Diabetic Retinopathy and Its Relation to Errors of Refraction

Jain, IS; Luthra, C. L.; Das, Tulsi

doi:10.1001/archopht.1967.00980020061012

Cited by 47 publications

(17 citation statements)

References 2 publications

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“…This suggests the presence of protective factors against diabetic retinopathy in MIDD. Some ocular factors, such as high myopia, amblyopia and retinitis pigmentosa, are known to provide a protective effect [29,30], but they were absent in our patients. It is widely accepted that protection by such factors occurs through a reduction in retinal metabolism, a decrease in oxygen needs, the production of vasoproliferative factors and/or a reduced retinal blood flow [31].…”

Section: Discussioncontrasting

confidence: 61%

Retinal and renal complications in patients with a mutation of mitochondrial DNA at position 3,243 (maternally inherited diabetes and deafness). A case–control study

et al. 2008

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Aims/hypothesis We assessed the prevalence and determinants of retinal and renal complications in patients with maternally inherited diabetes and deafness (MIDD).Methods This was a multicentre prospective study comparing the prevalence of retinopathy and renal disease in 74 patients with MIDD and 134 control patients matched for sex, age and clinical presentation at onset of diabetes, duration of diabetes and current treatment. Comparisons were adjusted for HbA 1c and hypertension. Diabetologia (2008) Results In MIDD patients, HbA 1c (7.6±1.6 vs 8.5±2.0%, p< 0.002), systolic blood pressure (126.6±16.2 vs 133.1± 17.3 mmHg, p<0.007) and prevalence of hypertension (33.8 vs 64.2%, p<0.0001) were lower than in control patients. Prevalence of diabetic retinopathy was 3.7-fold lower in MIDD patients (6/74, 8 vs 40/134, 29.6%, p< 0.0001). Differences between groups remained significant after adjustment for hypertension, systolic blood pressure and HbA 1c . In MIDD, urinary albumin excretion (314.8 vs 80.1 mg/24 h, p=0.035) and creatinine plasma levels (103.5 vs 82.2 µmol/l, p=0.0178) were higher and GFR was lower. Impaired renal function (GFR <60 ml/min) was four-to sixfold more frequent in MIDD. Differences between MIDD and control diabetic patients further increased when adjusted for HbA 1c and systolic blood pressure (p<0.0001). Adjustment for treatment with an ACE inhibitor or angiotensin II receptor antagonist did not modify the results. Conclusions/interpretation This study indicates that diabetic retinopathy is less prevalent in MIDD than in control diabetes. This suggests that retinal alterations due to mitochondrial disease may have a protective role. By contrast, nephropathy is far more frequent in MIDD, suggesting the presence of a specific renal disease independent of diabetic nephropathy.

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Section: Discussioncontrasting

confidence: 61%

Retinal and renal complications in patients with a mutation of mitochondrial DNA at position 3,243 (maternally inherited diabetes and deafness). A case–control study

et al. 2008

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“…Rand et al 23 found a higher prevalence of myopia among diabetic patients with retinopathy compared with diabetic patients without retinopathy. Jain et al 24 found no difference in prevalence of myopia in diabetic versus non-diabetic subjects, although diabetic patients with higher myopia were less likely to develop retinopathy.…”

mentioning

confidence: 96%

Long term influence of insulin dependent diabetes mellitus on refraction and its components: a population based twin study

Løgstrup

Sjølie

Kyvik

et al. 1997

British Journal of Ophthalmology

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Aim-To study whether refraction of the eye, or some of its components is influenced by duration of insulin dependent diabetes mellitus. Methods-From the young cohort of the population based Danish Twin Register, containing 20 888 twin pairs born between 1953 and 1982, all twin pairs having one or both partners aVected with IDDM were searched. Autorefraction, autokeratometry, and ultrasonic biometric measurements were carried out on 45 twin pairs: 16 monozygotic (MZ) twin pairs, 14 dizygotic twin pairs of same sex (DZss), and 15 dizygotic twin pairs of opposite sex (DZos). To obtain an estimate of the influence of duration of diabetes, the intrapair diVerences in duration of diabetes were correlated with intrapair diVerences in refraction and each of its components. Results-Refraction was statistically significantly negatively correlated with duration of diabetes in the DZss group, and axial length correspondingly positively correlated. Surprisingly, refraction and axial length in the MZ group, adjusted for confounding factors, were correlated with diabetes duration in the opposite direction than in the DZss group, although not reaching statistical significance. Lens thickness was statistically significantly positively correlated with duration of diabetes in both MZ and DZ twins. Anterior chamber depth was negatively correlated with duration of diabetes in all the zygosity groups. Conclusions-Studies of relations between refraction and duration of diabetes show diverging results. In the MZ group, a tendency to reduced axial length and corresponding hyperopia with increasing duration of diabetes was found. However, in the DZ group of same sex the opposite tendency was found. Increasing lens thickness and decreasing anterior chamber depth with increasing duration of diabetes have been confirmed in this study. (Br J Ophthalmol 1997;81:343-349) Refraction and its components are influenced by both environmental and inherited factors. Twin studies have earlier described the importance of genes in refraction, by high concordance rates of refraction in monozygotic twins compared with dizygotic twins.

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“…The presence of coexisting hypertension6 7 and hormonal changes associated with puberty and pregnancy may also contribute. By contrast, certain factors may be protective including glaucoma,8myopia,9 10 and ipsilateral carotid artery disease 11…”

mentioning

confidence: 99%

Diabetic retinopathy in Down's syndrome

Fulcher

Griffin

Crowley

et al. 1998

British Journal of Ophthalmology

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Aim-To determine the prevalence of diabetic retinopathy in patients with Down's syndrome and diabetes mellitus. Method-Nine patients with Down's syndrome and diabetes mellitus were assessed. Factors recorded included type and duration of diabetes, level of diabetic control, blood pressure, urinalysis, and results of ophthalmological examination. Results-The duration of diabetes ranged from 8 to 41 years (mean 17.6 years). All had satisfactory glycaemic control and blood pressure measurements on the low side of normal (mean 106.6/70 mm Hg). One patient had early background diabetic retinopathy. The remainder had no evidence of diabetic retinopathy. Conclusion-The low prevalence of diabetic retinopathy in these Down's syndrome patients, despite the long duration, is an interesting finding. It suggests some inherent protective factor against the development of diabetic retinopathy in this patient subgroup. (Br J Ophthalmol 1998;82:407-409)

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Diabetic Retinopathy and Its Relation to Errors of Refraction

Cited by 47 publications

References 2 publications

Retinal and renal complications in patients with a mutation of mitochondrial DNA at position 3,243 (maternally inherited diabetes and deafness). A case–control study

Retinal and renal complications in patients with a mutation of mitochondrial DNA at position 3,243 (maternally inherited diabetes and deafness). A case–control study

Long term influence of insulin dependent diabetes mellitus on refraction and its components: a population based twin study

Diabetic retinopathy in Down's syndrome

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