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J.R. Gallagher, John Paul Luckett, Maria Reinoso; Diabetic Retinopathy: Trends of Posterior Pole and Peripheral Involvement. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1888.
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Diabetic Retinopathy is the leading cause of blindness in the working age population (ages 20-64) in the United States, and as it stands there is no data regarding the incidence of presentation of its different anatomical location. We aim to identify the incidence of different locations of diabetic damage (i.e. in the macula, periphery, or both) at initial presentation of retinopathy and document progression of disease, and in addition, whether or not Clinically Significant Macular Edema (CSME) developed in studied eyes. We hypothesize that patients presenting with macular changes would be more likely to have progression of their retinopathy and development of CSME.
We performed a retrospective chart review of over 200 eyes at the LSU Healthcare Network Clinic and found those who presented with mild non-proliferative diabetic retinopathy (NPDR). We identified patient sex, diabetes type, location of microaneurysms and dot-blot-hemorrhages (macula, in the periphery, or both), and whether or not patients developed CSME during their follow up. We also documented the grade of retinopathy at twelve and twenty-four months. Statistical analysis was performed using a chi-squared test to identify disease progression at follow up based on location of retinopathy at presentation.
Upon presentation, 31.5% of patients had macular changes only, 38.7% had peripheral changes only, and 29.8% of patients had both macular and peripheral disease (p<.05). At one year 26.3%, 10.5%, and 26.3% of patients were noted to have progression with changes in the macula, periphery, or both, respectively. In addition, CSME developed in 60.1%, 17.4%, and 66% of patients in these groups, respectively (p<.05).
Our results indicate that progression of mild NPDR is more common in those patients that present with either macular disease or both macular and peripheral disease. Patients with changes in these areas were also more likely to develop CSME. The study will serve to benefit future patients by understanding the findings on presentation that predict future progression of disease and risk of development of CSME.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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