A study of diabetic retinopathy in diabetic foot ulcer disease in a tertiary health care center of Northern Karnataka

Abstract

Purpose: The goal of this study was to compare and analyze the grade of Diabetic Foot Ulcer (DFU) with the severity of Diabetic Retinopathy (DR).Material and Methods: This was a cross-sectional study of 117 subjects with various grades of DFU consulting a tertiary health care center in Northern Karnataka from August 2022 to August 2023. A detailed history was taken, including demographics. Snellen's visual Acuity, slit lamp examination of the anterior segment, dilated fundus examination with direct and indirect ophthalmoscopies, and digital fundus photograph using a digital fundus camera were performed on all the subjects. DFU grading was done using the widely accepted standard Wagner's classification system of diabetic foot ulcers [1]. DR grading was based on the Early Treatment Diabetic Retinopathy Study (ETDRS) classification [2].Results: The mean age of the patients was 55.63+/- 12.820 years. There were 80 males (68.4%) and 37 females (31.6%). Duration of diabetes mellitus is directly proportional to the severity of the retinopathy, which was statistically significant with a P value < 0.001. HbA1C (%) values were directly proportionate to the severity of retinopathy, which was again statistically significant with a P value < 0.001. Comparison of DFU grade with the severity of retinopathy showed a strong positive correlation with a P value < 0.001, which was highly statistically significant.Conclusion: Our study highlights the statistically significant correlation between the grades of DFU and severity of DR in all the subjects, thus concluding that patients with DFU have a higher risk of DR and vice-versa, highlighting the importance of regular screening for these two complications to prevent serious adverse outcomes of DM.