DIABETIC RETINOPATHY;

PREDICTIVE VALUE OF ELEVATED HBA1C LEVELS FOR THE PRESENCE OF DIABETIC RETINOPATHY

Abstract

Background: Diabetic retinopathy is one of the most common complications of
diabetes affecting more than 1/4th of the diabetics and is also the leading cause of blindness in
many parts of the globe. Regular fundoscopic examination for screening is a routine practice
in tertiary care hospitals but is not available in the primary care centers. This necessitates
the development of a reliable screening tool which will allow for early referral of those with
complications to the specialist centers. Objective: To determine the predictive value of HbA1c
levels for the presence of diabetic retinopathy. Study Design: A cross-sectional study. Setting:
Diabetic Clinic of Mayo Hospital, Lahore. Period: 04 months, January to April 2017. Method:
75 diabetic patients who presented in Diabetic clinic were investigated for HbA1c levels and
fundoscopic evaluation was done to detect retinal changes. Results: Out of 75 patients, 35
(46.7%) were female, 40 (53.3%) were male. Median age of the patients was 51 years. All patients
had HbA1c levels more than 6.0% and 62% patients had detectable changes on fundi while the
rest had no detectable retinal disease despite elevated HbA1c levels. Positive predictive value
(PPV) of elevated HbA1c levels for the presence of diabetic retinal changes was calculated to
be 62.66%. Conclusion: All the patients who had retinal disease on fundoscopy had HbA1c
levels of more than 6.0% (PPV = 62.66) which means that elevated HbA1c levels warrant a
fundoscopic retinal examination to rule out diabetic retinopathy.