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Br J Ophthalmol 2004;88:303-305 doi:10.1136/bjo.2003.023945
  • Letter

HLA typing is not predictive of proliferative diabetic retinopathy in patients with younger onset type 2 diabetes mellitus

  1. T Mimura1,2,
  2. S Amano1,
  3. S Kato1,
  4. M Araie1,
  5. H Funatsu2,
  6. S Kitano2,
  7. E Shimizu2,
  8. H Noma3,
  9. O Yoshino4,
  10. S Hori5
  1. 1Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
  2. 2Department of Ophthalmology, Diabetes Center Tokyo Women’s Medical University, Tokyo, Japan
  3. 3Department of Ophthalmology, Hiroshima University School of Medicine, Hiroshima, Japan
  4. 4Department of Obstetrics and Gynecology, University of Tokyo school of Medicine, Tokyo, Japan
  5. 5Department of Ophthalmology, Tokyo Women’s Medical University, Tokyo, Japan
  1. Correspondence to: Tatsuya Mimura MD, Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan; mimurambg.ocn.ne.jp
  • Accepted 21 April 2003

Chronic hyperglycaemia and the duration of diabetes are the most important factors in retinopathy. However, retinopathy progresses in some patients despite good glycaemia control. Also, poor glycaemia control does not always lead to retinopathy in younger onset patients, while still others develop severe retinopathy that is resistant to retinal photocoagulation.

These facts suggest that the risk factors for diabetes and retinopathy are not necessarily the same, and that the development of severe retinopathy may be influenced by genetic factors.1

Human leucocyte antigen (HLA) status has a significant role in immune responses and immunological tolerance and is a factor in the onset of type 2 diabetes.2–4 DR4, DR8, DR9, and several antigens of the DQ region are related to retinopathy in patients with type 1 diabetes.5,6 In addition, it was reported that HLA-DR was expressed in proliferative retinopathy.7,8 Little is known, however, about the relation between retinopathy with type 2 diabetes and the HLA antigen. Furthermore, most previous studies have not taken into consideration the background of glycaemic control or the duration of the diabetes. A group of younger onset type 2 diabetes patients with PDR, and a group who had no …

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