title: Comparative evaluation of ophthalmoscopy and angiography for the assessment of retinopathy in type 2 diabetes mellitus.
abstract: Diabetic retinopathy (DR) is emerging as a common cause of visual loss. This study was aimed at comparing the relative utility of fundus fluorescein angiography (FFA) with ophthalmoscopy (OPT) in its diagnosis with a cross-sectional cohort. A total of 100 patients of type 2 diabetes mellitus was divided into 3 groups depending on the duration from initial diagnosis and matched by important risk factors. Group A was < 5 years duration and had 31 patients; group B ranged between 5 and 15 years and had 40 patients; and group C were > 15 years with 29 patients. Parameters compared were: Normal retina (NR), background diabetic retinopathy (BDR), preproliferative diabetic retinopathy (PPR), proliferative diabetic retinopathy (PDR); and clinically significant maculopathy (MAC). Dye leakage (DL) and micro-aneurysms (MA) were assessed separately as they are recognised early markers of DR. Result analysis revealed that FFA is well correlated with OPT (0.99) for all groups except group A, where DL (35.5%) played a significant role in altering the correlation (0.85 versus 0.98--OPT versus FFA); 8% of total patients revealed a worse grade with FFA compared to OPT, so appropriate grading of retinopathy is better with FFA at any duration. Less severe varieties of DR predominate in all the groups (BDR-77.4%, 80%, 24.1% respectively), more severe varieties dominate in group C (17.2% and 58.6% of PPR and PDR respectively). MAC is present significantly in group C. FFA is strongly advised, at least in the high-risk groups, at initial diagnosis for detection of DL and also appropriate grading. OPT is a simple and adequate option beyond 5 years of duration. OPT is as good as FFA for the diagnosis of MAC.
authors.affiliation: Department of Medicine, NRS Medical College, Kolkata 700014.
authors.forename: Samar
authors.initials: S
authors.lastname: Banerjee
authors.forename: Uday Sankar
authors.initials: US
authors.lastname: Ghosh
authors.forename: Goutam
authors.initials: G
authors.lastname: Biswas
authors.forename: Sankha Jyoti
authors.initials: SJ
authors.lastname: Saha
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D011237:Predictive Value of Tests; D017064:Process Assessment, Health Care; D011446:Prospective Studies; D012160:Retina / Q000473:pathology