Occurrence of diabetic maculopathy according to diabetes control and hypertension prevalence

Abstract

INTRODUCTION. Diabetic retinopathy is nowadays most common microvascular complication in diabetic patients. Macular damage is inseparable feature of retinopathy and it is the main reason of visual acuity reduction. Hyperglycaemia is dominant pathogenic factor in angiopathy, however in some cases the systemic factors, especially hypertension, can have a harmful effect.
MATERIAL AND METHODS. 101 diabetic patients were observed. Diabetic maculopathy was diagnosed in 168 eyes. Diabetes control level and results of treatment were estimated by means of fructosamine level. From all patients we obtained visual acuity, ophthalmoscopy and fluorescein angiography. Function of central retina was evaluated by means of visual acuity. Retina was investigated in direct ophthalmoscopy. Angiography was also used in macula assessment.
RESULTS. Maculopathy was observed more often in hypertensive patients: 63,6% had focal, 30,3% had diffuse and 6,1% had ischaemic maculopathy. Pharmacological normalization of hypertension had a positive effect on the type of macular damage and had a correlation with milder types of maculopathy. In sufficient and insufficient diabetes control level more often diffuse (68,5%) and ischaemic (66,6%) maculopathy were found. In perfect and good diabetes control level more often types were: focus (60%) and diffuse (31,8%) maculopathy.
CONCLUSIONS. Diabetic maculopathy occurred more often in hypertensive patients and had milder course in patients with normalized hypertension. We also proved a beneficial effect of diabetes control on types of maculopathy.