Lima GV, Arreola VSL

Language: Spanish
References: 16
Page: 23-27
PDF size: 54.92 Kb.

ABSTRACT

Background. Choroidal fundus (a thinning of the retinal pigment epithelium that allows the observation of choroidal vessels) has been associated with lower diabetic retinopathy (DR) prevalence. We identified diabetes duration in patients who had choroidal fundus and DR and whether it was longer than in those who did not have the former, which could attribute the association to a delay in the development of the disease. Method. Diabetic patients without prior ophthalmic evaluation who had DR were assigned to one of two groups: without (1) or with (2) choroidal fundus. Diabetes duration was compared between groups by Student’s t for independent samples. Results. 114 patients were evaluated (age 34-81, mena 60), 77 were female (67.5%) and 58 (50.9%) had a history of arterial hypertension. Diabetes duration ranked from 2 to 40 years (mean 13, standard deviation ± 7.3). Baseline variables showed no statistical difference between groups. Diabetes duration mean was longer in group 1 (14.1 years) than in group 2 (12.7 years) but it was not statistically different (p = 0.2). Discussion. Although diabetes duration was longer in patients with choroidal fundus, the difference was not significant. A prospective study is needed to test the difference that was found, in order to determine whether it is enough to explain the lower rate of DR in patients with choroidal fundus.

REFERENCES

1. Chew EY, Benson WE, Culver VH, et al. Preferred Practice patterns. Diabetic Retinopathy. San Francisco, American Academy of Ophthalmology; 2003.

2. Ciulla TA, Amador AG, Zinman B. Diabetic retinopathy and diabetic macular edema. Pathophysiology, screening and novel therapies. Diabetes Care 2003; 2653-64.

3. Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL (eds.) Harrison’s Principles of Internal Medicine. 15ª ed. New York, McGraw-Hill; 2001.

4. González VME, González VC, Arredondo PB, Stern MP. Diabetic retinopathy in Mexico. Prevalence and clinical characteristics. Arch Med Res 1994; 25: 355-60.

5. Lima-Gómez V, Sánchez-Cornejo M, Rojas-Dosal JA. Causas de pérdida visual monocular y ceguera legal. Rev Hosp Jua Mex 2000; 67: 73-6.

6. Fong DS, Aiello LP, Gardner TW, et al. Retinopathy in diabetes. Diabetes Care 2004; 27 (suppl. 1): 85-7.

7. Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology 1998; 105: 1801-15.

8. Moss SE, Klein R, Klein BE. The 14-year incidence of visual loss in a diabetic population. Ophthalmology 1998; 106: 998-1003.

9. Cahill M, Halley A, Codd M, O’Meara N. Prevalence of diabetic retinopathy in patients with diabetes mellitus diagnosed after the age of 70 years. Br J Ophthalmol 1997; 81: 218-22.

10. Varma R, Torres M, Peña F, Klein R, Azen SP. Prevalence of diabetic retinopathy in adult Latinos. The Los Angeles Latino Eye Study. Opthalmology 2004; 111: 1298-1306.

11. Lima GV, Rojas DJA. Estrategia de detección masiva de retinopatía diabética. El día “D” en el Hospital Juárez de México. Cir Ciruj 2001; 68: 63-68.

12. Ryan SJ. Retina. 3rd ed. St. Louis, Mosby-Yearbook; 2002.

13. Baker RS, Rand LI, Krolewski AS, Maki T, Warram JH, Aiello LM. Influence of HLA-DR phenotype and myopia on the risk of nonproliferative and proliferative diabetic retinopathy. Am J Ophthalmol 1986; 102: 693-700.

14. Ando A. Ueda M, Uyama M, Masu Y, Ito S. Enhancement of the differentiation and myoid differentiation of retinal pigment epithelial cells by platelet derived growth factor. Br J Ophthalmol 2000; 84: 1306-11.

15. Lima GV, Rojas DJA, León RN. Fondo coroideo como factor protector en el desarrollo de retinopatía diabética. Gac Méd Méx 2001; 137: 413-8.

16. Chobanian AV, Bakris GL, Black HR, et al. Joint National committee on prevention, detection, evaluation and treatment of high blood pressure. Hypertension 2003; 42: 1206-52.