Frequency and severity of diabetic retinopathy in non-ocular diabetic complications

Background: The aim of this study was to estimate the prevalence, severity, and risk factors for diabetic retinopathy in diabetic cases admitted for non-ocular diabetic complications and to investigate the association between retinopathy and these complications.Methods: In this cross-sectional study, 84 diabetic patients admitted to our university-affiliated hospital for non-ocular diabetic complications were fully evaluated for proliferative and nonproliferative diabetic retinopathy. Cases of nonproliferative retinopathy (NPDR) were graded as microaneurysm, mild, moderate or severe. To determine the association of retinopathy with the complications that caused hospitalization, statistical analysis was performed using SPSS ver. 11.5.Results: The prevalence of diabetic retinopathy among our cases was 77.4% (65 patients), with proliferative diabetic retinopathy (PDR) present in 23 patients (35.4% of the retinopathy cases). Diabetic retinopathy was higher in patients who had been hospitalized for nephropathy than in patients with diabetic foot and diabetic ketoacidosis (DKA, p=0.001), and higher in those hospitalized for diabetic foot than for DKA (p=0.008). Among the 35 patients who had nephropathy and retinopathy, 16 subjects (45.7%) had PDR, and the other 19 subjects had NPDR. Twenty-seven patients had diabetic foot and retinopathy, six (22.7%) of whom had PDR, and 21 (77.8%) had NPDR. Factors significantly related to the occurrence of diabetic retinopathy were type 2 diabetes, presence of hypertension, elevated serum levels of creatinine, duration of diabetes and coexisting nephropathy or diabetic foot (all with p values <0.05). In the logistic regression model, diabetic duration had a slight association with PDR (p=0.06).Conclusion: Our data suggest that diabetic retinopathy in our patients is common, especially in patients with nephropathy. In addition to glycemic control, lowering of serum cholesterol and triglycerides as well as blood pressure may be effective in lowering the prevalence of diabetic retinopathy.