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Hiroshi Sasaki, Natsuko Hatsusaka, Hisanori Miyashita, Naoko Shibata, Yusuke Seki, Teppei Shibata, Hiromi Osada, Hidetoshi Ishida, Masami Kojima, Eri Kubo; Crystalline lens change peculiar to diabetes. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3642. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
We investigated the relationship among diabetes mellitus (DM), diabetic retinopathy (DMR) and crystalline lens changes by epidemiological surveys conducted in Japan, China, Taiwan, Iceland and Tanzania.
The epidemiological investigation included 1778 participants aged over 50 (mean: 61.5±9.5) years, comprising 115 Japanese residents of Wajima city, 1054 Chinese residents of Sanya and Taiyuan cities, and 609 Tanzanian residents of Mkuranga district. DM was confirmed by self-report. Cataract and DMR were diagnosed by one experienced ophthalmologist (HS) using a slit lamp microscope. Cataracts were grouped into 5 types: cortical (COR), nuclear (NUC), posterior subcapsular cataract (PSC), Retrodots (RD) and Waterclefts (WC). WC with vacuoles were grouped as VWC. COR and WC comprised 2 types: central (CEN+) within 3 mm diameter of the pupil center and peripheral (CEN-) outside this area. We used the Statistical Package for Social Science (SPSS) for logistic regression analysis, taking age, gender, smoker/non-smoker, and axial length and total UV exposure dose as objective variables to examine the risks of 5 types of cataracts with/without DM and DMR.
Regarding DM, the odds ratios were: COR (CEN-), 1.67 (1.12-2.48, 95% CI) (p<0.05); NUC, 0.62 (0.38-1.02) (p=0.062); PSC, 2.48 (1.36-4.52) (p<0.01); RD, 1.54 (1.08-2.20) (p<0.05); WC (CEN+), 0.32 (0.12-0.85) (p<0.05); and VWC (CEN-), 3.60 (2.10 - 6.15) (p<0.001). Regarding DMR, the odds ratios were: RD, 5.6 (2.1-14.8); and VWC (CEN-), 14.0 (3.6-54.9) (p<0.01). In the subjects with and without VWC (CEN-), prevalence of DM was 23.1% and 4.1%, and that of DMR, 12.8% and 1.3%, which were significantly higher in subjects with VWC (CEN-) (p<0.001).
The risks of RD and VWC (CEN-) in addition to cortical and posterior subcapsular cataract are high in patients with DM. Accordingly, these lens lesions may serve as a diagnostic tool in treatment of DM.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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