Abstract

Introduction: Diabetes Mellitus, a disorder of carbohydrate metabolism characterised primarily by hyperglycemia and glycosuria with secondary anomalies of the metabolism of proteins and fats, is a disease the etiology of which is still not clear. Diabetes Mellitus is a common metabolic disorder secondary to lack, diminished efficacy or both of endogenous insulin. Diabetes may be insulin dependent (Type 1 IDDM) or non insulin dependent (Type 2 NIDDM) diabetes mellitus. It is one of the most common non communicable diseases with an increasing incidence worldwide.  Among the various manifestations of Diabetes mellitus, diabetic retinopathy is the most common chronic complication associated with it and is the most common cause of legal blindness between the ages of 20 and 65 years. Diabetic Retinopathy is a microangiopathy primarily effecting pre cappilary venules, although larger vessels may also be involved. Bresnick (1967), stated that the prevalence of retinopathy in the diabetic population is positively associated with the duration of diabetes. He also stated that the risk of developing blindness from retinopathy also increases with increase in duration of diabetes. Signs of retinopathy occur in nearly all patients with type1 DM and in 80% with type2 DM after 20 years of diabetes mellitus (same duration). Other than being the major cause of legal blindness, diabetes mellitus is leading to loss of productivity and quality of life of patients with diabetes retinopathy with additional socio economic burden on society. However appropriate treatment can lead to decrease in the loss of vision caused by proliferative diabetic retinopathy by 90%.

Aims and Objectives

• To assess the prevalence of Diabetic Retinopathy in diabetic patients attending Ophthalmology Outpatient Department at Government Medical College Hospital Jammu.
• To find out the prevalence of patients with NPDR, PDR, Diabetic maculopathy in both Type 1 and Type 2 DM.

Material and Methods: The study was conducted on 150 patients and diagnosed cases of Diabetes mellitus(as per the WHO criteria) attending Eye OPD for ocular examination at the Upgraded Department of Ophthalmology, Government Medical College, Jammu were selected at random and enrolled in the study. The cases were non selective with regards to age, sex, ethnic origin and occupation and type of diabetes. Patients with angle closure glaucoma, hazy media, gestational DM and on long term steroids are excluded from the study. A detailed history of each patient was obtained regarding age, year of diagnosis of diabetes, age at onset and duration of diabetes, family history of diabetes and complete family history .Pupils of both eyes were dilated with 1% tropicamide eye drops to achieve maximum dilatation. Fundus examination of both eyes was done using direct ophthalmoscopy, posterior pole of the retina and macula examination will be done with slit lamp biomicroscopy with 90D lens as well as the periphery was be visualised, indirect ophthalmoscopy with 20D was  also be done. Any changes attributable to diabetes were documented Fundus photography and Fluorescein angiography was done in patients where required.

Results: Out of 150 diagnosed cases of diabetes mellitus,108 patients had retinopathy, thus prevalence was 72%, where as 42 diabetics had no retinopathy(28%).   

Conclusion: It was concluded that diabetic retinopathy in diabetic patients is dependent on certain risk factors and these are age, sex, duration of diabetes, fasting blood sugar levels, altered renal function tests and also type of diabetes.       

Keywords: diabetes mellitus (DM), glycosylated haemoglobin(Hb1Ac), non contact tonometer (NCT).