Systemic Factors Affecting Diabetic Retinopathy

Srivastava, Bipin K.; Ramya, B; Prathiba, Vijayaraghavan; Mohan, Viswanathan

doi:10.4103/jod.jod_35_17

Cited by 8 publications

(6 citation statements)

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“…The VEGF levels are upregulated in the retinal endothelial cells and ocular fluids in the eyes with hypertension. [ 27 ] Nishi et al . [ 28 ] found an association between the systemic risk factors and visual acuity at 2 and 4 years following vitrectomy for PDR which is similar to our findings of the association between hypertension and the final visual outcome in the T2DM group.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Baliga

Kumar

Babu

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To evaluate the clinical profile, visual outcomes, and complications among young adult patients with type 1 diabetes mellitus (insulin-dependent DM-T1DM) in comparison with patients with type 2 diabetes mellitus (T2DM) undergoing vitrectomy for complications of proliferative diabetic retinopathy (PDR). Methods: A retrospective review of patients between 18 and 45 years with T1DM undergoing vitrectomy for complications of PDR between June 2017 and June 2019, with a minimum follow-up of 12 months. Consecutive patients between 30 and 45 years with type 2 diabetes (non-insulin-dependent DM-T2DM) who underwent vitrectomy for the same indications were retrospectively enrolled as the control group. Results: There were 42 eyes (28 patients) in the T1DM group and 58 eyes (47 patients) in the T2DM group. The average age at operation was 35.9 ± 6.88 years and 39.8 ± 3.03 years, respectively ( P < 0.001). At the end of follow-up, the mean logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) improved from 1.53 ± 0.55 to 1.30 ± 0.93 ( P value 0.07) in the T1DM group and from 1.59 ± 0.46 to 1.00 ± 0.78 in the T2DM group ( P = 0.0001). The rate of the primary and final reattachment was 76.2% and 88.1% in the T1DM group and 84.5% and 96.6% in the T2DM group. Preoperative macular tractional retinal detachment (MTRD) and neovascular glaucoma (NVG) in both the groups, chronic kidney disease (CKD) and lack of preoperative Pan retinal photocoagulation (PRP) in the T1DM group, hypertension (HTN) and, resurgery in the T2DM group, were risk factors for poor vision at the final follow-up. Conclusion: The visual and anatomic outcomes were poorer in the T1DM patients which could be due to the longer duration of diabetes with worse glycemic control, associated comorbidities like CKD, and a higher incidence of MTRD.

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Section: Discussionmentioning

confidence: 99%

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Baliga

Kumar

Babu

et al. 2021

Indian Journal of Ophthalmology

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“…Since it was shown that serum BDNF levels decrease with age, a control group of apparently healthy age-matched adults was added. 11 DR progression is also influenced by hemodynamic changes such as anemia, as well as diabetes control, 12 therefore, in addition to measuring serum BDNF, CBC parameters and biochemical tests were also performed. According to our research, participants' histories of hypertension were significantly correlated with DR (p< 0.001).…”

Section: Discussionmentioning

confidence: 99%

Diabetic retinopathy and its relation to serum brain-derived neurotrophic factor level

El-Hamid

Farrag

El-Deen

2023

EJI

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Diabetes mellitus (DM) is a metabolic disorder of the proteins, lipids, and carbohydrates, results in hyperglycemia. Abnormalities in the function of insulin on target cells, its release from beta cells, or both may contribute to DM. The purpose of this research was to assess the progression of diabetic retinopathy (DR) to the levels of serum brain-derived neurotrophic factor (BDNF), glycated hemoglobin (HbA1c), and biochemical parameters. The study included 44 normal control subjects, 44 diabetic participants, who were separated into four groups based on their diabetes status and the results of fundoscopic examination. A commercial enzyme-linked immunosorbent assay kit was used to measure the levels of BDNF in the serum. The analysis revealed that diabetics had significantly lower serum BDNF levels than non-diabetics (p< 0.001). Also, there was a significant reduction in BDNF levels with the development of proliferative diabetic retinopathy in comparison with diabetics without DR (p < 0.001). In conclusion, serum BDNF levels decreased significantly in diabetics with and without DR compared to apparently healthy individuals, as well as with the progression of DR.

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“…Hypertension is one among the potential risk factors for the occurrence and progression of DR. Elevated BP affects hemodynamic and vascular endothelial growth factor (VEGF) induced pathways in DR. Elevated BP upregulates VEGF expression in retinal endothelial cells and worsens the DR.[ 33 34 ] United Kingdom Prospective Diabetes Study (UKPDS) had shown that patients with good control of BP (<150/85 mmHg) had a 34% reduction in severity of retinopathy and 47% decreased risk in worsening of visual acuity. [ 35 ] Similarly, in our study, SBP was uncontrolled in both groups with STDR with older onset DM having higher range of uncontrolled BP (142.0 ± 1.4 mmHg).…”

Section: Discussionmentioning

confidence: 99%

Severity of diabetic retinopathy and its relationship with age at onset of diabetes mellitus in India: A multicentric study

Parameswarappa

Rajalakshmi

Mohamed

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To present clinical profile and risk factors of sight-threatening diabetic retinopathy (STDR) among people with age of onset of diabetes (AOD) <25 versus ≥25 years. Methods: A retrospective chart analysis of consecutive patients with diabetic retinopathy (DR) n = 654) treated at 14 eye care centers across India between 2018 and 2019 was performed. Patients were divided into two groups, Group 1: AOD <25 years and Group 2: AOD ≥25 years. DR and diabetic macular edema (DME) were classified using the International Clinical Classification of DR severity scale. STDR included severe nonproliferative DR (NPDR), proliferative DR (PDR), and moderate to severe DME. A multilevel mixed-effects model was used for comparison between two groups: 1) Patients with DR and AOD <25 years and 2) Patients with DR and AOD ≥25 years. Bivariate and multivariate regression analyses were used to evaluate risk factors between the two groups. Results: A total of 654 patients were included, 161 (307 eyes) in AOD <25 and 493 (927 eyes) in AOD >25 group. There was a higher prevalence of PDR with high-risk characteristics in AOD <25 group (24% vs. 12%) at baseline and 12-month follow-up (25% vs. 6%); P < 0.001. Systolic hypertension and poor glycemic control were risk factors in both groups, with no difference in these modifiable risk factors between groups. Conclusion: People with youth-onset DM are likely to present with severer form of STDR despite similar modifiable risk factors. Therefore, strict control of systolic blood pressure, glycemic status, and regular screening for DR are recommended to reduce the risk of STDR irrespective of the age of onset of diabetes.

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Systemic Factors Affecting Diabetic Retinopathy

Cited by 8 publications

References 0 publications

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

Diabetic retinopathy and its relation to serum brain-derived neurotrophic factor level

Severity of diabetic retinopathy and its relationship with age at onset of diabetes mellitus in India: A multicentric study

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