Study Of Risk Factors For Diabetic Retinopathy

OBJECTIVE To study the spectrum of disease in the patients performed outvitreoretinal surgery in Shanghai First People’s Hospital in past five years, and theprevalence trend of diabetic retinopathy (DR) performed out vitreoretinal surgery, andclarify the risk factors for the development and progression of DR.METHODS (1)To collect the clinical data of the patients performed out vitreoretinalsurgery at the Department of Ophthalmology in Shanghai First People’s Hospital in2009-2013, and the clinical data are involved in gender, age, primary diagnosis,secondary diagnosis. Next, the spectrum of disease in the patients performed outvitreoretinal surgery were analyzed and the prevalence trend of the patients with DRwere studied in the last five years.(2) To collected the clinical data of the diabeticpatients at the Department of Ophthalmology and at the Department of Endocrinologyand Metabolism in Shanghai First People’s Hospitalin in2009-2013and gender, age,duration of diabetes, age of onset, systolic blood pressure(SBP), diastolic bloodpressure(DBP),waist circumference(WC), body mass index(BMI), and biochemicaldata include glycosylated hemoglobin(HbA1c), fasting plasma glucose(FPG), totalcholesterol(TC), triglyceride(TG), low-density lipoprotein-cholesterol(LDL), highdensity lipoprotein-cholesterol(HDL), microalbuminuria(MA), c-reactive protein, andestimated glomerular filtration rate(eGFR) were included in the clinical data.(3). Allthe patients were divided into two groups such as the diabetic paitents without DR andthe diabetic paitents with DR. Then, the diabetic paitents with DR were divided intonon-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy(PDR).(4) All calculations were performed using the statistical package for socialsciences (SPSS)19.0software, and a P value of0.05was considered statisticallysignificant.RESULTS(1) In the past five years, of the14,881patients performed out vitreoretinalsurgery who were recruited for this study, retinal detachment occurred in8339 patients (56.03%), diabetic retinopathy occurred in3143patients (21.21%), siliconeoil occurred in1646patients (11.06%), non-diabetic vitreous hemorrhage occurred in639patients (4.29%), epiretinal membranes occurred in425patients (2.86%), macularhole occurred in403patients (2.71%), various types of trauma, eyeball rupture andintraocular foreign bodies occurred in216patients (1.45%), entophthalmia occurredin45patients (0.3%), retinal necrosis occurred in13patients (0.09%), choroidalhemorrhage occurred in8patients (0.06%), and intraocular tumors occurred in4patients (0.02%).(2)The prevalence of DR were10.1%,15.1%,20.9%,25.9%,29.1%,respectively, showing an increasing trend in the past five years.(3)There weresignificant statistical differences of the data including age, duration of diabetes, age ofonset of diabetes, SBP, DBP, HbA1c, MA, eGFR between DR group and no-DRgroup and the univariate logistic regression analysis shows that age, duration ofdiabetes, SBP, HbA1c, MA, age of onset of diabetes, eGFR are the risk factors for thedevelopment of DR. After adjusting the impact of age and duration of diabetes, thelogistic regression analysis showed that age, duration of diabetes, SBP, HbA1c, MA,age of onset of diabetes are the independent risk factors for DR. Further, age, durationof diabetes, SBP, HbA1c, MA, age at onset of diabetes, eGFR were analysed byhierarchical regression analysis respectively, it was found that among, importantly,twas, however, there were no statistical significance about age, duration, systolicblood pressure, HbA1c, eGFR. In addition, it was found that the decrease ofglomerular filtration rate (eGFR) is the risk factor for the development of PDR.CONCLUSION In the last five years, DR ranked second in the spectrum of diseasein the patients performed out vitreoretinal surgery with a increased trend year by yearin our hospital. Through a statistical analysis, the development of DR is related to age,duration of diabetes, SBP, HbA1c, MA, age of onset. When diabetes onset age wasamong31-50, the risk of DR increased, and the age among31-40was the greatest riskfactor. In addition, eGFR was the risk factor of the development of PDR.