September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Prevalence of retinopathy and macular edema and evaluation of associated risk factors in patients with type 2 diabetes of short duration
Author Affiliations & Notes
  • Aida Jimenez-Corona
    Department of Ocular Epidemiology and Visual Health, Institute of Ophthalmology Conde de Valenciana, Mexico, City, Mexico
    General Directorate of Epidemiology, Ministry of Health, Mexico, City, Mexico
  • David Rivera-de-la-Parra
    Institute of Ophthalmology Conde de Valenciana, Mexico, City, Mexico
  • Sergio c Hernandez-Jimenez
    National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico, City, Mexico
  • Carlos A Aguilar-Salinas
    National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico, City, Mexico
  • Enrique O Graue-Hernandez
    Department of Cornea and Refractive Surgery, Institute of Ophthalmology Conde de Valenciana, Mexico, City, Mexico
  • Footnotes
    Commercial Relationships   Aida Jimenez-Corona, None; David Rivera-de-la-Parra, None; Sergio Hernandez-Jimenez, None; Carlos Aguilar-Salinas, None; Enrique Graue-Hernandez, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1605. doi:
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      Aida Jimenez-Corona, David Rivera-de-la-Parra, Sergio c Hernandez-Jimenez, Carlos A Aguilar-Salinas, Enrique O Graue-Hernandez; Prevalence of retinopathy and macular edema and evaluation of associated risk factors in patients with type 2 diabetes of short duration. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1605.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : To estimate the prevalence of diabetic retinopathy (DR) and macular edema and to assess the associated risk factors in patients with type 2 diabetes (T2DM) of short duration.

Methods : We determined the prevalence of DR in patients age 18 years and older with T2DM of short duration (less than 5 years) from a comprehensive diabetes management program. T2DM was defined as fasting plasma glucose >7.8 mmol/l or 2-hr post load plasma glucose >11.1 mmol/l or previous medical diagnosis. Patients underwent a non-mydriatic fundus examination with a digital-fundus camera (DRS, centervue). Each eye was photographed 3 times (centered in the macula, centered in the optic disk, and temporal to the macula) with a field of view of 40ο × 45ο. DR and macular edema were classified according to the Scottish Diabetic Retinopathy Grading Scale.

Results : Of 593 patients (311 women, 223 men; mean age 51.4 years, s.d. 10.4; mean T2DM duration 2.2 years, s.d. 1.6), 85 patients had DR (34 [40%] unilateral and 51 [60%] bilateral) and 17 patients had macular edema (bilateral in all cases). Age-sex adjusted prevalence of DR was 14.2% (95%CI 11.4-17.5). Prevalence increased with T2DM duration: <1 year, 6.1% (95%CI 3.4-11.0); 1-2 years, 9.3% (95%CI 6.9-12.6); ≥3 years, 13.9% (95%CI 10.1-19.0) (p trend=0.02). Age-sex adjusted prevalence of macular edema was 2.0 (95%CI 1.0-4.0). Prevalence increased with T2DM duration: <1 year, 1.3% (95%CI 0.5-3.9); 1-2 years, 1.9% (95%CI 1.0-4.0); ≥3 years, 2.8% (95%CI 1.2-6.5) (p trend=0.05). In multiple logistic regression, after adjustment for age, sex, hypertension, and T2DM duration, the prevalence of DR was higher in men (OR=1.81, 95%CI 1.08-3.05, p=0.025), subjects with T2DM duration ≥1 year (OR=1.30, 95%CI 1.06-2.29, p=0.05), subjects with HbA1c≥7 (OR=1.11, 95%CI 1.05-1.23, p=0.038), and subjects with hypertension (OR=1.79 (95%CI 1.05-3.04, p=0.032). As for the prevalence of macular edema, it was higher in men (OR=5.20, 95%CI 1.38-19.6, p=0.015); and in subjects with hypertension (OR=5.52, 95%CI 1.47-20.8, p=0.012).

Conclusions : Retinopathy may occur in early stages of diabetes, even in patients with impaired glucose tolerance who may have early retinopathy. A systematic screening should be carried out to identify retinal changes and treat the disease in its preclinical stage.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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