Comparisons of visual acuity, incidence, severity of diabetic retinopathy, and biochemical risk factors

Purpose: In patients with diabetes mellitus (DM), visual acuity (VA) was compared to diabetic retinopathy (DR) severity in relation to biochemical risk factors, age, gender, and race. Methods: Included were 27 type 1 (DM1), 47 type 2 (DM2) patients, and 34 controls. Evaluations included best corrected LogMAR VA; assessment of DR severity using the modified Airlie House stereoscopic fundus photographic standards and ETDRS grading; serum glucose; HbA1C; triglyceride; lipid peroxide; superoxide dismutase (SOD); and glutathione peroxidase. Excluded were eyes with media opacities, glaucoma, or age-related maculopathy. Results: Incidence and severity of NPDR and PDR did not differ significantly between DM patients. VA was significantly impaired in DM2 patients (ANOVA, p<0.01). DM2 patients with DR had significantly worse VA than DM1 patients with DR or control (ANOVA, p<0.01). VA in age-related controls was inverse y correlated with higher glucose (p=0.01). Glucose, HbA1C, and lipid peroxide were significantly higher, whereas SOD was significantly lower in DM patients compared to controls. Conclusions: Univariate and multivariate analyses indicated impaired VA in DM2 patients independent of age, and significant increases in glucose, HbA1C, and lower SOD in all zDM patients.