Diabetes, Metabolic Syndrome and Obesity (Jan 2024)
Risk Factors Associated with Diabetic Retinopathy with and without Macular Edema in Recently Diagnosed Patients with Type 2 Diabetes
Abstract
Ana Cristina García-Ulloa,1 Liliana Pérez-Peralta,1,2 Salvador Jaime-Casas,3 Aida Jiménez-Corona,2,4 David Rivera-De La Parra,1,2 Enrique Octavio Graue-Hernández,2 Sergio Hernández-Jiménez1 On behalf of the Group of Study CAIPaDi1Centro de Atención Integral del Paciente con Diabetes (CAIPaDi) Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; 2Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico; 3Escuela de Medicina, Universidad Panamericana, Mexico City, Mexico; 4Dirección General de Epidemiología, Secretaría de Salud, Mexico City, MexicoCorrespondence: Liliana Pérez-Peralta, Centro de Atención Integral del Paciente con Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15. Colonia Sección XVI, Tlalpan, Mexico City, 14080, Mexico, Tel +52 55 54870900 (5045), Email [email protected]: To evaluate the risk factors associated with diabetic macular edema (DME) in patients with a recent type 2 diabetes mellitus (T2DM) diagnosis.Patients and Methods: We conducted a case-control study at a third-level hospital in Mexico City. We enrolled patients ≥ 18 years old, with T2DM less than five years of diagnosis, without disabling complications, and non-smokers. The control group was patients with diabetic retinopathy and without macular edema (DR-DME). Cases were patients with DR+DME. We measured fasting glucose, creatinine, lipid profile, urinary albumin/creatinine ratio (ACR), and HbA1c. An ophthalmological examination consisted of visual acuity measurement, digital three-field fundus photography with an automatic non-mydriatic camera, slit lamp, and Optical coherence tomography (OCT) examination.Results: 183 and 61 patients with DR-DME and DR+DME, respectively, were included in the analysis. The prevalence of mild DR was higher in the DR-DME group, but the frequencies of moderate and severe retinopathy were higher in the DR+DME group. Patients in the DR-DME group had better vision than those in the DR+DME group. Logistic regression analysis revealed that age (OR, 1.07), HbA1c (OR, 1.19), and Albumin-to-Creatinine Ratio (ACR) > 30 mg/g (OR, 3.37) were associated with an increased possibility of DME compared to DR-DME.Conclusion: Our study provides insights into the association between risk factors and DME. We found a statistically strong association between HbA1c levels, age, and ACR. Patients with poor metabolic control should undergo an extensive medical examination to screen for DME, which may be related to the chronicity of DM and renal damage.Keywords: macular edema, recent diagnosis, diabetes mellitus, metabolic control
