THE EFFECT OF ORAL PROPRANOLOL ON THE RATES AND SEVERITY OF DIABETIC RETINOPATHY AMONG HYPERTENSIVE PATIENTS

Noor M. Al Adwan MD*, Rania Z. Rawashdeh MD, Lara Harahsheh MD, Sonia A. AL Hwaitat MD, Esra'a Kh. Ajaleen MD

ABSTRACT

Purpose: To evaluate the effect of oral propranolol on the incidence and severity of diabetic retinopathy (DR) and diabetic macular edema (DME) in hypertensive diabetic patients. Methods: This retrospective cohort study was conducted at King Hussein Medical Center. It analyzed medical records of 124 patients with type II diabetes and controlled hypertension who attended to the medical retina clinic from January 2021 to December 2024. Participants were divided into two groups; propranolol users (33%) and non-users (67%). Outcomes included DR severity, DME presence/severity (OCT parameters), visual acuity (BCVA), and treatment response to anti-VEGF/laser therapy. Statistical analysis employed chi-square tests and t-tests. Results: 120 patients (240 eyes) with a mean age of 65.3 years were enrolled in the study. Propranolol users showed significantly lower rates of vision-threatening retinopathy (11.9% vs 18.5%, p=0.002) and proliferative DR (7.3% vs 12.8%, p=0.003) when compared to non-users. DME prevalence was reduced in the propranolol group (35.9% vs 45.7%, p=0.001), with better CST (mean CST 285.4±42.1 vs 312.7±49.3μm, p<0.001) and visual acuity (BCVA 0.32±0.21 vs 0.41±0.25 logMAR, p<0.001). Treatment response was superior among propranolol users, requiring fewer anti-VEGF injections (3.2±1.4 vs 4.7±1.8, p<0.001) and laser sessions (1.4±0.7 vs 1.9±0.9, p<0.001), with higher DME resolution rates (47.2% vs 33.2%, p=0.005). Conclusion: Oral propranolol use was associated with reduced severity of DR, improved DME outcomes, and enhanced treatment response in hypertensive diabetics. These findings suggest potential dual benefits of propranolol for both blood pressure control and retinal protection.

Keywords: Diabetic retinopathy, diabetic macular edema, propranolol, beta-blockers, hypertension, anti-VEGF.