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The analysis of the prevalence of diabetic macular edema with the contribution of optical coherence tomography, systemic findings and risk factors in diabetic patients followed up in Dokuz Eylul University, Izmir, Turkey

Session Details

Session Title: Quick Fire Free Paper Session 02

Session Date/Time: Thursday 26/09/2013 | 14:30-16:00

Paper Time: 14:35

Venue: Hall G1 (Level 2)

First Author: D.Acan TURKEY

Co Author(s):    D. Er   N. Kocak   M. Calan   T. Gumus     

Abstract Details

Purpose:

The aim of this study is to analyze the prevalence of diabetic macular edema (DME) with the contribution of optical coherence tomography (OCT), systemic findings and risk factors in diabetic patients followed up in Dokuz Eylul University Endocrinology and Metabolic Diseases Department and Ophthalmology Department Retina Unit.

Setting:

A cross-sectional study was designed in Dokuz Eylul University Ophthalmology Department Retina Unit and Dokuz Eylul University Endocrinology and Metabolic Diseases Department.

Methods:

The study included information on 808 eyes of 413 patients with diabetes who were followed up between 1 January 2011 and 30 June 2012. The age, gender, body-mass index, type of diabetes, diabetic age and treatment modalities, systemic blood pressure, smoking and alcohol consumption were evaluated. In addition to these, renal functional tests, hemoglobine A1c (HbA1c) levels, serum lipid profile, albumin level in 24-hour urine were examined. Best corrected visual acuity, results of bio-microscopic and fundus examinations along with intraocular pressure were recorded. Central macular thickness (CMT) with optical coherence tomography (OCT), stereoscopic fundus photographs and fluorescein angiography were evaluated. The relationship between systemic findings and the prevalence of DME were studied.

Results:

93.5% (386) of the patients were type 2 and 6.5% (27) was type 1 diabetic. Mean diabetic age was 9.1±8.0 (0 – 37) years. 12.7% of 808 eyes had DME. DME prevalence rates of the patients, who had diabetes less or more than ten years, were 3% and 25.3% respectively (p=0.000). 9.5% of females and 16.2% of males had DME (p=0.039). Smoking had no significant correlation, but alcohol consumption increased predictive relative risk up to 5.6-fold. HDL levels were statistically lower in cases with DME compared with the cases without DME in the series (p=0.036) and DME prevalence was found significantly lower in cases taking preventive antihyperlipidemic drugs (p=0.024). DME was found to be 6.0% and 14.7% in the cases with HbA1c levels lower and higher than 6.5% respectively (p=0.022). DME prevalence was significantly higher in insulin-dependent group (p=0.000). DME was 9.2 % in patients without nephropathy, 23.2% with micro-albuminuria and 23.3% with macro-albuminuria (p=0.001). DME level was 7.8% in the patients without neuropathy and 17.1% with neuropathy (p=0.004). The major ocular factor associated with DME was the severity of diabetic retinopathy (p=0.000); furthermore, previous cataract surgery was an effective factor as well (p=0.000).

Conclusions:

This study is an unique research about DME prevalence in Turkey using OCT. The prevalence of DME was 12.7%. Male gender, alcohol consumption, high creatinine levels, nephropathy, neuropathy, low HDL cholesterol level, previous cataract surgery, severity of diabetic retinopathy, HbA1c ≥6.5%, insulin dependence and diabetes more than 10 years were statistically significant factors with regards to prevalence of DME. DME prevalence was found to be significantly lower in the cases taking preventive antihyperlipidemic drugs.

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