May 2007
Volume 48, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2007
Clinically Significant Macular Edema and Survival: Wisconsin Epidemiologic Study of Diabetic Retinopathy
Author Affiliations & Notes
  • F. E. Hirai
    Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
    Ophthalmology, Federal University of Sao Paulo, Sao Paulo, Brazil
  • M. D. Knudtson
    Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
  • B. E. K. Klein
    Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
  • R. Klein
    Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin
  • Footnotes
    Commercial Relationships F.E. Hirai, None; M.D. Knudtson, None; B.E.K. Klein, None; R. Klein, None.
  • Footnotes
    Support NIH Grant EY016379
Investigative Ophthalmology & Visual Science May 2007, Vol.48, 174. doi:
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      F. E. Hirai, M. D. Knudtson, B. E. K. Klein, R. Klein; Clinically Significant Macular Edema and Survival: Wisconsin Epidemiologic Study of Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):174.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose:: to investigate the association of clinically significant macular edema (CSME) with all cause and cause-specific mortality in a long-term diabetic population.

Methods:: the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) is an ongoing prospective population-based cohort study initiated in 1980-82 of individuals with diabetes diagnosed at either = 30 years of age (older-onset, n=1,370). Stereoscopic color retinal photos were graded for retinopathy using the modified Airlie House Classification scheme and CSME was defined by ETDRS criteria.

Results:: the prevalence of CSME was 7.5% and 5.9% for the older- and younger-onset groups, respectively. After 20 years of follow-up, 276 younger-onset and 1,123 older-onset persons died. When adjusting for age and gender CSME was not significantly associated with all-cause (hazard ratio and 95% confidence interval 1.41 (0.96-2.07), p=0.08) or ischemic heart disease mortality (1.14 (0.61-2.12), p=0.68) in the younger-onset group. In the older onset group, there was increasing all-cause and ischemic heart disease mortality when CSME was present: 1.55 (1.25-1.92), p<0.01 and 1.56 (1.15-2.13), p<0.01, respectively, when adjusting for age and gender. After controlling for other risk factors, the association remained significant for all-cause (1.28 (1.02-1.61), p=0.03) but was only marginally significant for ischemic heart disease (1.36 (0.97-1.89), p=0.07). CSME was not significantly associated with stroke mortality by in either group.

Conclusions:: CSME appears to be a risk indicator for decreased survival in persons with older-onset diabetes mellitus. The presence of CSME may identify individuals who should be under care for cardiovascular disease.

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • diabetic retinopathy 
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