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N. Vashisht, P. Venkatesh, P. Naithani, S. Khanduja, S. Sinha, S. Garg; Systemic Co-Morbidity in Patients Undergoing Diabetic Vitrectomy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2081.
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To study the systemic co-morbidity factors in patients undergoing diabetic vitrectomy & its co-relation with severity of diabetic eye disease (DED).
In this retrospective study records of 100 patients with diabetes mellitus (DM) who underwent parsplana vitrectomy (PPV) were reviewed. All the patients underwent thorough systemic clinical examination. The following systemic co-morbidity factors were evaluated hypertension (HTN), ischemic heart disease (IHD), cerebrovascular accidents (CVA), hyperlipidemia (HYL), diabetic nephropathy (DNP), diabetic neuropathy (DNU) & diabetic foot (DF). The sent laboratory investigations (blood & urine) were also reviewed.The data was analyzed with respect to the incidence of systemic co-morbidity in these patients & the possible correlation with respect to disease severity.
There were 62 males & 38 females with mean age of 56.3 years. The mean duration of DM was 13.2years & there were 89 patients with insulin-dependent DM (IDDM) & 11 with non-IDDM. 95 patients had proliferative diabetic retinopathy.The indications for PPV were vitreous haemorrhage-54, diabetic tractional detachment-30, vitreomacular traction-9, combined retinal detachment-4 & neovascular glaucoma-3 . The following was the incidence of co-morbidities HTN-71, DNP-67, HYL-45, IHD-33, DNU-27, CVA-19, DF-15 & foot amputation-8. Amongst the co-morbidity factors, the severity of DED in the non-operated eye (in terms of visual acuity and macular edema) correlated well with poor hypertension control and worse DNP.
Ophthalmologist should exert proper attention to systemic profile in diabetic population. The need of team work is stressed in appropriate management of diabetes mellitus. Adequate renal status and hypertension control could prevent worsening of DED.
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