Journal of Diabetes Investigation (Jul 2024)

Characterization of the visually impaired patients with diabetes mellitus in Japan

  • Yuka Sugihara,
  • Yoshihiro Takamura,
  • Yutaka Yamada,
  • Masakazu Morioka,
  • Makoto Gozawa,
  • Kumiko Kato,
  • Takao Hirano,
  • Fumiko Murao,
  • Miho Shimizu,
  • Sentaro Kusuhara,
  • Tomoya Murakami,
  • Yuki Takenaka,
  • Naoko Okabe,
  • Tatsuya Jujo,
  • Hiroto Terasaki,
  • Daisuke Nagasato,
  • Zhenyu Dong,
  • Shigeo Yoshida,
  • Shuntaro Ogura,
  • Kanako Yasuda,
  • Gaku Ishigooka,
  • Osamu Sawada,
  • Fumiaki Higashijima,
  • Masaru Inatani

DOI
https://doi.org/10.1111/jdi.14195
Journal volume & issue
Vol. 15, no. 7
pp. 882 – 891

Abstract

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ABSTRACT Aims/Introduction To 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 Methods Visually 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. Results Among 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. Conclusions In 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.

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