THE PREVALENCE AND RISK FACTORS ASSOCIATED WITH TYPE 2 DIABETIC RETINOPATHY IN RWANDA

Objective: To determine the prevalence and risk factors associated with type 2 diabetic retinopathy in Rwanda. Methods: A case-control study was conducted from January to September 2019 in four hospitals within the Republic of Rwanda. Type 2 diabetic patients were screened for retinopathy. Patients with retinopathy were considered as cases and those without retinopathy as controls. A study sample of 592 participants were enrolled, 66 cases and 526 controls. Diabetic retinopathy was assessed by indirect ophthalmoscopy performed for each eye with a slit-lamp +90D lens. Plasma glucose and Glycated hemoglobin (HbA1c) were measured by colorimetric enzymatic tests. Albuminuria was measured by quantitative spectrophotometric method. Triglycerides, Total, HDL and LDL cholesterol, Urea and Creatinine were assayed by colorimetric methods. A questionnaire was used to assess medical history and demographic status. Data were analyzed by use of SPSS version 20. Statistical analyses were performed by Chi square to show association between nominal and ordinal data. Multivariate logistic regression analysis to select independent variables was performed. Odds ratio was used as a measure of association. Results: The prevalence of diabetic retinopathy in this study population was 11.2%. Independent risk factors associated with diabetic retinopathy were long duration of diabetes, hyperglycemia, LDL cholesterol, triglycerides, and albuminuria. Conclusion: The prevalence of diabetic retinopathy is high and is associated with traditional modifiable risk factors. Early detection and management of diabetes mellitus and these risk factors, combined with good adherence to scheduled eye examination would greatly improve the quality of life of affected patients.

Investigation of BDNF gene expression level by analysis of dysregulation of miRNA-15a: An in-silico approach

Type 2 Diabetic retinopath (T2DR) remains the leading cause of vision loss and preventable blindness in adults aged 20–74 years, particularly in middle-income and high-income countries. The pathogenesis of T2DR is a predominant cause of visual impairment and a range of hyperglycemia linked pathways have been implicated in the initiation and progression of this condition. Apparently in the past T2DR was solely considered a vascular disease as opposed to the present time where it is recognised as a neuro-vascular disease. Some pro-survival neurotrophins such as brain derived neurotrophic factor (BDNF) are considered to guard retinal ganglion and amacrine cells from degenerative. Significant reduction in the levels of BDNF have been witnessed in diabetic patients as well as animal models. miRNAs are a group of 21-23 nucleotide long, highly conserved sequences of endogenous RNAs that do not encode for any protein. Researches carried out over the last decade gives plenty of proof about the miR-15a importance in T2DR. Henceforth, miR15a could be used for the experimental purposes. miRNAs can be considered as an efficient biomarker as they maintain their stability and utility over rigorous processing phases and the presence of quantitative detection boosts their therapeutical significance. Keywords: Type 2 Diabetic Retinopathy, Neurodegeneration, BDNF, Prognosis, Biomarker, miR-15a, Bioinformatics

Comparison of Ocular Lens Thickness of Type-2 Diabetic Retinopathy Patients with Non-diabetic Control, Measured by High Resolution Ultrasonography

Background & objective: The aim of this study was to verify whether the ocular lens of type-2 diabetic retinopathy patients was thicker (measured by high resolution Ultrasonography) than those of non-diabetic individuals.The study also evaluated the differences in lens thickness (LT) between right and left eyes of diabetic retinopathy patients, and the differences in LT between proliferative and background retinopathy cases. Methods: This case-control study was conducted on 68 subjects (34 cases and 34 controls) aged 20-60 years in the Department of Radiology and Imaging, BIRDEM Hospital from March 2015 to February 2016. Adult patients suffering from type-2 diabetic retinopathy confirmed by slit-lamp examination were selected as cases, while apparently healthy subjects were taken as control. Patients with history of heart failure, ocular surgery, acute eye conditions, such as, conjunctivitis, scleritis, cataract or any other co-morbidities were excluded. Ocular mean lens thickness was measured by high resolution ultrasonography and was compared between case and control groups by Un-paired t-Test. Results: The study showed that type 2 diabetic patients had significantly thicker lenses than their non-diabetic counterparts (in right eye:case 4.1 ± 0.3 mm versus control 3.7±0.1 mm, p<0.001 and in left eye:case 4.2 ± 0.3 mm vs. control 3.7±0.1 mm, p<0.001). The study also revealed that proliferative retinopathy cases had thicker lenses than any other diabetic retinopathy groups (p < 0.05) and there was also statistically significant difference of HbA1c level between proliferative and background type II diabetic retinopathy cases (p<0.05) Conclusion: The study concluded that lens thickness is increased in type-2 diabetic retinopathy patients than that in non-diabetic healthy controls.The proliferative diabetic retinopathy cases possess thicker lens than the background retinopathy cases. Ibrahim Card Med J 2020; 10 (1&2): 40-44

Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and type 2 diabetic retinopathy

AIM: To investigate the relationship between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and type 2 diabetic retinopathy (DR). METHODS: A total of 200 cases with type 2 diabetes mellitus were involved. All patients were divided into three groups according to the fundus examination: diabetes mellitus (DM, n=100), non-proliferative diabetic retinopathy (NPDR, n=62) and proliferative diabetic retinopathy (PDR, n=38). 100 healthy persons were selected as the normal control group (NCG, n=100). The related indicators, such as neutrophil count, lymphocyte count and platelet count, were measured. RESULTS: The value of NLR was significantly higher in PDR group patients than in NC group (1.81), DM group (1.76) and NPDR group (1.85) (P<0.05). The value of PLR was significantly higher in PDR group patients (126.18) than in DM group (111.64) (P<0.05). Logistic regression analysis showed that age (β= -0.047) was protective factor, course of diabetes (β=0.071) and systolic blood pressure (β=0.024) were risk factors for diabetic retinopathy (P<0.05), but the value of NLR and PLR was not statistically significant in the Logistic regression analysis. CONCLUSION: The value of NLR and PLR increased in the PDR group, but it is not independent risk factor for diabetic retinopathy.