Relationship between diabetic retinopathy severity and the timespan between the endocrinopathy diagnosis and the first ophthalmic examination.

PURPOSE: To investigate whether the time interval between type 2 diabetes mellitus (DM) diagnosis and the first fundoscopic examination is related with the presence and the severity of diabetic retinopathy (DR) observed. METHODS: A survey of 105 type 2 DM patients referred to ophthalmologic evaluation in the "Hospital das Clinicas" (HC), University of São Paulo Medical School (USPMS). RESULTS: Regarding classification of DR in the 105 patients, 15 (14.28%) did not show signs of DR, and 90 (85.72%) exhibited them on fundoscopy. Sixty patients underwent laser therapy, and 46.66% reported poor control of DM. Only 15.23% of DM patients were adequately screened for DR on the first year of their DM diagnosis. Among the 36 patients (34.30%) examined within five years of DM diagnosis, 58.33% did not present or demonstrate signs of mild DR and 22.20% of proliferative DR; 30 patients underwent an ophthalmologic examination after more than eleven years of DM diagnosis, 21.62% did not exhibit signs of DR and 59.46% were classified as proliferative DR. CONCLUSION: This study showed a statistically significant relationship between the time interval from the diagnosis of type 2 DM and the first fundoscopic examination with the severity of DR.

[Visual stability in diabetic retinopathy treated by panretinal laser photocoagulation]. / Estabilidade visual na retinopatia diabética tratada por panfotocoagulação com laser.

PURPOSE: To evaluate the effect of laser treatment in the visual acuity caused by advanced diabetic retinopathy without visual complaints. METHODS: A descriptive observational study was developed in advanced diabetic retinopathy patients not presenting visual complaints. The patients were submitted to argon laser panretinal photocoagulation after ophthalmological examination as well as retinography and retinal angiofluoresceinography. The same initial exams were repeated between third and fifth months after the treatment. The non-parametric Wilcoxon test was employed for statistical evaluation between the visual acuities before and after the treatment. RESULTS: The sample involved 67 eyes of 44 patients. Of these 67 eyes, 37 (55.2%) presented proliferative diabetic retinopathy and 30 (44.8%) showed severe and severe non proliferative diabetic retinopathy. The visual acuity before the treatment ranged from 0.5 to 1.0 (mean 0.81 +/- 0.16). There was no significant statistical difference between the visual acuity (p= 0.057) before and after the treatment during the follow-up period of five months. CONCLUSION: The visual stability after panretinal argon laser photocoagulation indicated the need of this treatment in early phases of diabetic retinopathy in order to preserve the visual function.