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Erschienen in: International Ophthalmology 3/2018

18.05.2017 | Original Paper

Impact of estimated glomerular filtration rate on diabetic macular edema

verfasst von: Shreyas Temkar, Nishanthini Karuppaiah, Brijesh Takkar, Dipankar Bhowmik, Manjari Tripathi, Sivasubramanian Ramakrishnan, Yog Raj Sharma, Rajpal Vohra, Rohan Chawla, Pradeep Venkatesh

Erschienen in: International Ophthalmology | Ausgabe 3/2018

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Abstract

Purpose

Diabetic macular edema (DME) is a major cause of visual impairment in patients with diabetes and is influenced by various systemic factors. This study evaluates the effect of renal status on DME using estimated glomerular filtration rate (eGFR) as a study marker.

Methods

This was a prospective observational cross-sectional study. One hundred and ninety-five patients of diabetic retinopathy (DR) were included. Group 1 had patients of DR without DME (n = 100), and group 2 had patients of DR with DME (n = 95). All patients were evaluated for DR/DME-related risk factors. eGFR was calculated in all patients. Spectral domain optical coherence tomography (SDOCT) was done to identify the various patterns and severity of DME.

Results

Group 2 patients had significantly higher comorbidities than those in group 1 (p < 0.001). Hba1c, total cholesterol, triglycerides, LDL/HDL ratio, systolic and diastolic blood pressures were significantly higher in group II (p < 0.001 in each). There was no significant difference between the groups in terms of blood urea, serum creatinine or eGFR. eGFR did not show a significant association with a specific SDOCT pattern or severity of DME.

Conclusion

Comorbidities are more common and more severe in patients with DME. However, eGFR as a marker was not useful in predicting either the severity or pattern of DME. eGFR, in its present form, may not be useful in the evaluation and management of patients with DME.
Literatur
3.
Zurück zum Zitat Klein R, Klein BE, Moss SE, Cruickshanks KJ (1995) The wisconsin epidemiologic study of diabetic retinopathy. XV. The long-term incidence of macular edema. Ophthalmology 102(1):7–16CrossRefPubMed Klein R, Klein BE, Moss SE, Cruickshanks KJ (1995) The wisconsin epidemiologic study of diabetic retinopathy. XV. The long-term incidence of macular edema. Ophthalmology 102(1):7–16CrossRefPubMed
4.
Zurück zum Zitat Hammes H-P, Welp R, Kempe H-P et al (2015) Risk factors for retinopathy and DME in Type 2 diabetes-results from the German/Austrian DPV database. PLoS ONE 10(7):e0132492CrossRefPubMedPubMedCentral Hammes H-P, Welp R, Kempe H-P et al (2015) Risk factors for retinopathy and DME in Type 2 diabetes-results from the German/Austrian DPV database. PLoS ONE 10(7):e0132492CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Ajoy Mohan VK, Nithyanandam S, Idiculla J (2011) Microalbuminuria and low hemoglobin as risk factors for the occurrence and increasing severity of diabetic retinopathy. Indian J Ophthalmol 59(3):207–210. doi:10.4103/0301-4738.81029 CrossRefPubMed Ajoy Mohan VK, Nithyanandam S, Idiculla J (2011) Microalbuminuria and low hemoglobin as risk factors for the occurrence and increasing severity of diabetic retinopathy. Indian J Ophthalmol 59(3):207–210. doi:10.​4103/​0301-4738.​81029 CrossRefPubMed
7.
9.
Zurück zum Zitat Wu D, Xuan Y, Ruan Y et al (2016) Prevalence of macro- and microvascular complications in patients with Type 2 diabetes and kidney disease with or without albuminuria in a single Chinese Diabetes Centre. Diab Vasc Dis Res 13(1):21–30. doi:10.1177/1479164115610247 CrossRefPubMed Wu D, Xuan Y, Ruan Y et al (2016) Prevalence of macro- and microvascular complications in patients with Type 2 diabetes and kidney disease with or without albuminuria in a single Chinese Diabetes Centre. Diab Vasc Dis Res 13(1):21–30. doi:10.​1177/​1479164115610247​ CrossRefPubMed
11.
Zurück zum Zitat Photocoagulation for diabetic macular edema (1985) Early treatment diabetic retinopathy study report number 1. Early treatment diabetic retinopathy study research group. Arch Ophthalmol Chic Ill 1960 103(12):1796–1806 Photocoagulation for diabetic macular edema (1985) Early treatment diabetic retinopathy study report number 1. Early treatment diabetic retinopathy study research group. Arch Ophthalmol Chic Ill 1960 103(12):1796–1806
13.
Zurück zum Zitat Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127(6):688–693CrossRefPubMed Otani T, Kishi S, Maruyama Y (1999) Patterns of diabetic macular edema with optical coherence tomography. Am J Ophthalmol 127(6):688–693CrossRefPubMed
14.
Zurück zum Zitat Ahmadpour-Baghdadabad M, Manaviat M, Shojaoddiny-Ardekani A (2013) Optical coherence tomography in diabetic macular edema: patterns and related risk factors. Nepal J Ophthalmol Biannu Peer Rev Acad J Nepal Ophthalmic Soc NEPJOPH 5(2):190–194. doi:10.3126/nepjoph.v5i2.8727 CrossRef Ahmadpour-Baghdadabad M, Manaviat M, Shojaoddiny-Ardekani A (2013) Optical coherence tomography in diabetic macular edema: patterns and related risk factors. Nepal J Ophthalmol Biannu Peer Rev Acad J Nepal Ophthalmic Soc NEPJOPH 5(2):190–194. doi:10.​3126/​nepjoph.​v5i2.​8727 CrossRef
16.
Zurück zum Zitat Brewer HB (2003) New features of the National Cholesterol Education Program Adult Treatment Panel III lipid-lowering guidelines. Clin Cardiol 26(4 Suppl 3):III19–III24CrossRefPubMed Brewer HB (2003) New features of the National Cholesterol Education Program Adult Treatment Panel III lipid-lowering guidelines. Clin Cardiol 26(4 Suppl 3):III19–III24CrossRefPubMed
19.
24.
Zurück zum Zitat Joshi SR, Parikh RM (2007) India–diabetes capital of the world: now heading towards hypertension. J Assoc Phys India 55:323–324 Joshi SR, Parikh RM (2007) India–diabetes capital of the world: now heading towards hypertension. J Assoc Phys India 55:323–324
26.
Zurück zum Zitat Jensen T, Deckert T (1992) Diabetic retinopathy, nephropathy and neuropathy. Generalized vascular damage in insulin-dependent diabetic patients. Horm Metab Res Suppl Ser 26:68–70 Jensen T, Deckert T (1992) Diabetic retinopathy, nephropathy and neuropathy. Generalized vascular damage in insulin-dependent diabetic patients. Horm Metab Res Suppl Ser 26:68–70
27.
Zurück zum Zitat Lopes de Faria JM, Jalkh AE, Trempe CL, McMeel JW (1999) Diabetic macular edema: risk factors and concomitants. Acta Ophthalmol Scand 77(2):170–175CrossRefPubMed Lopes de Faria JM, Jalkh AE, Trempe CL, McMeel JW (1999) Diabetic macular edema: risk factors and concomitants. Acta Ophthalmol Scand 77(2):170–175CrossRefPubMed
29.
Zurück zum Zitat The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus (1993) The diabetes control and complications trial research group. N Engl J Med 329(14):977–986. doi:10.1056/NEJM199309303291401 CrossRef The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus (1993) The diabetes control and complications trial research group. N Engl J Med 329(14):977–986. doi:10.​1056/​NEJM199309303291​401 CrossRef
30.
Zurück zum Zitat Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with Type 2 diabetes (1998) UK prospective diabetes study (UKPDS) group. Lancet Lond Engl 352(9131):837–853CrossRef Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with Type 2 diabetes (1998) UK prospective diabetes study (UKPDS) group. Lancet Lond Engl 352(9131):837–853CrossRef
31.
Zurück zum Zitat ACCORD Study Group, ACCORD Eye Study Group, Chew EY et al (2010) Effects of medical therapies on retinopathy progression in Type 2 diabetes. N Engl J Med 363(3):233–244. doi:10.1056/NEJMoa1001288 CrossRef ACCORD Study Group, ACCORD Eye Study Group, Chew EY et al (2010) Effects of medical therapies on retinopathy progression in Type 2 diabetes. N Engl J Med 363(3):233–244. doi:10.​1056/​NEJMoa1001288 CrossRef
32.
Zurück zum Zitat Keech AC, Mitchell P, Summanen PA et al (2007) Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet Lond Engl 370(9600):1687–1697. doi:10.1016/S0140-6736(07)61607-9 CrossRef Keech AC, Mitchell P, Summanen PA et al (2007) Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet Lond Engl 370(9600):1687–1697. doi:10.​1016/​S0140-6736(07)61607-9 CrossRef
34.
Zurück zum Zitat Aroca PR, Espeso Sentís O, Del Castillo DD (2000) Prospective study of correlation between diabetic retinopathy and microalbuminuria in diabetes type 1 patients. Arch Soc Esp Oftalmol 75(5):307–314PubMed Aroca PR, Espeso Sentís O, Del Castillo DD (2000) Prospective study of correlation between diabetic retinopathy and microalbuminuria in diabetes type 1 patients. Arch Soc Esp Oftalmol 75(5):307–314PubMed
35.
Zurück zum Zitat Sobngwi E, Mbanya JC, Moukouri EN, Ngu KB (1999) Microalbuminuria and retinopathy in a diabetic population of Cameroon. Diabetes Res Clin Pract 44(3):191–196CrossRefPubMed Sobngwi E, Mbanya JC, Moukouri EN, Ngu KB (1999) Microalbuminuria and retinopathy in a diabetic population of Cameroon. Diabetes Res Clin Pract 44(3):191–196CrossRefPubMed
36.
Zurück zum Zitat Singh SK, Behre A, Singh MK (2001) Diabetic retinopathy and microalbuminuria in lean Type 2 diabetes mellitus. J Assoc Phys India 49:439–441 Singh SK, Behre A, Singh MK (2001) Diabetic retinopathy and microalbuminuria in lean Type 2 diabetes mellitus. J Assoc Phys India 49:439–441
38.
Zurück zum Zitat Venkatesh P, Tibrewal S, Bhowmik D et al (2014) Prevalence of systemic co-morbidities in patients with various grades of diabetic retinopathy. Indian J Med Res 140(1):77–83PubMedPubMedCentral Venkatesh P, Tibrewal S, Bhowmik D et al (2014) Prevalence of systemic co-morbidities in patients with various grades of diabetic retinopathy. Indian J Med Res 140(1):77–83PubMedPubMedCentral
42.
Zurück zum Zitat Minnella AM, Savastano MC, Federici M et al (2016) Superficial and deep vascular structure of the retina in diabetic macularischaemia: OCT angiography. Acta Ophthalmol. doi:10.1111/aos.13099 CrossRefPubMed Minnella AM, Savastano MC, Federici M et al (2016) Superficial and deep vascular structure of the retina in diabetic macularischaemia: OCT angiography. Acta Ophthalmol. doi:10.​1111/​aos.​13099 CrossRefPubMed
Metadaten
Titel
Impact of estimated glomerular filtration rate on diabetic macular edema
verfasst von
Shreyas Temkar
Nishanthini Karuppaiah
Brijesh Takkar
Dipankar Bhowmik
Manjari Tripathi
Sivasubramanian Ramakrishnan
Yog Raj Sharma
Rajpal Vohra
Rohan Chawla
Pradeep Venkatesh
Publikationsdatum
18.05.2017
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 3/2018
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-017-0557-8

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