Anemic patients are significantly more likely to progress from nonproliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR), as well as diabetic macular edema (DME) and vision-threatening DR, according to research presented at this year’s Association for Research in Vision and Ophthalmology (ARVO) meeting.

A Philadelphia-based research team performed a retrospective study of adult patients whose charts had lab values from 2002 to 2016. Of the 69,982 NPDR patients included, 12,270 progressed to vision-threatening DR, 2,162 progressed to PDR and 10,322 progressed to DME. Both mild and moderate-to-severe anemia were significantly associated with these changes, according to the researchers. Oxygen delivery-related comorbidities (chronic pulmonary disease, decreased kidney function, increasing hemoglobin A1c, insulin use, hypertension and high diabetic complications) were also associated with all three progressions.