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Aisha Hasan, Jonathan Levine, Barton Levine; Correlating renal function and Diabetic Macular Edema in Latino and African American Populations with Type 2 Diabetes. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4833.
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Prior studies have shown the association between abnormal renal profiles and the development of diabetic retinopathy (DR) and diabetic macular edema (DME) in Asian and European populations. Our study seeks to exam whether or not this association also exists in the Latino and African American populations of our South Bronx community.
This is a retrospective chart review of adult Latino and African American patients with DME and any level of DR seen in our hospital’s eye clinic within the last year. An equal number of type 2 diabetic patients of the same demographic without DME and with or without DR were included for comparison. Demographic information, Hemoglobin A1c (HbA1c), and cholesterol levels was recorded for each patient. Renal profiles including serum creatinine levels, eGFR, and urinary albumin to creatinine ratios (ACR) were recorded as well. Patients were stratified based on presence or absence of DME. Lab data were compared and the unpaired Student’s t-test was used to calculate statistical significance. Log values of ACR was used for data analysis as the ACR values are not normally distributed. Patients taking angiotensin-converting-enzyme inhibitors or angiotensin-receptor-blocker were excluded from our study.
Thus far we have collected data from a total of 24 patients- 12 with DME and 12 without. Our DME group had a significantly higher mean microalbumin to creatinine ratio (ACR) compared to the non- DME group (2.417 vs 1.268, respectively, p < 0.005). The DME group also had a higher mean HbA1c (9.04 vs 7.13, p = 0.012). There was no significant difference between the DME and non DME groups in age (64 vs. 70), LDL cholesterol (71.91 vs. 76.83), eGFR (69.02 vs 66.84) or other laboratory values.
Our preliminary data suggests a possible association between elevated ACR values and DME in our African American and Latin American populations. A larger sample size will allow us to further stratify our patients based on ethnicity and severity of renal disease. Further studies should explore the utility of ACR values as a prognostic indicator of DME risk and the need for closer follow up with ophthalmology.
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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