Goran Pelčić

Refractive Changes Associated with Diabetes Mellitus

ABSTRACT Background and methods: Diabetes mellitus is the most prevalent endocrine disease in developed countries. In people with diabetes in addition to vision loss caused by diabetic retinopathy transient visual disturbances may occur frequently caused by refractive changes. These changes in refraction are associated with variations in blood glucose levels but the underlying mechanism is still not fully understood. A systematic review with a comprehensive literature search was performed in order to clarify the underlying mechanisms regarding the connection of glycaemic control and refractive shift. Results: Some studies have shown that increased blood sugar leads to a myopic shift whilst others demonstrated that this change is in a hyperopic direction. Changes in visual acuity in patients with diabetes could be an indicator of inadequate metabolic control or even the first sign of diabetes mellitus. Conclusion: This review gives a brief overview of current research regarding potential mechanisms of glycemic control influence on refractive error. The aim is to emphasize the importance of understanding the relationship of blood glucose concentration and refractive changes as one of the common but overlooked diabetic complications.

Prevalence of Open Angle Glaucoma in Risk Groups in Slavonia and Baranya Region

The aim of this prospective study was to detect primary open angle glaucoma (POAG) in its early stage in patients at a higher risk of its development, and to identify the risk group with the highest prevalence of POAG. The study was conducted at Department of Ophthalmology, Osijek University Hospital Centre, and included 250 patients divided into five groups, as follows: group 1, patients with diabetes type 1 and type 2; group 2, patients with arterial hypertension (blood pressure >140/90 mm Hg); group 3, patients with positive family history of POAG; group 4, patients with myopia between -3.0 and -8.0 diopters; and group 5, control group including patients aged 40 with no risk factors for POAG development. Study results showed that distribution of glaucoma patients was not equal across the groups. The prevalence of POAG in all patients was 5.6%, whereas in patients with positive family history of POAG it was 14%, which was statistically significantly higher than in patients with diabetes and myopia (4% both), as well as in control group. The difference was greatest in comparison to control group. There was no statistically significant difference in glaucoma incidence between the group of patients with positive family history (14%) and patients with systemic hypertension (6%). The results obtained suggest that of all risk factors analyzed, positive family history of POAG is the most important risk factor for glaucoma development in all risk groups.