Incidence of diabetic eye disease in accordance with duration, glycemic control, blood and ocular pressure

摘要

Introduction. Diabetic retinopathy remains the leading cause of visual disability and blindness among professionally active adults in economically developed societies, which is of particular concern because the prevalence and incidence of diabetes mellitus is expected to increase sharply during the next decade. There are several known factors responsible for the development of diabetic retinopathy, duration of disease and blood sugar level being the most important ones. Material and Methods. Prospective study of 280 diabetic patients (diabetes mellitus type 2) divided into 3 groups according to the duration of diabetes mellitus. All diabetic patients underwent complete ophthalmological examination in artificial mydriasis and optic coherence tomography. A full medical history included patient age, the time elapsed from diabetes diagnosis, current treatment of diabetes, presence of hypertension and glycemic control assessed by glycosylated hemoglobin measurement. Results. The mean age of patients was 63.5 years (SD±6.5, range 57-70 years). Mean duration of diabetes was 7.3 years in group I, 12.4 years in group II and 17.2 years in group III. The average value of glycosylated hemoglobin was 6.58% in the group I, 7.64% in the group II and 8.29% in the third group of patients. No statistically significant difference in intraocular pressure and the level of blood pressure were found among groups. Cataract was present in 104 patients (37.1%). Complications related to diabetes among all patients included in our study were: nonproliferative diabetic retinopathy in 48.5%, proliferative diabetic retinopathy in 25.7% and diabetic macular edema in 22.5% of patients. Conclusion. The duration of diabetes is one of the most significant factors for the development of diabetic maculopathy and the progression from nonproliferative to its proliferative stage. There is significantly higher incidence of proliferative diabetic retinopathy and diabetic macular edema in patients with increased serum level of glycosylated hemoglobin. Diabetes accompanied by hypertension is related to worsening of the clinical course of diabetic eye diseases and developing diabetic macular edema and proliferative diabetic retinopathy.