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Adam J. Plant, George Burlutsky, Joseph Chiha, Aravinda Thiagalingam, Pramesh Kovoor, Paul Mitchell; Diabetes and Diabetic Retinopathy in an Australian Cardiac Population: the Australian Heart Eye Study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5748.
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To determine the prevalence and severity of diabetic retinopathy (DR) in patients presenting to Westmead hospital (Sydney, Australia) for investigation of suspected coronary artery disease by coronary angiography.
In an Australian prospective cohort, patients undergoing coronary angiography for suspected heart disease were assessed for the presence and severity of retinopathy determined by retinal photography. Coronary artery disease was determined as significant by presence of previous coronary artery bypass graft (CABG) or coronary artery stenting, or a stenosis >50% at the time of angiography. Retinal photographs were graded from six-field retinal photographs of each eye according to the Airlie House classification scheme used in the Early Treatment of Diabetic Retinopathy Study (ETDRS). People were stratified into groups of no retinopathy (ETDRS 10), moderate retinopathy (ETDRS 14,15,20), severe retinopathy (ETDRS >= 35) and vision threatening diabetic retinopathy (VTDR) (ETDRS >= 53 or clinically significant macular oedema).
In our study, 434/1174 (37.0%, 95% CI 34.14-39.66) of patients presenting for angiography had diabetes mellitus. Of these, 134/1174 (11.4%, 95% CI 9.59-13.21) had DR. 47/1174 (4%) had moderate retinopathy, 87/1174 (7.41%) had severe retinopathy and 29/1174 (2.47%) had VTDR. The prevalence was 2.98% in persons aged 30 to 54, 5.96% in persons aged 55 to 69 and 2.47% in persons 70 years of age or older. Mean age of patients with DR was 62.1 (95% CI 40.0-84.1). After adjusting for age, sex and duration since diagnosis of diabetes, no associations with hypertension, hypercholesterolemia, BMI, waist measurement, smoking or coronary artery disease were found. However, males were roughly 3 times more likely (OR 3.19, 95% CI 1.11 to 9.19) to have moderate retinopathy.
Rates of DR in our study are larger than other comparable Australian based population studies. No significant association between DR and other cardiovascular risk factors or significant cardiac disease at the time of coronary angiogram was noted. Males appeared to have an increased risk of mild retinopathy after adjusting for age, and duration of diabetes.
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