Abstract

RISK FACTORS FOR DIABETIC RETINOPATHY AMONG JORDANIANS WITH TYPE II DIABETES

Walid N. Qubain* MD, Dua'a T. Daradkeh MD, Ahmed A. Husban MD, Hosamadden A. Alkayid MD and Sura Y. Soleman MD

ABSTRACT

Aim: to explore the prevalence and the role of the associated risk factors in the development of diabetic retinopathy among Jordanian diabetics and its effect on the severity of diabetic retinopathy. Method: this is a prospective study conducted at the ophthalmology department of King Hussein medical centre and prince Rashid Bin Al-Hassan military hospital between May. 2019 and May 2020. All patients who attend to the retinal clinic suffering from diabetic retinopathy were included in the study; History was initially obtained from each patient regarding age, sex, duration of diabetes, past medical and surgical history and past ocular history. Then detailed ocular examination was performed including visual acuity anterior segment examination using slit lamp microscope and posterior segment examination using 78D and 90D lens. Then laboratory investigations were pursued including fasting blood sugar, lipid profile, kidney function, liver function, hemoglobin level and HbA1c. Patients were divided into two groups according to the control of blood sugar according (HbA1c level). In each group diabetes was subdivided regarding the duration and the patients were evaluated regarding the presence of other risk factors (hypertension, anemia, renal failure, hyperlipidemia, pregnancy, smokin) among each group. Result: one thousand patients included in this study. The main age of patients was 58 years (58±12.5), 590 of them were males (59%). 684 patients had HbA1c of more than 7%. Systemic hypertension was the most common risk factor which existed in diabetic patients with good control of blood sugar. It was significantly associated with NPDR and maculopathy regardless the duration of DM. In patients with poor control of blood sugar it was significantly associated with PDR and maculopathy. Nephropathy was strongly associated with PDR and maculopathy Hyperlipidemia was significantly associated with maculopathy. Smoking, increased body mass index and male gender didn’t influence the progression of diabetic retinopathy. Conclusion: Severity and progression of diabetic retinopathy were influenced by the presence of systemic hypertension, hyperlipidemia and nephropathy. In addition to good control of blood sugar, efforts should be aimed for the control of those factors as well.

Keywords: Diabetic retinopathy, risk factors.