Association of grade of cataract with duration of diabetes, age and gender in patients with type II diabetes mellitus
Keywords:Cataract, Diabetes mellitus, Nuclear sclerosis, Cortical cataract, Posterior subcapsular cataract
Background: Despite the advancement in the diagnosis and surgical techniques, cataract remains one of the major leading causes for avoidable blindness in the world. This study was performed to evaluate the association of duration of diabetes mellitus, age and gender in predicting the morphological grade of cataract in patient with type II diabetes.
Methods: Sixty nine patients (35 males and 34 females) of age 50-70 years with diabetes type II who underwent cataract surgery were studied retrospectively. Patients were classified into those with immature cataract (IMSC), mature (MSC) and hypermature senile cataract (HMSC). Risk factors such as duration of diabetes, age and gender were analyzed by multiple regression analysis. Further, correlation between duration of diabetes and grade of cataract in males and females were also analyzed.
Results: IMSC was the most common type with no statistically significant difference in prevalence among the gender. The cataracts detected in diabetic patients of 15 or more years of duration turned out to be IMSC. Incidence of cataract in patients with diabetic duration of 0-5 years was 37%, 6-9 years was 28.5%, 10-14 years was 12% and >15 years was 22.5%. Multiple regression analysis revealed that the duration of diabetes and age was not significantly correlated with the grade of cataracts in either males or females.
Conclusions: The duration of diabetes, age or gender did not emerge as a significant risk factor for predicting grade of cataract in male or female diabetic patients. In fact, IMSC was found to be the most common among patients with >15 years of diabetic duration.
World Health Organization. Prevention of blindness and visual Impairment. http://www.who.int/ blindness/causes/en. [Accessed 7 September 2006].
Klein R, Klein BE, Moss MS. Visual impairment in diabetics. Ophthalmol. 1984;91:1-8.
Klein BE, Klein R, Moss MS. Prevalence of cataracts in a population-based study of persons with diabetes mellitus. Ophthalmol. 1985;92(9):1191-6.
Pollreisz A, Schmidt-Erfurth U. Diabetic Cataract—Pathogenesis, Epidemiology and Treatment. J. Ophthalmol. 2010;2010:1-8.
Kahn HA, Leibowitz HM, Ganley JP, Kini MM, Colton T, Nickerson RS, et al. The Framingham eye study. II. Association of ophthalmic pathology with single variables previously measured in the Framingham heart study. Am J Epidemiol. 1977;106(1):33-41.
Nielsen NV, Vinding T. The prevalence of cataract in insulin-dependent and non-insulin-dependent-diabetes mellitus, Acta Ophthalmologica, 1984;62: 595-602.
Harding JJ, Egerton M, van Heyningen R, Harding R S. Diabetes, glaucoma, sex, and cataract: analysis of combined data from two case control studies. Br J Ophthalmol. 1993;77:2-6.
Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.
Rowe N, Mitchell P, Cumming RG, Wans JJ. Diabetes, fasting blood glucose and age-related cataract: the Blue Mountains Eye Study. Ophthalmic Epidemiol. 2000;7:103-14.
Saxena S, Mitchell P, Rochtchina E. Five-year incidence of cataract in older persons with diabetes and prediabetes. Ophthalmic Epidemiol. 2004;11:271-7.
Kim SI, Kim SJ. Prevalence and Risk Factors for Cataracts in Persons with Type 2 Diabetes Mellitus. Korean J Ophthalmol. 2006;20:201-4.
Janghorbani M, Amini M. Cataract in type 2 diabetes mellitus in Isfahan, Iran: incidence and risk factors. Ophthalmic Epidemiol. 2004;11:347-58.
Kim TN, Lee JE, Lee EJ, Won JC, Noh JH, Ko KS, Rhee BD, Kim DJ. Prevalence of and Factors Associated with Lens Opacities in a Korean Adult Population with and without Diabetes: The 2008–2009 Korea National Health and Nutrition Examination Survey. PLoS One. 2014;9: e94189.
Janghorbani MB, Jones RB, Allison SP. Incidence of and risk factors for cataract among diabetes clinic attenders. Ophthalmic Epidemiol. 2000;7:13-25.
Schwab IR, Dawson CR, Hoshiwara I, Szuter CF, Knowler WC. Incidence of cataract extraction in Pima Indians: diabetes as a risk factor. Arch Ophthalmol. 1985;103(2):208-12.
Harding JJ, Harding RS, Egerton M. Risk factors for cataract in Oxford shire: diabetes, peripheral neuropathy, myopia, glaucoma and diarrhoea. Acta Ophthalmologica. 1989;67:510-7.
Klein BEK, Klein R, Moss SE. Incidence of cataract surgery in the Wisconsin epidemiologic study of diabetic retinopathy. Am J Ophthalmol. 1995;119:295-300.
West SK, Valmadrid CT. Epidemiology of risk factors for age-related cataract. Surv Ophthalmol. 1995;39:323-34.
Bernth-Peterson P, Bach E. Epidemiologic aspects of cataract surgery. Frequencies of diabetes and glaucoma in a cataract population. Acta Ophthalmol. 1983;61:406-16.
Kato S, Shiokawa A, Fukushima H, Numaga J, Kitano S, Hori S, Kaiya T, Oshika T. Glycemic control and lens transparency in patients with type 1 diabetes mellitus. Am J Ophthalmol. 2001;131:301-4.
Obrosova IG, Chung SS, Kador PF. Diabetic cataracts: mechanisms and management. Diabetes Metab Res Rev. 2010;26(3):172-80.
Dowler JG, Hykin PG, Hamilton AM. Phacoemulsification versus extracapsular cataract extraction in patients with diabetes. Ophthalmol. 2000;107(3):457-62.
Kirby DB. Cataract and diabetes. Arch Ophthalmol. 1933;9(6):966-73.
Caird FI, Hutchinson M, Pirie A. Cataract and diabetes. Br Med J. 1964;2(5410):665-8.