Retinopathy severity may increase a diabetic patient’s risk of cerebrovascular accidents, myocardial infarctions, congestive heart failure and even death, a recent study published in Ophthalmology suggests.

The retrospective cohort investigation enrolled 77,376 patients with type II diabetes, including 61,384 with no retinopathy, 12,765 with minimal non-proliferative diabetic retinopathy (NPDR), 2,620 with moderate-to-severe NPDR and 607 with proliferative diabetic retinopathy (PDR). Participants were an average of 60 years old, approximately 54% were male and roughly 31% were non-Hispanic white, while 41% were Hispanic.

The researchers considered the relationship between the stage of retinopathy and the five-year risk of different conditions and mortality using regression analysis that took into account several factors. These included age, sex, race/ethnicity, hemoglobin A1c levels, high- and low-density lipoprotein levels, hypertension history, systolic and diastolic blood pressure, tobacco and statin use, BMI, urine microalbumin and creatinine ratio and estimated glomerular filtration rate.

Diabetic retinopathy was significantly associated with all outcomes in the analysis. Compared with patients with no retinopathy, individuals with minimal NPDR had a higher risk of cerebrovascular accidents, myocardial infarctions, congestive heart failure and death. Similarly, patients with moderate-to-severe NPDR had a higher risk of each outcome, as did patients with PDR.

Retinal information may provide valuable insights into patients’ risk of future vascular disease and death, the study authors concluded in their paper.

Modjtahedi BS, Wu J, Luong TQ, et al. Severity of diabetic retinopathy and the risk of future cerebrovascular disease, cardiovascular disease, and all-cause mortality. Ophthalmology. 2020;S0161-6420(20):31195-7. [Epub ahead of print].