Frequency and Pattern of Retinopathy in Newly Diagnosed Type 2 Diabetic Patients

Retinopathy in Type 2 Diabetic Patients

Authors

  • Faisal Mehmood Department of Ophthalmology, Rashid Latif Medical College, Lahore, Pakistan
  • Syed Abdullah Mazhar Department of Ophthalmology, Rashid Latif Medical College, Lahore, Pakistan
  • Nesr Farooq Department of Ophthalmology, Shalamar Medical and Dental College, Lahore, Pakistan
  • Muhammad Awais Afzal Department of Ophthalmology, Narowal Medical College, Narowal, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i1.2653

Keywords:

Diabetic Retinopathy, Creatinine, Cholesterol, Hemoglobin

Abstract

Diabetic Retinopathy (DR) is among the leading causes of blindness in adults, particularly in individuals with type 2 Diabetes Mellitus (T2DM). Diabetic Retinopathy (DR) is one of the commonest reasons for blindness in the adult population especially in the type 2 Diabetes Mellitus (T2DM) population. It is important to detect and manage these diseases early to prevent vision loss. Objective: To evaluate the prevalence and pattern and the associated risk factors of Diabetic Retinopathy (DR) in newly diagnosed T2DM. Methods:  The study design was descriptive cross-sectional which was conducted at Arif Memorial Teaching Hospital/Rashid Latif Medical College, Lahore. The study enrolled 300 participants (age≥35 years) with newly diagnosed T2DM. After a general and systemic examination, data were collected, including laboratory data with blood glucose, HbA1c, serum cholesterol, and serum creatinine. Retinopathy grading was performed by fundoscopic examination into background, pre-proliferative and proliferative grades. The statistical analysis was performed in SPSS version 23.0. Results: In newly diagnosed T2DM, the overall prevalence of DR was 22% (66/300). Among cases of DR, 78% were NPDR, and 22% were PDR. Most of the NPDR was moderate (43%), mild (35%) and severe (22%). DR risk factors were HbA1c > 8% (OR: 3.5, p < 0.001) and hypertension (65% DR, p < 0.05). DR was not significantly correlated with BMI and other biochemical markers including serum creatinine. Conclusions: The prevalence of diabetic retinopathy was notably high among newly diagnosed T2DM patients, with HbA1c levels and hypertension identified as significant risk factors.

References

Vujosevic S, Aldington SJ, Silva P, Hernández C, Scanlon P, Peto T et al. Screening for diabetic retinopathy: new perspectives and challenges. The Lancet Diabetes & Endocrinology. 2020 Apr; 8(4): 337-47. doi: 10.1016/S2213-8587(19)30411-5. DOI: https://doi.org/10.1016/S2213-8587(19)30411-5

Mansour SE, Browning DJ, Wong K, Flynn Jr HW, Bhavsar AR. The evolving treatment of diabetic retinopathy. Clinical Ophthalmology. 2020 Mar: 653-78. doi: 10.2147/OPTH.S236637. DOI: https://doi.org/10.2147/OPTH.S236637

Fung TH, Patel B, Wilmot EG, Amoaku WM. Diabetic retinopathy for the non-ophthalmologist. Clinical Medicine. 2022 Mar; 22(2): 112-6. doi: 10.7861/clinmed.2021-0792. DOI: https://doi.org/10.7861/clinmed.2021-0792

Flaxel CJ, Adelman RA, Bailey ST, Fawzi A, Lim JI, Vemulakonda GA et al. Diabetic retinopathy preferred practice pattern®. Ophthalmology. 2020 Jan; 127(1): P66-145. doi: 10.1016/j.ophtha.2019.09.025. DOI: https://doi.org/10.1016/j.ophtha.2019.09.025

Antonetti DA, Silva PS, Stitt AW. Current understanding of the molecular and cellular pathology of diabetic retinopathy. Nature Reviews Endocrinology. 2021 Apr; 17(4): 195-206. doi: 10.1038/s41574-020-00451-4. DOI: https://doi.org/10.1038/s41574-020-00451-4

Tan TE and Wong TY. Diabetic retinopathy: Looking forward to 2030. Frontiers in Endocrinology. 2023 Jan 9; 13: 1077669. doi: 10.3389/fendo.2022.1077669. DOI: https://doi.org/10.3389/fendo.2022.1077669

Forrester JV, Kuffova L, Delibegovic M. The role of inflammation in diabetic retinopathy. Frontiers in Immunology. 2020 Nov; 11: 583687. doi: 10.3389/fimmu.2020.583687. DOI: https://doi.org/10.3389/fimmu.2020.583687

Zheng Y, He M, Congdon N. The worldwide epidemic of diabetic retinopathy. Indian Journal of Ophthalmology. 2012 Sep; 60(5): 428-31. doi: 10.4103/0301-4738.100542. DOI: https://doi.org/10.4103/0301-4738.100542

Lundeen EA, Burke-Conte Z, Rein DB, Wittenborn JS, Saaddine J, Lee AY et al. Prevalence of diabetic retinopathy in the US in 2021. Journal of the American Medical Association Ophthalmology. 2023 Aug; 141(8): 747-54. doi: 10.1001/jamaophthalmol.2023.2289. DOI: https://doi.org/10.1001/jamaophthalmol.2023.2289

Lin KY, Hsih WH, Lin YB, Wen CY, Chang TJ. Update in the epidemiology, risk factors, screening, and treatment of diabetic retinopathy. Journal of Diabetes Investigation. 2021 Aug; 12(8): 1322-5. doi: 10.1111/jdi.13480. DOI: https://doi.org/10.1111/jdi.13480

Jang HN, Moon MK, Koo BK. Prevalence of diabetic retinopathy in undiagnosed diabetic patients: a nationwide population-based study. Diabetes & Metabolism Journal. 2022 Feb; 46(4): 620-9. doi: 10.4093/dmj.2021.0099. DOI: https://doi.org/10.4093/dmj.2021.0099

Abebe HT. Determination of Sample Size and Errors. InPromoting Statistical Practice and Collaboration in Developing Countries. 2022 Jun: 321-338. Chapman and Hall/CRC. doi: 10.1201/9781003261148-27. DOI: https://doi.org/10.1201/9781003261148-27

Cai K, Liu YP, Wang D. Prevalence of diabetic retinopathy in patients with newly diagnosed type 2 diabetes: A systematic review and meta‐analysis. Diabetes/Metabolism Research and Reviews. 2023 Jan; 39(1): e3586. doi: 10.1002/dmrr.3586. DOI: https://doi.org/10.1002/dmrr.3586

Hashemi H, Rezvan F, Pakzad R, Ansaripour A, Heydarian S, Yekta A et al. Global and regional prevalence of diabetic retinopathy; a comprehensive systematic review and meta-analysis. InSeminars in Ophthalmology 2022 Apr; 37(3): 291-306. Taylor & Francis. doi: 10.1080/08820538.2021.1962920. DOI: https://doi.org/10.1080/08820538.2021.1962920

Ghamdi AH. Clinical predictors of diabetic retinopathy progression; a systematic review. Current Diabetes Reviews. 2020 Mar; 16(3): 242-7. doi: 10.2174/1573399815666190215120435. DOI: https://doi.org/10.2174/1573399815666190215120435

Cardoso CR, Leite NC, Dib E, Salles GF. Predictors of development and progression of retinopathy in patients with type 2 diabetes: importance of blood pressure parameters. Scientific Reports. 2017 Jul; 7(1): 4867. doi: 10.1038/s41598-017-05159-6. DOI: https://doi.org/10.1038/s41598-017-05159-6

Suedumrong C, Phongmoo S, Akarajaka T, Leksakul K. Diabetic Retinopathy Detection Using Convolutional Neural Networks with Background Removal, and Data Augmentation. Applied Sciences. 2024 Sep; 14(19): 8823. doi: 10.3390/app14198823. DOI: https://doi.org/10.3390/app14198823

Kirthi V, Nderitu P, Alam U, Evans JR, Nevitt S, Malik RA et al. The prevalence of retinopathy in prediabetes: a systematic review. Survey of Ophthalmology. 2022 Sep; 67(5): 1332-45. doi: 10.1016/j.survophthal.2022.04.002. DOI: https://doi.org/10.1016/j.survophthal.2022.04.002

Lin T, Gubitosi-Klug RA, Channa R, Wolf RM. Pediatric diabetic retinopathy: updates in prevalence, risk factors, screening, and management. Current Diabetes Reports. 2021 Dec; 21: 1-1. doi: 10.1007/s11892-021-01436-x. DOI: https://doi.org/10.1007/s11892-021-01436-x

Wong TY and Sabanayagam C. Strategies to tackle the global burden of diabetic retinopathy: from epidemiology to artificial intelligence. Ophthalmologica. 2020 Aug; 243(1): 9-20. doi: 10.1159/000502387. DOI: https://doi.org/10.1159/000502387

Sugeno A, Ishikawa Y, Ohshima T, Muramatsu R. Simple methods for the lesion detection and severity grading of diabetic retinopathy by image processing and transfer learning. Computers in Biology and Medicine. 2021 Oct; 137: 104795. doi: 10.1016/j.compbiomed.2021.104795. DOI: https://doi.org/10.1016/j.compbiomed.2021.104795

Rajalakshmi R, Prathiba V, Arulmalar S, Usha M. Review of retinal cameras for global coverage of diabetic retinopathy screening. Eye. 2021 Jan; 35(1): 162-72. doi: 10.1038/s41433-020-01262-7. DOI: https://doi.org/10.1038/s41433-020-01262-7

Matsushita Y, Takeda N, Nakamura Y, Yoshida-Hata N, Yamamoto S, Noda M et al. A comparison of the association of fasting plasma glucose and HbA1c levels with diabetic retinopathy in Japanese men. Journal of Diabetes Research. 2020 Oct; 2020(1): 3214676. doi: 10.1155/2020/3214676. DOI: https://doi.org/10.1155/2020/3214676

Vashist P, Senjam SS, Gupta V, Manna S, Gupta N, Shamanna BR et al. Prevalence of diabetic retinopahty in India: Results from the National Survey 2015-19. Indian Journal of Ophthalmology. 2021 Nov; 69(11): 3087-94. doi: 10.4103/ijo.IJO_1310_21. DOI: https://doi.org/10.4103/ijo.IJO_1310_21

Romero-Aroca P, López-Galvez M, Martinez-Brocca MA, Pareja-Ríos A, Artola S, Franch-Nadal J et al. Changes in the epidemiology of diabetic retinopathy in Spain: a systematic review and meta-analysis. InHealthcare. 2022 Jul; 10(7): 1318. doi: 10.3390/healthcare10071318. DOI: https://doi.org/10.3390/healthcare10071318

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Published

2025-01-31
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DOI: 10.54393/pjhs.v6i1.2653
Published: 2025-01-31

How to Cite

Mehmood, F., Mazhar, S. A., Farooq, N., & Afzal, M. A. (2025). Frequency and Pattern of Retinopathy in Newly Diagnosed Type 2 Diabetic Patients: Retinopathy in Type 2 Diabetic Patients . Pakistan Journal of Health Sciences, 6(1), 197–202. https://doi.org/10.54393/pjhs.v6i1.2653

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