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Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India

To provide the real-world outcomes of people with proliferative diabetic retinopathy (PDR) in India and highlight opportunities for improvement of their disease status and to evaluate their visual acuity (VA) status. A multicenter retrospective study in which ten centers in India with established vi...

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Autores principales: Khan, Rehana, Chandra, Shruti, Rajalakshmi, Ramachandran, Rani, Padmaja Kumari, Anantharaman, Giridhar, Sen, Alok, Desai, Abhishek, Roy, Rupak, Natarajan, Sundaram, Chen, Lanin, Chawla, Gajendra, Behera, Umesh Chandra, Gopal, Lingam, Gurudas, Sarega, Sivaprasad, Sobha, Raman, Rajiv
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7324375/
https://www.ncbi.nlm.nih.gov/pubmed/32601324
http://dx.doi.org/10.1038/s41598-020-67350-6
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author Khan, Rehana
Chandra, Shruti
Rajalakshmi, Ramachandran
Rani, Padmaja Kumari
Anantharaman, Giridhar
Sen, Alok
Desai, Abhishek
Roy, Rupak
Natarajan, Sundaram
Chen, Lanin
Chawla, Gajendra
Behera, Umesh Chandra
Gopal, Lingam
Gurudas, Sarega
Sivaprasad, Sobha
Raman, Rajiv
author_facet Khan, Rehana
Chandra, Shruti
Rajalakshmi, Ramachandran
Rani, Padmaja Kumari
Anantharaman, Giridhar
Sen, Alok
Desai, Abhishek
Roy, Rupak
Natarajan, Sundaram
Chen, Lanin
Chawla, Gajendra
Behera, Umesh Chandra
Gopal, Lingam
Gurudas, Sarega
Sivaprasad, Sobha
Raman, Rajiv
author_sort Khan, Rehana
collection PubMed
description To provide the real-world outcomes of people with proliferative diabetic retinopathy (PDR) in India and highlight opportunities for improvement of their disease status and to evaluate their visual acuity (VA) status. A multicenter retrospective study in which ten centers in India with established vitreoretinal services for over 10 years were invited to provide long-term data on PDR. This study population were of Indian nationality. Patients with a diagnosis of type 1 or 2 diabetes with a clinical diagnosis of active PDR in any or both eyes, who had long term follow-up for up to 10 years were included. Baseline data collected included age, sex, duration of diabetes, source of referral and best-corrected visual acuity, diabetic retinopathy status in both eyes. Available follow-up data on VA were collected at 6 months post baseline, 5 years and 10 years within a ± 3 months window. Evaluating the presenting VA of people with PDR, short-term outcomes at 6 months and the incidence of visual impairment (VI) at 5 and 10 years are the main outcome of the study. Data was available for 516, 424 and 455 patients at baseline, 5 years and 10 years respectively. Gender and duration of diabetes did not have statistically significant effect on VI outcomes. Eyes receiving treatment early in the disease course (i.e. baseline VA ≥ 6/12) had significantly better VA outcomes at 10 years versus eyes treated at a later stage (i.e. baseline VA < 6/12) (p = <0.0001). On comparing eyes with stable treated PDR and persistent PDR at end of 10 year follow up, a significantly higher percentage of eyes in the stable treated group maintained VA of ≥ 6/12 (55.1% vs. 24.2%) (p = < 0.0001), indicating persistent disease activity due to inadequate treatment results in worse VA outcomes. We found no trend in VI or blindness with increasing levels of age at both 5- and 10-year time points (p > 0.05). The age standardized incidence for VI was 11.10% (95% CI 8.1, 14.2) and for blindness was found to be 7.7% (95% CI 5.2, 10.3). Our results suggest that despite robust recent clinical trial results showing that pan retinal photocoagulation is an excellent treatment for PDR, people with diabetes in India need to be made aware of annual screening and treatment of their eyes to avoid vision impairment and blindness.
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spelling pubmed-73243752020-06-30 Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India Khan, Rehana Chandra, Shruti Rajalakshmi, Ramachandran Rani, Padmaja Kumari Anantharaman, Giridhar Sen, Alok Desai, Abhishek Roy, Rupak Natarajan, Sundaram Chen, Lanin Chawla, Gajendra Behera, Umesh Chandra Gopal, Lingam Gurudas, Sarega Sivaprasad, Sobha Raman, Rajiv Sci Rep Article To provide the real-world outcomes of people with proliferative diabetic retinopathy (PDR) in India and highlight opportunities for improvement of their disease status and to evaluate their visual acuity (VA) status. A multicenter retrospective study in which ten centers in India with established vitreoretinal services for over 10 years were invited to provide long-term data on PDR. This study population were of Indian nationality. Patients with a diagnosis of type 1 or 2 diabetes with a clinical diagnosis of active PDR in any or both eyes, who had long term follow-up for up to 10 years were included. Baseline data collected included age, sex, duration of diabetes, source of referral and best-corrected visual acuity, diabetic retinopathy status in both eyes. Available follow-up data on VA were collected at 6 months post baseline, 5 years and 10 years within a ± 3 months window. Evaluating the presenting VA of people with PDR, short-term outcomes at 6 months and the incidence of visual impairment (VI) at 5 and 10 years are the main outcome of the study. Data was available for 516, 424 and 455 patients at baseline, 5 years and 10 years respectively. Gender and duration of diabetes did not have statistically significant effect on VI outcomes. Eyes receiving treatment early in the disease course (i.e. baseline VA ≥ 6/12) had significantly better VA outcomes at 10 years versus eyes treated at a later stage (i.e. baseline VA < 6/12) (p = <0.0001). On comparing eyes with stable treated PDR and persistent PDR at end of 10 year follow up, a significantly higher percentage of eyes in the stable treated group maintained VA of ≥ 6/12 (55.1% vs. 24.2%) (p = < 0.0001), indicating persistent disease activity due to inadequate treatment results in worse VA outcomes. We found no trend in VI or blindness with increasing levels of age at both 5- and 10-year time points (p > 0.05). The age standardized incidence for VI was 11.10% (95% CI 8.1, 14.2) and for blindness was found to be 7.7% (95% CI 5.2, 10.3). Our results suggest that despite robust recent clinical trial results showing that pan retinal photocoagulation is an excellent treatment for PDR, people with diabetes in India need to be made aware of annual screening and treatment of their eyes to avoid vision impairment and blindness. Nature Publishing Group UK 2020-06-29 /pmc/articles/PMC7324375/ /pubmed/32601324 http://dx.doi.org/10.1038/s41598-020-67350-6 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the articleΓÇÖs Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the articleΓÇÖs Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Khan, Rehana
Chandra, Shruti
Rajalakshmi, Ramachandran
Rani, Padmaja Kumari
Anantharaman, Giridhar
Sen, Alok
Desai, Abhishek
Roy, Rupak
Natarajan, Sundaram
Chen, Lanin
Chawla, Gajendra
Behera, Umesh Chandra
Gopal, Lingam
Gurudas, Sarega
Sivaprasad, Sobha
Raman, Rajiv
Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India
title Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India
title_full Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India
title_fullStr Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India
title_full_unstemmed Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India
title_short Prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in India
title_sort prevalence and incidence of visual impairment in patients with proliferative diabetic retinopathy in india
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7324375/
https://www.ncbi.nlm.nih.gov/pubmed/32601324
http://dx.doi.org/10.1038/s41598-020-67350-6
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