Tommaso Rossi1, Giacomo Panozzo2, Giulia Della Mura2, Diana Giannarelli3, Daniele Ferrari4, Giovanni Alessio5, Carmela Palmisano5, Serena Telani4, Guido Ripandelli6. 1. IRCCS Ospedale Policlinico San Martino IRCCS - UOC Oculistica, Largo Rosanna Benzi 2, 16100, Genoa, Italy. tommaso.rossi@usa.net. 2. ESASO European School of Advances Studies in Ophthalmology, Lugano, Switzerland. 3. Department of Biostatistics, IRCCS Regina Elena National Cancer Institute, Rome, Italy. 4. IRCCS Ospedale Policlinico San Martino IRCCS - UOC Oculistica, Largo Rosanna Benzi 2, 16100, Genoa, Italy. 5. Department of Ophthalmology, University of Bari, Bari, Italy. 6. IRCCS Fondazione G. B. Bietti ONLUS, Rome, Italy.
Abstract
PURPOSE: To report on the prevalence of diabetes, diabetic macula oedema (DME) and retinopathy and their respective grading in a large cohort of patients undergoing cataract surgery. METHODS: Data on previous diagnosis of diabetes, fasting glucose, glycated haemoglobin, presence and type of retinopathy and other maculopathy of 3657 patients over 55 years of age undergoing cataract surgery in 13 centres scattered throughout Italy were analysed. RESULTS: A total of 20.4% of patients were known diabetics and 27.9% of diabetics showed signs of retinopathy. Haemoglobin A1C was higher than 48 mmol/L (6.5%) in 32% of diabetics and 2.4% non-diabetics. Fasting blood glucose level was higher than 120 mg/dL in 4.3% non-diabetics and 50% diabetics. Duration of diabetes did not significantly correlate with either fasting glucose or glycated haemoglobin, while higher grades of diabetic retinopathy were significantly more prevalent as duration of disease increased. DME was present in almost 40% of diabetics and 22% of patients showed non-diabetic maculopathy. DISCUSSION: Diabetic retinopathy and DME worsen after cataract extraction thus complicating long-term prognosis and requiring expensive injective therapy. Since unknown diabetics represent 2-4% of the many million cataract candidates and even known diabetics show poor metabolic control and high rates of DME, preoperative medical testing and accurate retinopathy screening may prove both ethically necessary and cost-effective.
PURPOSE: To report on the prevalence of diabetes, diabetic macula oedema (DME) and retinopathy and their respective grading in a large cohort of patients undergoing cataract surgery. METHODS: Data on previous diagnosis of diabetes, fasting glucose, glycated haemoglobin, presence and type of retinopathy and other maculopathy of 3657 patients over 55 years of age undergoing cataract surgery in 13 centres scattered throughout Italy were analysed. RESULTS: A total of 20.4% of patients were known diabetics and 27.9% of diabetics showed signs of retinopathy. Haemoglobin A1C was higher than 48 mmol/L (6.5%) in 32% of diabetics and 2.4% non-diabetics. Fasting blood glucose level was higher than 120 mg/dL in 4.3% non-diabetics and 50% diabetics. Duration of diabetes did not significantly correlate with either fasting glucose or glycated haemoglobin, while higher grades of diabetic retinopathy were significantly more prevalent as duration of disease increased. DME was present in almost 40% of diabetics and 22% of patients showed non-diabetic maculopathy. DISCUSSION: Diabetic retinopathy and DME worsen after cataract extraction thus complicating long-term prognosis and requiring expensive injective therapy. Since unknown diabetics represent 2-4% of the many million cataract candidates and even known diabetics show poor metabolic control and high rates of DME, preoperative medical testing and accurate retinopathy screening may prove both ethically necessary and cost-effective.
Authors: Alastair K Denniston; Usha Chakravarthy; Haogang Zhu; Aaron Y Lee; David P Crabb; Adnan Tufail; Clare Bailey; Toks Akerele; Sahar Al-Husainy; Christopher Brand; Louise Downey; Alan Fitt; Rehna Khan; Vineeth Kumar; Aires Lobo; Sajjad Mahmood; Kaveri Mandal; Martin Mckibbin; Geeta Menon; Salim Natha; Jong Min Ong; Marie D Tsaloumas; Atul Varma; Elizabeth Wilkinson; Robert L Johnston; Catherine A Egan Journal: Br J Ophthalmol Date: 2017-05-09 Impact factor: 4.638
Authors: T Tamayo; J Rosenbauer; S H Wild; A M W Spijkerman; C Baan; N G Forouhi; C Herder; W Rathmann Journal: Diabetes Res Clin Pract Date: 2013-12-01 Impact factor: 5.602