Which factors affect progression of DR

• The type of diabetes: in Type 1 DM proliferative retinopathy is more common, whereas in Type 2 DM diabetic maculopathy prevails.

• Age: the frequency of DR increases with Age.

• Diabetes duration: (see previous question).

• Blood glucose control: good glycaemic control has a beneficial effect on DR progression, despite an initial deterioration (Oslo group, 1992).

• Dyslipidaemia and arterial hypertension are associated with DR and diabetic nephropathy (DN) and also cause a deterioration of macular oedema. Furthermore, there is a strong correlation between proliferative DR, hypertension and hypercholesterolemia (EURODIAB, 2001).

• Diabetic nephropathy and diabetic retinopathy have a parallel course, especially during the first 12-15 years of the disease.

• Pregnancy can aggravate DR or cause its occurrence.

• Smoking aggravates DR in young patients with Type 1 DM. It can also convert background DR into proliferative DR.

• Alcohol abuse, oral contraceptive pills (progesterone content may contribute to acceleration of DR) and aspirin (its use does not prevent the occurrence or progression of DR), can affect the progression of DR.

• Local factors (myopia) have a protective effect on DR progression, whereas others can aggravate it, such as cataract surgery with intraoperative complications.

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