,

Bhatwadekar³

2021

CIA

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The elderly population in the United States is projected to almost double by the year 2050. In addition, the numbers of diabetics are rising, along with its most common complication, diabetic retinopathy (DR). To effectively treat DR within the elderly population, it is essential first to consider the retinal changes that occur due to aging, such as decreased blood flow, retinal thinning, and microglial changes, and understand that these changes can render the retina more vulnerable to oxidative and ischemic damage. Given these considerations, as well as the pathogenesis of DR, specific pathways could play a heightened role in DR progression in elderly patients, such as the polyol pathway and the vascular endothelial growth factor (VEGF) axis. Current ocular treatments include intravitreal corticosteroids, intravitreal anti-VEGF agents, laser photocoagulation and surgical interventions, in addition to better control of underlying diabetes with an expanding range of systemic treatments. While using therapeutics, it is also essential to consider how pharmacokinetics and pharmacodynamics change with aging; oral drug absorption can decrease, and ocular drug metabolism might affect the dosing and delivery methods. Also, elderly patients may more likely be nonadherent to their medication regimen or appointments than younger patients, and undertreatment with anti-VEGF drugs often leads to suboptimal outcomes. With a rising number of elderly DR patients, understanding how aging affects disease progression, pharmacological metabolism, and adherence are crucial to ensuring that this population receives adequate care.

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Section: Challenges For the Aging Populationmentioning

confidence: 99%