Associations of Serum Lipids with Macular Morphology in Patients without Diabetic Macular Edema

Abstract

Purpose: This study aims to assess optical coherence tomography (OCT) measured macular morphological parameters in diabetic patients without or with minimal diabetic retinopathy (DR) but no macular edema (DME), and their associations with known DR risk factors.

Methods: Cross-sectional data were collected from 76 patients with diabetes and without DME (70 without DR and 6 with minimum DR), who were recruited at a tertiary eye hospital in Tokyo. Minimum foveal thickness (MFT; μm), central macular thickness (CMT; Circle of 500μm radius; μm) and foveal volume (FV; mm3) were measured using spectral domain OCT (Heidelberg Spectralis SDOCT, Heidelberg Engineering, Germany). Associations between the three OCT measures and known risk factors of DR were examined using multiple linear regression models.

Results: Of 76 participants with good quality OCT and fundus images (mean age 59.2 years), MFT, CMT and FV in their right eyes were 220.7 μm±17.2, 273.5 μm ± 17.6 and 0.215± 0.014 mm3, respectively. After adjusted for age, gender, hemoglobin A1c, and urine protein, Higher level of Low-Density Lipoprotein (LDL) cholesterol was associated with increased MFT ( per 10 mmol/L increase in LDL, mean change in MFT: 1.463μm, 95% CI: 0.215 to 2.711), CMT ( per 10 mmol/L increase, mean change in CMT: 1.543μm, 95% CI: 0.379 to 2.706) and FV ( per 10 mmol/L increase, mean change in FV: 0.001 mm3, 95% CI: 1.402E-4 to 0.002).

Conclusions: We found that higher LDL cholesterol levels were associated with increased macular thickness and foveal volumes in this patient sample. These associations are in keeping with the associations between serum LDL levels with clinical DME. Further studies are needed to understand whether macular morphological parameters in patients with diabetes without DME are associated with future risk of developing clinical DME, and reveal the clinical implication of these findings.

Keywords: 498 diabetes • 499 diabetic retinopathy • 505 edema