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Daniela Florea, Tatiana Mansour, Traci Clemons, Konstantinos Balaskas, Catherine Egan, Tunde Peto; Diabetes mellitus in MacTel Can Diabetes Mellitus be a negative prognosticator in MacTel?. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1034. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
In the worldwide MacTel Study, increased prevalence of diabetes mellitus (DM), obesity, hypertension, and cardiovascular diseases were observed. Up to 28% of the cohort had diabetes, but relatively little is known about the impact of DM on the progression of MacTel. In this work, we looked at the association between the presence of DM with or without Diabetic Retinopathy (DR) and progression of the MacTel stage.
Patients with 5-year follow-up from the cohort of the MacTel Natural History Study with a confirmed diagnosis of MacTel and DM, and gradable color and fluorescein angiographic (FA) images were included. Patients both with and without Diabetic Retinopathy and/or Diabetic Maculopathy (DR/DMac) were selected. The stage of MacTel was determined by grading of the fundus images and FFAs according to the Gass and Blodi classification.RESULTS:
In this present study, 496 eyes of 248 patients with MacTel and DM (MT/DM) with or without DR/DMac present were graded at baseline and after 5 years’ follow-up. At the beginning of the study, 20% of all MT/MD cases had DR/DMac increasing to 40% after 5 years. There were 22 eyes with diabetic maculopathy (DMac) at baseline with 4 cases of visually threatening features, and 27 at 5-years follow-up, 6 with visually threatening features. We found a significant correlation between MacTel stage and presence of DR/DMac. Patients with DR/DMac had on average a more advanced stage of MacTel after 5 years compared to those without DR/DMac. Progression in the severity of MacTel was more significant (% average change 24.4%, p=0.03) for the DR/DMac group comparing slower progression for patients without DR/DMac (% average change of 8.84 %, p=0.01).
The purpose of our study was to investigate if DR/DMac has an impact on the Mactel progression. Our results show that patients with DR/DMac demonstrate a higher rate of progression towards more advanced stages of MacTel compared to patients without DR/DMac.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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