Association of severity of diabetic retinopathy with comorbidities in Type 2 diabetes mellitus

Introduction: Diabetes mellitus is emerging as a multisystem disease culminating in various complications especially to the ocular system if not treated at the earliest. The role of various comorbidities in aggravating the severity of diabetic retinopathy is sparsely studied. This study was performed to throw light at this aspect of the need for early identification of comorbidities and its role in progression of diabetic retinopathy. Methods: Study was conducted among 257 diagnosed type 2 diabetic patients with various grades of retinopathy as classified based on ETDRS classification. Clinical history and comprehensive systemic and ocular examination was done and laboratory profile of serum lipids and blood sugar values were collected. The analysis was carried out using SPSS software and results presented in percentages and p value <0.05 taken as significant. Results: 257 patients were studied with a mean age of 58.8+/- 10 years. Male female distribution 129:128. There were 221 non proliferative diabetic retinopathy, 33 proliferative diabetic retinopathy and 3cases of advanced diabetic eye diseases. The study group had 48.6% smokers, 40.5% hypertensives,13.6% coronary artery disease and 45.5% with serum lipid >200mg/dl. Present study revealed a positive association of retinopathy with hypertension (p value 0.034) and smoking (p value 0.002). Conclusion: Comorbidities associated with Diabetes mellitus were contributing to worsening of diabetic retinopathy. Hence the need for prompt identification and control of these should form a part of the routine management of any stage of diabetic retinopathy to prevent sight threatening complications.