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8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
1/16
“Proliferative diabetic retinopathy isassociate with microalbuminuria in
patients type 2 diabetes”
Meiki permatasari, S.Ked
Pembimbin ! dr. "ahmad syuhada, M.Kes, Sp.M
#K $
%ournal readin !
K&P'()*&"''( K+)()K S&()" "S P&"*'M)(' -)(*'( 'M)(/0S'1'
'K0+*'S K&1K*&"'( 0()3&"S)*'S M'+'/'4'*) -'(1'"+'MP0( 2567
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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)(*"108*)(
• 1iabetic patients with proteinuria orthose on dialyss ussually presentsevere forms of 1", but associationof 1" with early stae of diabeticnephropathy has not been entirelyestablished.
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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P0"PS&
*he aim of present study was todetermine if microalbuminuria isassociated with proliferative 1" in
type 2 diabetic patients while takininto account other possible factors
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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M&*1&
• ' cross9sectional study
• was conducted on 626: type 2 diabetic patients to determinewhether
• microalbuminuria is associated with proliferative diabeticretinopathy
• in these patients. Patients were evaluated by direct and indirect
• ophthalmoscopy and rouped accordin to the presence orabsence of
• proliferative diabetic retinopathy. *he areement of diabeticretinopathy
• classi;cation performed by ophthalmoscopy and by stereoscopic
• color fundus photoraphs
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8ontinue<
undus e=amination was performed in
all patients by a trained ophthalmoloist usin
direct and indirect ophthalmoscopy
throuh dilated pupils. "etinopathy was classi;ed
as non9proliferative #includin absentsins of 1" or sins of non9proliferative
1", i.e., microaneurysms, hemorrhae, hard
e=udates$ or proliferative #newly formed
blood vessels and>or rowth of ;brous tissueinto the vitreous cavity$. Patients with
panphotocoaulation
were classi;ed as presentin
proliferative 1".
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8ontinue<
*he severity of 1"
was raded based on the worst eye. )n 2
patients in whom the presence of media
opacities due to vitreous hemorrhae #6 patient$,
and cataract #6 patient$ prevented fundoscopy
in one eye, the contralateral eye
was used to classify 1". (o patient was
e=cluded as a result of unreadable fundoscopy
in both eyes. *he dianosis of proliferative1" based on fundoscopy performed
by the ophthalmoloists was used to classify
the patients
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8ontinue..
• 1emoraphic information, smokinhistory, anthropometric and bloodpressure measurements, lycemic
and lipid pro;le, and urinary albuminwere evaluated.
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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8linical and laboratory evaluation
• se=
• 'e
• 1iabetes duration
• Smokin habit
• Metabolic syndrome
• )nsuline use
• 0se of '8& inhibitor
• /ypertension
• 1iabetic (eprophati
• Microalbuminuria
• Macroalbuminuria
• 1ialisys
• Systolic blood pressure
• 1iastolic blood pressure
•
-ody mass inde=• ?aist9to9hip ratio
• lycosylated hemolobin
• *otal cholesterol
• /1+
• +1+
• *rilyserides
• Serum creatinin
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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"&S0+*
*able 6. clinical and laboratory characteristicsof 626: type 2 diabetic patients with and
without proliferative diabetic retinopathy
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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Withproliferativediabetic
retinopathy
Withoutproliferat
ivediabeticretinopha
ty
P
(umber of sub@ectsMale se='e #years$1iabetes duration #years$Smokin habit
Metabolic syndrome)nsuline use A0se of '8& inhibitors/ypertension1iabetic nephropathyMicroalbuminuria
Macroalbuminuria1ialysisSistolic blood pressure#mm/$1iastolic blood pressure#mm/$
-ody mass inde= #k>m2$?aist to hi ratio
22C6D: #EF.5B$75.D A F.F6E.7 A G.ED5 #6D,2B$
25F #F2.2B$6:D #7D.5B$626 #ED.6B$6CF #CG.CB$6G5 #CF.DB$:C #25.CB$
76 #27.GB$C2 #D6.CB$
6:C.2 A 22.CGE.7 A 6:.D2C.: A :.C5.FE A 5.5G
G.72 A 6.G:
FGCDF2
#DF.CB$EG.6 A65.:
65.6 AG.625D
#25.7B$G57
#G6.CB$
D6F#D2.DB$
D77#DC6B$
7:F#7E.GB$
D:CDE,2B
H5.5565.55E
H5.5565.567
H5.556
H5.556H5.556H5.556H5.5565.:67
H5.556
H5.5565.5525.D5C
H5.5565.D725.G7:
5.G7:
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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Withproliferativediabetic
retinopathy
Withoutproliferativediabetic
retinopathy
P
*otal cholesterol
#m>d+$/1+ #m>d+$+1+ #m>d+$ *rilycerides #m>d+$Serum creatinine#m>d+$
262.C A E:.6
:2.E A 66.76:D.6 A E:.6
6E5.7 #ED.69F5D.:$6.:G A 6.6:
262.C A E:.5
:7.: A 66.56DF.2 A DG.C6E5.C #27.79
6:C5.5$5.FC A 5.D2
5.G7:
5.5:25.25G5.FCC
H5.556
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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M0+*)3'")'*& '('+4S)S
“table 2. multiple loistic
reression analysisI
8/18/2019 Jurnal Reading Retinopati Diabetik Stase Mata
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• *o evaluate the association ofmicroalbuminuria with proliferative 1",patients with macroalbuminura #(J6EC$
and patients on dialysis #(JF6$ weree=cluded from reression model #on table2$
• Microalbuminuria #"J D.D, FEB 8)J 6.E79
7.FG, PJ 5.552$• )ts remained associated with proliferative
diabetic retinophaty
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8(8+0S)(
• *ype 2 diabetic patients withproliferative diabetic retinopathymore often presented renal
involvement, includin urinaryalbumin e=cretion within themicroalbuminuria rane
• *herefore, all patients withproliferative diabetic retinophatyshould undero an evaluation of
renal function includin urinary
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* / ' ( K 4 0