Metabolic Syndrome is Associated with Increased Severity of Diabetic Retinopathy

Purpose: To study the association of metabolic syndrome with severity of diabetic retinopathy. Materials and method: Seventy-one consecutive cases of type 2 diabetes mellitus of more than 10 years duration aged 38 to 82 years were included. Metabolic syndrome was identified as per American Heart Association- National Cholesterol Education Programme Adult Treatment Panel III (AHA-NCEP ATP III) criteria. All the cases were assessed for log MAR visual acuity, intraocular pressure (IOP) and seven field fundus photography. The photographs were scored for 16 diabetic lesions. A single severity level (identical to the ETDRS Interim Scale) was calculated for each eye by using the Vanderbilt Classification System. Data was analysed using paired t-test. Results: Of the 71 cases, 47 cases fulfilled at least 3 of the ATP III criteria for metabolic syndrome. Among the cases of metabolic syndrome, 18 cases fulfilled 3 criteria, 28 cases fulfilled 4 criteria and 1 case fulfilled all the 5 criteria. The analyses of the mean Vanderbilt score for severity of retinopathy showed significantly higher score (more severe retinopathy) in cases of metabolic syndrome (p<0.001). Higher IOP was observed in cases of metabolic syndrome (p<0.001). LogMAR visual acuity deteriorated (p<0.01), severity of retinopathy and intraocular pressure increased (p<0.001, p<0.001, respectively) with an increase in the number of components of metabolic syndrome. Triglyceride levels showed positive correlation with severity of retinopathy (p<0.001) and IOP (p<0.001). High density lipoprotein (HDL) levels also showed positive correlation with vision (p<0.001), severity of retinopathy (p<0.001) and IOP (p<0.001). Conclusion: Metabolic syndrome is significantly associated with increased severity of diabetic retinopathy, decreased visual acuity and increased IOP.