Prediction of Proliferative Diabetic Retinopathy With Hemoglobin Level

Abstract

Proliferative diabetic retinopathy (PDR) is a leading cause of blindness in the United States and has been linked to retinal hypoxia and characterized by small blood vessel proliferation, retinal microaneurysms, and vitreous hemorrhaging.¹Lower hematocrit (HCT) levels have been associated with the progression of diabetic kidney disease^2,3and with the incidence of PDR,⁴suggesting that anemia may increase complication risk. In contrast, however, stabilization of retinopathy has also been reported in those with end-stage renal disease,^5,6a condition associated with anemia. The association between hemoglobin (HGB) and retinopathy is likely, therefore, to be complex, particularly given the recent observation of unusually high HGB levels, reaching 18.8 g/dL, in study participants with nephropathic type 1 diabetes mellitus.⁷