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Severity of diabetic retinopathy and its relationship with age at onset of diabetes mellitus in India: A multicentric study
Authors:Deepika C Parameswarappa  Ramachandran Rajalakshmi  Ashik Mohamed  Sanagavarapu Kavya  Haripriya Munirathnam  George Manayath  Mathangi Ashok Kumar  Rajiv Raman  TP Vignesh  Kim Ramasamy  Sheena Mani  Alankrita Muralidhar  Manisha Agarwal  Giridhar Anantharaman  Neha Bijlani  Gajendra Chawla  Alok Sen  Sucheta Kulkarni  Umesh C Behera  Sobha Sivaprasad  Taraprasad Das  Padmaja Kumari Rani  on behalf of India Retinal Disease Study group
Abstract:
Purpose:To present clinical profile and risk factors of sight-threatening diabetic retinopathy (STDR) among people with age of onset of diabetes (AOD) <25 versus ≥25 years.Methods:A retrospective chart analysis of consecutive patients with diabetic retinopathy (DR) n = 654) treated at 14 eye care centers across India between 2018 and 2019 was performed. Patients were divided into two groups, Group 1: AOD <25 years and Group 2: AOD ≥25 years. DR and diabetic macular edema (DME) were classified using the International Clinical Classification of DR severity scale. STDR included severe nonproliferative DR (NPDR), proliferative DR (PDR), and moderate to severe DME. A multilevel mixed-effects model was used for comparison between two groups: 1) Patients with DR and AOD <25 years and 2) Patients with DR and AOD ≥25 years. Bivariate and multivariate regression analyses were used to evaluate risk factors between the two groups.Results:A total of 654 patients were included, 161 (307 eyes) in AOD <25 and 493 (927 eyes) in AOD >25 group. There was a higher prevalence of PDR with high-risk characteristics in AOD <25 group (24% vs. 12%) at baseline and 12-month follow-up (25% vs. 6%); P < 0.001. Systolic hypertension and poor glycemic control were risk factors in both groups, with no difference in these modifiable risk factors between groups.Conclusion:People with youth-onset DM are likely to present with severer form of STDR despite similar modifiable risk factors. Therefore, strict control of systolic blood pressure, glycemic status, and regular screening for DR are recommended to reduce the risk of STDR irrespective of the age of onset of diabetes.
Keywords:Age of onset of diabetes   diabetes mellitus   diabetic retinopathy   severity   sight-threatening
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