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Li Y, Hu P, Li L, Wu X, Wang X, Peng Y. The relationship between refractive error and the risk of diabetic retinopathy: a systematic review and meta-analysis. Front Med (Lausanne) 2024; 11:1354856. [PMID: 38895184 PMCID: PMC11183799 DOI: 10.3389/fmed.2024.1354856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Purpose This meta-analysis was conducted to collect all available data and estimate the relationship between refractive error and the risk of diabetic retinopathy (DR) in patients with diabetes, and to assess whether vision-threatening DR (VTDR) is associated with refractive error. Methods We systematically searched several literature databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wan Fang Data, and VIP databases. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using fixed or random effects models. Four models were developed to assess the relationship between refractive error and the risk and DR, VTDR: hyperopia and DR, VTDR; myopia and DR, VTDR; spherical equivalent (SE per D increase) and DR, VTDR; and axial length (AL per mm increase) and DR, VTDR. The included literature was meta-analyzed using Stata 12.0 software, and sensitivity analysis was performed. Publication bias in the literature was evaluated using a funnel plot, Begg's test, and Egger's test. Results A systematic search identified 3,198 articles, of which 21 (4 cohorts, 17 cross-sectional studies) were included in the meta-analysis. Meta-analysis showed that hyperopia was associated with an increased risk of VTDR (OR: 1.23; 95% CI: 1.08-1.39; P = 0.001), but not with DR (OR: 1.05; 95% CI: 0.94-1.17; P = 0.374). Myopia was associated with a reduced risk of DR (OR: 0.74; 95% CI: 0.61-0.90; P = 0.003), but not with VTDR (OR: 1.08; 95% CI: 0.85-1.38; P = 0.519). Every 1 diopter increase in spherical equivalent, there was a 1.08 increase in the odds ratio of DR (OR: 1.08; 95% CI: 1.05-1.10; P<0.001), but not with VTDR (OR: 1.05; 95% CI: 1.00-1.10; P = 0.06). AL per mm increase was significantly associated with a decreased risk of developing DR (OR: 0.77; 95% CI: 0.71-0.84; P<0.001) and VTDR (OR: 0.63; 95% CI: 0.56-0.72; P<0.001). Analysis of sensitivity confirmed the reliability of the study's findings. Conclusion This meta-analysis demonstrates hyperopia was associated with an increased risk of VTDR in diabetes patients. Myopia was associated with a reduced risk of DR. AL is an important influencing factor of refractive error. Every 1 mm increase in AL reduces the risk of DR by 23% and the risk of VTDR by 37%. Systematic review registration identifier: CRD42023413420.
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Affiliation(s)
- Yanqing Li
- Department of Refractive Surgery, China Aier Eye Hospital Group, Chongqing Aier Eye Hospital, Chongqing, China
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Pengcheng Hu
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Li
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xianhui Wu
- Department of Ophthalmology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xi Wang
- Department of Refractive Surgery, Dali Aier Eye Hospital, Dali, Yunnan, China
| | - Yanli Peng
- Department of Refractive Surgery, China Aier Eye Hospital Group, Chongqing Aier Eye Hospital, Chongqing, China
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Yii F, Bernabeu MO, Dhillon B, Strang N, MacGillivray T. Retinal Changes From Hyperopia to Myopia: Not All Diopters Are Created Equal. Invest Ophthalmol Vis Sci 2024; 65:25. [PMID: 38758640 PMCID: PMC11107950 DOI: 10.1167/iovs.65.5.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/30/2024] [Indexed: 05/19/2024] Open
Abstract
Purpose To quantitatively characterize retinal changes across different quantiles of refractive error in 34,414 normal eyes of 23,064 healthy adults in the UK Biobank. Methods Twelve optic disc (OD), foveal and vascular parameters were derived from color fundus photographs, correcting for ocular magnification as appropriate. Quantile regression was used to test the independent associations between these parameters and spherical equivalent refraction (SER) across 34 refractive quantiles (high hyperopia to high myopia)-controlling for age, sex and corneal radius. Results More negative SER was nonlinearly associated with greater Euclidian (largely horizontal) OD-fovea distance, larger OD, less circular OD, more obliquely orientated OD (superior pole tilted towards the fovea), brighter fovea, lower vascular complexity, less tortuous vessels, more concave (straightened out towards the fovea) papillomacular arterial/venous arcade and wider central retinal arterioles/venules. In myopia, these parameters varied more strongly with SER as myopia increased. For example, while every standard deviation (SD) decrease in vascular complexity was associated with 0.63 D (right eye: 95% confidence interval [CI], 0.58-0.68) to 0.68 D (left eye: 95% CI, 0.63-0.73) higher myopia in the quantile corresponding to -0.60 D, it was associated with 1.61 D (right eye: 95% CI, 1.40-1.82) to 1.70 D (left eye: 95% CI, 1.56-1.84) higher myopia in the most myopic quantile. OD-fovea angle (degree of vertical separation between OD and fovea) was found to vary linearly with SER, but the magnitude was of little practical importance (less than 0.10 D variation per SD change in angle in almost all refractive quantiles) compared with the changes in OD-fovea distance. Conclusions Several interrelated retinal changes indicative of an increasing (nonconstant) rate of mechanical stretching are evident at the posterior pole as myopia increases. These changes also suggest that the posterior pole stretches predominantly in the temporal horizontal direction.
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Affiliation(s)
- Fabian Yii
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
| | - Miguel O. Bernabeu
- Centre for Medical Informatics, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- The Bayes Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
- Princess Alexandra Eye Pavilion, Edinburgh, United Kingdom
| | - Niall Strang
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom
| | - Tom MacGillivray
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Curle Ophthalmology Laboratory, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, United Kingdom
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Kyei S, Kwasi Gyaami R, Abowine JB, Zaabaar E, Asiedu K, Boadi-Kusi SB, Mesuh JM, Assiamah F, Armah A, Ayerakwah PA. Risk of major myopia-associated non-communicable ocular health disorders in Ghana. PLoS One 2024; 19:e0297052. [PMID: 38236924 PMCID: PMC10795978 DOI: 10.1371/journal.pone.0297052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/24/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE To assess the differential association of myopia with major non-communicable ocular diseases in an African clinical cohort. METHODS A five-year hospital-based retrospective study of myopia cases. Patients' folders, Optical Coherence Tomography scans, and fundus photographs were reviewed for the abstraction of relevant data. Only records that employed recognized standards and classification systems for diagnosing and staging the various ocular conditions were included. Demographic characteristics, non-cycloplegic objective refractive findings, and non-communicable eye diseases were retrieved from the records. Myopia-associated risk factors were then determined using logistic regression and correlation. RESULTS Some 16018 patients (32027 eyes) met the inclusion criteria for at least one eye comprising 50.8% males (n = 8137) and 49.2% females (n = 7881). The mean age of the patients was 43.14 ± 17.88 years (range: 2-98 years). The mean spherical equivalent± Standard deviation for myopia was -2.30±3.23 DS (range: -0.50 to -25DS). Binary logistic regression analysis showed that myopic eyes had a higher odd of AC (OR, 0.53; 95% CI, 0.50-0.57), POAG (OR, 6.0; 95% CI, 5.26-6.82), DR (OR, 10.70; 95% CI, 3.91-29.27) and cataracts (OR, 20; 95% CI, 15.32-26.20) but not dry eye (OR, 0.74, 95% CI, 0.68-0.81), macular degeneration and pterygium (OR, 0.36; 95% CI, 0.32-0.40). CONCLUSION Africans with myopia are more at risk of developing allergic conjunctivitis, cataracts, POAG, and DR but not for dry eye, macular degeneration, and pterygium.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Biomedical and Clinical Research Center, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Rexford Kwasi Gyaami
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kofi Asiedu
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Bert Boadi-Kusi
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Frank Assiamah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Anthony Armah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Patience Ansomah Ayerakwah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Ten W, Yuan Y, Zhang W, Wu Y, Ke B. High myopia is protective against diabetic retinopathy in the participants of the National Health and Nutrition Examination Survey. BMC Ophthalmol 2023; 23:468. [PMID: 37978475 PMCID: PMC10655330 DOI: 10.1186/s12886-023-03191-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE To investigate the association of subjects with refractive error and diabetic retinopathy (DR) in the United States comparing results between different race groups. METHODS All data were derived from National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. The data were divided into four groups (emmetropia, mild myopia, high myopia, hypertropia) according to the spherical equivalent (SE), and those who met the enrollment conditions were selected as the study subjects. Multivariable logistic regression analysis was used to evaluate the relationship between refractive error and diabetic retinopathy risk. RESULTS A total of 1317 participants were included in the study, including 331 participants with diabetic retinopathy, and 986 without diabetic retinopathy. After adjustment for potential confounders, subjects with high myopia were associated with a lower risk of diabetic retinopathy. The odds ratio (OR) was 0.44, 95% confidence interval (CI): (0.20-0.96), P-value = 0.040 in the multivariate regression analysis. Subgroup analyses showed that subjects with high myopia in the non-Hispanic Black group were associated with decreased odds of diabetic retinopathy. (OR was 0.20, and 95% CI: 0.04-0.95, P-value = 0.042). CONCLUSION The results show that high myopia is associated with diabetic retinopathy in diabetic patients.
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Affiliation(s)
- Weijung Ten
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital,, Fudan University, Shanghai, China
| | - Ying Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Wei Zhang
- Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yue Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
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Li X, Tan TE, Wong TY, Sun X. Diabetic retinopathy in China: Epidemiology, screening and treatment trends-A review. Clin Exp Ophthalmol 2023; 51:607-626. [PMID: 37381613 DOI: 10.1111/ceo.14269] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023]
Abstract
Diabetic retinopathy (DR) is the leading cause of vision impairment in the global working-age population. In China, with one-third of the world's diabetes population estimated at 141 million, the blindness prevalence due to DR has increased significantly. The country's geographic variations in socioeconomic status have led to prominent disparities in DR prevalence, screening and management. Reported risk factors for DR in China include the classic ones, such as long diabetes duration, hyperglycaemia, hypertension and rural habitats. There is no national-level DR screening programme in China, but significant pilot efforts are underway for screening innovations. Novel agents with longer durations, noninvasive delivery or multi-target are undergoing clinical trials in China. Although optimised medical insurance policies have enhanced accessibility for expensive therapies like anti-VEGF drugs, further efforts in DR prevention and management in China are required to establish nationwide cost-effective screening programmes, including telemedicine and AI-based solutions, and to improve insurance coverage for related out-of-pocket expenses.
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Affiliation(s)
- Xiaorong Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Tien-En Tan
- Singapore Eye Research Institute, Singapore, Singapore National Eye Centre, Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore, Singapore
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore, Singapore National Eye Centre, Singapore, Singapore
- Duke-National University of Singapore Medical School, Singapore, Singapore
- Tsinghua Medicine, Tsinghua University, Beijing, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
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Lin Z, Li D, Wen L, Wang Y, Wang FH, Liang YB. ASSOCIATION OF OCULAR PERFUSION PRESSURE AND CEREBROSPINAL FLUID PRESSURE WITH CHANGES IN DIABETIC RETINOPATHY. Retina 2023; 43:1107-1113. [PMID: 36977320 DOI: 10.1097/iae.0000000000003792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
PURPOSE To investigate the association between mean ocular perfusion pressure (MOPP), estimated cerebrospinal fluid pressure (CSFP), and changes in diabetic retinopathy (DR) in a Northeastern Chinese population with Type 2 diabetes. METHODS A total of 1,322 subjects from the Fushun Diabetic Retinopathy Cohort Study were enrolled. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and intraocular pressure (IOP) were recorded. MOPP was calculated by the following formula: MOPP = 2/3 [DBP + 1/3 (SBP - DBP)] - IOP, and CSFP was estimated according to the following formula: CSFP = 0.44 × body mass index + 0.16 × DBP - 0.18 × age - 1.91. New development, progression, and regression of DR were graded based on fundus photographs at baseline and during follow-up examinations with a mean interval of 21.2 months using the modified Early Treatment Diabetic Retinopathy Study criteria. RESULTS Increasing MOPP was associated with the incidence of DR in the multivariate model (per 1-mmHg increase: relative risk, 1.06; 95% confidence interval, 1.02-1.10; P = 0.007) and showed a borderline negative association with DR regression (per 1-mmHg increase: relative risk, 0.98; 95% confidence interval, 0.97-1.00; P = 0.053). However, MOPP was not associated with progression of DR. Cerebrospinal fluid pressure was not associated with new development, progression, or regression of DR. CONCLUSION The MOPP, but not the CSFP, was found to influence the development, but not the progression of DR in this Northeastern Chinese cohort.
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Affiliation(s)
- Zhong Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning, China; and
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning, China; and
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning, China; and
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Lin Z, Wen L, Li D, Moonasar N, Zhai G, Wang Y, Wang FH, Liang YB. Refractive Error in a Chinese Population with Type 2 Diabetes: A Report from the Fushun Diabetic Retinopathy Cohort Study. Ophthalmic Epidemiol 2023; 30:38-45. [PMID: 35188061 DOI: 10.1080/09286586.2022.2031228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe the prevalence and risk factors for refractive errors in a northeastern Chinese population with type 2 diabetes. METHODS Subjects (age ≥30 years) from a community-based study, the Fushun Diabetic Retinopathy Cohort Study, were enrolled. All subjects underwent comprehensive ocular examinations, including autorefraction. Myopia, high myopia, and hyperopia were defined as a spherical equivalent (SE) of the right eye <-0.5 diopter (D), <-5.0D, and >0.5D, respectively. Astigmatism was defined as cylinder <-0.5D in a minus cylinder prescription. Anisometropia was defined as a difference of SE >1.0D between two eyes. RESULTS A total of 1929 participants (790 males, 41.0%) were enrolled. The age and gender standardized prevalence of myopia, high myopia, hyperopia, astigmatism, and anisometropia were 43.1% (95% confidence interval [CI]: 40.9%-45.3%), 8.5% (95% CI: 7.3%-9.8%), 21.5% (95% CI: 19.7%-23.4%), 61.0% (95% CI: 58.9%-63.2%), and 17.2% (95% CI: 15.5%-18.9%), respectively. Advancing age was associated with a higher frequency of hyperopia, astigmatism, and anisometropia, as opposed to a lower frequency of myopia. Female (adjusted odds ratio [aOR], 1.27; 95% CI, 1.02-1.57) participants, higher intraocular pressure (aOR, 1.03; 95% CI, 1.00-1.07), and lenticular opacity (aOR, 1.53; 95% CI, 1.20-1.94) were also found to be associated with myopia. Long duration of diabetes (>15 years) was found to be a significant factor for astigmatism (aOR, 1.62; 95% CI, 1.15-2.27) and anisometropia (aOR, 1.87; 95% CI, 1.29-2.71). CONCLUSION Nearly two-thirds of participants with type 2 diabetes had a refractive error. Age is a common factor with different types of refractive errors.
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Affiliation(s)
- Zhong Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Liang Wen
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Dong Li
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | | | - Gang Zhai
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Yu Wang
- Fushun Eye Hospital, Fushun, Liaoning Province, China
| | - Feng Hua Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Science Key Lab, Beijing, China
| | - Yuan Bo Liang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Li Z, Tong J, Liu C, Zhu M, Tan J, Kuang G. Analysis of independent risk factors for progression of different degrees of diabetic retinopathy as well as non-diabetic retinopathy among type 2 diabetic patients. Front Neurosci 2023; 17:1143476. [PMID: 37090790 PMCID: PMC10115960 DOI: 10.3389/fnins.2023.1143476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose To 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. Methods This 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. Results The 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). Conclusion Young 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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Affiliation(s)
- Zheng Li
- Department of Ophthalmology, The First People’s Hospital of Chenzhou, Chenzhou, Hunan, China
- Department of Ophthalmology, The Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, Hunan, China
| | - Jie Tong
- Department of Spinal Surgery, The First People’s Hospital of Chenzhou, Chenzhou, Hunan, China
- Department of Spinal Surgery, The Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, Hunan, China
| | - Chang Liu
- Department of Endocrinology, The First People’s Hospital of Chenzhou, Chenzhou, Hunan, China
| | - Mingqiong Zhu
- Department of Ophthalmology, The First People’s Hospital of Chenzhou, Chenzhou, Hunan, China
- Department of Ophthalmology, The Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, Hunan, China
| | - Jia Tan
- Department of Ophthalmology, Xiangya Hospital of Central South University, Changsha, Hunan, China
- *Correspondence: Jia Tan,
| | - Guoping Kuang
- Department of Ophthalmology, The First People’s Hospital of Chenzhou, Chenzhou, Hunan, China
- Department of Ophthalmology, The Affiliated Chenzhou Hospital, Hengyang Medical School, University of South China, Chenzhou, Hunan, China
- Guoping Kuang,
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Dong J, Hu L, Li C, Zhang R, Zheng M, Wu X, Wu C. Expression of Osteopontin and Integrin αvβ3 Receptor in Retina of Diabetic Guinea Pigs with High Myopia. Ophthalmic Res 2022; 66:144-150. [PMID: 36037800 DOI: 10.1159/000526586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The study aimed to investigate the effect of high myopia on the expression of retinal osteopontin (OPN) and integrin αvβ3 receptor in guinea pigs and determine the relationship between high myopia and diabetic retinopathy (DR). METHODS Ninety-three-week-old male guinea pigs were randomly divided into four groups that included normal control group (NOR, n = 18), high myopia group (HM, n = 24), diabetes group (DR, n = 24), and diabetes with high myopia group (DR+HM, n = 24). HM was induced by form deprivation (FDHM) in the right eye. The DR group was injected with 5% streptozotocin 280 mg/kg intraperitoneally in the lower left abdomen of guinea pigs. The DRHM group was subjected to the same treatment as the HM and DR groups. Eighteen guinea pigs in each group were randomly selected to complete the experimental measurement. After enucleation of eyeballs, HE and immunohistochemical staining were performed to observe the retina morphology and count the positive rate of OPN and integrin αvβ3 receptor. RESULTS Diabetic retinal changes were found in group DR and HM+DR. The degree of retinal change in group HM+DR was less than that in group DR. In the DR group, the morphology of retinal tissue was loose, the number of cells decreased, retinal microaneurysms were increased, and a small amount of small artery embolism and venous thrombosis were observed. Although the retinal structure in the HM+DR group also became thinner, looser, and disordered, only a small number of microaneurysms were observed compared with the diabetic group. Immunohistochemical staining showed that the expression of OPN and integrin αvβ3 receptors in the diabetic groups (DR, HM+DR) was significantly higher than in the HM and NOR groups. The positive expression rates of OPN and integrin αvβ3 receptors in group HM+DR were significantly lower than those in group DR (p < 0.05). CONCLUSION The expression of OPN and integrin αvβ3 receptor in the retina of diabetic guinea pigs with high myopia was lower than that of diabetic models, which may be due to the influence of high myopia on neovascularization in DR.
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Affiliation(s)
- Jinghong Dong
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Lingfei Hu
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Chenhao Li
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Rongrong Zhang
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Minmin Zheng
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Xueji Wu
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Changfan Wu
- Department of Ophthalmology, Yijishan Hospital of Wannan Medical College, Wuhu, China
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Su R, Jia Z, Fan F, Li J, Li K. Clinical Observation of Macular Vessel Density in Type 2 Diabetics with High Myopia. Ophthalmic Res 2022; 66:124-130. [PMID: 35995034 DOI: 10.1159/000526487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/08/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this study was to compare the macular retinal vessel density (VD) of diabetics with high myopia, diabetics without high myopia, and healthy controls. METHODS This cross-sectional study recruited type 2 diabetic (T2D) people with no history of ocular treatment in our hospital. Thirty T2D people with high myopia (30 eyes) were included in group A, while 30 T2D people (30 eyes) without myopia were included in group B. Another 30 healthy volunteers (30 eyes) were included in group C. The superficial and deep capillary plexuses VD of the macula were measured in all subjects by optical coherence tomography angiography. In T2D people with high myopia, the correlation between VD in macular regions and baseline data was investigated. RESULTS (1) Overall comparison of the 3 groups: no statistically significant differences in macular central superficial vessel density (SVD) were found in the three groups (p > 0.05). There were significant differences in the temporal, superior, nasal, inferior SVD between the 3 groups (p < 0.05). There were significant differences in macular central, temporal, superior, nasal, and inferior deep vessel density (DVD) between the three groups (p < 0.05). (2) Comparison of B (no myopia, T2D group) and C (healthy control group): inferior SVD in group B was lower than that in group C (p < 0.05). Temporal, superior, nasal, and inferior DVD in group B were lower than those in group C (p < 0.05). (3) A (high myopia group, T2D) compared with B (no myopia, T2D group), A group compared with C (healthy control group): temporal, superior, nasal, inferior SVD and DVD in group A were all lower than those in group B and C (p < 0.05), DVD in group B was lower than those in group C (p < 0.05). (4) The mean SVD and DVD were not correlated with age, IOP, anterior chamber depth, corneal curvature, but they were negatively correlated with axial length and duration of diabetes in the T2D people with high myopia. CONCLUSION Myopia and diabetes are two important factors affecting macular retinal VD. Comparing with the eyes of T2D people without high myopia, the VD in macular regions shows a higher decline in the eyes of T2D people with high myopia.
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Affiliation(s)
- Ruifeng Su
- Department of Ophthalmology, Hebei Medical University, Shijiazhuang, China,
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China,
- Department of Ophthalmology, The Affiliated Hospital of Chengde Medical College, Chengde, China,
| | - Zhiyang Jia
- Department of Ophthalmology, Hebei Medical University, Shijiazhuang, China
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
| | - Fang Fan
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
| | - Juan Li
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
| | - Kejun Li
- Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, China
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Wang W, Chen Y, Xiong K, Gong X, Liang X, Huang W. Longitudinal associations of ocular biometric parameters with onset and progression of diabetic retinopathy in Chinese adults with type 2 diabetes mellitus. Br J Ophthalmol 2022; 107:738-742. [PMID: 35115303 DOI: 10.1136/bjophthalmol-2021-320046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 01/13/2022] [Indexed: 11/04/2022]
Abstract
AIMS To investigate the associations of ocular biometric parameters with incident diabetic retinopathy (DR), incident vision-threatening DR (VTDR) and DR progression. METHODS This community-based prospective cohort study recruited participants with type 2 diabetes aged 35-80 years from 2017 to 2019 in Guangzhou, China. Refractive error and ocular biometric parameters were measured at baseline, including axial length (AL), axial length-to-corneal radius (AL/CR) ratio, corneal curvature (CC), lens thickness (LT), anterior chamber depth (ACD), lens power and corneal diameter (CD). RESULTS A total of 1370 participants with a mean age of 64.3±8.1 years were followed up for two consecutive years. During the follow-up period, 342 out of 1195 (28.6%) participants without DR at baseline had incident DR, 15 out of 175 (8.57%) participants with baseline DR had DR progression and 11 of them progressed to VTDR. After multiple adjustments, a longer AL (OR=0.76; 95% CI, 0.66 to 0.86; p<0.001) and a larger AL/CR ratio (OR=0.20; 95% CI, 0.07 to 0.55; p=0.002) were associated with significantly reduced risks of incident DR but were not associated with incident VTDR or DR progression. Refractive status and other ocular biometric parameters investigated, including ACD, CC, CD, lens power and LT were not associated with any of the DR outcomes (all p>0.05). CONCLUSIONS A longer AL and a larger AL/CR ratio are protective against incident DR. These parameters may be incorporated into future DR risk prediction models to individualise the frequency of DR screening and prevention measures.
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Affiliation(s)
- Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yifan Chen
- John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kun Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xia Gong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xiaoling Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China .,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China.,Guangdong Provincial Clinical Research Center for Ocular Diseases, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, People's Republic of China
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Kong H, Zang S, Hu Y, Lin Z, Liu B, Zeng X, Xiao Y, Du Z, Guanrong W, Ren Y, Fang Y, Xiaohong Y, Yu H. Effect of High Myopia and Cataract Surgery on the Correlation Between Diabetic Retinopathy and Chronic Kidney Disease. Front Med (Lausanne) 2022; 9:788573. [PMID: 35721047 PMCID: PMC9198540 DOI: 10.3389/fmed.2022.788573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/21/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To investigate the effect of high myopia and cataract surgery on the grading of diabetic retinopathy (DR) and their roles in the correlation between DR and chronic kidney disease (CKD). METHODS A total of 1,063 eyes of 1,063 diabetic patients were enrolled. We conducted binary and multiple multivariate regressions to analyze the ocular and systemic risk factors of DR. Based on the presence of myopia and history of cataract surgery, we divided the cases into four subgroups, namely those with high myopia, with the history of cataract surgery, with both conditions, and with neither, then determined the correlation between the stages of DR and CKD in each subgroup. RESULTS In the binary analysis, high myopia was identified as the protective factor for DR odds ratio (OR): 0.312 [95% confidence interval (CI): 0.195-0.500, p < 0.001], whereas cataract surgery was one of the independent risk factors for DR [OR: 2.818 (95% CI: 1.507-5.273), p = 0.001]. With increased stages of DR, high myopia played an increasingly protective role [mild non-proliferative DR (NPDR), OR = 0.461, p = 0.004; moderate NPDR OR = 0.217, p = 0.003; severe NPDR, OR = 0.221, p = 0.008; proliferative DR (PDR), OR = 0.125, p = 0.001], whereas cataract surgery became a stronger risk factor, especially in PDR (mild NPDR, OR = 1.595, p = 0.259; moderate NPDR, OR = 3.955, p = 0.005; severe NPDR, OR = 6.836, p < 0.001; PDR, OR = 9.756, p < 0.001). The correlation between the stages of DR and CKD in the group with neither high myopia nor cataract surgery history was the highest among all subgroups. CONCLUSION High myopia was a protective factor, whereas cataract surgery is a risk factor for DR, and both factors showed stronger effects throughout the (natural disease) grading of DR. The stages of DR and CKD showed a higher correlation after adjustment of the ocular confounding factors.
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Affiliation(s)
- Huiqian Kong
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Siwen Zang
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
- Refractive Surgery Center, Guangzhou Aier Eye Hospital, Aier Institute of Refractive Surgery, Guangzhou, China
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Zhanjie Lin
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
- Graduate School, Shantou University Medical College, Shantou, China
| | - Baoyi Liu
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Xiaomin Zeng
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Yu Xiao
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Zijing Du
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Wu Guanrong
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Yun Ren
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
- Graduate School, Shantou University Medical College, Shantou, China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
| | - Yang Xiaohong
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
- *Correspondence: Yang Xiaohong
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Eye Institute, Southern Medical University, Guangdong Academy of Medical Sciences/The Second School of Clinical Medicine, Guangzhou, China
- Honghua Yu
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13
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Abstract
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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Affiliation(s)
- Rajvardhan Azad
- Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Sony Sinha
- Department of Ophthalmology, Patna Medical College, Patna, Bihar, India
| | - Prateek Nishant
- Department of Ophthalmology, All India Institute of Medical Sciences, Patna, Bihar, India
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Hamati JN, Das AV, Prashanthi GS, Behera UC, Narayanan R, Rani PK. Factors protecting against diabetic retinopathy in a geriatric Indian cohort. Indian J Ophthalmol 2021; 69:3167-3172. [PMID: 34708765 PMCID: PMC8725154 DOI: 10.4103/ijo.ijo_1495_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: Diabetic retinopathy (DR) is a potentially sight-threatening complication of diabetes mellitus. The majority of cases are in older adults. This study aims to evaluate modifiable and nonmodifiable protective factors against DR in a geriatric Indian population. Methods: This retrospective observational study uses data from a multitiered ophthalmology network to evaluate several demographic and clinical variables against diabetic retinopathy and visual acuity. Results: Our data show that high myopia, the female sex, and no cataract surgery are associated with lower prevalence of DR (OR = 0.21, 0.65, and 0.76, respectively; P < 0.001). We also found that among those with DR, people categorized as payers, retirees, and those living in urban or metropolitan areas have better visual acuity (OR = 0.65, 0.65, 0.83, and 0.73, respectively; P < 0.001). Among those with DR, females, presence of cataracts, and no cataract surgery had lower associations with sight-threatening DR (STDR) (OR = 0.68, 0.37, and 0.76, respectively; P < 0.001). Prevalence of DR decreased in older age groups while controlling for DM duration. Conclusion: It is probable that high myopia, the female sex, and better glycemic control are protective against DR and STDR in our study cohort of adults over 60 years of age. It is possible that occupations involving manual labor, delayed cataract surgery, and living past the age of 70 are also protective against DR.
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Affiliation(s)
- Jacquelyn N Hamati
- Department of Ophthalmology, Sidney Kimmel Medical College, Thomas Jefferson University; Department of Public Health, Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania, United States of America
| | - Anthony Vipin Das
- Department of EyeSmart EMR and AEye; Department of Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Gumpili Sai Prashanthi
- Department of EyeSmart EMR and AEye; Department of Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Umesh C Behera
- Department of Vitreoretinal Diseases, L. V. Prasad Eye Institute, Bhubaneshwar, Odisha, India
| | - Raja Narayanan
- Department of EyeSmart EMR and AEye; Department of Indian Health Outcomes, Public Health and Economics Research Center, L. V. Prasad Eye Institute, Hyderabad, Telangana, India
| | - Padmaja K Rani
- Smt. Kanuri Santhamma Center for Vitreo Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India, Indiaz
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Thakur S, Verkicharla PK, Kammari P, Rani PK. Does myopia decrease the risk of diabetic retinopathy in both type-1 and type-2 diabetes mellitus? Indian J Ophthalmol 2021; 69:3178-3183. [PMID: 34708767 PMCID: PMC8725115 DOI: 10.4103/ijo.ijo_1403_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To study the relationship between the severity of myopia and the severity of diabetic retinopathy (DR) in individuals with type 1 or type 2 diabetes mellitus (DM). Methods This retrospective study was conducted using data from electronic medical records from a multicentric eyecare network located in various geographic regions of India. Individuals with type 1 or type 2 DM were classified according to their refractive status. Severe nonproliferative DR (NPDR), PDR, or presence of clinically significant macular edema (CSME) with any type of DR was considered as vision-threatening diabetic retinopathy (VTDR). Results A total of 472 individuals with type-1 DM (mean age 41 ± 10 years) and 9341 individuals with type-2 DM (52 ± 9 years) were enrolled. Individuals with a hyperopic refractive error had a significant positive association with the diagnosis of VTDR (odds ratio (OR) 1.26; 95%CI 1.04-1.51, P = 0.01) and moderate nonproliferative DR (OR 1.27; 95%CI 1.02-1.59, P = 0.03) in type-2 DM; however, no significant association was found in type-1 DM. After adjusting for age, gender, anisometropia, and duration of diabetes, the presence of high myopia (< - 6 D) reduced the risk of VTDR in type 2 DM (OR 0.18; 95% CI 0.04-0.77, P = 0.02), but no association was found in type 1 DM. Mild and moderate myopia had no significant association with any forms of DR in both type-1 and type-2 DM. Conclusion Hyperopic refractive error was found to increase the risk of VTDR in persons with type 2 DM. High-myopic refractive error is protective for VTDR in type 2 DM, but not in type-1 DM.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Priyanka Kammari
- Department of EyeSmart EMR and AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Padmaja Kumari Rani
- Smt. Kanuri Santamma Centre for Vitreoretinal Diseases, Kallam Anji Reddy Campus, L V Prasad Eye Institute, Hyderabad, Telangana, India
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