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K. Guan, C. Hudson, W.C. Lam, M. Mandelcorn, R.G. Devenyi, P.T. Harvey, M. Rawji, T. Wong, R. Nrusimhadevara, J.G. Flanagan; Baseline Hemodynamics and Retinal Thicknessof Diabetic Patients at Risk for the Development of Treatable Diabetic Macular Edema (DME) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4018.
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Purpose: To define the sample characteristics at baseline of patients with diabetes stratified by grade of retinopathy, including patients at particular risk for the development of sight-threatening DME. Methods: Group 1: 47 subjects without retinopathy. Group 2: 45 subjects with micro-aneurysms and / or hard exudates within 2 disc diameters of the fovea. Group 3: 31 subjects with pre-treatable macular edema. LogMAR visual acuity (VA) and LOCS III assessment was undertaken at each visit. Retinal hemodynamics (diameter, velocity and flow) were assessed in a superior retinal arteriole using the Canon Laser Blood Flowmeter (CLBF), model 100. Foveal average (FAV) thickness within a 600 µm radius circle and perifoveal average thickness (PFAV) within a 2500 µm radius annulus was measured using the Retinal Thickness Analyzer (RTA). An index of edema was also measured for a 500 um circle and a full field annulus using the Macular Edema Module (MEM) of the Heidelberg Retina Tomograph II (HRTII). All measures were compared between groups using a student's t-test with an α=0.05. Results: There was a significant difference in logMAR VA between groups 1 and 2 (mean -0.08 vs -0.03 respectively, p=0.03). The LOCS III assessment showed a significant difference in nuclear opalescence, cortical cataracts and posterior subcapsular cataract between groups 1 and 3 (mean 2.07 vs 2.41, p=0.04; 0.46 vs 1.07, p=0.004; 0.18 vs 0.40, p=0.004 respectively). No significant difference was found between groups for retinal diameter and blood velocity using the CLBF. The difference between groups 1 and 3 approached significance for blood flow (mean 7.83 µl/min vs 9.07 µl/min, p=0.07). No significant difference was found between groups for the FAV or PFAV of the RTA. For the MEM, the difference between groups 1 and 3 approached significance for the 500 µm circle only (mean 0.64 vs 0.75, p=0.08). Conclusions: These results establish the baseline characteristics of a cohort of diabetics that are currently being followed over time with respect to retinal hemodynamics and retinal thickness. There was a difference between groups for visual acuity, type and extent of cataract and a trend toward differences in blood flow and edema index.
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