The Effect of Primary Open Angle Glucoma on Progression of Diabetic Retinopathy in Type 2 Diabetic Patients in Alsayem Eye Hospital

  • Zuhal Alhassan Mohamed Osman MBBS,Gezira University 6/2004.
  • Tarig Omar MD Vitreoretinal surgeon Makka Eye Hospital
  • Mahmoud Abdula Salim MD Vitreoretinal surgeon Dept. of surgery University of Gezira

Abstract

Background: Diabetic retinopathy is a serious complication of diabetes. Five percent of patients of type 2 diabetes (NIDDM) have signs of eye problems when diabetes is diagnosed.Control of blood sugar, blood pressure and cessation of smoking, have an important role in slowing the progression of retinopathy and other eye problems caused by diabetes. 


Objectives: To determine whether there is a difference in progression of diabetic retinopathy among patients with and without primary open angle glucoma (POAG).


Design: comparative cross –sectional study. 


Participants: 160 patients who were on regular follow up and treatment in both retina and glaucoma clinics in Al-Sayem Eye Hospital were enrolled in the study. Patients were divided into 2 groups, the study group: included 80 patients who were type 2 diabetics with POAG (group A) .The control group were having type 2 diabetes without POAG (group B).The patients were compared for the grade of diabetic retinopathy according to international clinical diabetic retinopathy disease severity scale. For maculopathy patients were also classified according to international clinical diabetic macular edema disease severity scale. Risk factors for both groups were studied as follow: age, duration of DM, control of DM, systemic hypertension and smoking. Results: In multivariate analyses adjusting for above risk factors and examination for both groups. Diabetic retinopathy was not found in the study group (100%), compared to patients in the control group (patients without POAG) in which no diabetic retinopathy was found in only 8.8%. Mild NPDR was found in 14 patients (43.7%), moderate non prolifrative diabetic retinopathy(NPDR) was observed in 70 patients (32.5%), and severe NPDR in 24 patients (15%). Mild maculopathy was observed in only 4 patients in the study group (5%), all of them were poorly controlled with duration of diabetes of >11 years.In the control group, the majority of patients had no diabetic macular edema(DME) (65%). Mild DME was found in 48 patients (30%). Eight patients only in the control group had moderate DME.


Conclusion: POAG and increased cup disc ratio are associated with a lower risk of DR, particularly vision-threatening retinopathy. 

References

1. AnanyaMandal, MD. What is diabetes? [Internet], Updated: Feb 9, 2014. Available from: http://www.news-medical.net.
2. Beverleigh H Piepers. Is type 2 diabetes realy a world-wide epidemic ? [Internet ]. Ezinearticles. 2010 July 11. Available from: http:///www.enzinearticle.com.
3. Dr. Awad Mohamed Ahmed .Diabetic care in sudan, emerging issues and acute needs. Health delivery diabetic voice. 2006, Volume 51, Issue 3.
4. Jack J. Kanski, Brad Bowling, Ken Nischal, Andrew Pearson. Clinical ophthalmology a systemic approach. Seventh edition. Edinburgh: Elsevier saunders, 2011.
5. International Clinical Classification System For Diabetic Retinopathy And Diabetic Maculr Edema. Global diabetic retinopathy project task force and invitational workshop, AAO Hoskins center for quality eye care, 2012.
6. Lihteh Wu, Priscilla Fernandez-loaiza, Johanna Sauma, Erick Henandez-bogantes and MarisseMasis. Classification of diabetic retinopathy and diabetic macular edema.
World journal of diabetes. 2013 Dec15. Volume 4, Issue 6, Page 290.
7. G B Arden. The absence of diabetic retinopathy in patients with retinitis pigmentosa: implications for pathophysiology and possible treatment. British journal of ophthalmology 2001. Volume 85, Pages 366-370.
8. Sihota R, Tandon R. Primary adult glaucoma. Parson`s diseases of the eye. Second edition. New Delhi. Butterworth Heinemann Elseiver 2003, Page 270-273
9. Arora VK, Parasad . Intraocular pressure and diabetic retinopathy.[internet]. 2010/ 8/29. Available from; http://www.ijo.in/ print article.
10. Dr. SawsanSalih. Diabetic retinopathy in type 2 diabetes with POAG. In Mekkah eye complex. Sudan medical specialization board, 2011.
11. Naurse R, Suetsugu M, terasawa T, Ito T, Hara K, Takebayashi K, Morita k, et al. Oxidative stress and ant oxidative potency are closely associated with diabetic retinopathy and nephropathy in patients with type 2 diabetes. Saudi medical journal. 2013 Feb, 135-41. Available from: http:/www.ncbi.nih.gov/pubmed/23396458 12. SadiqHussain, Muhammad Rashad Qamar and EhsanUllah. Risk factors of retinopathy in type 2 diabetes mellitus at a tertiary care hospital [internet]. Pakistan journal of medical science. Bahawalpur, Pakista, 2013April; 29(2):536-9.
13. R. Kawasaki, S. Tanaka, T. Yamamoto, H Sone , Y. Ohashi, Y. Akanuma, N. Yamada and H Yamashita. On behalf of the Japan diabetes complications study group. Incidence and progression of diabetic retinopathy in Japanese adults with type 2 diabetes: 8 year follow-up study of the Japan Diabetes Complications Study (JDCS). Published online: September 2011, Volume 54, Issue 9, pp2288 - 2294.
14. Oscar B. Crofford, Carolyn Siebert, Patricia A. Cleary Diabetes control and complications trial, [internet]. WebMD: 2006 August. [Updated, 2010 March]. Available from: www.webmd.com/diabetes/control-complications-trial.
15. Dr .Almoez Ibrahim. Diabetic retinopathy among newly diagnosed type2 diabetics in Jabir Abu Ezz Diabetic Center, Sudan medical specialization board, 2008.
16.Yamamoto T, limuro S, OhashiY,Sone H, Yamashita H, Ito H. Prevalence and risk factors for diabetic maculopathy, and its relationship to diabetic retinopathy in elderly Japanese patients with type 2 diabetes mellitus.[Internet]. Japanese elderly intervention trial research group. Pubmed. 2012 Apr 12.
17. Eckhard zander, Sabin Herrurth, BeateBahol, Peter Heinke, Uwe Herrmann, KlausDieter Kohnert, et al, Maclopathy in Patients With diabetes mellitus type 1and type 2 ; associations with risk factors . British journal of ophthalmology. 2006 Sep 21. Volume 84. Page 871-876.
Published
2017-06-01
How to Cite
MOHAMED OSMAN, Zuhal Alhassan; OMAR, Tarig; SALIM, Mahmoud Abdula. The Effect of Primary Open Angle Glucoma on Progression of Diabetic Retinopathy in Type 2 Diabetic Patients in Alsayem Eye Hospital. Gezira Journal of Health Sciences, [S.l.], v. 13, n. 1, june 2017. ISSN 1810-5386. Available at: <http://journals.uofg.edu.sd/index.php/gjhs/article/view/1014>. Date accessed: 14 nov. 2019.
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Articles