medigraphic.com

2004, Number 3

<< Back Next >>

Cir Cir 2004; 72 (3)

Lens opacity in diabetics. Prevalence and association to visual deficiency and retinopathy

Lima-Gómez V, Ríos-González LC

Language: Spanish
References: 22
Page: 171-175
PDF size: 65.80 Kb.


ABSTRACT

Introduction: Prevalence of lens opacity (LO) and its association with visual deficiency (VD, visual capacity < 20/40) and diabetic retinopathy (DR) were identified in diabetic patients to estimate rate of patients in whom VD could be lowered by surgery and whether DR rate was higher in patients with LO. Materials and methods: Type 2 diabetics without prior ophthalmic examination were evaluated; rate of LO was determined and compared with those previously reported by z for rates. Patients with LO were assigned to group 1 and those without to group 2. Rates of VD and RD in each group were compared by c2 test and odds ratio (OR). Results: Three hundred thirteen patients were evaluated (age range 41-87 years, mean 58.5 years) and mean diabetes duration mean was 7.8 years. LO rate was higher than expected (49%, p < 0.001): 109 patients in group 1 (53.4%) and 18 in group 2 (16.5%) had VD (p < 0.001, OR 5.59), while 46 patients in group 1 and 13 in group 2 (11.9%) had DR, which was not clinically different (p = 0.03, OR 2.15). Discussion: Presence of LO should be considered during ophthalmic evaluation in diabetics; VD could be erroneously attributed to DR, whose detection could be limited by LO. Should LO cause significant visual impairment, extraction would help improve vision if there is no DR and would help to have an adequate optic medium to follow-up and treat the latter, if it is present.


REFERENCES

  1. Riley AF, Malik TY, Grupcheva CN, Fisk MJ, Craig JP, McGhee CN. The Auckland Cataract Study: co-morbidity, surgical techniques, and clinical outcomes in a public hospital service. Br J Ophthalmol 2002;86:185-190.

  2. Albert DM, Jackobieck FA, Robinson L. Principles and practice of ophthalmology. St. Louis, MO, USA: W.B. Saunders Co.; 1994.

  3. Leske MC, Wu SY, Hennis A, et al. Diabetes, hypertension, and central obesity as cataract risk factors in a black population. The Barbados Eye Study. Ophthalmology 1999;106:35-41.

  4. Klein R, Klein BE, Linton KLP, De Mets DL. The Beaver Dam Eye Study: visual acuity. Ophthalmology 1991;98:1310-1315.

  5. Klein BEK, Klein R, Lee KE. Diabetes, cardiovascular disease, selected cardiovascular risk factors and the 5-year incidence of eye-related cataract and progression of lens opacities. The Beaver Dam Eye Study. Am J Ophthalmol 1998;126:782-790.

  6. Truscott RJ. Human cataract: the mechanisms responsible; light and butterfly eyes. Int J Biochem Cell Biol 2003;35:1500-1504.

  7. Cerami A, Blondee M, et al. Advanced glycation: an important pathological event in diabetic and age related ocular disease. Br J Ophthalmol 2001;85:746-753.

  8. Klein BEK, Klein R, Moss SE. Prevalence of cataracts in a population-based study of persons with diabetes mellitus. Ophthalmology 1985;92:1191-1196.

  9. Frost NA, Sparrow JM. The assessment of lens opacities in clinical practice: results of a national survey. Br J Ophthalmol 2001;85:319-321.

  10. Ederer F, Hiller R, Taylor HR. Senile changes and diabetes in two population studies. Am J Ophthalmol 1981;91:381-395.

  11. Klein BEK, Klein R, Moss SE. Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Am J Ophthalmol 1995;119:295-300.

  12. Leske MC, Connel AM, Wu SY, Hyman L, Schachat, A. Prevalence of lens opacities in the Barbados Eye Study. Arch Ophthalmol 1997;115:105-111.

  13. Cumming RG, Mitchell P. Alcohol, smoking and cataracts: The Blue Mountains Eye Study. Arch Ophthalmol 1997;115:1296-1303.

  14. Lima-Gómez V, Rojas-Dosal JA. Organización de campañas de detección de retinopatía diabética. Rev Mex Oftalmol 2001;75:98-102.

  15. Glynn RJ, Christen WG, Manson JE, Bernheimer J, Hennekens CH. Body mass index. An independent predictor of cataract. Arch Ophthalmol 1995;113:1131.

  16. Pavan-Langston D. Manual of occular diagnosis and therapy. 5th ed. Philadelphia, PA, USA: Lippincott Williams & Wilkins; 2002.

  17. Lima-Gómez V, Mora-Pérez E. Causas de deficiencia visual en pacientes diabéticos mexicanos. Rev Endocrinol Nutr 2001;9:176-180.

  18. Klein R, Klein BEK, Moss SE. Visual impairment in diabetes. Ophthalmology 1984;91:1-8.

  19. Wagner T, Knaflic D, Rauber M, et al. Influence of cataract surgery on the diabetic eye: a prospective study. Ger J Ophthalmol 1996;5:79-83.

  20. Squirrell D, Bhola R, Bush J, Winder S, Talbot JF. A prospective, case-controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated pharcoemulsification cataract surgery in patients with type 2 diabetes. Br J Ophthalmol 2002;86: 565-571.

  21. Dowler J, Hykin PG. Cataract surgery in diabetes. Curr Opin Ophthalmol 2001;12:175-178.

  22. Chew EY, Benson WE, Remaley NA, Lindley AA, Burton TC, Csaky K, Williams GA, Ferris FL 3rd. Results after lens extraction in patients with diabetic retinopathy: Early Treatment Diabetic Retinopathy Study Report Number 25. Arch Ophthalmol 1999;117:1600-1606.




2020     |     www.medigraphic.com