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C.-H. Lai, T.-H. Chou, P.-C. Wu, C.-N. Kuo; Relationship of Diabetic Macular Edema With Glycosylated Hemoglobin (HbA1c). Invest. Ophthalmol. Vis. Sci. 2008;49(13):2730.
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To evaluate the correlation between the glycosylated hemoglobin (HbA1C) and the central foveal thickness measured by optical coherence tomography (OCT) in patients with history of DM.
Retrospective review of medical records of central foveal thickness measured by OCT and lab data of HbA1c. OCT was performed in bilateral eyes, but thicker one was selected for analysis. HbA1C was compared with foveal thickness measured by OCT within previous three months. Clinically significant macular edema (CSME) was diagnosed according to central foveal thickness over than 325 µm in OCT.
One hundred and four eyes of 104 patients were included in this cross-sectional study. Sixty and four patients were male and 40 were female. The mean age ± SD was 61.9 ± 9.385 years (range, 38 to 77 years). The mean DM duration was 11.2 ± 5.5 years (range, 1 to 30 years). The mean value of HbA1c was 7.8 ± 1.4 % (range, 5.1 to 12.1 %). The mean central foveal thickness was 257.3 ± 79.3µm (range, 151 to 526 µm).A trend towards higher risk was seen for factors of age ≤50, DM duration < 10 yrs and HbA1c ≥ 8% (p ≤ 0.10). These three variables were included in multivariate analysis. Two variables including age ≤50 and DM duration < 10 yrs were independently associated with CSME in diabetic eyes. HbA1c of 8 or over was associated with an increased risk of CSME in diabetic eyes (adjusted odds ratio [OR], 5.4; 95% confidence interval [CI], 1.5-19.1, P = 0.07). Age of 50 or less was associated with increased risk of CSME in diabetic eyes (adjusted OR, 6.4; 95% CI, 1.6-26.4, P = 0.01).
Patients with HbA1c of 8 or over had an increase in foveal thickness measured by OCT in diabetic eyes and there was a statistical significant correlation between younger age, shorter DM duration and thicker foveal thickness. It was presumed to be due to no stratified analysis of type I and type II DM. Strictly sugar control decreased the risk of diabetic macular retinopathy besides OCT could be a excellent detector of early diabetic macular edema.
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