Diabetic Retinopathy : Spectrum Of Clinical Presentation And Correlation With Hba1c Levels

Abstract

Background: Diabetic retinopathy remains a leading global cause of vision loss; however, it is one of the most preventable conditions regarding vision loss. The development and progression of the condition depend on poor glycemic control. Hemoglobin A1c (HbA1c) levels are the standard measure of glycemic control over time. Knowledge of the clinical range of DR and the correlating levels of HbA1c is helpful to implement corrective actions in a timely fashion. It will improve the outcomes of patients.

Objectives: To study the clinical range of diabetic retinopathy in type 2 diabetes patients. To investigate the association between the extent of HbA1c and the presence of retinopathy.

 Study design: Cross-sectional study.

Place and Duration of study: From January 2024 to January 2025, the study was conducted in the Department of Ophthalmology, Bacha Khan Medical College, Mardan.

Methods: The study examined 120 patients with type 2 diabetes mellitus attending the ophthalmology clinic, who underwent a comprehensive ophthalmic evaluation for diabetic retinopathy which included slit lamp, biomicroscope, and fundus photographic documentation. Diabetes control was assessed using the HbA1c test, and the data was analyzed employing SPSS version 24. The relation of HbA1c with various levels of Diabetic Retinopathy was analyzed using descriptive statistics, Chi-square, and logistic regression, with a significance threshold of p=0.05.

Results: The average age of the patients was 54.6±9.8 years, and the gender distribution included 65 males and 55 females. The total prevalence of diabetic retinopathy was 62.5%(n=75), with 46.7%(n=56) classified as non-proliferative and 15.8%(n=19) classified as proliferative.Out of all diabetic retinopathy patients, 20%(n=24) presented with maculopathy. Significant variation was noted between the average HbA1c of patients with and without diabetic retinopathy at 8.9 ± 1.5% and 7.2 ± 1.2% respectively, p < 0.001. The severity of diabetic retinopathy was strongly positively correlated to the HbA1c with an r value of 0.68, p < 0.001.

Conclusion: This study discovered that a significant number of type 2 diabetes mellitus patients suffer from diabetic retinopathy. Poor glycemic control and higher retinopathy severity, linked by higher HbA1c levels, show the need for more stringent glycemic control in preventing vision-threatening complications of diabetic retinopathy.Implementing the recommended routine screening for interventions on patients with considerably high HbA1c levels can alleviate diabetic retinopathy burden, especially in resource-poor setting