Study of association of diabetic retinopathy with dyslipidemia in type II diabetes mellitus

Abstract

Diabetic retinopathy is the leading cause of visual disability in the working-age population of industrialized countries. It is considered the hallmark of generalized microangiopathy occurring in a diabetic patient. The aim: association of Diabetic Retinopathy and CSME with mean values of lipids and Association of the pattern of hard exudates in the fundus in patients with Diabetic retinopathy with or without CSME with mean values of lipids. Materials and methods: 320 eyes of 160 urban diabetic patients who were seen at the OPD, at Pushpagiri Eye Institute, Secunderabad having diabetic retinopathy were included in the study. Detailed history was taken to note the duration of diabetes, hypertension, history of CAD, CVA, CKD. Patients with duration of diabetes >=5 years were enrolled. Thorough work up was done with slit lamp and indirect ophthalmoscope and posterior segment was examined to evaluate the stage of diabetic retinopathy and presence or absence of CSME. Patients with DR were investigated for Fasting Lipid Profile and HbA1c. Results: a total of 320 eyes of 160 patients were included in the study. In patients with CSME, mean values of Total Cholesterol, Triglycerides, LDL, HDL, VLDL were higher in the plaque pattern of hard exudates in the macula compared to Discrete and Circinate. There was a statistically significant difference between the mean values of total cholesterol (p=0.00), triglycerides (p =0.035), ldl(p=0.00) in discrete and plaque patterns. There was slightly higher prevalence of PDR among hypertensives compared to non-hypertensives. There was no significant association between DR stage and hypertension(p=0.628). The correlation between CSME and BCVA could not be determined accurately due to the presence of cataract in most of the patients. Conclusion: this study demonstrated that, diabetic retinopathy is not associated with lipid profile whereas there is statistically significant correlation between mean values of total cholesterol, triglycerides, LDL, VLDL and clinically significant macular edema (CSME)