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Peter Ririe, baochan nguyen; Angiographically-identified retinal microaneurysms as a marker for cumulative diabetic microvascular damage. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6310.
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© ARVO (1962-2015); The Authors (2016-present)
Early diabetic retinopathy is defined histologically by microaneurysms, which are outpouchings of the capillary wall due to loss of pericytes. Funduscopic examination is less sensitive for the detection of microaneurysms than examination by fluorescein angiography. The eye provides a unique opportunity to visualize diabetic damage non-invasively. This study analyzes the number of microaneurysms a person possesses and compares this with the individual’s risk for diabetic kidney disease.
Institutional review board approval was obtained and a retrospective chart review was conducted of all Diabetics seen at Parkland Health and Hospital Systems who had undergone fluorescein angiography between February 2009 and February 2014. Inclusion criteria: Ages 18-70, type 1 or 2 diabetics who received a fluorescein angiogram and were followed at Parkland Memorial Hospital from 2/1/2009 to 2/1/2014. Patients were divided into good (Hgb A1c ≤ 7.0) and poor (Hgb A1c > 7.0) glycemic control groups. The change in microaneurysm count was plotted for each group and a logistical regression analysis conducted. Change in creatinine was also obtained for each glycemic control group and the significance of observed differences between the two groups was obtained using standard two tailed t-tests.
A total of 1,137 patient charts were reviewed. 15 charts were identified as meeting inclusion and exclusion criteria. Time between FAs ranged from 7 to 22 months with an average of 13.8 months. 5 were classified as having good glycemic control and 10 as poor glycemic control. Mean MA change for good glycemic control -10 and for poor glycemic control +62.66, p value 0.048. No statistically significant difference identified for mean change in creatinine between the good and poor glycemic control groups. Average change in creatinine for the good glycemic control group was +0.036 mg/dL and +0.485 mg/dL for the poor glycemic control group with a p value of 0.33.
This study shows a statistically significant increase in microaneurysm count over an average time frame of 13.8 months for diabetics classified as having poor glycemic control compared to those with good glycemic control. The observed increase in microaneurysm count in the poor glycemic control group however was not associated with a statistically significant increase in creatinine.
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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