Mohammad Kashif, Nazia Sultan, Mohammad Arshad Raza.
Association of Anemia with Diabetic Retinopathy in Patients with Type II Diabtese Mellitus.
Ophthalmol Update Jan ;13(2):85-9.

Aims/Objectives: (1) To evaluate the association between anemia and diabetic retinopathy (DR) including non proliferative DR (NPDR), proliferative DR (PDR) and diabetic macular edema (DME) in Type II Diabetes Mellitus (T2DM). (2) To identify anemia as an independent risk factor for DR in diabetic patients without significant renal dysfunction. (3) To correlate the severity of anemia with the severity of DR. Materials and Methods: In this case control study 170 DM patients (85 cases and 85 controls) above 40 years of age were included. All patients underwent stereoscopic fundus photography and if present the severity of DR was classified according to International Clinical Diabetic Retinopathy and Disease Severity Scale, cases were divided into 3 groups, NPDR, PDR and DME, while patients with normal fundus were included in control group. All patients underwent complete blood count (CBC) for hemoglobin estimation for detection of anemia. The statistical analysis was done using SPSS version 20. T-test and chi-square test were used for odd ratios and comparisons. Results: In the present study anemia was seen 38.8% in cases and 11.1% in controls (p<0.0001). 66.6% patients with severe NPDR and 45.8% with PDR had anemia (P < 0.0001). Odd ratio for anemia in cases and controls was 3.86, and for NPDR, PDR and DME was 3.6, 5.1, 3.0 respectively at 95% of Confidence Interval. The mean hemoglobin level in cases and controls was 10.3+3.2 and 13.6+1.35 g/dl (p<0.0001 ). Conclusion: The results showed that T2DM patients with DR had lower level of Hb and severity of anemia was positively co-related with severity of DR. It is suggested that the level Hb should be evaluated periodically in diabetic patients.

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