Vision-threatening diabetic retinopathy necessitating vitrectomy in a tertiary care hospital in coastal Karnataka, South India

  • Narasimha Vasista Reddy
  • Yogish Subraya Kamath Manipal University
  • Lavanya G. Rao
  • Krishna Addoor Rao
  • Shailaja Bhat Shenoy
  • Sulatha V. Bhandary
Keywords: diabetic retinopathy, India, proliferative, tertiary care centers, vitrectomy, vitreoretinopathy

Abstract

Background: The proportion of diabetic patients having vision-threatening diabetic retinopathy and those needing to undergo vitrectomy was documented.

Methods: A cross-sectional observational study was conducted at a tertiary care hospital in coastal Karnataka, South India. All patients with diabetes mellitus visiting the ophthalmology department in the study period were screened for retinopathy, and the data regarding the presence of maculopathy and proliferative retinopathy were included as vision-threatening retinopathy.

Results: Of the 1,435 diabetic patients included, 38.4% had retinopathy changes due to diabetes, with 8.71% having vision-threatening retinopathy and 1.81% needing vitrectomy.

Conclusion: Although the proportion of vision-threatening retinopathy is small, the rapidly increasing diabetic population requires the setting up of more resources for tackling this condition, at least at the tertiary levels of the health-care system. However, considering the increased human and economic resources involved in setting up vitrectomy units, more emphasis on strengthening screening programs for early detection and referral to reduce the progression of retinopathy to advanced stages would be appropriate.

Author Biographies

Yogish Subraya Kamath, Manipal University

Associate Professor, Department of Ophthalmology,

Kasturba Medical College, Manipal University, Manipal [PIN: 576104],

Karnataka, India

Sulatha V. Bhandary

Professor and Head of Department of Ophthalmology, Kasturba Medical College, Manipal ,India

References

Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96:614-618.

Fong DS, Aiello L, Gardner TW, et al. Retinopathy in diabetes. Diabetes Care. 2004;27:S84-S87.

Heng LZ, Comyn O, Peto T, et al. Diabetic retinopathy: pathogenesis, clinical grading, management and future developments. Diabet Med. 2013;30:640-650.

Mohamed QA, Ross A, Chu CJ. Diabetic retinopathy (treatment). BMJ Clin Evid. 2011;pii:0702. PMID: 21609511 PMCID: PMC3217806.

Ramavat PR, Ramavat MR, Ghugare BW, Vaishnav RG, Joshi MU. Prevalence of diabetic retinopathy in Western Indian Type 2 Diabetic population: a hospital-based cross-sectional study. J Clin Diagn Res. 2013;7:1387-1390.

Namperumalsamy P, Nirmalan PK, Ramasamy K. Developing a screening program to detect sight-threatening diabetic retinopathy in South India. Diabetes Care. 2003;26:1831-1835.

Raymond NT, Varadhan L, Reynold DR, et al. Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community: a crosssectional study. Diabetes Care. 2009;32:410-415.

Ruta LM, Magliano DJ, Lemesurier R, Taylor HR, Zimmet PZ, Shaw JE. Prevalence of diabetic retinopathy in Type 2 diabetes in developing and developed countries. Diabet Med. 2013;30:387-398.

Gilbert CE, Babu RG, Gudlavalleti AS, et al. Eye care infrastructure and human resources for managing diabetic retinopathy in India: The India 11-city 9-state study. Indian J Endocrinol Metab. 2016;20:S3-S10.

Tomita M, Kabeya Y, Okisugi M, et al. Diabetic microangiopathy is an independent predictor of incident diabetic foot ulcer. J Diabetes Res. 2016;2016:5938540. doi: 10.1155/2016/5938540.

Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA. 2007;298:902-916.

Rema M, Premkumar S, Anitha B, Deepa R, Pradeepa R, Mohan V. Prevalence of diabetic retinopathy in urban India: the Chennai Urban Rural Epidemiology Study (CURES) eye study, I. Invest Ophthalmol Vis Sci. 2005;46:2328-2333.

Raman R, Rani PK, Reddi Rachepalle S, et al. Prevalence of diabetic retinopathy in India: Sankara Nethralaya Diabetic Retinopathy Epidemiology and Molecular Genetics Study report 2. Ophthalmology. 2009;116:311-318.

Ozawa GY, Bearse MA Jr, Adams AJ. Male-female differences in diabetic retinopathy? Curr Eye Res. 2015;40:234-246.

Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 3. The Diabetic Retinopathy Vitrectomy Study Research Group. Ophthalmology. 1988 Oct;95(10):1307-1320.

Gupta B, Sivaprasad S, Wong R, et al. Visual and anatomical outcomes following vitrectomy for complications of diabetic retinopathy: the DRIVE UK study. Eye (Lond). 2012;26:510-516.

Bäcklund LB, Algvere PV, Rosenqvist U. New blindness in diabetes reduced by more than one-third in Stockholm County. Diabet Med. 1997;14:732-740.

Diabetes Control and Complications Trial Research Group, Nathan DM, Genuth S, Lachin J, et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977-986.

Mohan V, Deepa M, Pradeepa R, et al. Prevention of diabetes in rural India with a telemedicine intervention. J Diabetes Sci Technol. 2012;6:1355-1364.

Published
2020-01-17
How to Cite
Reddy, N., Kamath, Y., Rao, L., Rao, K., Shenoy, S., & Bhandary, S. (2020). Vision-threatening diabetic retinopathy necessitating vitrectomy in a tertiary care hospital in coastal Karnataka, South India. Asian Journal of Ophthalmology, 17(1), 101-107. https://doi.org/10.35119/asjoo.v17i1.497