This retrospective cohort study aimed to examine whether dyslipidaemia is a risk factor for progressing to proliferative diabetic retinopathy (PDR) and consequently requiring pan retinal photocoagulation (PRP) treatment in type 1 diabetics. In previous studies including the ETDRS study an association between serum triglyceride and development of PDR in both type 1 and type 2 diabetics has been found. This study looked at the baseline blood tests for cholesterol and lipids for 218 type 1 diabetics and correlated these with how many patients went on to have PRP treatment over a period of 13 years. Patients who had active PDR at baseline were excluded from the study. The results concluded that there is an association between raised serum triglycerides and the incidence of PRP, however, after adjusting for other established risk factors this association was not statistically significant.

Dyslipidaemia is thought to be a contributing factor to diabetic retinopathy and maculopathy and diabetic patients are started on medication to control lipids. The limitations of this study were that the cohort followed over 13 years was relatively small and they did not have any data on whether patients were started on treatment for dyslipidaemia. If the majority of patients had been started on lipid lowering treatments after the baseline lipid blood test this could have had an effect on their severity of diabetic retinopathy. The results from this study demonstrate that serum triglycerides could be an important factor to control in preventing progression of diabetic retinopathy. Ideally further studies on the role of lipids in diabetic retinopathy and the effects of lipid lowering treatments on diabetic retinopathy are needed.

Long-term associations between serum lipids and pan retinal photocoagulation in type 1 diabetes.
Jorgensen J, Jorgensen T, Green A, et al.
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Khadijah Basheer

Moorfields Eye Hospital, London, UK.

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