title: Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal.
abstract: BACKGROUND
  Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics.
  
  
  OBJECTIVE
  to study the systemic association of proliferative diabetic retinopathy.
  
  
  METHODS
  A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classified using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid profile, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.
  
  
  RESULTS
  A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.
  
  
  CONCLUSIONS
  Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.
authors.affiliation: Tilganga Institute of Ophthalmology, Kathmandu, Nepal.
authors.forename: R
authors.initials: R
authors.lastname: Thapa
authors.forename: S
authors.initials: S
authors.lastname: Bajimaya
authors.forename: S
authors.initials: S
authors.lastname: Sharma
authors.forename: B B
authors.initials: BB
authors.lastname: Rai
authors.forename: G
authors.initials: G
authors.lastname: Paudyal
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000209:etiology*; D050171:Dyslipidemias / Q000150:complications / Q000175:diagnosis; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006782:Hospitals, Special; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D008055:Lipids / Q000097:blood; D008269:Macular Edema / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis; D012307:Risk Factors; D062606:Tertiary Care Centers
chemical_list: D001786:Blood Glucose; D003404:Creatinine; D006442:Glycated Hemoglobin; D008055:Lipids; C517652:hemoglobin A1c protein, human