Diabetic Nephropathy in Type 2 Diabetic Retinopathy Requiring Panretinal Photocoagulation
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Purpose: To investigate the risk factors of diabetic nephropathy in patients with diabetic retinopathy requiringpanretinal photocoagulation (PRP) and the visual prognosis. Methods: A retrospective review of electronic medical records was conducted at Seoul St. Mary’s Hospital,comprising 103 patients with type 2 diabetes mellitus and diabetic retinopathy who underwent PRP from1996 to 2005. Patients with type 1 diabetes mellitus, non-diabetic renal disease, non-diabetic retinal disease,visually significant ocular disease, high-risk proliferative diabetic retinopathy, and advanced diabeticretinopathy were excluded. The patients were divided into three groups: no nephropathy (group 1, n = 45),microalbuminuria (group 2, n = 16), and advanced nephropathy (group 3, n = 42). Duration of diagnosis of retinopathyand nephropathy, glycosylated hemoglobin, visual acuity, complications, and treatment history wereinvestigated. Results: The mean glycosylated hemoglobin of group 3 (8.4 ± 1.2) was higher than that of group 1 (7.7 ± 1.0)or group 2 (7.7 ± 1.0) (p = 0.04). Mean interval from PRP to diagnosis of nephropathy was 8.8 ± 6.0 years ingroup 2 and 8.7 ± 4.9 years in group 3. The significant decrease in visual acuity in group 3 (28 eyes, 35.9%)was significantly higher than that in group 1 (15 eyes, 18.1%, p = 0.01) or group 2 (6 eyes, 20.7%, p = 0.03). Only vitreous hemorrhage showed a significantly higher incidence in groups 2 and 3 than in group 1 (p = 0.02). Multivariate regression analysis revealed that female sex and lower glycosylated hemoglobin were significantlyassociated with a protective effect on development of nephropathy. Conclusions: In the clinical setting, many patients with PRP-requiring diabetic retinopathy develop nephropathyan average of 8 to 9 years after PRP. Male sex and higher glycosylated hemoglobin could be risk factorsof nephropathy.
Abstract
Purpose: To investigate the risk factors of diabetic nephropathy in patients with diabetic retinopathy requiringpanretinal photocoagulation (PRP) and the visual prognosis. Methods: A retrospective review of electronic medical records was conducted at Seoul St. Mary’s Hospital,comprising 103 patients with type 2 diabetes mellitus and diabetic retinopathy who underwent PRP from1996 to 2005. Patients with type 1 diabetes mellitus, non-diabetic renal disease, non-diabetic retinal disease,visually significant ocular disease, high-risk proliferative diabetic retinopathy, and advanced diabeticretinopathy were excluded. The patients were divided into three groups: no nephropathy (group 1, n = 45),microalbuminuria (group 2, n = 16), and advanced nephropathy (group 3, n = 42). Duration of diagnosis of retinopathyand nephropathy, glycosylated hemoglobin, visual acuity, complications, and treatment history wereinvestigated. Results: The mean glycosylated hemoglobin of group 3 (8.4 ± 1.2) was higher than that of group 1 (7.7 ± 1.0)or group 2 (7.7 ± 1.0) (p = 0.04). Mean interval from PRP to diagnosis of nephropathy was 8.8 ± 6.0 years ingroup 2 and 8.7 ± 4.9 years in group 3. The significant decrease in visual acuity in group 3 (28 eyes, 35.9%)was significantly higher than that in group 1 (15 eyes, 18.1%, p = 0.01) or group 2 (6 eyes, 20.7%, p = 0.03). Only vitreous hemorrhage showed a significantly higher incidence in groups 2 and 3 than in group 1 (p = 0.02). Multivariate regression analysis revealed that female sex and lower glycosylated hemoglobin were significantlyassociated with a protective effect on development of nephropathy. Conclusions: In the clinical setting, many patients with PRP-requiring diabetic retinopathy develop nephropathyan average of 8 to 9 years after PRP. Male sex and higher glycosylated hemoglobin could be risk factorsof nephropathy.
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