Proportion of severity of retinal hard exudates and its association with systemic risk factors

Abstract

Background: Diabetic macular edema (DME) characterized by deposition of hard exudates in central retina is now the leading cause of visual loss in persons with diabetes mellitus. Several studies have shown association between severity of retinal hard exudates and various components of serum lipid. The aim of this study is to estimate the proportion of severity of retinal hard exudates with risk factors like dyslipidemia, duration of diabetes, hypertension, HbA1c levels and microalbuminuria. Methods: A hospital based cross sectional study was done involving 242 diabetic retinopathy patients. After dilated fundus examination, severity of retinal hard exudates was graded by photographs with Topcon fundus camera using modified airlie house classification. These grades were divided into three groups. Group 1 (absent or minimal hard exudates) included patients with grade 0, 1 or 2 hard exudates; group 2 (hard exudates present), included patients with grade 3 or 4 hard exudates and group 3 (prominent hard exudates), patients with grade 5 hard exudates. Values of serum lipid profile, HbA1C and urine microalbumin were analysed in association with severity of retinal hard exudates.Results: Out of the 242 diabetic retinopathy patients, the male female ratio was 1:1 and the mean age was 59.8±7.4 years. There were 12% patients in group one, 52.5% in group two and 35.5% in group three. On univariate analysis, severity of hard exudates was significantly associated with serum cholesterol (p value<0.01), LDL (p value<0.01) triglycerides (p value<0.01), HbA1c (p value<0.01), systemic hypertension (p value<0.01) and urine microalbumin (p value=0.01). Conclusions: Severity of retinal hard exudates in diabetic retinopathy patients is significantly associated with risk factors like systemic hypertension, dyslipidemia, raised HbA1C levels and urine microalbumin.

To study the association of dyslipidemia with macular edema and hard exudates in diabetic maculopathy in an industrial hospital in Chhattisgarh

“…[76] Silpa D et al (2021) reported that the mean HbA1c was 7.56%. 16 Renal Function Tests: In group A, the mean blood urea was 14.27±4.39 mg/dl while in group B, it was 15.05±4.21 mg/dl (non-significant; p-value 0.423). In group A, the mean serum creatinine was 0.84±0.14 mg/dl while in group B, it was 0.84±0.13 mg/dl (non-significant; p-value 0.793).…”

“…Prakash G et al (2016) reported that diabetic retinopathy patients had longer diabetes duration (11±1.8 years) than patients without diabetic retinopathy (9±2.5 years); pvalue 0.04. Silpa D et al (2021) reported that percentage distribution of the diabetic patients according to duration of diabetes showed 42.6% in15 years group. Mean duration of diabetes mellitus in the sample population was 12.7±5.4 years.…”

“…Mean duration of diabetes mellitus in the sample population was 12.7±5.4 years. 16 Ezhilvendhan K et al (2021) reported that the patients with diabetic retinopathy had significantly longer duration of diabetes at the time of presentation than those without retinopathy (7.9 vs. 6.2 years: P <0.001). 18 This result is expected given the fact that the longer the duration of the disease, the longer patients are exposed to many risk factors and the higher the incidence of various DM-related chronic complications, which may be caused by the interaction of multiple factors.…”

“…Mean age was 59.8±7.4 years with highest being 86 and lowest 36 years. 16 Decline in lean body mass and the increase in body fat particularly visceral adipocytes ("central obesity") that accompanies aging may contribute to insulin resistance. It has recently been proposed that an age-associated decline in mitochondrial function contributes to insulin resistance in elderly.…”

“…Silpa D et al (2021) reported that percentage distribution of the diabetic patients according to gender showed equal male: female ratio of 1:1. 16 Ezhilvendhan K et al (2021) reported that majority of diabetes mellitus participants were males (57.5%) with a male: female of 1.35:1. 18…”