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Daniel V Will, Daniel V Will; HbA1c testing in patients with microvascular retinal abnormalities found on indirect ophthalmoscopy.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3844.
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© ARVO (1962-2015); The Authors (2016-present)
Retinal telangiectasia and microaneurysms are commonly identified on indirect ophthalmoscopy and evaluated for underlying causes including diabetes. This study reviews the relationship of hemoglobin A1c (HbA1c) testing in a series of adult patients evaluated for possible diabetes based on clinically suspicious microvascular abnormalities. This is clinically relevant as patients with elevated HbA1c are at increased risk of developing diabetes and cardiovascular disease.
A retrospective electronic chart review was conducted on a series of patients from 2014 to 2019 not known to have serum glucose abnormalities who underwent HbA1c testing as a component of evaluation of retinal microvascular abnormalities. Patient demographics and HbA1c results were analyzed and compared to previously published HbA1c levels for similar age groups. Patients with previously diagnosed prediabetes or diabetes were excluded. The design of study and data used did not require IRB approval.
Chart review assembled 99 patients (56 female, 43 male) who underwent HbA1c testing for initial evaluation of retinal microvascular abnormalities. The mean age of the population was 71.3 years. The mean HbA1c on initial testing was 5.825%. The percentage of patients with HbA1c 5.5% or higher on initial testing was 78.8% and HbA1c 5.7% or higher was 61.6%. 7% of patients had HbA1c 6.5% or higher and diagnosed with adult onset diabetes.
A high percentage of patients with microvascular abnormalities suspicious for diabetic retinopathy were found to have HbA1c blood test result in ranges considered at substantial risk of developing diabetes and cardiovascular disease with the majority of patients falling in the prediabetic range. Further studies are warranted.
This is a 2020 ARVO Annual Meeting abstract.
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