Prospective clinical study of ocular manifestations in patients with type 2 diabetes mellitus

Abstract

Purpose: The purpose of this study is to determine the common ocular manifestations in diabetes and their relation to the duration and severity of the diabetes. Methodology: This is a prospective, observational study of patients attending the outpatient department and those referred to the tertiary eye care hospital in Bagalkote district of Karnataka from October 2012 to March 2014. Type 2 diabetic patients were recruited on the basis of history, clinical examination, and blood investigations. Along with detailed demographic history, all participants underwent complete slit-lamp anterior segment, posterior segment examination and intraocular pressure measurement was done. Estimation of random blood sugar at admission and fasting blood sugar and postprandial blood sugar second day of admission along with urine sugar, albumin, and microscopy. If necessary based on the indication, fundus fluorescein angiography was also performed. Results: Out of 350 patients evaluated, 211 were male (60.3%) and 139 (39.7%) were female. Diabetic retinopathy (DR) was the most common complication (36.8%), followed by cataract 35.4%, glaucoma (4.6%), and other pathologies such as conjunctivitis, recurrent hordeolum, and dacrocystitis. The strongest predictor for the prevalence of retinopathy in persons with Type 2 diabetes is the duration of diabetes and was proven statistically significant. Both prevalence and severity of retinopathy correlate with HBA1C level in our study group. The most common type of cataract found was cortical type (41.2%) followed by senile posterior cortical (29.8%). Diabetes predisposes to infection in different body parts, and ocular structures are not an exception. Conclusion: DR was the most common ocular complication of diabetes, followed by cataract and primary open angle glaucoma. The prevalence and severity of DR were higher in patients with the longer duration of diabetes.