Influence of type 2 diabetes mellitus on the central retinal area in patients with proliferative diabetic retinopathy
Background. The purpose of the study was to determine whether the state of the central retinal area depends on the duration of type 2 diabetes mellitus (DM) and glycemia level in patients with proliferative diabetic retinopathy (DR). Materials and methods. The study included 62 patients with type 2 DM who according to the results of clinical and instrumental examination were divided into non-proliferative (n = 31, 31 eyes) and proliferative DR (n = 31, 31 eyes) groups using the Early Treatment of Diabetic Retinopathy Study classification. An ophthalmologic examination included visual acuity check with optimal optical correction, tonometry, biomicroscopy, ophthalmoscopy and optical coherence tomography. Results. In patients with proliferative DR in the subcompensated stage of DM, the thickness and volume of the macular retina were 309.0 ± 130.0 μm and 7.6 ± 2.7 mm3, respectively, whereas in the decompensated stage — 287.0 ± 40.0 μm and 7.80 ± 0.57 mm3 (p > 0.05). With the progression of DR, a statistically significant decrease in the optimal correlated visual acuity (p = 0.012) and an increase in the volume of the macular retina (by 6.9 %, p = 0.034) were revealed. More demonstrative changes in the retina tissue (p < 0.05) were revealed in patients with proliferative DR complicated by macular edema. Conclusions. In patients with proliferative DR, there was no difference in the state of the eye in subcompensated and decompensated stages of type 2 DM. Progression from non-proliferative to proliferative DR is manifested by a decrease in the correlated visual acuity, an increase in the thickness and volume of the macular retina in the central zone, which may be determined by the development of edema due to the progression of the pathological process.
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Kaminskiy OV. Official criteria for diagnostics of diabetes mellitus, normoglycemia and glycemic self-control. Mezhdunarodnyi Endokrinologicheskii Zhurnal. 2017;13(3):184-190. Doi: 10.22141/2224-0718.104.22.1687.104117. (in Ukrainian).
He F, Xia X, Wu XF, Yu XQ, Huang FX. Diabetic retinopathy in predicting diabetic nephropathy in patients with type 2 diabetes and renal disease: a meta-analysis. Diabetologia. 2013;56(3):457-66. doi: 10.1007/s00125-012-2796-6.
Mottl AK, Pajewski N, Fonseca V, et al. The degree of retinopathy is equally predictive for renal and macrovascular outcomes in the ACCORD Trial. J Diabetes Complications. 2014;28(6):874-9. doi: 10.1016/j.jdiacomp.2014.07.001.
Thomas RL, Dunstan FD, Luzio SD, et al. Prevalence of diabetic retinopathy within a national diabetic retinopathy screening service. Br J Ophthalmol. 2015;99(1):64-8. doi: 10.1136/bjophthalmol-2013-304017.
Azrak C, Baeza-Díaz MV, Palazón-Bru A, et al. Validity of Optical Coherence Tomography as a Diagnostic Method for Diabetic Retinopathy and Diabetic Macular Edema. Medicine (Baltimore). 2015;94(38):e1579. doi: 10.1097/MD.0000000000001579.
Gozlan J, Ingrand P, Lichtwitz O. et al. Retinal microvascular alterations related to diabetes assessed by optical coherence tomographyangiography: A cross-sectional analysis. Medicine (Baltimore). 2017;96(15):e6427. doi:10.1097/MD.0000000000006427.
Raman R, Gupta A, Krishna S, Kulothungan V, Sharma T. Prevalence and risk factors for diabetic microvascular complications in newly diagnosed type II diabetes mellitus. Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetic Study (SN-DREAMS, report 27). J Diabetes Complications. 2012;26(2):123-8. doi: 10.1016/j.jdiacomp.2012.02.001.
Broe R, Rasmussen ML, Frydkjaer-Olsen U, et al. The 16-year incidence, progression and regression of diabetic retinopathy in a young population-based Danish cohort with type 1 diabetes mellitus: The Danish cohort of pediatric diabetes 1987 (DCPD1987). Acta Diabetol. 2014;51(3):413-20. doi: 10.1007/s00592-013-0527-1.
Thomas RL, Dunstan F, Luzio SD, et al. Incidence of diabetic retinopathy in people with type 2 diabetes mellitus attending the diabetic retinopathy screening service for wales: retrospective analysis. BMJ. 2012;344:e874. doi: 10.1136/bmj.e874.
Jones CD, Greenwood RH, Misra A, Bachmann MO. Incidence and progression of diabetic retinopathy during 17 years of a population-based screening program in England. Diabetes Care. 2012;35(3):592-6. doi: 10.2337/dc11-0943.
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