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Sapna Gangaputra, Marib Akanda, Shilpa Kodati, H Nida Sen; Diabetic retinopathy in patients with ocular inflammation. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2915.
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© ARVO (1962-2015); The Authors (2016-present)
Diabetic retinopathy is a leading causes of preventable blindness worldwide. The standard of care treatment of uveitis is oral corticosteroid. Hyperglycemia requiring treatment was seen in about 1% of 2073 patients in a retrospective large uveitis cohort. We performed retrospective exploratory analysis to assess the prevalence of diabetic retinopathy in patients with uveitis.
Patients with primary infectious and noninfectious ocular inflammation seen at the National Eye Institute uveitis clinic from 2005 to 2016 were reviewed using electronic medical records. Patients were classified using the 5 step international clinical diabetic retinopathy scale into no diabetic retinopathy, mild non proliferative diabetic retinopathy (NPDR), moderate NPDR, severe NPDR and proliferative diabetic retinopathy (PDR). Results were tabulated into two categories – any retinopathy, or vision threatening retinopathy that combined severe NPDR and PDR. We compared our results to several published population-based and large survey based datasets, that included various races and geographic locations.
We identified 105 patients, median age 58 years (range 26-86 years), predominantly female (53%), black (56%), with majority noninfectious etiology (88%), bilateral (59%) uveitis. Six of the patients had poor view to the fundus and images were ungradable for diabetic retinopathy and were excluded from this analysis. Of the remaining 99 patients, 72 patients (73%) had no retinopathy in either eye. Any retinopathy in atleast one eye was noted in 27% and vision threatening retinopathy was seen in 8% of patients. As compared to existing population based reports, the frequency of any retinopathy was considerably lesser in our population (32-54% reported), but the frequency of vision threatening retinopathy was similar (2-11% reported).
This exploratory study suggests diabetic retinopathy occurs less often in uveitis patients. Whether ocular inflammation (or its treatment) provides protective effect from diabetic retinopathy is unclear. A large prospective study is needed to evaluate the association between diabetic retinopathy and ocular inflammation
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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