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Elizabeth M Walsh, Robin D Hamilton, Carlos Pavesio; A Retrospective Observational Study on the Prevalence of Pseudophakic Cystoid Macular Oedema (CMO) in a Diabetic Population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4174. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To perform a retrospective observational study to establish the incidence of pseudophakic CMO in diabetic cataract surgery and identify risk factors.
866 electronic records of diabetic cataract operations undertaken by the Medical Retinal or Vitreoretinal Services at Moorfields Eye Hospital, London, UK, were analysed. Patient demographics and clinical variables including diabetes type and duration, National Screening Committee (NSC) retinopathy grading, Best Corrected Visual Acuity (BCVA), previous focal laser, surgical complications, post-surgical treatment regimen and the use of adjuvants, were collected from the OpenEyes electronic patient management software. Tomographic analysis was performed on a TOPCON 3D OCT-2000 and Central Macular Thickness (CMT) measurements were collected from OpenEyes or the Topcon OCT viewer.
The incidence of pseudophakic CMO was 9%; a further 4% had a documented combination of post-operative CMO and diabetic macular oedema, whilst another 8% had an exacerbation of macular oedema associated with other retinal conditions.Duration of T2DM was found to be a risk factor, the mean duration being 21 years (±7.85) in those with CMO, compared to 13 years (±10.27) in those without. CMO was found in 8% of cases with T1DM, 13% of T2DM on insulin and 7% of T2DM not requiring insulin (RR 1.6; 95% CI 0.01-0.27; p<0.05).No Retinopathy (R0) was found to be protective, present in 48% of those without CMO, compared to 13% of those with (RR 0.27; 95% CI 0.14-0.26; p<0.05); Mild Retinopathy (R1) was found pre-operatively in 42% (CMO) and 27% (no CMO) (RR 1.58; 95% CI 0.04-0.17; p<0.05); Moderate to Severe Retinopathy (R2) in 14% (CMO) and 4% (no CMO) (RR 3.59; 95% CI 0.14-0.40; p<0.05); and Proliferative Retinopathy (R3) in 30% (CMO) and 21% (no CMO) (RR 1.45; 95% CI 0.00-0.15; p<0.05). Maculopathy (M1) was identified in 43% (CMO) and 11% (no CMO) (RR 4.01; 95% CI 0.26-0.42; p<0.05), whereas previous focal laser was found in 36% (CMO) and 11% (no CMO) (RR 3.24; CI 0.19-0.36; p<0.05).
This study identified multiple risk factors in the development of pseudophakic CMO in diabetic patients, some of which may be preventable, others that may require adjuvant or prophylactic therapy, depending on the extent of pre-existing diabetic eye disease and/or diabetic control.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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