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S. A. Skolik, L. Caspers; Proliferative Diabetic Retinopathy Occurs Significantly Less Often in Diabetic Patients With Clinical Arthritis Than in Those Without Arthritis. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1365.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the development of retinopathy in patients with diabetes mellitus of more than twenty years duration who have co-existing arthritis compared to patients with diabetes of the same duration without arthritis. Additionally, to evaluate whether the severity of retinopathy differed among patients whose arthritis onset occurred subsequent to the year of onset of their diabetes.
A retrospective chart review identified 117 patients with diabetes and arthritis (group "A/DM") and these patients were matched with patients with diabetes mellitus but free of arthritis (group "NoA/DM") from the same patient population for age, race, length and type of diabetes. Years of diabetes A/DM v NoA/DM was 20-54 (mean 27.8) v 20-56 (mean 26.2), and type-1 (n=73), type-2 (n=44). Arthritic subtype and year of onset of joint pain was determined. Masked grading of retinopathy from fundus photographs using modified ETDRS criteria was performed. The two groups show no significant difference in glycosylated hemoglobin, chronic aspirin use, history of smoking or hypertension.
Fewer persons in the A/DM group developed proliferative diabetic retinopathy (PDR) than in the NoA/DM group, 14(12.0%) v 111(94.9%) (p<0.0001). Any fundus manifestation of diabetic retinopathy, non-proliferative (NPDR) with or without PDR, also developed less often in A/DM v NoA/DM, 30 (25.6%) v 117(100%) (p<0.0001). In this study, PDR developed in only 1.4% of arthritic patients (1/73) who subsequently developed diabetes compared to in 28.2% of diabetic patients (11/39) that went on to developed arthritis (p<0.0001).
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