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Robert Garoon, Lai Jing, Robert Coffee; Glycemic Control and Clinical Outcomes in Diabetics Receiving Intravitreal Injections. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1755.
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Limited data exists on the role that diabetic control plays into overall outcomes of patients receiving intravitreal injections for diabetic macular edema and whether these injections play a role in affecting a patient’s control of their diabetes and overall health. We performed a retrospective chart review to learn about relations between macular anatomy, visual function, and diabetic control, as measured by Hemoglobin A1c (HgbA1c) levels, with regards to the number of intravitreal injections received.
We analyzed 195 eyes from 134 patients over 4 years (2010-2014). All patients from the retina clinic at the Veterans Affairs Hospital in Houston, TX receiving an intravitreal injection for diabetic macular edema were included. Main outcome measures were HgbA1c, best corrected visual acuity (BCVA), and central macular thickness (CMT) as measured by spectral domain- optical coherence tomography (OCT), which was measured at 3-month intervals. Patients were excluded if they had other causes of retinal pathology or macular edema, received fewer than two intravitreal injections, had not been followed for at least 6 months, or had inadequate data available for collection. Data analysis was performed using Wilcoxon Sign-rank test.
The average age of the patient was 64.5 years (range 48-88 years). Eyes received an average of 7.95 injections over the course of its treatment. The average HgbA1c did not show a statistically significant change throughout the patients’ treatments (pre-first injection HgbA1c of 8.36 and post- final injection HgbA1c of 8.39, p =0.608). There was a statistically significant improvement in BCVA (20/62 to 20/53,<br /> p = 0.031) and a statistically significant change in CMT (426 μm to 353 μm, p<0.01).
Our results indicate that intravitreal injections do not have an impact on patient’s glycemic control. HgbA1c values trended upwards, although not significantly, on average during course of treatment. Despite a lack of glycemic control, visual outcomes and macular anatomy are improved in eyes receiving treatment for macular edema.
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