Characterization of the visually impaired patients with diabetes mellitus in Japan

Author:

Sugihara Yuka12ORCID,Takamura Yoshihiro12ORCID,Yamada Yutaka2,Morioka Masakazu2,Gozawa Makoto2,Kato Kumiko13,Hirano Takao14,Murao Fumiko15,Shimizu Miho16,Kusuhara Sentaro17ORCID,Murakami Tomoya18,Takenaka Yuki19,Okabe Naoko110,Jujo Tatsuya111,Terasaki Hiroto112,Nagasato Daisuke113,Dong Zhenyu14,Yoshida Shigeo115,Ogura Shuntaro116,Yasuda Kanako117,Ishigooka Gaku118,Sawada Osamu119,Higashijima Fumiaki120,Inatani Masaru2

Affiliation:

1. J‐CREST (Japan Clinical REtina STudy group) Kagoshima Japan

2. Department of Ophthalmology, Faculty of Medical Sciences University of Fukui Yoshida Japan

3. Department of Ophthalmology, Graduate School of Medicine Mie University Tsu Japan

4. Department of Ophthalmology, School of Medicine Shinshu University Matsumoto Japan

5. Department of Ophthalmology Tokushima University Graduate School Tokushima Japan

6. Department of Ophthalmology Sapporo City General Hospital Sapporo Japan

7. Division of Ophthalmology, Department of Surgery, Graduate School of Medicine Kobe University Kobe Japan

8. Department of Ophthalmology, Faculty of Medicine University of Tsukuba Tsukuba Japan

9. Department of Ophthalmology National Defense Medical College Tokorozawa Japan

10. Department of Ophthalmology Nara Medical University Kashihara Japan

11. Department of Ophthalmology St Marianna University School of Medicine Kawasaki Japan

12. Department of Ophthalmology, Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan

13. Department of Ophthalmology Saneikai Tsukazaki Hospital Himeji Japan

14. Department of Ophthalmology, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Japan

15. Department of Ophthalmology Kurume University School of Medicine Kurume Japan

16. Department of Ophthalmology and Visual Science Nagoya City University Graduate School of Medical Sciences Nagoya Japan

17. Department of Ophthalmology Tokyo Medical University Hachioji Medical Center Tokyo Japan

18. Department of Ophthalmology Osaka Medical and Pharmaceutical University Takatsuki Japan

19. Department of Ophthalmology Shiga University of Medical Science Otsu Japan

20. Department of Ophthalmology, School of Medicine Yamaguchi University Ube Japan

Abstract

ABSTRACTAims/IntroductionTo conduct a multicenter survey of visually impaired patients with diabetes mellitus (DM) and to identify the physical and ocular characteristics that lead to blindness in Japan.Materials and MethodsVisually impaired patients with diabetes mellitus in Japan were divided into blind and low‐vision groups according to the World Health Organization classification. Data on parameters related to diabetes mellitus and ocular complications in the right and left eyes were collected from 19 highly advanced medical facilities and compared between the two groups.ResultsAmong 408 visually impaired persons (blind group: 257, low‐vision group: 151), 72.1% were under 70 years of age. The rates of neovascular glaucoma (NVG) (right eye, P = 0.041; left eye, P = 0.0031) or proliferative diabetic retinopathy (PDR) (right eye: P = 0.014, left eye: P = 0.0047) and the rate of proliferative membrane beyond half of the retinal area (right eye: P = 0.0263, left eye: P = 0.037) were significantly higher in the blind group. The direct cause of visual impairment was retinal atrophy, common in both groups. Neovascular glaucoma and diabetic macular edema were equally prevalent in the blind and low‐vision groups, respectively.ConclusionsIn Japan, blind patients with diabetes mellitus are characterized by severe conditions such as neovascular glaucoma and progressive proliferative diabetic retinopathy upon their initial visit to an advanced care facility. These results highlight the importance of monitoring retinopathy through regular ophthalmological examinations, internal medicine, and appropriate therapeutic intervention.

Funder

Japan Society for the Promotion of Science

Publisher

Wiley

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