Risk Factors For Retinopathy Research Articles

Epidemiological investigation and risk factors of diabetic retinopathy in Yunnan Province

To investigate the prevalence and epidemiological characteristics of diabetic retinopathy (DR) in Yunnan Province, explore its risk factors, and provide a basis for the prevention and treatment of chronic complications of diabetes mellitus (DM). This is a large cross-sectional study, in all, 1 524 DM patients in 16 communities and villages of Yunnan Province who were registered in health service centers were included in this study from August to November 2019. All patients completed a uniform questionnaire, anthropometric measurements, biochemical measurements, and auxiliary examinations. Logistic regression analysis was used to screen the risk factors of DR. The prevalence rates of DR, mild non-proliferative DR (mild-NPDR), and referable DR (RDR) were 16.0% (244/1 524), 4.5% (69/1 524), and 11.5% (175/1 524), respectively. Glycated hemoglobin A1c (HbA1c)≥7.0% was the risk factor of mild-NPDR (OR=1.872, 95%CI 1.055-3.323) and RDR (OR=4.821, 95%CI 2.917-7.969). Blood pressure≥130/80 mmHg (1 mmHg=0.133 kPa) was the risk factor of mild-NPDR (OR=1.933, 95%CI 1.112-3.358) and RDR (OR=1.505, 95%CI 1.063-2.130). In Yunnan Province, 16.0% DM patients had accompanying DR, wherein about 71.7% of them required an ophthalmology referral, and the high incidence of RDR in DM patients was associated with poor control of blood glucose and blood pressure.

The incidence and risk factors of retinopathy of prematurity in South Korea: A nationwide cohort study.

Retinopathy of prematurity (ROP) is a major treatable cause of childhood blindness. Thus, epidemiological investigations are necessary for detecting and preventing ROP. Determining risk factors for ROP are also essential to improve screening methods. Therefore, we aimed to investigate the incidence and risk factors of ROP in Korea. The National Health Insurance Service (NHIS) covers almost all Koreans. Furthermore, the National Health Screening Program for Infants and Children (NHSPIC) is a government-run, health-screening program for children aged < 6 years. We used the NHIS-Infants and Children's Health Screening cohort database to evaluate the incidence of preterm infants and ROP. The database contains data on 84,005 participants, drawn from 5% of the NHSPIC survey on participants born annually during 2008 to 2012. Sociodemographic factors and systemic diseases were assessed as potential risk factors for ROP. We identified 2615 premature infants (3.11%); 846 of them had ROP (cumulative incidence: 32.4%). Although preterm births increased annually in 2008 to 2012, the ROP incidence in preterm infants did not increase by the birth year. Twenty patients (2.4%) with ROP underwent laser photocoagulation or surgery. Extremely low birth weight was a high risk factor (odds ratio [OR] = 49.86, P < .001). Moreover, chorioamnionitis (OR = 2.77, P = .028), respiratory distress syndrome (OR = 4.09, P < .001), apnea (OR = 1.59, P = .008), anemia (OR = 2.41, P < .001), and intraventricular hemorrhage (OR = 2.34, P < .001) were found to be risk factors for ROP. In conclusion, the incidence of premature babies increased between 2008 and 2012. However, the overall incidence of ROP among premature infants remained unchanged by birth year. Our findings revealed the roles of birth weight, respiratory conditions, anemia, and intraventricular hemorrhage in ROP.

Risk Factors for Hydroxychloroquine Retinopathy and Its Subtypes

ImportanceThe major toxic effect of hydroxychloroquine is retinopathy. Thus, current guidelines recommend limiting the dose and screening annually for retinopathy among all long-term users, but individual patient factors may be associated with retinopathy risk.ObjectiveTo identify risk factors beyond hydroxychloroquine dose and duration of use for hydroxychloroquine retinopathy.Design, Setting, and ParticipantsThis cohort study of 4677 patients in the Kaiser Permanente Northern California integrated health network who initiated hydroxychloroquine, continued treatment, and underwent retinopathy screening after 5 years of use was conducted from July 1, 1997, to December 31, 2020, with up to 15 years of follow-up. Statistical analysis was performed in August 2023.ExposureCandidate risk factors included age at hydroxychloroquine initiation, sex, race and ethnicity, indications, chronic kidney disease (CKD), liver disease, diabetes, tamoxifen use, and medications that interact with hydroxychloroquine metabolism. Hydroxychloroquine dose was assessed from pharmacy dispensing records.Main Outcome and MeasuresIncident hydroxychloroquine retinopathy was adjudicated from masked review of guideline-recommended screening studies and classified as parafoveal or pericentral pattern. Multivariable Cox proportional hazards regression was used to assess potential risk factors for hydroxychloroquine retinopathy within 15 years of initiation.ResultsOf 4677 long-term hydroxychloroquine users (mean [SD] age at initiation, 52.4 [14.1] years; 3877 women [82.9%]), 125 patients developed hydroxychloroquine retinopathy within 15 years (102 parafoveal, 23 pericentral). Older age at time of hydroxychloroquine initiation was associated with retinopathy risk, with adjusted hazard ratios (HRs) of 2.48 (95% CI, 1.28-4.78) for those aged 45 to 54 years, 3.82 (95% CI, 2.05-7.14) for those aged 55 to 64 years, and 5.68 (95% CI, 2.99-10.79) for those aged 65 years or older compared with those younger than 45 years. The risk of retinopathy was higher among females than males (HR, 3.83 [95% CI, 1.86-7.89]), among patients with CKD stage 3 or greater (HR, 1.95 [95% CI, 1.25-3.04]), and among individuals with tamoxifen use (HR, 3.43 [95% CI, 1.08-10.89]). The likelihood of pericentral retinopathy was higher among Asian patients (HR, 15.02 [95% CI, 4.82-46.87]) and Black patients (HR, 5.51 [95% CI, 1.22-24.97]) compared with non-Hispanic White patients.Conclusions and RelevanceThis study suggests that increasing age, female sex, CKD stage 3 or greater, and tamoxifen use were associated with a higher risk of hydroxychloroquine retinopathy, whereas being younger than 45 years at hydroxychloroquine initiation and male sex were associated with a lower risk. Race and ethnicity were also associated with the pattern of retinopathy. These factors should be incorporated into hydroxychloroquine dosing decisions.

Systemic risk factors for diabetic retinopathy in patients with type 2 diabetes mellitus- A cross-sectional study in a South Indian cohort

Purpose: Diabetic retinopathy (DR) is a multifactorial disease. The objective of the current study was to evaluate the systemic risk factors for diabetic retinopathy in patients with type 2 DM in a South Indian Cohort. Materials and Methods: Design: Cross-sectional analytical. All participants fulfilling the eligibility criteria were recruited into two groups: with DR (Group 1) and without DR (Group 2). Both groups were compared for the risk factors using univariate and logistic regression analysis and adjusted Odds ratios (OR) were calculated. Patients in Group 1 were further divided into subgroups based on severity of DR and risk factors were analysed across the subgroups. Results: 93 patients were recruited in each group. Comparing Group 1 versus Group 2: On logistic regression analysis, factors like HbA1c &gt;8% (adjusted OR 7.1), duration &gt;10 years (adjusted OR 22.15), insulin treatment (adjusted OR 6.34), CKD (adjusted OR 12.18), and hypertension (adjusted OR 8.22) were associated with presence of any stage DR. Comparing risk factors across Group 1: HTN and insulin treatment were associated with severity of DR. Conclusion: Insulin treatment for type 2 DM was found to be an additional risk factor in our study. However, this finding needs to be further validated in future prospective cohort studies on larger sample sizes.

Profile and risk factors of sight-threatening retinopathy of prematurity: Experience from SNCU in North India.

This research aimed to identify the clinical profile and risk factors of retinopathy of prematurity (ROP) among "at-risk" newborns treated at a sick newborn care unit (SNCU) located at high altitude in North India, with the intention of contributing to formulate regional and national ROP screening guidelines. In a prospective observational study from 2021 to 2022, outborn and inborn babies eligible for ROP screening were screened. Total 39/122 screened neonates had laser for Type 1 ROP, and 22/39 (56.4%) had aggressive ROP (AROP). The average birth weight (BW) was 1803.87 g, and the average gestational age was 34 weeks. Respiratory distress, bronchopulmonary dysplasia, sepsis, and apnea were present in 57.3%, 13%, 52.5%, and 25.4%, respectively. Sight-threatening ROP was present in 50% below 28+6 weeks, 27% between 29 and 30+6 weeks, 52% between 31 and 33+6 weeks, and 15% with gestation >34 weeks. Two babies with Type 1 ROP weighed >2 kg and one had AROP. Upon regression analysis, BW <1500 g, gestation <32 weeks, oxygen >48 h, clinical sepsis, total SNCU stay >14 days, continuous positive airway pressure support with oxygen >50%, and >10 days to achieve full feeds were associated with severe ROP. Caffeine to treat apnea and kangaroo mother care reduced ROP. None had short-term unfavorable outcome. With similar infrastructure and work force shortage in most SNCUs, these findings can be generalized. The burden of Type 1 and AROP is increasing, as seen in higher gestation and BWs. This needs revision of ROP screening criteria at local and national level. It is crucial to emphasize on the importance of pediatrician and ophthalmologist collaboration, early ROP screening, diagnosis, and treatment to stop disease progression to severe ROP.

Risk factors for diabetic retinopathy, diabetic macular edema, and sight-threatening diabetic retinopathy

ObjectiveTo identify the risk factors for the development of diabetic retinopathy (DR), diabetic macular edema (DME), and sight-threatening DR (STDR) based on a city-wide diabetes screening program. Research design and methodsDiabetic patients were prospectively recruited between June 2016 and December 2022. All patients underwent dilated fundus photography centered on the disc and macula or macular spectral domain optical coherence tomography (SD-OCT) scan. Complete medical history was documented. Systematic examination, blood analysis, and urinalysis were performed. Multivariate logistic regression analysis adjusting for age and sex was conducted. ResultsOut of 7274 diabetic patients, 6840 had gradable images, among which 3054 (42.0%) were graded as DR, 1153 (15.9%) as DME, and 1500 (20.6%) as STDR. The factors associated with DR, DME, and STDR included younger age (odds ratio [OR]: 0.96, 0.97, and 0.96 respectively), lower BMI (OR: 0.97, 0.95, and 0.95 respectively), longer duration of diabetes (OR: 1.07, 1.03, and 1.05 respectively) and positive of urinary albumin (OR: 2.22, 2.56, and 2.88 respectively). Other associated factors included elevated blood urea nitrogen (OR: 1.22, 1.28, and 1.27 respectively), higher LDL-cholesterol, lower blood hemoglobin (OR: 0.98, 0.98, and 0.98), insulin intake, presence of diabetic foot pathologies and diabetic peripheral neuropathy. We also identified novel risk factors, including high serum potassium (OR: 1.37, 1.46, and 1.55 respectively), high-serum sodium (OR: 1.02, 1.02, and 1.04 respectively). Better family income was a protective factor for DR, DME, and STDR. Alcohol consumption once a week was also identified as a protective factor for DR. ConclusionsSimilar risk factors for DR, DME, and STDR were found in this study. Our data also indicates high serum sodium, high serum potassium, low blood hemoglobin, and level of family income as novel associated factors for DR, DME, and STDR, which can help with DR monitoring and management.

Nutritional interventions to prevent retinopathy of prematurity.

Very preterm infants are at high risk of growth failure. Poor weight gain is a prominent risk factor for retinopathy of prematurity (ROP) and optimizing nutrition could potentially promote growth and reduce ROP. Most infants at risk of ROP need parenteral nutrition initially and studies of enhanced parenteral provision of lipids and amino acids have suggested a beneficial effect on ROP. Higher amino acid intake was associated with lower incidence of hyperglycemia, a risk factor for ROP. For very preterm infants, providing unpasteurized fortified raw maternal breast milk appears to have a dose-dependent preventive effect on ROP. These infants become deficient in arachidonic acid (ArA)and docosahexaenoic acid(DHA) after birth when the maternal supply is lost. Earlier studies have investigated the impact of omega-3 fatty acids on ROP with mixed results. In a recent study, early enteral supplementation of ArA 100 mg/kg/d and DHA 50 mg/kg/d until term equivalent age reduced the incidence of severe ROP by 50%. IMPACT: Previous reviews of nutritional interventions to prevent morbidities in preterm infants have mainly addressed bronchopulmonary dysplasia, brain lesions and neurodevelopmental outcome. This review focusses on ROP. Neonatal enteral supplementation with arachidonic acid and docosahexaenoic acid, at levels similar to the fetal accretion rate, has been found to reduce severe ROP by 50% in randomized controlled trials.

Prediction and analysis of risk factors for diabetic retinopathy based on machine learning and interpretable models

ObjectiveDiabetic retinopathy is one of the major complications of diabetes. In this study, a diabetic retinopathy risk prediction model integrating machine learning models and SHAP was established to increase the accuracy of risk prediction for diabetic retinopathy, explain the rationality of the findings from model prediction and improve the reliability of prediction results. MethodsData were preprocessed for missing values and outliers, features selected through information gain, a diabetic retinopathy risk prediction model established using the CatBoost and the outputs of the mode interpreted using the SHAP model. ResultsOne thousand early warning data of diabetes complications derived from diabetes complication early warning dataset from the National Clinical Medical Sciences Data Center were used in this study. The CatBoost-based model for diabetic retinopathy prediction performed the best in the comparative model test. ALB_CR, HbA1c, UPR_24, NEPHROPATHY and SCR were positively correlated with diabetic retinopathy, while CP, HB, ALB, DBILI and CRP were negatively correlated with diabetic retinopathy. The relationships between HEIGHT, WEIGHT and ESR characteristics and diabetic retinopathy were not significant. ConclusionThe risk factors for diabetic retinopathy include poor renal function, elevated blood glucose level, liver disease, hematonosis and dysarteriotony, among others. Diabetic retinopathy can be prevented by monitoring and effectively controlling relevant indices. In this study, the influence relationships between the features were also analyzed to further explore the potential factors of diabetic retinopathy, which can provide new methods and new ideas for the early prevention and clinical diagnosis of subsequent diabetic retinopathy.

Epidemiology and risk factors of diabetic retinopathy in upper Egypt: a 3-year prospective study

Objective To determine the prevalence and risk factors of diabetic retinopathy (DR) in adult diabetic patients during 3 years. Patients and methods This is a cross-sectional study that was carried out on the adult diabetic population who attended a large private referral ophthalmology center in Assiut City, Upper Egypt for 3 years. All cases were subjected to full history taking, ophthalmological examination, and dilated fundus examination for evidence of DR, and besides, the associated systemic complications were assessed. Results The study included a total of 2178 cases and the prevalence of DR was 18.2%. DR was more prevalent in females than males (67.9% vs. 32.1%). Also, DR was significantly associated with insulin use, moderate and poor control of diabetes mellitus, uncontrolled hypertension (HTN), dyslipidemia, and nephropathy (P&lt;0.01 for all). The risk factors for DR were; older age (adjusted odds ratio (AOR) 1.69; 95% CI =0.91–1.97; P≤0.01), female sex (AOR 1.65; 95% CI =1.21–1.86; P =0.02), smoking (AOR 1.73; 95% CI =1.41–2.11; P =0.02), longer duration of DM (&gt; 15 years) (AOR 2.87; 95% CI =2.48–3.29; P ≤0.01), insulin use (AOR 1.42; 95% CI =0.94–1.65; P=0.03), poor control of DM (AOR 3.98; 95% CI =3.69–5.41; P≤0.01), presence of HTN (AOR 2.62; 95% CI =2.37–2.89; P≤0.01) and dyslipidemia (AOR 1.65; 95% CI =1.42–2.02; P=0.03). Conclusion The prevalence of DR in adult diabetic patients was 18.2% and the significant risk factors for DR (arranged descendingly in power) were; poor control of DM, longer duration of DM (&gt; 15 years), presence of HTN, smoking, high age, dyslipidemia, female sex, and insulin use.

Risk factors for diabetic retinopathy: a case-control study

Purpose To emphasize the severity of the issue, it is crucial to recognize that diabetic retinopathy (DR) is not only the biggest contributor to blindness in India, but it is also becoming increasingly prevalent with each passing day. This study offers information from a matched case-control study conducted in an Indian tertiary care hospital on several risk factors for DR. The objective of the investigation is to identify the primary diabetes mellitus (DM) risk factors and the amount by which they influence diabetes pathogenesis. Methods The outpatient and inpatient departments participated in a matched research study. Diabetics with DR were included among the patients, while diabetics without DR were included in the controls. Before performing structured interviews, a total of 252 people (126 cases and 126 controls) were recruited and matched for age (±2 years) and sex. Results The average age in the DR and non-DR categories was 63.7 9.5 years and 63.3 10.4 years, respectively. Smoke (OR=1.92, P=0.02), alcoholism (OR=2.62, P=0.03), a poor diet (OR=2.72, P=0.0008), nonadherence to dietary advice (OR=4.41, P=0.0001), other microvascular disorders (OR=3.79, P=0.0001), dyslipidaemia (OR=1.85, P=0.0), and hypertension (OR=5.91, P=0.0001). Drug abnormalities (adjusted odds ratio (AOR)=7.89, P=0.0001) and hypertension (AOR=1.16, P=0.0001) were indicated as risk factors for the development of DR in multivariate regression research. Conclusion According to our findings, DM with inconsistent anti-diabetic drug use and hypertension are more likely to acquire DR. Modifiable risk factors for DR include insulin, physical inactivity, dyslipidemia, alcoholism, and smoking. With the increasing frequency of DR educating DM about lifestyle changes that may minimize their risk of developing DR is more critical than ever.

Frequency and risk factors of retinopathy of prematurity: a 5-year single-center study in a Tertiary Care Hospital

Aim Our study aimed to determine the frequency of retinopathy of prematurity (ROP) in a cohort of premature infants screened for ROP, to confirm the efficacy of our screening program used in the NICU to avoid childhood blindness. In addition, we aimed to study the associated risk factors affecting ocular status including birth weight (BW), gestational age (GA), mechanical ventilation, length of intensive care unit (ICU) stay, and number of ROP follow-up. Methods This was a retrospective cohort study conducted from March 2016 to March 2021. Data were retrieved from the records of preterm infants admitted to the neonatal intensive care unit in King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia. The included data: Comprised perinatal data such as sex, BW, GA, multifetal gestation, and delivery type. Neonatal course: Need for surfactant, oxygen therapy, and mechanical ventilation (MV) duration. Neonatal complications: Chronic lung diseases [(respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD)], sepsis, neonatal jaundice, patent ductus arteriosus (PDA), hydrocephalus, and intraventricular hemorrhage (IVH). ROP examination: stage, zone, plus disease, extent, treatment, and number of the follow-up. Results In all, 337 preterm infants met the screening criteria and were included in the study. The majority (52%, n=177) were male; 148 (43.9%) were products of multifetal gestation, the mean GA was 29.35±2.77, and the median BW was 1195.1±338 gm. Caesarean section was the main mode of delivery in 80.5% of our sample (269 babies). ROP was detected in 181 (53.7%) infants, of which 110 (32.6%) had Stage 1, 57 (17%) Stage 2, and 14 (4.15%) had Stage 3. The majority (89.4%) were involved in zone 2–3, and five patients had the plus disease (1.48%). The number of ROP follow-up ranged between 2 and 25 visits either in the NICU or in the eye clinic following their discharge with a mean of 2.347. Conclusion The incidence of ROP in our sample was high relative to other local studies, which was related to the relatively high number of multifetal gestations with high chance of low birth weight as our center is an expert facility in in vitro fertilization. Male patient had a high incidence of development of different stages of ROP. Preterm babies with complicated neonatal course like NEC, Chronic Lung Disease, and IVH had high incidence of development of ROP.

Associations between lipid abnormalities and diabetic retinopathy across a large United States national database.

While dyslipidaemia has been suggested as a potential risk factor for diabetic retinopathy (DR), previous studies have reported conflicting findings. This study aimed to better characterize the relationship between abnormal serum levels of various lipid markers and the risk of the development and progression of DR. This retrospective cohort study utilized a United States national database of electronic medical records. Adults with a history of type 2 diabetes mellitus without type 1 diabetes mellitus were divided into cohorts based on the presence of abnormal serum levels of various lipid markers. Propensity score matching was performed to match cohorts with abnormal lipid levels to those with normal lipid levels on covariates. The cohorts were then compared to evaluate the hazard ratios (HR) of receiving a new DR diagnosis, pars plana vitrectomy, panretinal photocoagulation, vitreous haemorrhage, proliferative diabetic retinopathy, diabetic macular oedema (DMO), and traction retinal detachment. The database contained 1,126,231 eligible patients (mean age: 60.8 [14.2] years; 46.0% female). Among patients without prior DR, low HDL (HR = 0.94, CI = 0.90-0.98), total cholesterol (HR = 0.88, CI = 0.85-0.91), and high triglyceride (HR = 0.91, CI = 0.86-0.97) levels were associated with a decreased risk of receiving a DR diagnosis. Among patients with preexisting DR, high LDL levels was associated with an increased risk of DMO (HR = 1.42, CI = 1.15-1.75), whereas low HDL levels was associated with a marginally decreased risk (HR = 0.92, CI = 0.85-0.99). Elevated levels of markers of dyslipidaemia are inversely associated with the risk of receiving a DR diagnosis, but this relationship is blunted after the onset of DR.

Statins as a risk factor for diabetic retinopathy: a Mendelian randomization and cross-sectional observational study

BackgroundDiabetic retinopathy (DR) is the foremost cause of vision loss among the global working-age population, and statins are among the most frequently prescribed drugs for lipid management in patients with DR. The exact relationship between statins and DR has not been determined. This study sought to validate the causal association between statins usage and diabetic retinopathy.MethodsThe summary-data-based Mendelian randomization (SMR) method and inverse-variance-weighted Mendelian randomization (IVW-MR) were used to identify the causal relationship between statins and DR via the use of expression quantitative trait loci (eQTL) data for 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) (31,684 blood samples), low density lipoprotein cholesterol-related GWAS data (sample size: 440,546), and DR-related GWAS data (14,584 cases and 176,010 controls). Additionally, a cross-sectional observational study based on the data from the National Health and Nutrition Examination Survey (NHANES) was conducted to supplement the association between DR and statins (sample size: 106,911). The odds ratios (ORs) with corresponding 95% confidence intervals (CIs) was employed to evaluate the results.ResultsBased on the results of the MR analysis, HMGCR inhibitors were causally connected with a noticeably greater incidence of DR (IVW: OR = 0.54, 95% CI [0.42, 0.69], p = 0.000002; SMR: OR = 0.66, 95% CI [0.52, 0.84], p = 0.00073). Subgroup analysis revealed that the results were not affected by the severity of DR. The sensitivity analysis revealed the stability and reliability of the MR analysis results. The results from the cross-sectional study based on NHANES also support the association between not taking statins and a decreased risk of DR (OR = 0.54, 95% CI [0.37, 0.79], p = 0.001).ConclusionsThis study revealed that a significant increase in DR risk was causally related to statins use, providing novel insights into the role of statins in DR. However, further investigations are needed to verify these findings.

TCERG1L hypermethylation is a risk factor of diabetic retinopathy in Chinese children with type 1 diabetes.

To identify the differential methylation sites (DMS) and their according genes associated with diabetic retinopathy (DR) development in type 1 diabetes (T1DM) children. This study consists of two surveys. A total of 40 T1DM children was included in the first survey. Because no participant has DR, retina thinning was used as a surrogate indicator for DR. The lowest 25% participants with the thinnest macular retinal thickness were included into the case group, and the others were controls. The DNA methylation status was assessed by the Illumina methylation 850K array BeadChip assay, and compared between the case and control groups. Four DMS with a potential role in diabetes were identified. The second survey included 27 T1DM children, among which four had DR. The methylation patterns of the four DMS identified by 850K were compared between participants with and without DR by pyrosequencing. In the first survey, the 850K array revealed 751 sites significantly and differentially methylated in the case group comparing with the controls (|Δβ|>0.1 and Adj.P<0.05), and 328 of these were identified with a significance of Adj.P<0.01. Among these, 319 CpG sites were hypermethylated and 432 were hypomethylated in the case group relative to the controls. Pyrosequencing revealed that the transcription elongation regulator 1 like (TCERG1L, cg07684215) gene was hypermethylated in the four T1DM children with DR (P=0.018), which was consistent with the result from the first survey. The methylation status of the other three DMS (cg26389052, cg25192647, and cg05413694) showed no difference (all P>0.05) between participants with and without DR. The hypermethylation of the TCERG1L gene is a risk factor for DR development in Chinese children with T1DM.

Serum vitamin D is substantially reduced and predicts flares in diabetic retinopathy patients.

Research has suggested that vitamin D deficiency is associated with diabetic retinopathy (DR). Our study aimed to determine whether vitamin D deficiency is the cause of diabetic retinopathy or if diabetic retinopathy reduces vitamin D levels. Participants with type-2 diabetes were recruited for this prospective observational clinical study and were divided into a diabetic group without retinopathy and a diabetic group with retinopathy, with additional healthy volunteers serving as a control group. The differences in clinical characteristics among the three groups were also compared. Patients without retinopathy were then followed for 1 year to monitor the incidence of diabetic retinopathy. After follow-up, participants were divided into subgroups based on whether diabetic retinopathy occurred. The baseline data of the subgroups were compared, and the independent risk factors were analyzed. Vitamin D levels were generally low. Participants with diabetic retinopathy had significantly lower vitamin D levels than did those without retinopathy (P < 0.01). A comparison of the two subgroups revealed lower baseline vitamin D concentrations in the new-DR subgroup than in the non-DR subgroup (P < 0.01). Vitamin D deficiency and elevated HbA1c levels were found to be independent risk factors for diabetic retinopathy (OR = 0.935, 95% CI: 0.867-0.981, P = 0.006; OR = 2.208, 95% CI: 1.764-2.764, P < 0.01). The limit of vitamin D intake according to the receiver-operating characteristic (ROC) curve was 26.01 ng/mL, and the area under the ROC curve was 0.603 (95% CI: 0.559-0.706, P = 0.002). Vitamin D levels were significantly lower in patients diagnosed with diabetic retinopathy. More importantly, vitamin D deficiency may accelerate the onset of diabetic retinopathy.

Risk Factors for Retinopathy of Prematurity in Preterm Infants in Kerman, Iran.

Retinopathy of prematurity (ROP) is the main cause of blindness in premature infants. Despite developments in neonatal care and management guidelines, ROP is becoming increasingly prevalent worldwide. Hence, the identification of risk factors for ROP is critical to diminish the burden of the disease. This cross-sectional study included all infants with gestational age 36 weeks referred to the ophthalmology clinic at Shafa hospital, Kerman, Iran from 2014 to 2015. Ophthalmologic examinations were performed followed by demographic and ophthalmic data collection and analysis. A total of 579 preterm neonates were screened including 325 boys and 254 girls. The incidence of ROP was 17.96%. Mean birth weight (BW) and gestational age (GA) were 1668.0 grams and 31.2 weeks, respectively. The results indicated that BW, GA, duration of hospitalization and oxygen therapy were significantly related to the development of ROP, however, after multivariate logistic regression analysis, only BW and duration of hospitalization remained significant. There were no significant associations between gender, type of delivery, or assisted reproductive technologies, and ROP (P = 0.461, 0.461, and 0.826, respectively). BW and duration of hospitalization were significant risk factors for ROP in the current study. BW was also strongly associated with the need for therapy.

IDF23-0018 Elevated Non-HDL Cholesterol Levels as A Risk Factor for Diabetic Retinopathy Among Type 2 Diabetes Mellitus Patients

IDF23-0018 Elevated Non-HDL Cholesterol Levels as A Risk Factor for Diabetic Retinopathy Among Type 2 Diabetes Mellitus Patients

Prevalence of Diabetic Retinopathy in Diabetic Subjects Visiting Diabetic Centers of Lahore, Pakistan

One of the chronic illnesses with the highest rate of growth in the globe and a major contributor to acquired visual loss is diabetes mellitus (DM). Globally, diabetic retinopathy (DR), a particular microvascular consequence of DM, continues to be the primary cause of acquired visual loss. Objective: To ascertain the percentage prevalence of diabetic retinopathy in diabetic subjects and the relationship between diabetic retinopathy and potential risk factors. Methods: This study was conducted at Services Hospital, Lahore. The time duration of study was from November 2018 to June 2019. The patients were asked to fill a designed questionnaire which contained questions regarding patient’s demographic data, habits and history about the disease. Results: A total of 1000 diabetic patients were enrolled and among them 511 (51.1%) had diabetic retinopathy. Among 369 males, 173 (46.9%) males had diabetic retinopathy and among 631 females, 338 (53.6%) females had diabetic retinopathy. The mean age of studied population was 53.77±0.35 years. Logistic regression model indicated that age (years), gender, systolic blood pressure (mmHg), diastolic blood pressure (mmHg), HbA1c level (mmol/L), span of diabetes (years), family history of diabetes, sedentary lifestyle were the risk factors for incidence of diabetic retinopathy in this study. Conclusions: The occurrence of DR is high in the studied population. Age (years), span of diabetes (years), HbA1c level (mmol/L) and not doing exercise were seen to be exhibiting more important role towards the development of diabetic retinopathy.

Comparative analysis of risk factors for retinopathy of prematurity in single and multiple birth neonates

AimTo conduct a comparative analysis of risk factors for retinopathy of prematurity (ROP) in single- and multiple-born neonates.MethodsIn a retrospective evaluation of 521 premature neonates, encompassing singletons, twins, and triplets born at or before 34 weeks of gestational age with a birthweight of less than 2000 g and who completed the ROP screening program, between 2020 and 2023, in outpatient referral ROP screening clinic affiliated by Shiraz University of Medical Sciences, were included. Neonates with the eligibility criteria were enrolled in the screening program from 28 days old age and followed up to discharge or treatment based on national ROP screening guideline. Data on ROP severity, outcome, treatment modality, and risk factors, including gestational age (GA), birth weight (BW), sex, duration of neonatal intensive care unit (NICU) admission, oxygen supplementation, mechanical ventilation, blood transfusion, method of delivery, and maternal and neonatal comorbidities, were extracted and compared between premature neonates from singleton and multiple births.Results The analysis of the ROP severity distribution revealed 238 neonates (45.7%) with low-risk (type 2 prethreshold ROP or less severe) ROP and 16 (3.1%) with high-risk (type I prethreshold ROP or more severe) ROP who underwent treatment. According to the comparative analysis of risk factors in neonates with ROP requiring treatment, multiple birth neonates exhibited significantly greater GA (27.50 ± 3.27 vs. 30.00 ± 2.00 vs. 31.14 ± 0.38 weeks, p = 0.032 for singletons, twins and triplets, respectively); greater BW (861.67 ± 274.62 vs. 1233.33 ± 347.75 vs. 1537.14 ± 208.86 g, p = 0.002); and shorter duration of NICU admission (60.17 ± 21.36 vs. 34.00 ± 12.17 vs. 12.00 ± 6.32 days, p = 0.001) and oxygen supplementation (47.33 ± 16.57 vs. 36.00 ± 8.49 vs. 4.60 ± 2.41 days, p = 0.001). There was no significant difference between single-born neonates and multiple-born neonates regarding the prevalence of other risk factors. Multiple-born neonates with no ROP and low risk ROP showed significantly lower GA and BW compared to singletons (p < 0.001).ConclusionMultiple gestation neonates may develop high-risk ROP requiring treatment at a greater gestational age and birth weight and at a lower duration of oxygen supplementation and NICU admission compared to the single birth neonates. This pattern prompts a reevaluation of screening criteria, suggesting a potential need to consider multiple birth neonates with lower traditional risk factors in screening programs. This pattern should be further evaluated in larger populations of multiple born premature neonates.

Systemic risk factors of retinopathy in patients with systemic lupus erythematosus.

To investigate the risk factors of lupus retinopathy (LR) in patients with systemic lupus erythematosus (SLE). This is a retrospective, cross-sectional study. LR patients admitted at Peking Union Medical College Hospital from June 2013 to April 2023 were reviewed. Age- and gender-matched SLE patients without retinopathy were selected as controls. Medical records including clinical manifestations, laboratory data and ophthalmic examination were collected. Univariate and multivariate logistic regression analyses were conducted. One hundred and twelve LR patients (198 eyes) were included, with 12 cases (14 eyes) presenting with retinal macrovascular obstruction, and 100 cases (184 eyes) only exhibiting microvasculopathy. Multivariate analysis indicated the presence of haemolytic anaemia, decreased haemoglobin (HGB) and higher relative percentage of neutrophils were independent risk factors for LR (p < 0.05). The first two were also risk factors for retinal microvasculopathy, whereas secondary antiphospholipid syndrome (APS) was for macrovascular obstruction. In male group, LR had significant associations with decreased HGB, no matter which types of retinopathy (p < 0.05). In female group, LR was significantly associated with haemolytic anaemia, presence of antiphospholipid antibodies, decreased white blood cells and relative high percentage of neutrophils. Specifically, haemolytic anaemia (p = 0.002) was significantly associated with retinal microvasculopathy, and APS (p = 0.003) was significantly associated with macrovasculature obstruction. LR was related to haemolytic anaemia, decreased HGB levels and higher percentage of neutrophils. Retinal microvasculopathy accounted for most cases and macrovasculature obstructions were rare. Male and female patients have distinct risk factors. Early ophthalmic screening is recommended especially for those with risk factors of LR.