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| |  Patients With Peripheral Neuropathy Twice as Likely to Have Diabetic Retinopathy: Presented at WOC By Karen Dente BERLIN -- June 10, 2010 -- New findings presented on June 7 at the World Ophthalmology Congress (WOC) 2010 provide insight into the susceptibility of diabetic retinopathy for diabetic patients also suffering from peripheral neuropathy. "We initiated this study to examine the relationship between peripheral neuropathy and diabetic retinopathy in an Asian population to provide us with further insight into the pathogenesis of these known complications of diabetes," said lead study author Gavin Tan, Singapore Eye Research Institute in Singapore. The Singapore Malay Eye Study is a population-based cross-sectional survey that included 3,280 patients aged 40 to 80 years. Diabetes was defined in patients included in the study by random glucose levels of at least 11.1 mmol/L of blood, the use of diabetic medication, or the diagnosis by a physician. A total of 768 patients with diabetes were included. Of these, 35% had diabetic retinopathy and 20% peripheral neuropathy. Peripheral neuropathy was defined as abnormal responses to a 10-g monofilament with <4 or 5 points felt in either foot or a neurothesiometer test. Photographs of the retina were taken from both eyes and graded for diabetic retinopathy using the modified Airlie House classification system. The odds of diabetic retinopathy were higher in those with peripheral neuropathy (odds ratio [OR] = 1.99; P < .001), abnormal neurothesiometer readings (OR = 4.29; P < .009), and abnormal monofilament testing (OR = 1.75; P < .004). Using an age and gender adjusted model, moderate and severe diabetic neuropathy was associated with peripheral neuropathy (OR = 3.17), chronic kidney disease (OR = 2.45), nephropathy (OR = 1.89), and peripheral artery disease (OR =1.91). In a multivariate analysis, all associations were significant except for peripheral artery disease. "Patients with peripheral neuropathy were twice as likely as those without to have diabetic retinopathy," Dr. Tan concluded. "This association was stronger for moderate or severe diabetic retinopathy even after adjusting for haemoglobin [Hb] A1C. Diabetics should therefore be screened regularly for retinopathy," he said. Glycaemic control measured by Hb A1C was not a risk factor for peripheral neuropathy suggesting that other factors predisposing diabetics to peripheral neuropathy may also increase their susceptibility to diabetic retinopathy, according to these findings. [Presentation title: The Relationship Between Peripheral Neuropathy and Diabetic Retinopathy in an Asian Population (The Singapore Malay Eye Study). Poster MO-169]
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