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Fulltext HbA1c and retinal sensitivity in diabetics using microperimetry

Sharanjeet-Kaur, Ismail SA, Mutalib HA, Ngah NF

J Optom, 2018 05 26;12(3):174-179.
PMID: 29843983 DOI: 10.1016/j.optom.2018.03.007

PURPOSE: The purpose of this study was to determine the relationship between HbA1c values and retinal sensitivity at central 10° using the MP-1 microperimeter.
METHODS: A prospective study was carried out on 32 healthy subjects (control group) and 60 diabetic patients. The diabetic patients were divided into 2 groups. Group 1 comprised of 30 patients without diabetic retinopathy (DR) and group 2 had 30 patients with mild non-proliferative DR. A full-threshold microperimetry of the central 10° of retina (the macula) was performed on all subjects, utilizing 32 points with the MP-1. The relationship between light sensitivity and HbA1c value was calculated using linear regression analysis.
RESULTS: Total mean sensitivity at 10° for group 1 without DR, group 2 with mild NPDR and control group were 18.67±0.83, 17.98±1.42 and 19.45±0.34 (dB), respectively. There was a significant difference in total mean retinal sensitivity at 10° between the 3 groups (F(2,89)=18.14, p=0.001). A simple linear regression was calculated to predict HbA1c based on retinal sensitivity. A significant regression equation was found (F(1,90)=107.61, p=0.0001, with an R2 of 0.545). The linear regression analysis revealed that there was a 0.64dB decline in mean retinal sensitivity within the central 10° diameter with an increase of 1mmHg of HbA1c.
CONCLUSION: Retinal sensitivity at the central 10° of the macula is affected by changes in HbA1c values.

Matched MeSH terms: Diabetic Retinopathy/physiopathology*
Identification and localization of fovea on colour fundus images using blur scales

Ganesan K, Acharya RU, Chua CK, Laude A

Proc Inst Mech Eng H, 2014 Sep;228(9):962-70.
PMID: 25234036 DOI: 10.1177/0954411914550847

Identification of retinal landmarks is an important step in the extraction of anomalies in retinal fundus images. In the current study, we propose a technique to identify and localize the position of macula and hence the fovea avascular zone, in colour fundus images. The proposed method, based on varying blur scales in images, is independent of the location of other anatomical landmarks present in the fundus images. Experimental results have been provided using the open database MESSIDOR by validating our segmented regions using the dice coefficient, with ground truth segmentation provided by a human expert. Apart from testing the images on the entire MESSIDOR database, the proposed technique was also validated using 50 normal and 50 diabetic retinopathy chosen digital fundus images from the same database. A maximum overlap accuracy of 89.6%-93.8% and locational accuracy of 94.7%-98.9% was obtained for identification and localization of the fovea.

Matched MeSH terms: Diabetic Retinopathy/pathology
Implantation and diabetes: analysis of 525 cases

Lim AS, Ang BC, Heng LK, Hart PM, Ngui MS, Chew P, et al.

Ann Acad Med Singap, 1989 Mar;18(2):174-7.
PMID: 2751233

This is a retrospective study of 525 posterior chamber implants in diabetics performed by A S M Lim and B C Ang of Singapore. The patients were reviewed by visiting ophthalmologists--J E Kennedy (Sydney), M Ngui (East Malaysia) and P M Hart (Belfast). This study did not show any significant difference in the complication of post-operative visual acuity between diabetics and non-diabetics. 95% obtained 6/12 vision or better when pre-existing disease was excluded. It also showed that posterior chamber implants can be inserted in eyes with maculopathy or proliferative retinopathy if laser treatment was effectively done before or after surgery.

Matched MeSH terms: Diabetic Retinopathy/complications; Diabetic Retinopathy/pathology
Intravenous fluconazole for bilateral endogenous Candida endophthalmitis

Annamalai T, Fong KC, Choo MM

J Ocul Pharmacol Ther, 2011 Feb;27(1):105-7.
PMID: 21235384 DOI: 10.1089/jop.2010.0117

To report a case of bilateral endogenous candida endophthalmitis treated with intravenous fluconazole.

Matched MeSH terms: Diabetic Retinopathy/complications
Fulltext Intravitreal triamcinolone versus laser photocoagulation as a primary treatment for diabetic macular oedema--a comparative pilot study

Norlaili M, Bakiah S, Zunaina E

BMC Ophthalmol, 2011 Nov 23;11:36.
PMID: 22111945 DOI: 10.1186/1471-2415-11-36

BACKGROUND: Diabetic macular oedema is the leading causes of blindness. Laser photocoagulation reduces the risk of visual loss. However recurrences are common and despite laser treatment, patients with diabetic macular oedema experienced progressive loss of vision. Stabilization of the blood retinal barrier introduces a rationale for intravitreal triamcinolone treatment in diabetic macular oedema. This study is intended to compare the best corrected visual acuity (BCVA) and the macular oedema index (MEI) at 3 month of primary treatment for diabetic macular oedema between intravitreal triamcinolone acetonide (IVTA) and laser photocoagulation.
METHODS: This comparative pilot study consists of 40 diabetic patients with diabetic macular oedema. The patients were randomized into two groups using envelope technique sampling procedure. Treatment for diabetic macular oedema was based on the printed envelope technique selected for every patient. Twenty patients were assigned for IVTA group (one injection of IVTA) and another 20 patients for LASER group (one laser session). Main outcome measures were mean BCVA and mean MEI at three months post treatment. The MEI was quantified using Heidelberg Retinal Tomography II.
RESULTS: The mean difference for BCVA at baseline [IVTA: 0.935 (0.223), LASER: 0.795 (0.315)] and at three months post treatment [IVTA: 0.405 (0.224), LASER: 0.525 (0.289)] between IVTA and LASER group was not statistically significant (p = 0.113 and p = 0.151 respectively). The mean difference for MEI at baseline [IVTA: 2.539 (0.914), LASER: 2.139 (0.577)] and at three months post treatment [IVTA: 1.753 (0.614), LASER: 1.711 (0.472)] between IVTA and LASER group was also not statistically significant (p = 0.106 and p = 0.811 respectively).
CONCLUSIONS: IVTA demonstrates good outcome comparable to laser photocoagulation as a primary treatment for diabetic macular oedema at three months post treatment.
TRIAL REGISTRATION: ISRCTN05040192 (http://www.controlled-trial.com).

Matched MeSH terms: Diabetic Retinopathy/drug therapy*; Diabetic Retinopathy/surgery*
Investigation of SLC2A1 26177A/G gene polymorphism via high resolution melting curve analysis in Malaysian patients with diabetic retinopathy

Ng ZX, Kuppusamy UR, Tajunisah I, Fong KC, Chua KH

J Diabetes Complications, 2012 Sep-Oct;26(5):388-92.
PMID: 22795339 DOI: 10.1016/j.jdiacomp.2012.05.014

PURPOSE:
In this study, we aimed to investigate the possible association between SLC2A1 26177A/G polymorphism and diabetic retinopathy (DR) in Malaysian patients with type 2 diabetes.

METHODS:
Genomic DNA was extracted from 211 Malaysian type 2 diabetic patients (100 without retinopathy [DNR], 111 with retinopathy) and 165 healthy controls. A high resolution melting assay developed in this study was used to detect SLC2A1 26177A/G polymorphism followed by statistical analysis.

RESULTS:
A statistically significant difference in 26177G minor allele frequency between healthy controls (19.7 %) and total patient group (26.1 %) (p<0.05, Odd ratio = 1.437, 95% Confidence interval = 1.015-2.035) as well as between healthy controls (19.7 %) and DNR patients (27.5%) (p<0.05, Odd ratio = 1.546, 95% Confidence interval = 1.024-2.336) was shown in this study. However, when compared between DR and DNR patients, there was no significant difference (p>0.05).

CONCLUSIONS:
This is the first study which shows that SLC2A1 26177G allele is associated with type 2 diabetes in Malaysian population but not with DR.

Matched MeSH terms: Diabetic Retinopathy/genetics*; Diabetic Retinopathy/metabolism
Fulltext Lack of association between Gly82Ser, 1704G/T and 2184A/G of RAGE gene polymorphisms and retinopathy susceptibility in Malaysian diabetic patients

Ng ZX, Kuppusamy UR, Poh R, Tajunisah I, Koay AC, Fong KC, et al.

Genet. Mol. Res., 2012 Mar 01;11(1):455-61.
PMID: 22427038 DOI: 10.4238/2012.March.1.2

Diabetic retinopathy is the most common diabetic eye disease, occurring in about 60% of type 2 diabetic patients. Other than known clinical risk factors, the influence of genes has been suggested as part of the development of diabetic retinopathy. We investigated the association of Gly82Ser, 1704G/T and 2184A/G polymorphisms in the RAGE gene with retinopathy in type 2 diabetic patients in Malaysia. Ninety-eight unrelated retinopathy patients and 185 unrelated healthy controls from all over Malaysia were recruited in this study. The allele and genotype frequencies of the three gene polymorphisms were investigated using PCR-RFLP. The allele frequency of the three polymorphisms did not differ significantly between the control and the retinopathy group (P > 0.05). Analysis of the frequency of GA+AA, GT+TT and AG+GG in the retinopathy group did not reveal significant differences (P > 0.05) compared to the control group. We conclude that RAGE gene Gly82Ser, 1704G/T and 2184A/G polymorphisms are not associated with retinopathy development in the Malaysian population.

Matched MeSH terms: Diabetic Retinopathy/genetics*
Fulltext Lipoprotein (A) levels in type 2 diabetic patients with diabetic retinopathy

Ergün UGO, Oztüzün S, Seydaoglu G

Med J Malaysia, 2004 Aug;59(3):406-10.
PMID: 15727389

To examine a possible association between lipoprotein(a) [Lp(a)] levels and diabetic retinopathy in patients with type 2 diabetes mellitus. 100 type 2 diabetic patients were assessed with the following parameters: age, body mass index, duration of diabetes, blood pressure, fasting plasma glucose, total cholesterol, HDL-cholesterol, triglycerides, blood urea nitrogen, creatinine, Lp(a), and albumin excretion rate (AER). Retinopathy was classified as normal retina (NR), non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) by an ophthalmologist. The PDR group had higher cholesterol (t=-2.24, p<0.05) and creatinine (z=-2.547, p<0.05) levels than the NPDR group. The PDR group had a higher value of AER (z=-2.439, p<0.01) than the NR group. The possibility of developing diabetic retinopathy after 10 years of diabetes was found to be 6.5 fold high (OR; 6.57, 95% CI 1.74-24.79; p<0.05). The Lp(a) levels were similar in the patients with retinopathy and those without retinopathy. In the study, there was no evidence for a relationship between the serum Lp(a) levels and diabetic retinopathy in type 2 diabetic patients.
Study site: diabetic outpatient clinic at Haydarpasa Numune Education and Research Hospital in Istanbul, Turkey.

Matched MeSH terms: Diabetic Retinopathy/blood*; Diabetic Retinopathy/etiology
Localization of optic disc and fovea in retinal images using intensity based line scanning analysis

Kamble R, Kokare M, Deshmukh G, Hussin FA, Mériaudeau F

Comput Biol Med, 2017 08 01;87:382-396.
PMID: 28595892 DOI: 10.1016/j.compbiomed.2017.04.016

Accurate detection of diabetic retinopathy (DR) mainly depends on identification of retinal landmarks such as optic disc and fovea. Present methods suffer from challenges like less accuracy and high computational complexity. To address this issue, this paper presents a novel approach for fast and accurate localization of optic disc (OD) and fovea using one-dimensional scanned intensity profile analysis. The proposed method utilizes both time and frequency domain information effectively for localization of OD. The final OD center is located using signal peak-valley detection in time domain and discontinuity detection in frequency domain analysis. However, with the help of detected OD location, the fovea center is located using signal valley analysis. Experiments were conducted on MESSIDOR dataset, where OD was successfully located in 1197 out of 1200 images (99.75%) and fovea in 1196 out of 1200 images (99.66%) with an average computation time of 0.52s. The large scale evaluation has been carried out extensively on nine publicly available databases. The proposed method is highly efficient in terms of quickly and accurately localizing OD and fovea structure together compared with the other state-of-the-art methods.

Matched MeSH terms: Diabetic Retinopathy/diagnosis; Diabetic Retinopathy/pathology
Fulltext Mental health state and quality of life questionnaire in low vision assessment: a case report

Omar R, Rahman MH, Knight VF, Mustaphal M, Mohammed Z

BMC Res Notes, 2014;7:667.
PMID: 25245590 DOI: 10.1186/1756-0500-7-667

BACKGROUND: Vision impairment associated with diabetic retinopathy, is well known and low vision rehabilitation is always recommended. In this report, the importance of objective measure of mental health and quality of life screening in diabetic retinopathy low-vision assessment is discussed.
CASE PRESENTATION: We describe the case of a 43-year-old Asian female who has mild vision impairment due to tractional retinal detachment secondary to diabetic retinopathy and how mental health screening and quality of life screening during low vision rehabilitation can improve in the management of this patient.
CONCLUSION: Although vision impairment was mild, the psychological impact was enormous and affected her quality of life substantially. This case report illustrates that recognition of the mental health and quality of life impact on visual impairment is critical to the rehabilitation management of low vision patients with diabetic retinopathy.

Matched MeSH terms: Diabetic Retinopathy
Fulltext Molecular Markers of Diabetic Retinopathy: Potential Screening Tool of the Future?

Pusparajah P, Lee LH, Abdul Kadir K

Front Physiol, 2016;7:200.
PMID: 27313539 DOI: 10.3389/fphys.2016.00200

Diabetic retinopathy (DR) is among the leading causes of new onset blindness in adults. Effective treatment may delay the onset and progression of this disease provided it is diagnosed early. At present retinopathy can only be diagnosed via formal examination of the eye by a trained specialist, which limits the population that can be effectively screened. An easily accessible, reliable screening biomarker of diabetic retinopathy would be of tremendous benefit in detecting the population in need of further assessment and treatment. This review highlights specific biomarkers that show promise as screening markers to detect early diabetic retinopathy or even to detect patients at increased risk of DR at the time of diagnosis of diabetes. The pathobiology of DR is complex and multifactorial giving rise to a wide array of potential biomarkers. This review provides an overview of these pathways and looks at older markers such as advanced glycation end products (AGEs), inflammatory markers, vascular endothelial growth factor (VEGF) as well as other newer proteins with a role in the pathogenesis of DR including neuroprotective factors such as brain derived neurotrophic factor (BDNF) and Pigment Epithelium Derived Factor (PEDF); SA100A12, pentraxin 3, brain natriuretic peptide, apelin 3, and chemerin as well as various metabolites such as lipoprotein A, folate, and homocysteine. We also consider the possible role of proteins identified through proteomics work whose levels are altered in the sera of patients with DR as screening markers though their role in pathophysiology remains to be characterized. The role of microRNA as a promising new screening marker is also discussed.

Matched MeSH terms: Diabetic Retinopathy*
Fulltext Molecular mechanisms of diabetic retinopathy, general preventive strategies, and novel therapeutic targets

Safi SZ, Qvist R, Kumar S, Batumalaie K, Ismail IS

Biomed Res Int, 2014;2014:801269.
PMID: 25105142 DOI: 10.1155/2014/801269

The growing number of people with diabetes worldwide suggests that diabetic retinopathy (DR) and diabetic macular edema (DME) will continue to be sight threatening factors. The pathogenesis of diabetic retinopathy is a widespread cause of visual impairment in the world and a range of hyperglycemia-linked pathways have been implicated in the initiation and progression of this condition. Despite understanding the polyol pathway flux, activation of protein kinase C (KPC) isoforms, increased hexosamine pathway flux, and increased advanced glycation end-product (AGE) formation, pathogenic mechanisms underlying diabetes induced vision loss are not fully understood. The purpose of this paper is to review molecular mechanisms that regulate cell survival and apoptosis of retinal cells and discuss new and exciting therapeutic targets with comparison to the old and inefficient preventive strategies. This review highlights the recent advancements in understanding hyperglycemia-induced biochemical and molecular alterations, systemic metabolic factors, and aberrant activation of signaling cascades that ultimately lead to activation of a number of transcription factors causing functional and structural damage to retinal cells. It also reviews the established interventions and emerging molecular targets to avert diabetic retinopathy and its associated risk factors.

Matched MeSH terms: Diabetic Retinopathy*
New Evidence Showing yet another Link between Sight-Threatening Diabetic Retinopathy and Obstructive Sleep Apnea: How Relevant is this to my General Practice?

Chidambaram R

J Coll Physicians Surg Pak, 2018 Nov;28(11):893.
PMID: 30369389 DOI: 10.29271/jcpsp.2018.11.893
Matched MeSH terms: Diabetic Retinopathy/complications*; Diabetic Retinopathy/physiopathology
Fulltext Ophthalmic problems among the elderly in Malaysia

Singh P

Med J Malaysia, 1997 Sep;52(3):213-6.
PMID: 10968087
Matched MeSH terms: Diabetic Retinopathy/etiology; Diabetic Retinopathy/therapy
Fulltext Ophthalmology inpatient consultation: does it make a difference to inpatient management?

Tajunisah I, Azida J, Zurina ZA, Reddy SC

Med J Malaysia, 2009 Jun;64(2):130-3.
PMID: 20058572 MyJurnal

Ophthalmology consultation is one of the commonest requested services for inpatients in a tertiary hospital. A total of 290 ophthalmology consultation requests were received over a period of six months (average 12 consultation requests per week) and from these, 222 patients were examined. The patient demographics, the hospitalization data, type of consultations (screening, new problem, preexisting problem), reasons for consultations and the ophthalmology diagnosis were determined. Out of 290 consultation requests, internal medicine services requested the highest number (95, 32.8%); the commonest type of consultation was screening for eye diseases (161, 55.5%) and the most common reason for consultation was to rule out diabetic retinopathy (125, 43.1%). The top five ophthalmology diagnoses after examination were diabetic retinopathy (45, 20.3%), diabetic retinopathy ruled out (37, 16.6%), conjunctivitis (12, 5.4%), refractive error (11, 4.8%) and normal ocular examination (11, 4.9%). Inpatient ophthalmologic procedures were performed in 146 patients, the commonest of which was retinal laser photocoagulation. A total of 133 (59.9%) inpatients had a change in their management as a result of the ophthalmology consultation.

Matched MeSH terms: Diabetic Retinopathy/diagnosis
Plasma, aqueous and vitreous homocysteine levels in proliferative diabetic retinopathy

Lim CP, Loo AV, Khaw KW, Sthaneshwar P, Khang TF, Hassan M, et al.

Br J Ophthalmol, 2012 May;96(5):704-7.
PMID: 22353698 DOI: 10.1136/bjophthalmol-2011-301044

To compare homocysteine (Hcy) concentration in the blood plasma, vitreous and aqueous of eyes with proliferative diabetic retinopathy (PDR) against control, and to investigate associations between Hcy concentration in blood plasma with that of aqueous and vitreous in these two groups.

Matched MeSH terms: Diabetic Retinopathy/blood*
Fulltext Pneumatic retinopexy for treatment of posterior pole detachment following vitreoretinal surgery for diabetic tractional retinal detachment threatening the fovea

Bastion ML

BMJ Case Rep, 2012;2012.
PMID: 22878988 DOI: 10.1136/bcr-2012-006303

To describe the usage of 100% perfluoropropane and subsequent laser retinopexy for the repair of posterior pole retinal detachment in a previously vitrectomised patient with diabetic tractional detachment.

Matched MeSH terms: Diabetic Retinopathy/complications; Diabetic Retinopathy/physiopathology; Diabetic Retinopathy/surgery*
Fulltext Potential Effects of Sweet Potato (Ipomoea batatas) in Hyperglycemia and Dyslipidemia-A Systematic Review in Diabetic Retinopathy Context

Naomi R, Bahari H, Yazid MD, Othman F, Zakaria ZA, Hussain MK

Int J Mol Sci, 2021 Oct 06;22(19).
PMID: 34639164 DOI: 10.3390/ijms221910816

Hyperglycemia is a condition with high glucose levels that may result in dyslipidemia. In severe cases, this alteration may lead to diabetic retinopathy. Numerous drugs have been approved by officials to treat these conditions, but usage of any synthetic drugs in the long term will result in unavoidable side effects such as kidney failure. Therefore, more emphasis is being placed on natural ingredients due to their bioavailability and absence of side effects. In regards to this claim, promising results have been witnessed in the usage of Ipomoea batatas (I. batatas) in treating the hyperglycemic and dyslipidemic condition. Thus, the aim of this paper is to conduct an overview of the reported effects of I. batatas focusing on in vitro and in vivo trials in reducing high glucose levels and regulating the dyslipidemic condition. A comprehensive literature search was performed using Scopus, Web of Science, Springer Nature, and PubMed databases to identify the potential articles on particular topics. The search query was accomplished based on the Boolean operators involving keywords such as (1) Beneficial effect OR healing OR intervention AND (2) sweet potato OR Ipomoea batatas OR traditional herb AND (3) blood glucose OR LDL OR lipid OR cholesterol OR dyslipidemia. Only articles published from 2011 onwards were selected for further analysis. This review includes the (1) method of intervention and the outcome (2) signaling mechanism involved (3) underlying mechanism of action, and the possible side effects observed based on the phytoconstiuents isolated. The comprehensive literature search retrieved a total of 2491 articles using the appropriate keywords. However, on the basis of the inclusion and exclusion criteria, only 23 articles were chosen for further review. The results from these articles indicate that I. batatas has proven to be effective in treating the hyperglycemic condition and is able to regulate dyslipidemia. Therefore, this systematic review summarizes the signaling mechanism, mechanism of action, and phytoconstituents responsible for those activities of I. batatas in treating hyperglycemic based on the in vitro and in vivo study.

Matched MeSH terms: Diabetic Retinopathy/etiology; Diabetic Retinopathy/prevention & control*
Pre-Emptive Topical Ketorolac Tromethamine 0.5% for Panretinal Photocoagulation

Chewa Raja JS, Singh S, Ismail F

J Ocul Pharmacol Ther, 2021 Jun;37(5):313-317.
PMID: 33794664 DOI: 10.1089/jop.2020.0089

Purpose: To evaluate the efficacy of topical ketorolac tromethamine 0.5% given pre-emptively a day before, for alleviating pain in patients undergoing panretinal photocoagulation (PRP) treatment. Methods: A controlled single-blinded study was conducted on 33 patients with diabetic retinopathy (DR; severe nonproliferative DR, proliferative DR, or advanced diabetic eye disease) who required PRP treatment in both eyes simultaneously. Each eye of the patients was randomly assigned for ketorolac tromethamine 0.5% eyedrop or placebo. Both eyedrop bottles were randomly labeled. Eyedrops were self-administered by the patients, 4 times a day before the procedure (at 6 am, 12 noon, 6 pm, and 12 midnight) and every 15 min for 1 h (4 times) before the laser. Each patient was subjected to PRP using a Visulas 532s Zeiss device set to spot size 200 μm, time 0.10 s, and ∼600 burns in each eye. The pain score was evaluated immediately after treatment in each eye independently with Scott's visual analog scale (VAS) and the McGill Pain Questionnaire (MPQ). Results: VAS pain score in ketorolac-treated eyes (median 3.0, interquatile range [IQR] ±2.5) was lower than in placebo-treated eyes (median 5.0, IQR ±3.0). Total Pain Rate Index score from MPQ was lower in ketorolac-treated eyes (median 3.0, IQR ±3.0) than in placebo-treated eyes (median 3.0, IQR ±2.5). Both pain score differences are statistically significant with P ˂ 0.05. Conclusion: Topical ketorolac tromethamine 0.5% given pre-emptively a day before is effective in alleviating pain in patients undergoing PRP treatment.

Matched MeSH terms: Diabetic Retinopathy/drug therapy*; Diabetic Retinopathy/surgery
Fulltext Predictive factors of visual outcome of Malaysian cataract patients: a retrospective study

Thevi T, Godinho MA

Int J Ophthalmol, 2017;10(9):1452-1459.
PMID: 28944207 DOI: 10.18240/ijo.2017.09.19

AIM: To explore the associations between various characteristics of Malaysian cataract patients and their management, and their post-operative visual outcomes, to inform relevant bodies to reduce cataract-related blindness.

METHODS: We conducted a descriptive secondary data analysis of cataract surgery patients in Melaka Hospital, from 2007 to 2014 using the National Eye Database (NED). Patient-related factors (demographic features, systemic and ocular comorbidities) and management-related factors (surgical duration, type of surgery, type of lens) were analysed for their association with visual outcome (acuity).

RESULTS: Most patients were Malays (48.23%) and Chinese (38.55%) aged 60-79y (range 0-100y). Hypertension (58.61%) and diabetes (44.89%) were major systemic comorbidities. Glaucoma (6.71%) and diabetic retinopathy (10.12%) were the main ocular comorbidities. Other comorbidities were age-related macular degeneration, pterygium, corneal opacities, macula diseases, vitreous haemorrhage, retinal detachment and pseudoexfoliation (0.70%-1.60%). Preoperatively 7150 (55.03%) eyes presented with poor vision. Uncomplicated phacoemulsification performed quickly with foldable lenses gave good results.

CONCLUSION: Primary care physicians should initiate early detection to prevent late presentation of cataracts causing poor vision and should discuss the risks and benefits of cataract surgery while emphasizing the role of pre-existing comorbidities which may affect the visual outcomes. For good results, phacoemulsification should be done within 30min, without complications, using foldable posterior chamber intraocular lens.

Matched MeSH terms: Diabetic Retinopathy

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