Retinopathy in Type 2 Diabetes With Microalbuminuria

1. S C Reddy
2. Y M Khin
3. M I Nurjahan
4. A Ramli

1. Dept. of Ophthalmology, International Medical University Clinical School,
Seremban, Malaysia, # Dept. of Ophthalmology, UCSI School of medicine, KT
campus, Marang, Malaysia
2. Dept. of Internal Medicine, International Medical University Clinical School,
Seremban, Malaysia
3. Dept. of Family Medicine, International Medical University Clinical School,
Seremban, Malaysia.
4. Klinik Kesihatan, Ministry of Health Malaysia, Seremban, Malaysia.

Purpose: To determine the prevalence of retinopathy and its association with risk
factors in type 2 diabetes patients with microalbuminuria (nephropathy).

Methods: Fundus examination was done with direct ophthalmoscope after dilating the pupils. Retinal changes were graded as no retinopathy, background retinopathy, preproliferative retinopathy, proliferative retinopathy and maculopathy. The association of risk factors (duration and control of diabetes, hypertension, hyperlipidemia, smoking, obesity) were evaluated with prevalence of retinopathy.

Results: The mean age of 137 patients examined (from September 2006 to February 2008) was 58 years (range 35 -79 years). The mean durationof diabetes was 9.5 years (range 1-37 years). Diabetic retinopathy was seen in 50 (36.5%) patients --- background 37 (27%), preproliferative 3 ( 2.2%) and proliferative 10 (7.3%).

Maculopathy was noted in 17 out of 50 (34%) retinopathy cases. Duration of diabetes (p=0.002), control of diabetes (p=0.002), hypertension (p=0.03), and neuropathy (p=0.001) were significantly associated with retinopathy in t hese patients. However, gender (p=0.52), race (p=0.73), hyperlipidemia (p=0.29), smoking (p=0.43) and obesity (p=0.43) were not significantly associated with retinopathy.

Conclusion: All diabetic patients with microalbuminuria should undergo fundus
examination at regular intervals so that retinopathy can be diagnosed early and treated (if necessary) to prevent blindness.