A study of retinal changes in diabetes mellitus in association with glycosylated haemoglobin, haemoglobin and duration of diabetes mellitus in tertiary care teaching hospital

Abstract

Introduction: Prevalence of diabetic retinopathy in India is 21.27%. Diabetic retinopathy was detected in 1.78% of the diabetic patients screened. Diabetic retinopathy is a major, potentially preventable, long term, microvascular complication of diabetes mellitus and a leading cause of visual disability and blindness in working-age population, which is the hallmark of generalized microangiopathy.Materials and Methods: This is Cross Sectional Study Conducted Among Out Patients attending Ophthalmology OPD and Inpatients of tertiary care teaching hospital. Patients were enrolled for the study after obtaining written informed consent. Total 214 patients were screened in this study. Staging of Diabetic Retinopathy was done using Modified Arlie House classification. Result: Amongst the total number of diabetic retinopathy patients, 138 (64.5%) patients were males and 76 (35.5%) patients were females. Out of the total number of females in the study 77.6% had diabetic retinopathy and amongst males 73.1% had diabetic retinopathy and severity of DR is more in males (10.9% versus 7.9%). There was no statistical significance seen with gender and diabetic retinopathy (chi square x2 =1.819, p=0.611). Retinopathy was seen in 74.8% of the subjects in study. Among them 37.9% were shown mild changes of DR and whereas 9.8% were having severe or very severe retinopathy. Median duration of diabetes is 2 years. Among them 15.9% were having diabetes for more than 10 years and 11.7% had from less than 1 year duration. Maximum number of people (35.5%) were having the duration of 1 - 5year.A positive co-orelation was observed between glycosylated haemoglobin and haemoglobin with severity of diabetic retinopathy. Conclusion: Glycosylated Hemoglobin levels was significantly correlated to severity of diabetic retinopathy. Haemoglobin level have been significantly correlated to severity of diabetic retinopathy. Glucose control and anemia are identified to be important modifiable risk factors in diabetes mellitus patients. The presence of these risk factors should warn the ophthalmologists about the need to monitor the retina. Low haemoglobin level, which is common in patients from developing countries like India, needs to be detected and treated, thereby reducing the risk for developing DR.