Risk factors for progression of diabetic retinopathy

Abstract

Gabija Stankevičiūtė1, Konstancija Ambrazaitė1 1Lithuanian University of Health Sciences, Medical Academy, Kaunas, Lithuania Abstract Diabetic retinopathy (DR) is the most common complication of type 1 and 2 diabetes mellitus (DM) and is diagnosed in 77%-82.6% of people with the diagnosis of DM of 15 years or more [1]. About 60% of patients diagnosed with DR are in the working-age population. It is thought that the progression of DR is due to a combination of risk factors rather than a single cause [2]. Some research suggests that the main risk factors for DR progression are uncontrolled glycaemic control and arterial hypertension; other factors, such as adolescence, pregnancy, cataract surgery, dyslipidaemia and inflammation, only further exacerbate the already existing interaction between the previously mentioned risk factors [3]. On the other hand, the already existing dyslipidaemia and inflammation in DM can be associated with further comorbidities, although subjected to longer periods of time [2,3,4]. Moreover, the delayed statin treatment is associated with the complications of DR, such as blindness, glaucoma, bleeding into the vitreous body, oedema of the macula, retinal detachment – conditioned to the presence of dyslipidaemia and the absence of arterial hypertension [3,5,6,7]. Thereby, the controversy in the literature highlights the need to explore the factors which influence the progression of diabetic retinopathy. Aim: to analyze scientific literature and provide a review of literature related to the risk factors of diabetic retinopathy. Methods: literature review and data collection sources were selected from PubMed and Cochrane Library scientific databases, following dates from 2016 to 2021, using original language keywords: “diabetic retinopathy”, “risk factors”, “diabetes mellitus”, “dyslipidaemia”, “glycaemic control”. Conclusions: the main risk factors for DR progression are glycaemic control, pregnancy, cataract surgery, and arterial hypertension. Other factors such as dyslipidaemia, systemic inflammation and diabetic retinopathy have synergistic effect within the progression of DR. Keywords: diabetic retinopathy, risk factors, diabetes mellitus, dyslipidaemia, glycaemic control. https://doi.org/10.53453/ms.2021.06.10