June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
A collaborative multicenter retrospective study on the prevalence and incidence of visual impairment and blindness in patients presenting with active proliferative diabetic retinopathy in India.
Author Affiliations & Notes
  • Rehana Khan
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Shruti Chandra
    NIHR Moorfields Biomedical Research Centre, United Kingdom
  • Rajalakshmi Ramachandran
    Madras Diabetes Research Foundation, Madras Diabetes Research Foundation & Dr.Mohan’s Diabetes Specialities Centre, Chennai, India
  • Padmaja Kumari Rani
    Smt Kanuri Santhamma centre for Vitreoretinal Diseases, LV Prasad Eye Institute, India
  • Giridhar Anantharaman
    Department of Vitreo Retina, Giridhar Eye Institute, India
  • Alok Sen
    Department of Retina and Uvea, Sadguru Netra Chikitsalaya, India
  • Abhishek Desai
    Shri Ganapati Nethralaya, India
  • Rupak Roy
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Lanin Chen
    Department of Vitreo Retina Surgery, Aditya Jyot Eye Hospital, India
  • Gajendra Chawla
    Vision Care & Research Centre, India
  • Umesh Chandra Behera
    Department of Retina and Vitreous Service, LV Prasad Eye Institute, India
  • Sobha Sivaprasad
    NIHR Moorfields Biomedical Research Centre, United Kingdom
  • Rajiv Raman
    Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
  • Footnotes
    Commercial Relationships   Rehana Khan, None; Shruti Chandra, None; Rajalakshmi Ramachandran, None; Padmaja Kumari Rani, None; Giridhar Anantharaman, None; Alok Sen, None; Abhishek Desai, None; Rupak Roy, None; Lanin Chen, None; Gajendra Chawla, None; Umesh Chandra Behera, None; Sobha Sivaprasad, None; Rajiv Raman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3825. doi:
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      Rehana Khan, Shruti Chandra, Rajalakshmi Ramachandran, Padmaja Kumari Rani, Giridhar Anantharaman, Alok Sen, Abhishek Desai, Rupak Roy, Lanin Chen, Gajendra Chawla, Umesh Chandra Behera, Sobha Sivaprasad, Rajiv Raman; A collaborative multicenter retrospective study on the prevalence and incidence of visual impairment and blindness in patients presenting with active proliferative diabetic retinopathy in India.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3825.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To provide the real world outcomes of people with Proliferative diabetic retinopathy (PDR) in India and to evaluate their visual acuity, short term outcomes at 6 months and incidence of visual impairment at 5 and 10 years.

Methods : 20 centers in India with established vitreoretinal services for over 10 years were invited to provide long-term data on PDR. 10 centers were able to provide this data. Patients with a diagnosis of type 1 or 2 diabetes with a clinical diagnosis of active PDR in any or both eyes, who presented to these centres and had long term follow-up for above 10 years were included. Study population consisted of treatment naïve PDR and those with persistent PDR post initial panretinal photocoagulation (PRP). The patients could also have concomitant diabetic macular edema (DME). The data were analyzed for outcome at 6 months, 5 and 10 years. Baseline data collected included age, sex, duration of diabetes, referral source and best-corrected visual acuity. PDR status was defined as low risk PDR (LR-PDR) and high-risk PDR (HR-PDR) according to DRS study. Follow-up data on visual acuity were collected at 6 months post baseline, 5 years and 10 years within a +/- 3 months window.

Results : Data was available on a total of 519 patients. Over 10 years, incident visual impairment based on worsening from 6/12 or better and from 6/18 or better were 17.6% and 11.11% with majority of these cases seen in age-group 40-59 years. Moreover, 452 had visual acuity better than 6/60 and 441 eyes had visual acuity of better than 3/60 at baseline and these eyes had the potential to become blind by 10 years. 12.1% and 7.7% became worse than 6/60 and 3/60 respectively by 10 years. The PDR status of the eyes at 10 years was also analyzed based on the baseline status. Of the 499 eyes with LR-PDR, 57.7% were stable and 19.6% continued to be LR-PDR. 5.2% progressed to HR-PDR and 7.2% developed advanced PDR. Out of 299 eyes with baseline HR-PDR, 40.8% were stable treated PDR, 9.3% progressed to advanced PDR. Only 19.7% of the eyes with baseline advanced PDR were stable and treated.

Conclusions : Our results suggest that despite robust recent clinical trial results showing that PRP is an excellent treatment for PDR, people with diabetes in India need to be made aware of repetitive screening to avoid vision impairment.

This is a 2020 ARVO Annual Meeting abstract.

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