Investigating the Association of Biochemical and Clinical Parameters with the Severity of Diabetic Retinopathy in Bangladesh

Abstract

Diabetic retinopathy (DR) is a significant microvascular complication of diabetes leading to vision impairment and blindness. While various clinical and biochemical parameters are linked with the severity of DR, there is no such study to ascertain these association in Bangladeshi population. This cross-sectional study investigated the association of various biochemical and clinical parameters with the severity of non-proliferative diabetic retinopathy in Bangladeshi patients. A cohort of 90 Bangladeshi patients with non-proliferative DR was recruited and followed for 8 months for developing different stages of DR severity (mild, modern and severe). Visual acuity (VA), Non-Contact Tonometer (NCT) readings, and biochemical parameters including C-reactive protein (CRP), random blood sugar (RBS), lipid profile (triglyceride, total cholesterol), serum ferritin, and vitamin D levels were assessed using appropriate laboratory techniques. The average value for visual activities (V/A) in different stages of non-proliferative DR is significantly different (p<0.001). In the same way, the average for Non-Contact Tonometer (NCT), C-reactive protein (CRP), Random Blood Sugar (RBS), and Diastolic Blood Pressure is significantly different in different stages of non-proliferative DR. No significant associations were found with lipid profile, serum ferritin, or vitamin D. Correlation analysis revealed a moderate positive correlation between RBS and NCT (r=0.225, p<0.05), and significant negative correlations of V/A, NCT, and CRP, reinforcing the link between inflammation/ocular pressure and visual function. Linear regression models identified CRP, RBS, and Duration of Diabetes as positive predictors for NCT, and total cholesterol (positive), CRP (negative), and RBS (negative) as predictors for visual acuity. Our findings indicate that visual acuity, non-contact tonometer measurements, C-reactive protein, and random blood sugar levels are significantly associated with the severity of non-proliferative diabetic retinopathy. These parameters serve as valuable indicators for assessing DR progression and emphasize the critical roles of regular ophthalmic examinations and stringent glycemic control in managing the disease. Longitudinal studies are needed to further validate these associations and their predictive power.