June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Correlation between Diabetic Macular Edema (DME) and extraocular complications observed during diabetes
Author Affiliations & Notes
  • Olivier Lichtwitz
    Ophthalmology, Hospital University of Poitiers, Poitiers, France
  • Nicolas Leveziel
    Ophthalmology, Hospital University of Poitiers, Poitiers, France
  • Michèle Boissonnot
    Ophthalmology, Hospital University of Poitiers, Poitiers, France
  • Aurélie Miot
    Endocrinollogy, Hospital University of Poitiers, Poitiers, France
  • Xavier Piguel
    Endocrinollogy, Hospital University of Poitiers, Poitiers, France
  • Florence Torremocha
    Endocrinollogy, Hospital University of Poitiers, Poitiers, France
  • Pierre-Jean Saulnier
    Center of Clinical Investigation, INSERM CIC 802, Poitiers, France
  • Richard Maréchaud
    Endocrinollogy, Hospital University of Poitiers, Poitiers, France
  • Samy Hadjadj
    Endocrinollogy, Hospital University of Poitiers, Poitiers, France
  • Footnotes
    Commercial Relationships Olivier Lichtwitz, None; Nicolas Leveziel, None; Michèle Boissonnot, None; Aurélie Miot, None; Xavier Piguel, SANOFI (F), NOVONORDISK (F), BMS (F), NOVARTIS (F); Florence Torremocha, None; Pierre-Jean Saulnier, None; Richard Maréchaud, None; Samy Hadjadj, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 4918. doi:
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      Olivier Lichtwitz, Nicolas Leveziel, Michèle Boissonnot, Aurélie Miot, Xavier Piguel, Florence Torremocha, Pierre-Jean Saulnier, Richard Maréchaud, Samy Hadjadj; Correlation between Diabetic Macular Edema (DME) and extraocular complications observed during diabetes. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4918.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

Diabetic macular edema is the main cause of visual loss during diabetes. Some clinical (hypertension, nephropathy) or biological parameters (glycatedhemoglobin) are well-known risk factors for DME. The objective of the study was to identify clinical factors that may be associated with the presence of the DME.

 
Methods
 

This is a longitudinal study including type 2 diabetic patients to evaluate the risk of complications related to diabetes. The diagnosis of DME was established with retinal color photographs and/or fundus examination. Epidemiological data, cardiovascular events (angina, myocardial infarction, transient ischemic attack, stroke)and other complications (nephropathy, history of amputation) were analysed.Diabetic patients with DME were compared with diabetic patients without DME.

 
Results
 

Among 2864 patients (mean age 63 years, mean duration of diabetes of 14.7 years, mean HbA1c 7.6%) included in the study, 357 patients (12.5%) had a DME (131 women, 226 men, mean age 65.8 years, mean duration of diabetes of 18,7 years, glycosylated haemoglobin 7.7%). In univariate analysis, DME was significantly associated with the duration of diabetes (OR=1.04, p<0.0001), glycatedhemoglobinlevels (OR=1.18, p=0.001), systolic blood pressure (OR=1.02, p<0.0001), history of cardiovascular disease (OR=2.4, p<0.0001), renal impairment (OR>7, p<0.0003) and with any history of amputation (OR=3.7, p<0.0001). In multivariate analysis, DME was significantly associated with the duration on diabetes (OR adjusted=1.03, CI 95% 1.01-1.05, p=0,002), glycatedhemoglobin (OR adjusted =1.2, CI 95% 1.1-1.4, p=0.0003), systolic blood pressure (OR adjusted =1.01, CI 95% 1.01-1.02, p=0,01), renal impairment (OR adjusted>5, p<0.006) and with any history of amputation (OR adjusted =2.6, CI 95% 1.4-5, p=0.003).

 
Conclusions
 

This study demonstrates a strong association between DME andany history amputation. Our study provides other associations between DME and extraocular events that have been previously investigated in other studies. A common microvascular determinism may be explained the relationship between amputation and DME. The identification of clinical and biological risk factors for DME could lead to define more precisely the at-risk population. Based on these risk factors, a prospective follow-up of patients may lead to validate predictive models fordevelopment of DME.

  
Keywords: 688 retina • 498 diabetes • 505 edema  
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