Vision-threatening diabetic retinopathy necessitating vitrectomy in a tertiary care hospital in coastal Karnataka, South India
Abstract
Background: The proportion of diabetic patients having vision-threatening diabetic retinopathy and those needing to undergo vitrectomy was documented.
Methods: A cross-sectional observational study was conducted at a tertiary care hospital in coastal Karnataka, South India. All patients with diabetes mellitus visiting the ophthalmology department in the study period were screened for retinopathy, and the data regarding the presence of maculopathy and proliferative retinopathy were included as vision-threatening retinopathy.
Results: Of the 1,435 diabetic patients included, 38.4% had retinopathy changes due to diabetes, with 8.71% having vision-threatening retinopathy and 1.81% needing vitrectomy.
Conclusion: Although the proportion of vision-threatening retinopathy is small, the rapidly increasing diabetic population requires the setting up of more resources for tackling this condition, at least at the tertiary levels of the health-care system. However, considering the increased human and economic resources involved in setting up vitrectomy units, more emphasis on strengthening screening programs for early detection and referral to reduce the progression of retinopathy to advanced stages would be appropriate.
References
Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96:614-618.
Fong DS, Aiello L, Gardner TW, et al. Retinopathy in diabetes. Diabetes Care. 2004;27:S84-S87.
Heng LZ, Comyn O, Peto T, et al. Diabetic retinopathy: pathogenesis, clinical grading, management and future developments. Diabet Med. 2013;30:640-650.
Mohamed QA, Ross A, Chu CJ. Diabetic retinopathy (treatment). BMJ Clin Evid. 2011;pii:0702. PMID: 21609511 PMCID: PMC3217806.
Ramavat PR, Ramavat MR, Ghugare BW, Vaishnav RG, Joshi MU. Prevalence of diabetic retinopathy in Western Indian Type 2 Diabetic population: a hospital-based cross-sectional study. J Clin Diagn Res. 2013;7:1387-1390.
Namperumalsamy P, Nirmalan PK, Ramasamy K. Developing a screening program to detect sight-threatening diabetic retinopathy in South India. Diabetes Care. 2003;26:1831-1835.
Raymond NT, Varadhan L, Reynold DR, et al. Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community: a crosssectional study. Diabetes Care. 2009;32:410-415.
Ruta LM, Magliano DJ, Lemesurier R, Taylor HR, Zimmet PZ, Shaw JE. Prevalence of diabetic retinopathy in Type 2 diabetes in developing and developed countries. Diabet Med. 2013;30:387-398.
Gilbert CE, Babu RG, Gudlavalleti AS, et al. Eye care infrastructure and human resources for managing diabetic retinopathy in India: The India 11-city 9-state study. Indian J Endocrinol Metab. 2016;20:S3-S10.
Tomita M, Kabeya Y, Okisugi M, et al. Diabetic microangiopathy is an independent predictor of incident diabetic foot ulcer. J Diabetes Res. 2016;2016:5938540. doi: 10.1155/2016/5938540.
Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA. 2007;298:902-916.
Rema M, Premkumar S, Anitha B, Deepa R, Pradeepa R, Mohan V. Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I. Invest Ophthalmol Vis Sci. 2005;46:2328-2333.
Raman R, Rani PK, Reddi Rachepalle S, et al. Prevalence of diabetic retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study report 2. Ophthalmology. 2009;116:311-318.
Ozawa GY, Bearse MA Jr, Adams AJ. Male-female differences in diabetic retinopathy? Curr Eye Res. 2015;40:234-246.
Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 3. The Diabetic Retinopathy Vitrectomy Study Research Group. Ophthalmology. 1988 Oct;95(10):1307-1320.
Gupta B, Sivaprasad S, Wong R, et al. Visual and anatomical outcomes following vitrectomy for complications of diabetic retinopathy: the DRIVE UK study. Eye (Lond). 2012;26:510-516.
Bäcklund LB, Algvere PV, Rosenqvist U. New blindness in diabetes reduced by more than one-third in Stockholm County. Diabet Med. 1997;14:732-740.
Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, Lachin J, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-986.
Mohan V, Deepa M, Pradeepa R, et al. Prevention of diabetes in rural India with a telemedicine intervention. J Diabetes Sci Technol. 2012;6:1355-1364.
Copyright (c) 2020 Narasimha Vasista Reddy, Yogish Subraya Kamath, Lavanya G. Rao, Krishna Addoor Rao, Shailaja Bhat Shenoy, Sulatha V. Bhandary
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication, with the work twelve (12) months after publication simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).