Persistent diabetic macular edema is associated with elevated hemoglobin A1c - 18/08/11
Inquiries to Quan Dong Nguyen, MD, MSc, The Wilmer Eye Institute, Maumenee 721, 600 North Wolfe Street, Baltimore, MD, 21287; fax: (410) 614-8577Résumé |
Purpose |
To assess the correlation between persistent diabetic macular edema and hemoglobin A1c (HbA1C).
Design |
Retrospective study.
Methods |
Records of type 2 diabetic patients who received eye care for persistent clinically significant macular edema (CSME) from January 2002 to January 2004 were reviewed. Subjects who met one of two criteria were identified: 1) persistent CSME, detected by contact lens biomicroscopy and fluorescein angiography, despite at least two focal laser photocoagulations (FLP) performed at least 3 months before the current diagnosis, or 2) a history of CSME with resolution of macular edema at the time of examination. Patients also needed to have had their HbA1C measured at the Johns Hopkins Hospitals within 3 months of meeting these criteria.
Results |
The study identified 92 patients (152) eyes with persistent CSME and 32 patients (56 eyes) with resolved CSME. HbA1C values ranged from 5.3% to 15.6% (mean, 8.9%; median, 8.7%) and 5.3% to 9.7% (mean, 6.7%; median, 6.6%) among patients with persistent and resolved edema (P = .0005). Among the 32 patients with persistent unilateral CSME, mean HbA1C was 8.6% (median 8.5%), and among the 60 patients with bilateral CSME, mean HbA1C was 9.1% (median, 8.9%). Of patients with persistent CSME, 74% had HbA1C greater than 7.5% compared with 12.5% of the patients with resolved CSME (P = .0005).
Conclusions |
Persons with type 2 diabetes and persistent CSME have higher HbA1C at time of their disease than patients with resolved CSME. Patients with bilateral disease have more elevated HbA1C than those with unilateral disease.
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| Dr. Do is supported by the Heed Ophthalmic Foundation Clinician-Scientist Award and the Ronald G. Michels Fellowship Foundation. Dr. Nguyen is supported by a Career-Development Award from the National Eye Institute (grant EY 13552). |
Vol 139 - N° 4
P. 620-623 - avril 2005 Retour au numéro
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