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Asymmetric diabetic retinopathy.

Rajvardhan Azad1, Sony Sinha2, Prateek Nishant3

  • 1Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.

Indian Journal of Ophthalmology
|October 28, 2021
PubMed
Summary

Asymmetric diabetic retinopathy (DR) affects 5%-10% of proliferative DR patients. Factors include vascular, inflammatory, and degenerative conditions, requiring comprehensive diagnosis for effective management.

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Area of Science:

  • Ophthalmology
  • Diabetology
  • Vascular Medicine

Background:

  • Diabetes mellitus prevalence is rising globally.
  • Diabetic retinopathy (DR) is a significant complication.
  • Asymmetric DR, where one eye shows advanced disease and the other does not, requires specific attention.

Purpose of the Study:

  • To synthesize existing literature on factors associated with asymmetric diabetic retinopathy (DR).
  • To define asymmetric DR and outline its prevalence.
  • To detail diagnostic approaches and differential diagnoses for asymmetric DR.

Main Methods:

  • Thematic synthesis of literature.
  • Iterative literature review in Medline and Google Scholar.
  • Inclusion of 45 original articles, 21 case reports, and 18 review articles (1965-2020).
Keywords:
Carotid artery diseasediabetes mellitusneovascularizationocular ischemic syndrome

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Main Results:

  • Asymmetric DR is defined as proliferative DR in one eye and less severe DR in the other for at least 2 years.
  • Associated factors include vascular (e.g., carotid disease), inflammatory (e.g., uveitis), and degenerative conditions (e.g., high myopia).
  • Diagnostic modalities range from standard ocular exams to advanced imaging (OCT, UWF-FA, OCTA) and systemic/carotid evaluations.

Conclusions:

  • Asymmetric DR is an important clinical entity affecting 5%-10% of proliferative DR cases.
  • A multifactorial etiology necessitates a comprehensive diagnostic workup.
  • Increased ophthalmologist awareness is crucial for timely diagnosis and management of asymmetric DR.