Diabetic Retinopathy and Periodontitis: Implications from a Systematic Review and Meta-Analysis

Area of Science:

• Endocrinology and Metabolic Disorders
• Ophthalmology
• Periodontology

Background:

• Diabetes mellitus is a global health concern linked to microvascular complications like diabetic retinopathy (DR) and periodontitis.
• The interrelationship between DR and periodontitis requires further investigation for improved patient management.

Purpose of the Study:

• To systematically review and meta-analyze the association between diabetic retinopathy and periodontitis in patients with Type 1 and Type 2 diabetes.
• To assess the current evidence regarding the link between these two conditions.

Main Methods:

• A comprehensive search of multiple databases (PubMed/MEDLINE, Scopus, EMBASE, Google Scholar, Web of Science) was conducted.
• Ten studies with 1828 participants were included for qualitative synthesis, risk of bias assessment (ROBINS-E, GRADE), and random-effects meta-analysis.
• The PECO framework guided the study selection process.

Main Results:

• Eight of ten studies indicated a significant association between severe periodontitis (pocket depth ≥5 mm) and DR.
• Meta-analysis revealed that diabetics with periodontitis had 4.48 times higher odds of developing retinopathy (P = .003).
• High heterogeneity (I² = 86%) was observed, and the overall GRADE level of evidence was very low.

Conclusions:

• A majority of studies suggest a link between severe periodontitis and increased DR risk, but the evidence certainty is low.
• Periodontal health may play a role in managing diabetic patients.
• High-quality, longitudinal studies are needed to establish causality and understand the relationship between periodontitis and DR progression.