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Chan Wu, Rongping Dai, Fangtian Dong, Yao Zhang, Wenhui Li; Prevalence and risk factors of hard exudate among Chinese Patients with diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2883.
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© ARVO (1962-2015); The Authors (2016-present)
Hard exudate plays an important role in permanent vision loss in patients with diabetic retinopathy. Reports on risk factors of hard exudate are limited. The purpose of this pilot study was to investigate the prevalence of hard exudate and its potential risk factors among Chinese patients with diabetic retinopathy.
472 patients with diabetes were consecutively enrolled for a prospective cohort study from Jan 2011 to Dec 2014 from the department of endocrinology of a national medical center. Baseline evaluation included social-demographic information, medical history, physical examination, laboratory evaluation and comprehensive assessment of diabetic complications. Seven-standard field color fundus photographs with stereoscopic images of optic disc and macula were taken through dilated pupils for all patients using a digital fundus camera. Fundus images were graded for degree of retinopathy and assessed for the presence of hard exudate by two independent ophthalmologists. Prevalence and clinical characteristic of hard exudate were analyzed with descriptive methods. Uni-variable and multi-variable logistic regression models were used to explore potential factors for hard exudate.
Median age of patients was 51 years, and 61% was men. The median duration from diagnosis of diabetes was 7 years. 86(18%) patients were diagnosed with diabetic retinopathy (DR) at enrollment, among whom 32 (37%) had hard exudate. 14/32(44%) patients had macular involvement of hard exudate. In uni-variable models, hypertension (odds ratio (OR)=1.7, P=0.09), chronic HBV infection (OR=1.9, P=0.02), lower BMI (OR=1.3 for each unit decrease in BMI, P=0.05), and higher serum Vitamin B12 level (OR=1.2 for each 100pg/ml increase of serum level, P=0.05) were associated increased risk of hard exudate. In multivariable models, lower BMI (adjusted OR=1.4, 95% CI: [1.1-2.0], for each unit decrease of BMI) and higher serum Vitamin B12 level (adjusted OR=2, 95%CI: [1.1-3.8], for each 100pg/ml increase of serum level) remained significant.
Hard exudate was an important form of retinopathy among this group of Chinese patients with diabetes, and macular involvement was common. BMI and Vitamin B12 level may be associated with the occurrence of hard exudate which finding warrants further investigation.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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