title: Diabetic retinopathy in tessellated fundus.
abstract: BACKGROUND
  Duration of diabetes, poor control, age of the patient, frequent hypoglycemia, hypercholesterolemia, over-weight, smoking, alcohol, renal failure and pregnancy have all been suggested as factors which may influence the onset of diabetic retinopathy. However, there are cases without retinopathy in spite of duration of 30 to 40 years of diabetes and presence of one or other above mentioned risk factors, suggesting role of local factors to prevent angiopathy.Our study aims to assess whether tessellated fundus is a protective factor for diabetic retinopathy.
  
  
  METHODS
  This was hospital based descriptive study. The patients included in the study were 40 years and above having diabetes for 10 years and beyond. Diabetic retinopathy was graded following Early treatment Diabetic retinopathy Study.
  
  
  RESULTS
  Tigroid fundus was negatively associated with diabetic retinopathy (OR 0.49 with 95% confidence interval 0.21-1.11) and maculopathy (OR 0.43 with 95% confidence interval 0.15-1.3). Age 40-50 years (OR 0.67 with 95% confidence interval 0.24-1.83), female gender (OR 0.71 with confidence interval 0.31-1.61), HbA1c <6.5(OR 0.36 with confidence interval 0.99-1.31) and duration 10-15 years of onset of diabetes (OR 0.58 with confidence interval 0.22-1.37) was negatively associated with diabetic retinopathy in tigroid fundus diabetics. Age 40-50 years (OR 2.12 with confidence interval 0.43-10.5), female gender (OR 2.51 with confidence interval 0.38-10.88), HbA1c<6.5 (OR 3.12 with confidence interval 0.59-16.58) and duration 10-15 years of onset of diabetes (OR 1.5 with confidence interval 0.1-18.54) was positively associated with retinopathy in non-tigroid fundus.
  
  
  CONCLUSIONS
  Tessellated fundus was observed as decreased risk for the development of diabetic retinopathy and maculopathy.
authors.affiliation: Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Pokharel
authors.affiliation: Depatment of Ophthalmology, National Academy of Medical Sciences, Nepal.
authors.forename: D
authors.initials: D
authors.lastname: Sherpa
authors.affiliation: Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Nepal.
authors.forename: R
authors.initials: R
authors.lastname: Shrestha
authors.affiliation: Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Nepal.
authors.forename: O K
authors.initials: OK
authors.lastname: Malla
authors.affiliation: Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Nepal.
authors.forename: C L
authors.initials: CL
authors.lastname: Pradhananga
authors.affiliation: Department of Ophthalmology, Kathmandu Medical College Teaching Hospital, Nepal.
authors.forename: R P
authors.initials: RP
authors.lastname: Pokhrel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015862:Choroid Diseases / Q000150:complications*; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009390:Nepal; D015995:Prevalence; D012160:Retina / Q000503:physiopathology; D055213:Retinal Pigment Epithelium / Q000378:metabolism; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014792:Visual Acuity
chemical_list: D006442:Glycated Hemoglobin