EFFECT OF DIABETIC RETINOPATHY PROGRESSION ON VISUAL ACUITY IN TYPE II DM PATIENTS
Main Article Content
This study aims to assess the effect of DR severity on visual acuity and to identify additional contributing factors. An observational analytic study with a cross-sectional design was conducted using medical records of Type II DM patients diagnosed with DR at Dr. Mohammad Hoesin General Hospital, Palembang, between January 2021 and October 2024. Statistical analysis was performed using Fisher’s exact test to evaluate significance, followed by logistic regression to determine the most influential factor. The results showed a significant association between DR severity and visual acuity (p=0.008), while other factors including macular edema (p=0.137), age (p=1.000), gender (p=1.000), intraocular pressure (p=1.000), HbA1c levels (p=1.000), and history of hypertension (p=1.000), were not significantly associated. In conclusion DR severity has a significant and dominant influence on the visual acuity of DR patients.
Keywords:
Diabetic Retinopathy
Visual Acuity
Severity
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29. Sim DA, Keane PA, Zarranz‐Ventura J, Fung S, Powner MB, Platteau E, et al. The Effects of Macular Ischemia on Visual Acuity in Diabetic Retinopathy. Investigative Opthalmology & Visual Science. 2013;54(3):2353.
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32. Tallo AS, Andayani A, Manuaba IBP. Karakteristik pasien diabetic retinopathy di Poliklinik Mata RSUP Sanglah periode Januari – Desember 2020. Intisari Sains Medis. 2022 Aug 30;13(2):583–90.
33. Talpur BR. Analysis of Intraocular Pressure in Healthy Individuals and Type 2 Diabetes Patients With and Without Diabetic Retinopathy: A Comparative Study. The Professional Medical Journal. 2023;30(09):1113–23.
34. Tsegaw A, Alemu S, Dessie A, Patterson C, Phillips DIW, Trimble ER. Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients Attending the Diabetic Clinic of the University of Gondar Hospital, Northwest Ethiopia. J Ophthalmol. 2021;2021:1–7.
35. World Health Organization. The Top 10 Causes of Death [Internet]. 2020 [cited 2024 May 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
36. Yalçın NG, Özdek Ş. The Relationship Between Macular Cyst Formation and Ischemia in Diabetic Macular Edema. Turk J Ophthalmol. 2019;49(4):194–200.
37. Yang Z, Tan TE, Shao Y, Wong TY, Li X. Classification of Diabetic Retinopathy: Past, Present and Future. Front Endocrinol (Lausanne) [Internet]. 2022 Dec 16 [cited 2024 Jun 13];13. Available from: /pmc/articles/PMC9800497/
2. Almutairi NM, Alahmadi S, Alharbi M, Gotah S, Alharbi M. The Association Between HbA1c and Other Biomarkers With the Prevalence and Severity of Diabetic Retinopathy. Cureus [Internet]. 2021 Jan 6 [cited 2024 Jun 14];13(1). Available from: /pmc/articles/PMC7863112/
3. Anišić K, Davidović S. Correlation Between Eye and Renal Complications of Diabetes. Med Pregl. 2018;71(9–10):295–9.
4. Cheung N, Mosley TH, Islam A, Kawasaki R, Sharrett AR, Klein ML, et al. Retinal Microvascular Abnormalities and Subclinical Magnetic Resonance Imaging Brain Infarct: A Prospective Study. Brain. 2010;133(7):1987–93.
5. Elvira EES. Retinopati Diabetes. Continuing Medical Education. 2019;4(3):220–4.
6. Figueira J, Henriques J, Carneiro Â, Marques-Neves C, Flores R, Castro-Sousa JP, et al. Guidelines for the Management of Center-Involving Diabetic Macular Edema: Treatment Options and Patient Monitorization. Clinical Ophthalmology. 2021;Volume 15:3221–30.
7. Fung THM, Patel B, Wilmot EG, Amoaku WMK. Diabetic Retinopathy for The Non-Ophthalmologist. Clinical Medicine, Journal of the Royal College of Physicians of London. 2022 Mar 1;22(2):112–6.
8. Izzettinoğlu MÖ, Garip R. Retrospective Analysis of the Impacts of Treatment Regimens on the Progression and Prognosis of Diabetic Retinopathy and Visual Acuity in Trakya University School of Medicine. Turkish Medical Student Journal. 2021;8(1):17–21.
9. Khan R, Chandra S, Rajalakshmi R, Rani PK, Anantharaman G, Sen A, et al. Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India. Scientific Reports 2020 10:1 [Internet]. 2020 Jun 29 [cited 2024 Jun 13];10(1):1–8. Available from: https://www.nature.com/articles/s41598-020-67350-6
10. Kim S, Moon BY, Cho HG, Yu DS. Visual Acuity Outcomes in Diseases Associated With Reduced Visual Acuity: An Analysis of the National Health Insurance Service Database in Korea. Int J Environ Res Public Health. 2022;19(14):8689.
11. Kim YJ, Kim JG, Lee JY, Lee KS, Joe SG, Park J, et al. Development and Progression of Diabetic Retinopathy and Associated Risk Factors in Korean Patients With Type 2 Diabetes: The Experience of a Tertiary Center. J Korean Med Sci. 2014;29(12):1699.
12. Kostev K, Rathmann W. Diabetic Retinopathy at Diagnosis of Type 2 Diabetes in the UK: A Database Analysis. Diabetologia. 2012;56(1):109–11.
13. Kusuhara S, Fukushima Y, Ogura S, Inoue N, Uemura A. Pathophysiology of Diabetic Retinopathy: The Old and the New. Diabetes Metab J [Internet]. 2018 Oct 1 [cited 2024 Jun 26];42(5):364. Available from: /pmc/articles/PMC6202564/
14. Lee R, Wong TY, Sabanayagam C. Epidemiology of Diabetic Retinopathy, Diabetic Macular Edema and Related Vision Loss. Eye and Vision. 2015;2(1).
15. Lemeshow S, Hosmer Jr DW, Klar J, Lwanga SK. Adequacy of Sample Size in Health Studies. John Wiley & Sons; 1990.
16. Lin KY, Hsih WH, Lin YB, Wen CY, Chang TJ. Update in The Epidemiology, Risk Factors, Screening, and Treatment of Diabetic Retinopathy. J Diabetes Investig. 2021 Aug 1;12(8):1322–5.
17. Made I, Wibawa S, Budhiastra P, Ketut N, Susila N. KARAKTERISTIK PASIEN RETINOPATI DIABETIK DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR PERIODE [Internet]. Vol. 7. Nopember; 2018. Available from: https://ojs.unud.ac.id/index.php/eum
18. Maheshwary AS, Oster SF, Yuson RMS, Cheng L, Mojana F, Freeman WR. The Association Between Percent Disruption of the Photoreceptor Inner Segment–Outer Segment Junction and Visual Acuity in Diabetic Macular Edema. Am J Ophthalmol. 2010;150(1):63-67.e1.
19. Nadia FA. The Relationship Between Diabetic Retinopathy Degree With Visual Acuity and Retinal Nerve Fiber Layer Thickness in Type 2 Diabetes Mellitus Patients. Sumatera Medical Journal. 2022;5(3).
20. Nursalim AJ, Sumual V, Mata K, Kandou RD. Hubungan antara Tajam Penglihatan dengan Derajat Non-Proliferative Diabetic Retinopathy pada Pasien Diabetes Melitus Tipe 2.
21. Ong KL, Stafford LK, McLaughlin SA, Boyko EJ, Vollset SE, Smith AE, et al. Global, Regional, and National Burden of Diabetes from 1990 to 2021, with Projections of Prevalence to 2050: A Systematic Analysis for The Global Burden of Disease Study 2021. The Lancet. 2023 Jul;402(10397):203–34.
22. PERDAMI. Pedoman Nasional Pelayanan Kedokteran Retinopati Diabetika. Perdami [Internet]. 2018;6–26. Available from: https://perdami.or.id/wp-content/uploads/2022/03/Panduan-Nasional-Pelayanan-Kedokteran-Retinopati-Diabetik.pdf
23. Ponto KA, Koenig J, Pető T, Lamparter J, Raum P, Wild PS, et al. Prevalence of Diabetic Retinopathy in Screening-Detected Diabetes Mellitus: Results From the Gutenberg Health Study (GHS). Diabetologia. 2016;59(9):1913–9.
24. Primaputri A, Sri Irmandha K, Karim M, Hapsari P, Surdam Z, Rahmy Sujuthi A. Hubungan Jenis Retinopati Diabetik dengan Lama Menderita Diabetes Melitus dan Kadar HbA1C. Fakumi Medical Journal: Jurnal Mahasiswa Kedokteran. 2022;2(8):585–91.
25. Ramadan I, Hendryanny E, Zulkifli Y. Hubungan Derajat Retinopati Diabetik dengan Perubahan Visus Retinopati Diabetik di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung 2020. 2020; Available from: http://dx.doi.org/10.29313/kedokteran.v7i1.26497
26. Sapra A, Bhandari P. Diabetes. StatPearls [Internet]. 2023 Jun 21 [cited 2024 May 13]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK551501/
27. Scanlon PH, Loftus J, Starita C, Stratton IM. The Use of Weighted Health‐related Quality of Life Scores in People With Diabetic Macular Oedema at Baseline in a Randomized Clinical Trial. Diabetic Medicine. 2014;32(1):97–101.
28. Shaniaputri T, Iskandar E, Fajriansyah A. Prevalence of Diabetic Retinopathy in Puskesmas in Bandung Raya from January 2019 to December 2020. Bandung Raya eJKI. 2022;10(1):39–45.
29. Sim DA, Keane PA, Zarranz‐Ventura J, Fung S, Powner MB, Platteau E, et al. The Effects of Macular Ischemia on Visual Acuity in Diabetic Retinopathy. Investigative Opthalmology & Visual Science. 2013;54(3):2353.
30. Sim DA, Keane PA, Zarranz‐Ventura J, Fung S, Powner MB, Platteau E, et al. The Effects of Macular Ischemia on Visual Acuity in Diabetic Retinopathy. Investigative Opthalmology & Visual Science. 2013;54(3):2353.
31. Syawal H, Awaluddin W, Kemenkes P, Prodi M, Keperawatan I V. Faktor yang Berhubungan dengan Ketajaman Penglihatan Pasien Diabetes Melitus Tipe 2 di Wilayah Kerja Puskesmas Kecamatan Biringkanaya Kota Makassar. Vol. 09, Politeknik Kesehatan Makassar. 2019.
32. Tallo AS, Andayani A, Manuaba IBP. Karakteristik pasien diabetic retinopathy di Poliklinik Mata RSUP Sanglah periode Januari – Desember 2020. Intisari Sains Medis. 2022 Aug 30;13(2):583–90.
33. Talpur BR. Analysis of Intraocular Pressure in Healthy Individuals and Type 2 Diabetes Patients With and Without Diabetic Retinopathy: A Comparative Study. The Professional Medical Journal. 2023;30(09):1113–23.
34. Tsegaw A, Alemu S, Dessie A, Patterson C, Phillips DIW, Trimble ER. Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients Attending the Diabetic Clinic of the University of Gondar Hospital, Northwest Ethiopia. J Ophthalmol. 2021;2021:1–7.
35. World Health Organization. The Top 10 Causes of Death [Internet]. 2020 [cited 2024 May 13]. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
36. Yalçın NG, Özdek Ş. The Relationship Between Macular Cyst Formation and Ischemia in Diabetic Macular Edema. Turk J Ophthalmol. 2019;49(4):194–200.
37. Yang Z, Tan TE, Shao Y, Wong TY, Li X. Classification of Diabetic Retinopathy: Past, Present and Future. Front Endocrinol (Lausanne) [Internet]. 2022 Dec 16 [cited 2024 Jun 13];13. Available from: /pmc/articles/PMC9800497/
