Co-existence of Age-Related Macular Degeneration and Diabetic Retinopathy in a Tertiary Referral Center in Greece

Abstract

Purpose: To investigate the co-existence of diabetic retinopathy (DR) and age-related macular degeneration (AMD), based on five-year data in a University setting.

Methods: Participants in the study included 1739 patients with diabetes mellitus, who were examined in our setting from 2015 to 2019. The presence of DR and AMD was recorded while the clinical characteristics of patients were evaluated.

Results: In our study sample, 183 out of 1739 patients with diabetes mellitus (10.5%) were diagnosed with AMD, 116 without any sign of DR, and 67 with DR. In the group of patients with DR, dry AMD was noticed mostly in patients with mild non-proliferative DR (NPDR) (11.5% dry AMD) compared to those with moderate NPDR (4.5% dry AMD), severe NPDR (4.2%) and proliferative DR (PDR) (2.4%). Similar results were found for neovascular AMD (3% in mild NPDR, 1.9% in moderate NPDR, 1% in severe NPDR, and 1.8% in PDR). There was a significant correlation between the co-existence of both diseases and the severity of DR, with AMD being less prevalent in patients with more severe DR. In patients with diabetic macular edema, dry AMD was observed in 12 (4.6%) and neovascular AMD in nine (3.4%).

Conclusions: The five-year prevalence of AMD in DR patients was 9% while in diabetic patients without DR it was found to be 11.5%. Therefore, the co-existence of DR and AMD is not common, suggesting that DR may be protective for AMD development.

Keywords: age-related macular degeneration; diabetic retinopathy; epidemiology; fundoscopy; retina.

Figure 1. Percentage of patients with AMD (dry or neovascular) at different stages of DR, namely mild NPDR, moderate NPDR, severe NPDR, and PDR.

AMD: Age-related macular degeneration, DR: Diabetic retinopathy, NPDR: Non-proliferative diabetic retinopathy, PDR: Proliferative diabetic retinopathy