Abstract
BackgroundDiabetic macular edema (DME) with neurosensory retinal detachment (NSD) remains an important cause of visual loss in patients with diabetes. The aim of the study was to elucidate the association of systemic and ocular risk factors with NSD in DME.MethodsIn a retrospective case–control study, we reviewed clinical records of all the subjects with DME seen between January 2010 and December 2010. Cases and controls were selected based on optical coherence tomography and stereoscopic biomicroscopy review. NSD was defined as subfoveal fluid accumulation under detached retina with or without overlying foveal thickening. The association between the presence of NSD, blood pressure, lipid status and various other biochemical parameters was evaluated.ResultsGroup I (cases) included 37 eyes of 33 patients having DME with NSD and Group II (controls) included 30 eyes of 21 patients having DME without NSD. Patients ranged in age (mean ± SD) from 50 to 62 years (56.6 +/-6.78) for cases and from 51 to 65 years (58.4+/-7.84) for controls. The duration of diabetes ranged from 4 to 15 year (mean 9.45+/-6.08) among cases and 4 to 14 years (9.7+/-5.12) among controls. Significant risk factors for NSD were high values of systolic and diastolic blood pressure (p = 0.039 and 0.043 respectively).ConclusionHigh systolic and diastolic blood pressures are independent and significant risk factors for NSD in DME.
Highlights
Diabetic macular edema (DME) with neurosensory retinal detachment (NSD) remains an important cause of visual loss in patients with diabetes
There were no significant differences in the two groups in terms of the mean age (p = 0.375), duration of diabetes (p = 0.876), fasting blood sugar and post prandial blood sugar levels (p = 0.959 and 0.436 respectively), glycosylated hemoglobin (p = 0.859), hemoglobin (p = 0.118) and presence of hypertension (p = 0.634)
Hypertension, proteinuria, dyslipidemia, uncontrolled renal parameters, and PRP for PDR, have been associated with increased risk of DME. All these factors are known to correlate with increased incidence of DME, very few studies have correlated the presence of uncontrolled systemic disease and biochemical parameters with increased incidence of NSD in DME
Summary
Diabetic macular edema (DME) with neurosensory retinal detachment (NSD) remains an important cause of visual loss in patients with diabetes. The aim of the study was to elucidate the association of systemic and ocular risk factors with NSD in DME. The presence of NSD in DME associated with subretinal exudation has been reported to be associated with poor visual prognosis after vitrectomy [2]. The high percentage of NSD in CRVO [9] may have played a role in the poor response of macular edema to grid laser photocoagulation in the multicenter trial on CRVO by the Central Retinal Vein Occlusion Study Group [15].
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