Researchers recently sought to determine if anemia and oxygen delivery-related comorbidities—such as chronic pulmonary disease, decreased kidney function, increased hemoglobin A1c, insulin use, hypertension and high diabetic complications severity index—affect a patient’s risk of progression from nonproliferative diabetic retinopathy (NPDR) to vision-threatening diabetic retinopathy (VTDR), proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME). They presented their findings last Sunday at the annual ARVO conference in Vancouver. The team discovered that anemia, independent of kidney disease, plays a significant role in progression from NPDR to VTDR, PDR or DME. They note that oxygen delivery-related comorbidities associated with NPDR progression lends support to the underlying mechanisms of anemia in DR pathogenesis.
This retrospective cohort study evaluated 69,982 NPDR patients from a national medical claims database. Of the total participants, 12,270 progressed to VTDR, 2,162 progressed to PDR and 10,322 progressed to DME. The team found that both mild and moderate/severe anemia were associated with an increased risk of progression to VTDR, PDR and DME. They add that oxygen delivery-related comorbidities were also significantly associated with an increased risk for progression to VTDR, PDR or DME.
Li Y, Yu Y, VanderBeek BL, et al. Anemia and the risk of progression from non-proliferative diabetic retinopathy to vision threatening diabetic retinopathy. ARVO 2019. Abstract 1072-A0030.