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Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, 1. Göz Kliniği Purpose: To determine the risk factors affecting visual acuity in insulin-dependent diabetic subjects with diabetic retinopathy.
Methods: 72 eyes of 36 insulin-dependent diabetic patients attending to our clinic due to diabetic retinopathy were retrospectively analyzed. Medical history and detailed ocular findings were collected from patients' cards and records in diabetes clinic. Age, gender, age at the onset of diabetes, duration of diabetes, hemoglobin A1c (HbA1c) level, and presence of hypertension (HT), cataract, neovascularisation of iris (NVI), clinically significant macular edema (CSME), cystoid macular edema (CME), intraocular hemorrhage (IOH), fractional retinal detachment (TRD), preretinal hemorrhage, diabetic retinopathy (DR) and neovascular glaucoma (NVG) were the factors, which were evaluated for their effects on visual acuity. The multivariate-adjusted association between these factors and severe visual loss was evaluated with logistic regression analysis. On the other hand, Chi-square and Anova tests were used to investigate the independent effects of these factors on visual acuity.
Results: As analyzed by multiple logistic regression model, HbA1c level, and presence of cataract, CME and IOH were found to be associated with severe visual loss (p<0,05); whereas, the effects of age, gender, age at the onset of diabetes, duration of diabetes, HT, NVI, NVG, CSME, TRD, preretinal hemorrhage and DR on visual acuity were found to be statistically insignificant (p>0,05). On the other hand, when the factors were investigated independently, high HbA1c level and presence of NVI, CSME, CME, IOH and proliferative DR were the statistically significant factors for visual loss (p<0,05); whereas, age, gender, age at the onset of diabetes, duration of diabetes, HT, cataract, NVG, TRD and preretinal hemorrhage did not have a statistically significant effect on visual acuity (p>0,05).
Conclusion: It is important to determine the risk factors effecting the visual acuity in decreasing the incidence of severe visual loss in insulin-dependent diabetic subjects. Keywords : Insulin-dependent diabetes mellitus, visual acuity, diabetic retinopathy