Can nasal septum deviation be one of the factors affecting diabetic retinopathy?

Abstract

Aim: Information on the extraocular causes of diabetic retinopathy is limited. Therefore, when researching etiology in a patient with diabetic retinopathy, if glucose, blood pressure and cholesterol are normal, other reasons must be investigated. Our aim was to evaluate the effect of nasal septum deviation (NSD) on the presence and severity of diabetic retinopathy in patients with diabetes mellitus. Methods: This prospective case-control study included 100 eyes of 50 patients with only diabetes mellitus (DM+ NSD-, control group) and 120 eyes of 60 patients with DM and nasal septum deviation (DM+NSD+, NSD group). After evaluation of NSD patients using a nasal obstruction symptom evaluation scale (NOSE scale), 22 patients were classified as mild, 21 as moderate, and 17 as severe. Anterior segment and dilated fundus examinations were performed in all patients. Diabetic retinopathy (DR) was classified as mild, moderate, and severe non-proliferative DR and proliferative DR (PDR). Results: The mean age of patients in the NSD and control groups was 58.7 (15.2) years (range: 41–69) and 59.6 (8.1) years (range: 44–67), respectively. The prevalence of DR and PDR were 70% (n=14) and 30% (n=6), respectively, in the severe NSD group (P=0.045 and P=0.035, respectively). The relationship between PDR and other factors in patients with NSD were evaluated, and a correlation was detected with DM duration (P=0.024, OR=1.272), HbA1c (P=0.032, OR=3.085), and NOSE scale severity (P=0.040, OR=2.566). Conclusion: The results of the present study show an increased risk of DR and PDR in patients with severe NSD. In addition to other risk factors in PDR etiology, NSD should also be considered.

Keywords

• diabetic retinopathy
• proliferative diabetic retinopathy
• nasal septum deviation
• hypoxia

Nazal septum deviasyonu, diyabetik retinopatiyi etkileyen faktörlerden biri olabilir mi?

Öz

Amaç: Diyabetes Mellituslu hastalarda nazal septum deviasyonunun diyabetik retinopatinin varlığı ve şiddeti üzerine etkisini değerlendirmek. Yöntemler: Bu prospektif vaka kontrol çalışmasına Diabettes Mellitus (DM) olan 50 hastanın 100 gözü ve nazal septum deviasyonu (NSD) olan DM'li 60 hastanın 120 gözü (kontrol grubu) dahil edildi. NSD hastaları burun tıkanıklığı semptom değerlendirme ölçeği (NOSE ölçeği) ile değerlendirme sonrası hastalar; 22 hafif, 21 orta ve 17 ağır evre olarak sınıflandırıldı. Tüm hastalara ön segment ve dilate fundus muayenesi yapıldı. Diyabetik Retinopati(DR);hafif, orta, şiddetli non-proliferatif DR ve proliferatif DR olarak sınıflandırıldı. Bulgular: NSD grubundaki hastaların yaş ortalaması 58,7 (15,2) (dağılım, 41-69) ve kontrol grubundaki hastaların yaş ortalaması 59,6 (8,1) (dağılım, 44-67) idi. DR prevalansı şiddetli evre NSD grubunda %70 (n=14), proliferatif DR prevalansı %30 (n=6) idi ve aradaki fark anlamlı bulundu (sırasıyla P=0,045, P=0,035). Proliferatif DR ile NSD hastalarındaki diğer faktörler arasındaki ilişki değerlendirildi ve DM süresi (P=0,024, OR=1,272), HbA1c (P=0,032, OR=3,085) ve NOSE skalası şiddeti (P=0,040, OR= 2,566) arasında pozitif ilişki saptandı. Sonuç: Sonuçlarımız ağır tip NSD hastalarında artmış DR ve proliferatif DR riskini göstermektedir. Bu nedenle PDR etiyolojisinde diğer risk faktörlerine ek olarak NSD de düşünülmelidir.

Anahtar Kelimeler

• Diyabetik retinopati
• Proliferatif diyabetik retinopati
• Nazal septum sapması
• Hipoksi

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