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Multicenter Study
. 2021 Nov;69(11):3255-3261.
doi: 10.4103/ijo.IJO_1459_21.

Severity of diabetic retinopathy and its relationship with age at onset of diabetes mellitus in India: A multicentric study

Deepika C Parameswarappa  1 , Ramachandran Rajalakshmi  2 , Ashik Mohamed  3 , Sanagavarapu Kavya  1 , Haripriya Munirathnam  4 , George Manayath  4 , Mathangi Ashok Kumar  5 , Rajiv Raman  5 , T P Vignesh  6 , Kim Ramasamy  6 , Sheena Mani  7 , Alankrita Muralidhar  8 , Manisha Agarwal  8 , Giridhar Anantharaman  9 , Neha Bijlani  10 , Gajendra Chawla  10 , Alok Sen  11 , Sucheta Kulkarni  12 , Umesh C Behera  13 , Sobha Sivaprasad  14 , Taraprasad Das  1 , Padmaja Kumari Rani  1
Affiliations
Multicenter Study

Severity of diabetic retinopathy and its relationship with age at onset of diabetes mellitus in India: A multicentric study

Deepika C Parameswarappa et al. Indian J Ophthalmol. 2021 Nov.

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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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Bar graph depicting higher proportion of patients in Group 1 (age of onset of diabetes < 25 years) with PDR (proliferative diabetic retinopathy) and HRC (high-risk characteristics) at baseline as well as follow-up when compared to Group 2 (age of onset of diabetes ≥25 years)
Figure 2
Figure 2
Bar graph depicting higher systolic blood pressure (SBP) in STDR (sight-threatening diabetic retinopathy) patients in both the groups (Group 1: age of onset of diabetes <25 years and Group 2: age of onset of diabetes ≥25 years) when compared to patients with N-STDR (non-sight threatening diabetic retinopathy)
See this image and copyright information in PMC

Comment in

References

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