|Year : 1988 | Volume
| Issue : 1 | Page : 3
Vision threatening diabetic retinopathy
I S Jain
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Jain I S. Vision threatening diabetic retinopathy. Indian J Ophthalmol 1988;36:3
In developed countries, diabetic retinopathy ranks number one amongst the various causes of age related blindness like glaucoma and macular degeneration
In India which is a country at an interim stage of development blindness rate due to Diabetic Eye Disease is on the increase, because of increase in the average span of life, better standards of living and better care of the diabetic.
To assess the magnitude of the problem, the Department of Ophthalmology at the PGI launched a project to screen the diabetic population attending the Diabetic Clinic and the Eye out-patient service, with the aim of knowing the prevalence rate of vision threatening diabetic retinopathy. It was observed that retinopathy was present in42.9% cases, out of which 15.2% cases had vision threatening retinopathy. Our figures match closely with those reported by Constable et al (1984) who found 43.4% and 13.9% respectively. In a study conducted by our department and the department of Endocrinology, the non-insulin dependent diabetes mellitis (NIDDM) is about 10 times more prevalent than insulin dependent diabetes mellitis (IDDM). The knowledge of statistical data is an important element for the planning and evaluation of many activities in Eye Health Care for the prevention of Blindness due to the disease.
Retinopathy in NIDDM cases was 16 times more prevalent than IDDM
45.5% of IDDM cases had retinopathy and 27.3% of these cases had vision threatening retinopathy. Grey et al (1986) also reported a prevalence rate of 43.4% of retinopathy, out of which 13.3% had sight threatening retinopathy. In NIDDM 42.7% cases had retinopathy, out of which 14.4% of cases had vision threatening retinopathy.
The increased percentage of sight threatening cases in our series could possibly be due to their remaining undetected for long because of late ophthalmoscopic examination. It is a fact that in 75% of our cases retinopathy was diagnosed only by the ophthalmologist Hence the importance of a complete ocular examination of every diabetic by the ophthalmologist cannot be overstressed.
The most important single factor in the development of retinopathy is the duration of diabetes and presently there is no way of preventing the development of retinopathy.
Non ocular factors in the development of diabetic retinopathy include diabetic control, hypertension and renal disease. Recently there has been a tremendous improvement in the overall prognosis of vision in diabetics by early treatment of diabetic retinopathy by Laser Photocoagulation and several such studies are now available to support such an approach.
For us in India, in order to plan services for effective patient management it is necessary to know the likely work load involved in terms of Laser Photocoagulation and vitreous surgery.
Both Physicians and Ophthalmologists should make every effort for early detection and treatment of vision threatening diabetic retinopathy to prevent the avoidable of blindess due to Diabetes.
NIDDM - Non Insulin Dependent Diabetes Melitus
IDDM - Insulin Dependent Diabetes Melitus
| References|| |
Grey RHD; Melcolm N; O' Reilly and Morres, A, Ophthalmic surgery of a Diabetic Clinic I, Ocular findings, Br. J. Ophthal. 70: 797-803 1986.
Diabetic Retinopathy study Research Group, Photocoagulation treatment of Proliferation, Diabetic Retinopathy, Ophthalmology 88: 583-600 1981.
Cantrill HL: The Diabetic Retinopathy study and the early treatment of diabetic retinopathy study, Int. Ophthal. Clin. 24 : 13-29 1984.
Constable I.J. et al : Assisting the risk of Diabetic Retinopathy, Am. J. Ophthal 97 : 53-61 1984.