Early Assessment of the Risk Factors for Diabetic Retinopathy Can Reduce the Risk of Peripheral Arterial and Cardiovascular Diseases in Type 2 Diabetes

Tang, Juan; Li, Tao; Li, Pinhong; Ma, Yuefei; Liu, Momo; Shan, Qiaoyun; Guo, Fengqi; Zhou, Ting; Wei, Quan

doi:10.1159/000479931

Cited by 11 publications

(8 citation statements)

References 53 publications

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“…No further statistically signi cant differences were identi ed in this group, possibly due to the restricted number of patients included (n=21). Hypertension and hypercholesterolemia were previously identi ed as the most common modi able risk factors for DR [34][35][36]. However, in the current analysis these variables did not present a statistically signi cant association with the development of DR in the total cohort (Table 2) as well as in the subgroup analyses conducted for DM type I (Table 4) and DM type II patients (Table 5).…”

Section: Discussioncontrasting

confidence: 63%

Diabetic retinopathy in Greece: prevalence and risk factors studied in the medical retina clinic of a Greek tertiary hospital

et al. 2022

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Purpose: To determine the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME) in a cohort of Greek diabetic patients and identify possible risk factors. Methods: Population-based, non-interventional, cross-sectional study of 300 diabetic Greek patients attending the medical retina clinics of a tertiary hospital. Clinical and imaging data were recorded and statistical analysis was performed. Con dence intervals (CI) at 95% and statistically signi cant p values ≤0.05 were set.Results: A total of 300 diabetic patients were included. Of these patients, 21 (7%) were diagnosed with diabetes mellitus (DM) type I and 279 (93%) with DM type II. The average duration of diabetes was 15 ± 9.4 years (95% CI, 13.9-16.1) and the mean level of HbA1c was 7.2 ± 1.3 (95% CI, 7.1-7.4) overall. Prevalence of DR was 38.7% (116 patients), only 15 patients (5%) had proliferative DR and diabetic macular edema (DME) was detected in 19 patients (6.3%). In DM type I patients, 52.4% had DR and 9.5% had DME, while in the DM type II group, 37.6% had DR and 6.1% had DME. Binary logistic regression analysis identi ed duration of diabetes, increased HbA1c and hypertriglyceridemia as potential risk factors.Conclusions: This study is the rst one to present the extent and severity of DR and DME in a Greek cohort of diabetic patients and also identify risk factors associated with these entities. Our ndings highlight the signi cance of a properly organized national screening program for the early detection and management of the vision threatening complications of DR.

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Section: Discussioncontrasting

confidence: 63%

Diabetic retinopathy in Greece: prevalence and risk factors studied in the medical retina clinic of a Greek tertiary hospital

et al. 2022

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“…A significant association between carotid disease and changes in the retinal microvasculature has also been found in adolescents with T1D [38]. Diabetic retinopathy has also been associated with other markers of peripheral arterial disease [39], peripheral vascular disease in T1D [40], and arterial stiffness [41].…”

Section: Discussionmentioning

confidence: 93%

The relationship between carotid disease and retinopathy in diabetes: a systematic review

Drinkwater

Davis

2020

Cardiovasc Diabetol

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Background: Since studies of the relationship between carotid disease and diabetic retinopathy (DR) have shown apparent inconsistencies, the aim of this study was to conduct a systematic review of available published data. Methods: Electronic databases were searched independently by two reviewers, according to an iterative protocol, for relevant articles. The search term used was "diabetes AND (carotid disease OR intima-media OR carotid plaque OR carotid stenosis OR carotid arterial disease OR carotid artery disease OR carotid atherosclerosis) AND (retinopathy OR diabetic retinopathy)". Results: From 477 publications, 14 studies were included. There were differences in the variables used as markers of carotid disease and DR across the included studies. Ten studies used carotid disease as the dependent variable, and the remainder used DR. All but one study involved cross-sectional data. Most studies reported a statistically significant association between at least one parameter of carotid disease as assessed by ultrasound and DR presence or severity. Only four studies reported no significant association. A common limitation was the use of convenience participant sampling. Conclusions: There appears to be an increased likelihood of DR when there is ultrasonographic evidence of carotid disease, and vice versa. The available studies suggest that there may be a direct relationship between DR and carotid macrovascular disease and/or that these complications co-exist due to shared risk factors. If carotid disease is detected, retinal assessment should be performed. If DR is identified, intensive cardiovascular disease risk management should be considered. Additional longitudinal studies are needed to assess the directionality of the association.

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“…CVD have been associated with DR. 21,22 Targher et al 23 performed a retrospective study, finding a relation between CVD and non-proliferative DR but this disappeared when adjusting for hypertension and advanced nephropathy. Diabetic cardiomyopathy may be considered as a sort of CVD despite being classified as a microvascular consequence, and that is why it is associated with DR. 7 We did not find any relation between DR and IC or CVA.…”

Section: Discussionmentioning

confidence: 99%

Macro and microangiopathy related to retinopathy and choroidopathy in type 2 diabetes

Bartol-Puyal

Isanta

Calvo

et al. 2021

European Journal of Ophthalmology

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Purpose: To describe the relationship between diabetic retinopathy (DR) and choroidal thickness (CT), and systemic macro and microangiopathy in patients with type 2 diabetes (T2D). Methods: Cross-sectional study enrolling 200 eyes (100 T2D naïve patients) without macular edema. DR was graded and swept-source optical coherence tomography Triton DRI (Topcon) was used to measure CT, which gave automatic measurements in ETDRS grid. An endocrinologist examined all the patients and searched in their medical records for data about macro and microangiopathy: ischemic cardiopathy (IC), cerebrovascular accident (CVA), peripheral artery disease (PAD), nephropathy, and peripheral polyneuropathy (PPN). Results: Mean age was 67.38 ± 8.15 years, mean axial length was 23.26 ± 0.09 mm, and mean IOP was 16.75 ± 3.06 mmHg. Sixty eyes had no DR, 46 had mild, 64 had moderate, 20 had severe, and 10 had proliferative DR. IC was correlated with horizontal choroidal zones ( p < 0.05 and η between 0.16 and 0.21) but not with DR ( p = 0.16). CVA was neither correlated with CT ( p > 0.05) nor with DR ( p = 0.39). PAD was not correlated with CT ( p > 0.05) but it was with DR ( p = 0.03). The type of nephropathy was correlated both with CT in vertical sectors ( p < 0.05 and η between 0.15 and 0.27) and DR ( p = 0.01, τ = 0.24). PPN was not correlated with CT ( p > 0.05) but it was with DR ( p = 0.03). Conclusions: DR is correlated with microangiopathy (nephropathy and PPN) but not with macroangiopathy (IC, CVA, and PAD). CT is mildly correlated with nephropathy and IC. Some choroidal regions are more sensitive than others to each diabetic macro and microvascular manifestation.

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Early Assessment of the Risk Factors for Diabetic Retinopathy Can Reduce the Risk of Peripheral Arterial and Cardiovascular Diseases in Type 2 Diabetes

Cited by 11 publications

References 53 publications

Diabetic retinopathy in Greece: prevalence and risk factors studied in the medical retina clinic of a Greek tertiary hospital

Diabetic retinopathy in Greece: prevalence and risk factors studied in the medical retina clinic of a Greek tertiary hospital

The relationship between carotid disease and retinopathy in diabetes: a systematic review

Macro and microangiopathy related to retinopathy and choroidopathy in type 2 diabetes

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