Objective: The aim of this research was to determine the role of various associated factors (hyperlipidemia, hypertension, positive diabetic family history, positive hypertensive family history, and smoking) in the development and progression of diabetic retinopathy. Methods: We carried out this prospective cohort series at Jinnah Hospital, Lahore in the timeframe of October 2017 to June 2018 on a total of 100 diabetic patients who presented not even a single sign of diabetic retinopathy. The glycemic control of the registered patients was (HbA1c < 6.5%). Patients were included through non-probability sampling methods after receiving an informed and written consent of research participation. We evaluated the patients for smoking, hyperlipidemia, and hypertension. These patients went through two years follow up a program for the assessment of development and progression of diabetic retinopathy. Results: In the total one hundred patients 43 were female and 57 were male with a dominance of male over female in terms of population. The mean age of the study participants was (50.72 +/- 9.29) years. More patients were NIDDM (82%). Mean disease duration among research participants was (8.31 +/- 6.83) years. The proportion distribution of patients was such as there were smokers (11%), hypertensive (37%), hyperlipidemia (6%), diabetic family history (62%) and hypertensive family history (30%). There were 9 patients diagnosed with diabetic retinopathy at the end of the follow up the program. There was an increase in the onset of diabetic retinopathy with age factor; however, the difference was insignificant statistically. IDDM cases posed comparatively high diabetic retinopathy frequency and patients with positive diabetic family history and hypertension once again with an insignificant variation. There was no significant difference among smokers & non-smokers and gender-wise distribution. Diabetic retinopathy increased with prolonged disease duration. Diabetic retinopathy incidence was high among hyperlipidemia and hypertensive cases. Conclusion: Patient's age more than fifty years, disease duration more than twenty years, insulin dependent DM, hyperlipidemia, hypertension and positive family history of hypertension and diabetes were associated risks in the development and progression of diabetic retinopathy.
