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Antonio Ferreras, Beatriz Abadia, Pilar Calvo, Francisco Bartol, Guayente Verdes, Carlos Isanta, Michele M Iester, Michele Figus, Ana Belen Pajarin; Effect of adherence to the Mediterranean diet on diabetic retinopathy and choroidal thickness. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1913.
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© ARVO (1962-2015); The Authors (2016-present)
Mediterranean diet (MD) has been suggested to protect against cardiovascular disease through several mechanisms. However, evidence regarding MD effects on diabetic retinopathy (DR) remains unknown. The PREvención con DIeta MEDiterránea (PREDIMED) Study developed and validated a 14-item tool to assess the adherence to MD. The aim of this study was to compare the score of the PREDIMED questionnaire between healthy individuals and type 2 diabetes mellitus patients with and without DR. Additionally, the relationship between adherence to MD and choroidal thickness was evaluated.
The study protocol adhered to the tenets of the Declaration of Helsinki. Thirty-three normal individuals, 36 diabetic patients without DR, and 84 with DR were consecutively selected. All participants underwent a full ophthalmic examination, imaging of the macula with swept-source optical coherence tomography, a fasting blood sample and the PREDIMED questionnaire. The choroidal layer was automatically segmented and measured in the Early Treatment of Diabetic Retinopathy Study (ETDRS) macular grid. The PREDIMED score, choroidal thicknesses and clinical parameters were compared between groups using ANOVA (Scheffe post-hoc test). Furthermore, Pearson correlations were calculated between them.
The diabetic group with DR comprised 27 mild non-proliferative (NP) DR eyes, 40 moderate NPDR eyes, 12 severe NPDR eyes and 5 proliferative diabetic retinopathy eyes. Mean age and axial length did not differ between the groups. The subfoveal choroidal thickness was reduced in both diabetic groups, the diabetic eyes without DR (189.2±82.3 µm; p=0.020) and the DR group (195.5±69.3 µm; p<0.001), compared with the control group (239.9±63.6 µm). The PREDIMED score and high-density lipoprotein (HDL) cholesterol were higher in the control group (8.58±1.5 and 64.03±15.8 mg/dl, respectively) than in the DR group (7.06±1.6 and 43.12±10.1 mg/dl, respectively; p<0.001). Mild inverse correlations were found between the PREDIMED score and glycosylated hemoglobin (HbA1c) levels (r=-0.218; p=0.007). The PREDIMED score did not correlate with choroidal thickness.
Adherence to MD was lower in diabetic patients with DR. Macular choroidal thickness was reduced in diabetic patients. Further studies are needed to elucidate the role of MD in RD.
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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