Prevalence and characteristics of primary open-angle glaucoma in patients with diabetic retinopathy in type 2 diabetes mellitus
Keywords:diabetic retinopathy, primary open-angle glaucoma, type 2 diabetes mellitus, prevalence
Background. Numerous literature data made it possible to establish the dependence of primary open-angle glaucoma (POAG) in patients with diabetic retinopathy (DR) on type 2 diabetes mellitus (DM2). The purpose was to determine the prevalence and characteristics of primary open-angle glaucoma in patients with diabetic retinopathy in type 2 diabetes mellitus. Material and methods. One thousand four hundred and fifty patients with DM2 were examined, in whom the stage of DR was determined according to the classification of American Academy of Ophthalmology (2002). POAG stage was established according to the classification of A.P. Nesterov and A.Ya. Bunin (1976) and classification of perimetric changes by glaucoma stages. The age of patients, 970 (66.9 %) men and 480 (33.1 %) women, was from 45 to 75 years. The duration of DM2 was from 2 to 15 years. For statistical studies, MedStat and MedCalc v.15.1 (Medcalc Software bvba) were used. Results. In patients with DM2 and DR of different stages, the prevalence of POAG amounted to 20.8 %, which is 4–6 times higher than in the general population. Among individuals with DR stage I (no retinopathy), 71.6 % had POAG stage I and II, among patients with non-proliferative DR, 87.6 % had stages II and III, and among those with proliferative DR, 78.4 % had stages III and IV. Among all patients with DR and POAG, the proportion of normal tension glaucoma was 18.6 %, which did not differ from that in POAG without DM2. 42.9 % of patients initially had the development of DM2 in past medical history, joined by POAG in 1–7 years, and 57.1 % first had POAG, joined by DM2 in 1–8 years. Depending on the duration of the disease, the severity of both DR and POAG increased, which indicated the dependence of DR and POAG severity on disease duration and acceleration of their development if they combined. Conclusions. The results of the study confirmed the wider prevalence and mutual burden of DR course in DM2 and POAG, which justifies the need to study the general mechanisms of their pathogenesis.
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