The elevated risk of sight-threatening cataract in diabetes with retinopathy: a retrospective population-based cohort study

Abstract

Background The effect of diabetic retinopathy (DR) on the development of sight-threatening cataracts was assessed using the National Health Insurance Research Database of Taiwan. Methods Patients diagnosed with diabetes mellitus (DM) and DR were enrolled in the study group. Age- and sex-matched DM individuals without DR and patients without DM served as the DM control group and non-DM control group, respectively, both with 1:4 ratios. The outcome was set as the performance of cataract surgery. Cox proportional hazard regression was used to calculate the adjusted hazard ratio (aHR) of DR considering multiple factors underlying cataract formation. Results A total of 3297 DR patients, 13,188 DM control patients and 13,188 non-DM control subjects were enrolled. The study group included 919 events of sight-threatening cataracts (27.87%), the DM control group included 1108 events (8.40%), and the non-DM control group included 957 events (7.26%). A multivariable analysis indicated that the study group presented a higher aHR of cataract surgery (2.93, 95% CI: 2.60–3.30) and a higher cumulative probability of cataract surgery than both the DM control and non-DM control groups (both log rank P < 0.001). In addition, both the proliferative DR (3.90, 95% CI: 3.42–4.45) and nonproliferative DR (2.35, 95% CI: 2.08–2.65) subgroups showed a higher aHR of cataract surgery than the DM control group. Conclusion The presence of DR increases the risk of sight-threatening cataracts that warrant surgery, and the effect is prominent among patients with both proliferative DR and nonproliferative DR.

Effects of Gold Nanoparticles Phytoreduced with Rutin in an Early Rat Model of Diabetic Retinopathy and Cataracts

“…Meng et al explained this phenomenon through the overexpression of NADPH oxidase 4 enzyme activity, and thus, through the overproduction of ROS, as a result of high doses of insulin [ 46 ]. Furthermore, a possible link could exist between the early worsening of DR and early lens opacification, based on the reasoning that both CA and DR develop in the same intraocular medium, frequently in tandem [ 47 ]. The early worsening of DR can be explained by the osmotic force theory, which states that a forceful reduction in glucose, an osmotically active molecule, by insulin use, can lead to a shift in intraocular pressure [ 48 ].…”