Giridhar Eye Institute, Cochin, Kerala, India.
NIHR Biomedical Research Centre, Moorfields Eye Hospital, UK.
Indian J Ophthalmol. 2022 Aug;70(8):3021-3025. doi: 10.4103/ijo.IJO_172_22.
To determine the associations of predominant peripheral lesions (PPLs) with systemic comorbidities in individuals with diabetic retinopathy.
This is a multicenter cross-sectional observational study conducted across three tertiary eye care centers in south India between January 2019 and July 2021. Ultra-widefield fundus images of consecutive patients with varying severity of diabetic retinopathy with data on systemic comorbidities were classified based on the presence or absence of PPL. Systemic comorbidities (hypertension, diabetic kidney disease, coronary artery disease, dyslipidemia, and anemia) were compared between the two groups.
A total of 879 participants (70.1% males) were included in the study, of which 443 (50.4%) patients had PPL. The mean age of the study participants was 56 ± 10 years, mean age of onset of diabetes was 41.24 ± 11.6 years, and mean duration of diabetes was 15.39 ± 7.6 years. The number of PPL increased with increasing severity of DR. Of all the systemic comorbidities analyzed, we found that coronary artery disease (CAD) had a significant association with PPL (Odds ratio [OR]-1.69; 95% confidence interval [CI], 1.12-2.55; P = 0.013) after adjusting for diabetic retinopathy severity, duration of diabetes, and age of onset of diabetes.
The presence of PPL is a marker for coronary artery disease and early referral to cardiology is warranted.
确定主要周边病变（PPL）与糖尿病视网膜病变患者全身合并症的关系。
这是一项在印度南部的三个三级眼科中心进行的多中心横断面观察性研究，于 2019 年 1 月至 2021 年 7 月期间进行。根据是否存在 PPL，对具有不同严重程度糖尿病视网膜病变且有全身合并症数据的连续患者的超广角眼底图像进行分类。比较两组之间的全身合并症（高血压、糖尿病肾病、冠心病、血脂异常和贫血）。
本研究共纳入 879 名参与者（70.1%为男性），其中 443 名（50.4%）患者存在 PPL。研究参与者的平均年龄为 56±10 岁，糖尿病发病的平均年龄为 41.24±11.6 岁，糖尿病的平均病程为 15.39±7.6 年。随着 DR 严重程度的增加，PPL 的数量也随之增加。在分析的所有全身合并症中，我们发现冠心病（CAD）与 PPL 有显著关联（优势比[OR]-1.69；95%置信区间[CI]，1.12-2.55；P=0.013），校正糖尿病视网膜病变严重程度、糖尿病病程和糖尿病发病年龄后。
PPL 的存在是冠心病的一个标志物，需要早期转介至心脏病科。
