Correlation of facility of aqueous outflow and intraocular pressure in various stages of diabetic retinopathy : a hospital based study

Sathya, K (2014) Correlation of facility of aqueous outflow and intraocular pressure in various stages of diabetic retinopathy : a hospital based study. Masters thesis, Stanley Medical College, Chennai.

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Abstract

AIM: To determine the correlation of aqueous outflow facility and intraocular pressure in various stages of diabetic retinopathy and to determine their relationship with glycemic control of the patient. MATERIALS AND METHODS: A total of 150 diabetic patients were included in our study. It included 25 patients with No Diabetic retinopathy, 25 patients each in mild, moderate,severe, very severe Non proliferative Diabetic Retinopathy, 25 patients in Proliferative Diabetic Retinopathy. Patients with bilaterally symmetrical stage of DR were selected for our study. Patients with other systemic complications, closed angle, secondary glaucoma, known case of glaucoma, ocular surgery in the past were excluded. All patients underwent detailed systemic and ocular examination,applanation tonometry,tonography, perimetry. Systemic examination for glycemic status with FASTING, POST PRANDIAL BLOOD SUGAR, HbA1C.patients with significantly low aqueous outflow facility were followed up every 3 months in this one year study. RESULTS: Average aqueous outflow facility was found to be decreased with advance in the stage of diabetic retinopathy in both the eyes. It was found to be statistically significant ( RE p-Value=0.000, LE p-Value= 0.000 ). Mean intraocular pressure was found to be increased with advance in the stage of diabetic retinopathy in both the eyes. It was found to be statistically significant ( RE p-Value= 0.000, LE p-Value = 0.006). Average aqueous outflow facility was found to be decreased with increase in mean HbA1C level in various stages of diabetic retinopathy in both eyes. ( RE r= -0.761, p- Value=0.000, LE r= -0.759, p-Value= 0.000 ) . Average IOP was found to be increased with increase in mean HbA1C level in various stages of diabetic retinopathy in both the eyes. It was found to be statistically significant.(REr=0.628, p-Value= 0.000, LE r= 0.608, p-Value= 0.000). Among the 150 patients 43 patients had significantly reduced aqueous outflow facility at their first visit examination. Hence they were followed up every 3 months. A mong 43 patients advised follow up , 22 patients attended regular follow up of maximum 3 visits every 3 months in this one year study period. A t the end of this one year period 2 of the 22 patients were found to develop early glaucomatous field changes in their visual field. They were also found to have continued poor glycemic control ( HbA1C > 6.5), significantly low aqueous outflow facility and intraocular pressure slightly increased compared to the initial recording. CONCLUSION: This study has revealed that performing tonography and detecting patients with significantly low aqueous outflow facility can be a guidance for early diagnosis of development of POAG rather than relying on IOP alone . Hence tonography can be used as one of the examination techniques.

Item Type: Thesis (Masters)
Uncontrolled Keywords: diabetic retinopathy; aqueous outflow; intraocular pressure
Subjects: MEDICAL > Ophthalmology
Depositing User: Devi S
Date Deposited: 21 Sep 2017 05:55
Last Modified: 21 Sep 2017 05:55
URI: http://repository-tnmgrmu.ac.in/id/eprint/3233

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