REFRACTIVE CORRECTIONS OF PATIENTS WITH RETINOPATIA DIABETICA
Keywords:
diabetic retinopathy, refractive error, optical correction, visual acuity, glycemic control, retinal pathologyAbstract
Diabetic retinopathy (DR) is a leading cause of visual impairment and blindness among adults with diabetes mellitus. The pathological changes in the retinal vasculature, including microaneurysms, hemorrhages, exudates, and neovascularization, compromise retinal integrity and visual function. In addition to retinal lesions, patients with DR often experience refractive instability, manifesting as fluctuations in visual acuity and shifts in refractive error. Accurate refractive correction in this population is essential but challenging, as it requires consideration of both ocular structural changes and systemic metabolic control. This study aimed to evaluate the patterns of refractive errors and the effectiveness of optical correction in patients with various stages of diabetic retinopathy, with the goal of optimizing visual rehabilitation. A prospective clinical study was conducted on 330 patients (n = 660 eyes) diagnosed with diabetic retinopathy at the Department of Ophthalmology, Eye Department in the “Ferid Murad” Hospital Gostivar , over a period of 7 months. Patients underwent a comprehensive ophthalmic examination, including uncorrected and best corrected visual acuity testing (Snellen chart), objective refraction using autorefractometry, subjective refraction, slit lamp biomicroscopy, intraocular pressure measurement, and dilated fundus examination with indirect ophthalmoscopy. The stage of diabetic retinopathy was graded based on the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Refractive correction was prescribed based on stable refractive values confirmed on at least two separate visits, spaced one week apart, to account for glycemic fluctuations.
References
Aiello, L. P. et al. (2018). Diabetic Retinopathy. In: Ryan’s Retina, 6th ed. Elsevier.
American Diabetes Association. (2024). Standards of Medical Care in Diabete, Diabetes Care.;47 (Suppl. 1): S1-S300.
Cheung, N., Mitchell, P., Wong, TY. (2010). Diabetic retinopathy. The Lancet.;376(9735):124–136.
Grauslund, J. (2022). Diabetologia; 65(9):1415-1423
Guceva, N. L. (2020). Oftalmologija , Shtip 83-85 M.
Harkaran, S., Rana, D.O., Jason Hsu, MD., Jonathan, C., Tsui, MD., Jennifer, I., Lim, MD. (2022). Diabetic retinopaty. June Harrison’s Principles of Internal Medicine. 21st ed. McGraw Hill;
International Council of Ophthalmology. (2017). ICO Guidelines for Diabetic Eye Care. 2017.
Jack, J. Kanski. (2004). Klinicka Oftalmologija. V izdanie ,datastatus -Beograd 445-454.
Janev, K. (2012). Opsta Oftalmologija -treto izdanie. Skopje, 312-315.
Kierstan, B. (2022). Director of Patient Education, American Academy of Ophthalmology 2000-Present Diabetic retinopathy :cause ,sumptoms, tretman oct 27,
Klein, R, Klein, BE., Moss SE, et al. (1984). The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Ophthalmol.;102(4):520-526.
Misita R. Vasilije. (2000). Dijabeticna retinopatija lecenje laserfotokoagulacijom, Zavod za ucebnike i nastavna sredstva, Beograd (2000) Sapra A, 11.
Resnikoff, S. et al. (2008). Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ.;86(1):63–70.
Robbins & Cotran. (2021). Pathologic Basis of Disease. 10th ed. Elsevier;
Zaduzbina Andrejevic. (2011). Mavija dijabeticka retinopatija i rizik faktori, Beograd, 11.
