Mohammed Muhazir, S M (2020) A Study on Incidence and Risk Factors of Diabetic Retinopathy in Patient with Diabetic Maculopathy. Masters thesis, Stanley Medical College, Chennai.
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Abstract
INTRODUCTION: Diabetic retinopathy is the most common form of diabetic eye disease. Diabetic retinopathy usually only affects people who have had diabetes for a significant number of years. Diabetic retinopathy usually affects a certain period of having the disease. Diabetes mellitus. The development of Diabetic retinopathy also depends on comorbid factors like blood pressure and lipidemic status. Diabetic Macular edema is an affection of Posterior pole of retina which reduce visual acuity irrespective of presence of Diabetic Retinopathy. Diabetic macular edema can present with retinopathy or it can present alone without retinopathy of the rest of the retina. AIM OF THE STUDY: Analysis and comparison of association of Diabetic Retinopathy in patients with Diabetic Maculopathy and to study the risk factors associated with Diabetic Maculopathy. MATERIALS AND METHODS: It is a cross sectional analytical study done in Diabetes Mellitus patients, attending our outpatient department. The study was carried out at the Department of Ophthalmology, Govt. Stanley Medical College and Hospital, Chennai during a 1 year period of study from Jan 2018- Jan 2019, with assistance from the Department of Diabetology, Govt. Stanley Medical College and Hospital. This study was done in accordance with the ethical committee guidelines. All the patients were informed about the purpose of study and an informed consent was obtained. A thorough clinical history regarding defective vision other co-morbidities – Hypertension, Anemia, Rheumatological disease, chronic kidney disease, Coronary Artery Disease, thyroid disorders, and treatment history – concerning Topical drugs, Insulin, Oral Hypoglycemic drugs, statins, Anti Hypertensives, Dialysis, Anti- Rheumatological agents, Iron supplements, and cases were selected here based on inclusion and exclusion criteria. A complete Ophthalmological examination were done including Anterior segment and Posterior segment using Slit Lamp Biomicroscopy and Detailed Fundus examination using direct ophthalmoscope, +90D and Indirect ophthalmoscopy (in cases of media haziness) in these patients with Pupillary dilatation being done using 1%Tropicamide drops Diabetic Retinopathy and Diabetic Maculopathy were identified and graded according to Early Treatment Diabetic Retinopathy Study (ETDRS). All Diabetic patients with Diabetic Maculopathy with and without Retinopathy were chosen. Group one consisted of patients who had both Diabetic Retinopathy and Diabetic Maculopathy. Group two consisted of patients who had only Diabetic Maculopathy. Both group patients had risk factors like Hypertension, Dyslipidemia (23), Anemia, Rheumatological disease, Chronic kidney disease. For all the patient BP was measured in Sitting position and blood investigations like Complete blood count, Lipid Profile, Renal function test, ASO, CRP, RA Factor were taken. RESULTS: Out of 150 patients 146 patients(97.3% ) had both Diabetic Retinopathy (DR) and Diabetic Maculopathy (DM) and 4 patients (2.7%) had only Diabetic Maculopathy alone. Most patients in this study belonged to the age group 46-50 years. Males (54.7%) were more commonly affected than females (45.3%) in our study. Most common Diabetic Retinopathy grading in our study was MILD NPDR (32%). Out of 150 patients 46% of the patients had Hypertension, 22% of the patients had Dyslipedemia,39.3 % of the patients had Anemia, 8.7 % of the patients had Chronic Kidney Disease (CKD) and 1.3% of the patients had Rheumatological disease in our study. Out of 150 patient who had Diabetic Maculopathy 29.3% of the patient had Clinically Significant Macular Edema (CSME) and 70.7% of the patient had Diabetic Maculopathy without CSME. Out of 44 patient who had CSME 47.1% of them had Severe Visual impairment due to involvement of macula. present in 37 patients (24.7%), Severe NPDR was present in 32 patients (21.3%), Low Risk PDR was present in 8 patients (5.3%), High Risk PDR was present in 5 patients (3.3%), Advanced Diabetic Eye disease is present in 16 patients (10.7%). All the risk factors were present in Group 1 patients .The factors which were present in Group 2 (i.e only Diabetic Maculopathy patients) were Hypertension and Dyslipidemia. CONCLUSION: This study, done to evaluate the association between the occurrence of Diabetic Retinopathy (DM) and the occurrence of Diabetic Maculopathy (DM) showed that Diabetic Maculopathy can occur in isolation without the involvement of rest of the retina. The risk factors associated with isolated Diabetic Maculopathy seems to be, Hypertension, Dyslipidemia among others.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221713052 |
| Uncontrolled Keywords: | Incidence, Risk Factors, Diabetic Retinopathy, Diabetic Maculopathy. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Feb 2021 07:51 |
| Last Modified: | 14 Feb 2021 07:51 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14169 |
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