A study on the severity of diabetic retinopathy and macular edema in diabetes mellitus patients on hemodialysis

Abstract

Introduction: Diabetes Mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Microvascular abnormalities of DM include both nephropathy and retinopathy. Diabetic retinopathy (DR) tends to deteriorate with failing renal function. Diabetic nephropathy constitutes the most common cause of End Stage Renal Disease (ESRD). ESRD patients require Renal Replacement Therapy (RRT) for survival. Hemodialysis is one of the major methods of RRT. Aim: Aim of the study is to study the prevalence and severity of DR and Diabetic Macular Edema (DME) in diabetic patients on hemodialysis. Study Design: A cross sectional observational study. Methodology:105 diabetic patients undergoing hemodialysis for ESRD were subjected to detailed ophthalmic examination with a special emphasis on fundus examination for DR and macularedema. The severity of diabetic retinopathy and macular edema were graded according to International Clinical Diabetic Retinopathy Severity Scale and International Clinical Diabetic Macular Edema Severity Scale respectively. Results: In the present study prevalence of DR was 89.8% and prevalence of DME was 23%. Prevalence of Non-Proliferative Diabetic Retinopathy (NPDR) 61.4% was more than Proliferative Diabetic Retinopathy (PDR) 38.6 percent. Conclusion: The visual morbidity due to PDR and DME was high among the diabetic patients undergoing hemodialysis.