Use of Conjunctival Vessel Width for Assessment of Severity of Retinopathy in Type-2 Diabetes Mellitus Patients
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 5
Abstract
Introduction: Diabetes mellitus is defined as a metabolic disorder of multiple etiologies characterized by chronic hyperglycaemia with disturbances of carbohydrate, protein and fat metabolism resulting from defects in insulin secretion, insulin action, or both. The manifestations of diabetes in eye from conjunctiva to optic nerve have been studied in depth and well documented. The two most important visual complications of DR are diabetic macular edema (DME) and proliferative DR (PDR). The assessment of severity of retinopathy may be possible by means of evaluation of conjunctival microangiopathy in diabetic patients. So study aimed at assessment of width of the most prominent temporal bulbar conjunctival vessel in patients of type 2 DM with varying levels of retinopathy. Material and Methods: This cross-sectional study involved 140 (280 eyes) diagnosed patients of diabetes mellitus with disease duration of 15 to 19 years. Using the Appasamy anterior segment imaging system, measurement of conjunctival vessel width was done. Using the ETDRS system the diabetic patients were divided based on the severity of retinopathy and analysis of conjunctival vessel width with varying severity of retinopathy was done. Results: In the study population average conjunctival vessel width was 28.8 microns in diabetics without retinopathy and in patients with retinopathy the average width was 33.96 microns which increased with increasing severity of retinopathy. Increasing severity of diabetic retinopathy resulted in significant increase in the conjunctival vessel width [p < 0.0001]. Vessel engorgement and straightening due to macrovessel dilatation in diabetic patients is marked in cases with longer duration of disease. Conclusion: Diabetic retinopathy (DR) is a microvascular complication of diabetes and research has clearly demonstrated that blindness from diabetes is almost entirely preventable with early diagnosis, optimization of risk factors and timely photocoagulation where appropriate.
Authors and Affiliations
Rishi Sharma, Alok Sati, Sandeep Shankar, V. S. Gurunadh
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