Prevalence Of Diabetic Macular Edema Research Articles

The prevalence and systemic risk factors of diabetic macular edema: a cross-sectional study from Turkey

BackgroundThe aim of this study was to evaluate the prevalence of diabetic macular edema (DME) utilizing optical coherence tomography (OCT), and to clarify the effects of the systemic findings and risk factors on the development of DME.MethodsThis cross-sectional study was conducted in the departments of ophthalmology and endocrinology at the Dokuz Eylul University School of Medicine in Izmir, Turkey. The demographics, type and duration of diabetes mellitus, treatment modality, smoking and alcohol consumption habits, as well as the systemic blood pressure, renal functional tests, hemoglobulin A1c level, serum lipid profile, and 24-h urine albumin level were noted and statistically analyzed. The relationships between the systemic findings and DME were studied.ResultsFour-hundred and thirteen eyes of 413 diabetic patients who were examined between January 2011 and July 2012 were enrolled in this study. The prevalence of DME was 15.3% among the patients. The males exhibited DME significantly more frequently than the females (p = 0.031), and the duration of diabetes was significantly longer in those patients with DME (p < 0.001). Those patients without DME frequently used antihyperlipidemic drugs and had a higher level of high density lipoprotein cholesterol (p = 0.040 and p = 0.046, respectively). The patient’s alcohol consumption, nephropathy, neuropathy, previous cataract surgery, severity of diabetic retinopathy, and insulin usage were statistically significant factors with regard to the DME prevalence.ConclusionsThis study demonstrated the prevalence of DME in Turkey by utilizing OCT. The development of DME can be avoided or limited and the response to treatment may be improved by the regulation of the DME risk factors.

Clinical Diagnosis and New Classification of Diabetic Retinopathy and Diabetic Macular Edema

Diabetic retinopathy and diabetic macular edema are the most common causes of preventable blindness among the working class in many countries. The prevalence of diabetic macular edema, which is frequently associated with vision loss, is increasing. Classification of diabetic retinopathy is essential for precise and punctual treatment and follow-up, and ultimately for enhancing the quality of life of diabetic patients. Studies in recent years have shared protocols for diagnosis, classification, and follow-up.

Prevalence of diabetic retinopathy among self-reported adult diabetics in districts of Eastern Nepal in a community based study.

Diabetic retinopathy (DR) is the leading cause of blindness among working age adults around the world. Each year more and more people live with this condition, which can result in life-changing complications. To determine the prevalence and risk factors of diabetic retinopathy (DR) in a large community based screening programme, in order to estimate the future burden of the disease. A cross sectional community based study was conducted between 1st January and 31st December 2014 in a purposive sample of adults with selfreported diabetes mellitus (DM) from Morang and Sunsari district of Nepal. A structured questionnaire was used to collect patient data. Ophthalmological evaluation was done and fundus was examined for grading DR using direct and indirect ophthalmoscope. Among the 698 diabetic patients, mean age was 55.02±11.8 years (ranging from 24 to 91 years). 12.3% of diabetic were not under any treatment. Only 69.3% of patients had visited eye specialist for diabetic retinopathy screening. Prevalence of DR was found to be 15.3%; 13.9% had non-proliferative DR and 1.4% had proliferative DR. Prevalence of diabetic macular edema was 2.1%. In Morang district prevalence of DR was 14.2% and in Sunsari district it was 16.2%. In the binary-logistic regression analysis, duration of diabetes was associated with significantly increased risk of DR (OR: 1.13; 95% confidence interval (CI), 1.09 to 1.17; p<0.001). History of absence of arterial hypertension decreased the risk of DR (OR: 0.56; 95% CI, 0.36 to 0.87; p=0.01). One sixth of the patients with diabetes in the Eastern region of Nepal have retinopathy. Diabetic retinopathy risk increased with duration of diabetes and decreased with history of no co-existing arterial hypertension.

Diabetic retinopathy in type 1 diabetes patients in Western Norway.

To describe the prevalence of diabetic retinopathy (DR), associated risk factors and health-related quality of life (HRQoL) in a population-based cohort of patients with type 1 diabetes mellitus (DM1). All patients underwent a general and ophthalmic examination including seven-field stereo fundus photography for grading of DR and diabetic macular oedema (DMO). Kaplan-Meier survival analyses were performed to evaluate disease progression in relation to diabetes duration, age and year of diabetes onset. HRQoL and its association with DR were assessed by the Medical Outcomes Study Short Form 36 (SF-36) questionnaire. A total of 237 DM1 patients were included. Mean age at inclusion was 34years (range, 4-75years), and mean diabetes duration was 19years (range, 5months-63years). A total of 145 patients (61%) had DR. Sixty-two patients (26%) had mild, 39 (16%) moderate and 13 (5%) severe nonproliferative DR, while 31 (13%) had proliferative DR. The prevalence of DMO was 8%. The most important risk factors predicting severity of DR were diabetes duration (p<0.0001) and HbA1c level (p<0.0001). Neuropathy (p=0.006), nephropathy (p=0.004) and male gender (p=0.02) were also significant predictors of DR. Compared to normative SF-36 data, there was a linear trend of decreasing HRQoL with increasing severity of DR that was statistically significant for the four physical dimension scores. The prevalence of DR in DM1 was largely within the range of previous reports. Diabetes duration, HbA1c level, neuropathy, nephropathy and male gender were all significant predictors of DR severity. The patients with more severe DR had lower HRQoL.

Prevalence of Diabetic Macular Edema in association with Severity of Diabetic Retinopathy

Prevalence of Diabetic Macular Edema in association with Severity of Diabetic Retinopathy

Prevalence and Pattern of Macular Edema in Diabetes

Objective: Diabetic macular edema (DME) is the major cause of vision loss in patients with diabetic retinopathy (DR). The purpose of this study was to assess the prevalence of DME in pre diagnosed Type II diabetes mellitus cases, to analyze DME pattern based on Optical Coherence Tomography (OCT) images and to correlate it with glycemic control. Methods: In cross sectional study, 200 eyes of 100 pre diagnosed type II diabetes mellitus cases were examined for DR, DME and OCT was performed to look for central macular thickness. Result: 200 eyes were examined, 95 of them were diagnosed to have DR and 19 eyes were diagnosed to have DME. Three characteristics were found in the images of OCT in cases with DME: Diffuse retinal thickening in 9 eyes(42.4%), cystoid macular edema in7 eyes(36.8%) and serous retinal detachment in 3(15.8%). Statistical analysis showed that there was positive correlation of prevalence of DME with poor glycemic control (p<0.046), duration of diabetes (p<0.013), and severity of DR (p<0.000) but not with pattern of DME. There was statistic significance between central macular thickness and increasing grade of DME (p<0.000). Conclusion: The prevalence of DME is 9.5% in type II diabetes mellitus cases in this study. Prevalence is correlated with DR severity, duration of diabetes, and poor glycemic control. Three patterns of DME are demonstrated with OCT images. The macular thickness is correlated to severity of DME.

Prevalence of and risk factors for diabetic macular edema in the United States.

Diabetic macular edema (DME) is a leading cause of vision loss in persons with diabetes mellitus. Although there are national estimates for the prevalence of diabetic retinopathy and its risk factors among persons with diabetes, to our knowledge, no comparable estimates are available for DME specifically. To estimate the prevalence of DME in the US population and to identify associated risk factors. A cross-sectional analysis of 1038 participants aged 40 years or older with diabetes and valid fundus photographs in the 2005 to 2008 National Health and Nutrition Examination Survey. The overall prevalence of DME and its prevalence according to age, race/ethnicity, and sex. Of the 1038 persons with diabetes analyzed for this study, 55 had DME, for an overall weighted prevalence of 3.8% (95% CI, 2.7%-4.9%) or approximately 746, 000 persons in the US 2010 population aged 40 years or older. We identified no differences in the prevalence of DME by age or sex. Multivariable logistic regression analysis showed that the odds of having DME were higher for non-Hispanic blacks than for non-Hispanic whites (odds ratio [OR], 2.64; 95% CI, 1.19-5.84; P = .02). Elevated levels of glycosylated hemoglobin A1c (OR, 1.47; 95% CI, 1.26-1.71 for each 1%; P < .001) and longer duration of diabetes (OR, 8.51; 95% CI, 3.70-19.54 for ≥ 10 vs <10 years; P < .001) were also associated with DME prevalence. These results suggest a greater burden of DME among non-Hispanic blacks, individuals with high levels of hemoglobin A1c, and those with longer duration of diabetes. Given recent treatment advances in reducing vision loss and preserving vision in persons with DME, it is imperative that all persons with diabetes receive early screening; this recommendation is even more important for those at higher risk for DME.

Prevalence, Demographics, and Treatment Characteristics of Visual Impairment due to Diabetic Macular Edema in a Representative Canadian Cohort

Diabetic macular edema (DME) is the leading cause of blindness in the diabetic population. However, there is limited understanding of the epidemiology of DME with visual impairment (VI) and treatment in patients with diabetes in Canada. This observational, retrospective study used records from the Southwestern Ontario database to observe the demographics, prevalence, and treatment characteristics of VI due to DME compared to a healthy population in a real-world Canadian setting. Data was compared between a cohort of 8,368 diabetic (type 1 or 2) patients, who were ≥18 years old and had a diagnosis of DME with VI (visual acuity <20/40 in Snellen equivalent), and 76,077 age- and gender-matched subjects representing a healthy population. Among diabetic patients, prevalence of DME was 15.7%, and prevalence of VI due to DME was 2.56%. Laser monotherapy was the most frequently used treatment. Public funding covered costs for 85% of persons with DME while 18% were paid for with private funds. This study provides insight into the demographics, prevalence, and treatment of VI due to DME in a representative Canadian cohort. This data can help to inform evaluation of current DME treatment patterns and of proposed new treatment on drug plan budgets in Canada.

Prevalence of diabetic retinopathy and macular edema in type 2 diabetes patients in the endocrinology department of Tianjin

According to the analysis of 9 237 hospitalized type 2 diabetic patients, the prevalence of diabetic retinopathy ( DR )was 32.9％ , with the prevalence of mild, moderate, and serious non-proliferative DR and proliferative DR being 10. 1％, 18. 3％, 3.2％, and 1.3％ respectively. The prevalence of diabetic macular edema ( DME ) was 3.56％ in type 2 diabetics and i 0. 8％ in patients with DR. Diabetes duration and proteinuria were the common risk factors of DR and DME. Key words: Diabetes mellitus, type 2; Retinopathies; Macular edema

Prevalence of diabetic macular oedema and related health and social care resource use in England

AimsTo address the absence from the public health ophthalmology literature of age- and sex-specific prevalence and related resource use for diabetic macular oedema (DMO) in England, UK.MethodsCalculation of age- and...

An epidemiological surrey on diabetic macular edema in Huizhou city

Objective To investigate the prevalence of diabetic macular edema (DME) in Huizhou city and to explore the relationship of DME with the degrees of diabetic retinopathy (DR) and visual loss and the course of diabetes mellitus (DM). Methods Population samples in Huizhou were randomly selected to survey with questionnaires for DM screening. The patients then received vision tests, +90D front- position eyeground examination under a slit-lamp microscope, fundus photography, and fluorescence fundus an-giography (FFA) for DR and DME. Results Of 645 with DM, 262 developed DR and 92 occurred DME. The incidence of DME was 0.91% in Huizhou population, 1.43% in patients with DM, and 35.1% in the diabetic patients with DR. In DME 38.20% was mild, 31.46% was moderate, and 30.33% was severe. DME worsened with the increasing degree of DR (r= 0.945, P= 0.035). Visual loss was significantly correlated with the degree of DME (r= 0.972, P= 0.005). The grading of DME was markedly associated with the disease course of DM (r= 0.954, P= 0.008). Conclusions DME leads to severe vision impairment in diabetic patients. The patients with DME should be screened and treated earlier to reduce the incidence of DR-induced blindness. The degree of DME is markedly related with the stages of DR, visual loss, and course of diabetes. Key words: Diabetic macular edema; Diabetic retinopathy; Diabetes mellitus

Influence of Serum Lipids on Clinically Significant versus Nonclinically Significant Macular Edema: SN-DREAMS Report Number 13

Purpose To estimate the prevalence of diabetic macular edema, both clinically significant macular edema (CSME) and nonclinically significant macular edema (non-CSME), and report the associations of dyslipidemia on them. Design A population-based cross-sectional study in India. Participants After all exclusions, 1414 subjects with diabetes underwent an examination. Methods The CSME was defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines; stereo digital fundus pairs were studied. The dyslipidemia cases were classified according to the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III). Main Outcome Measures Prevalence of CSME and non-CSME and association of serum lipids with them. Results The prevalence was 31.76% (95% confidence interval [CI], 26.04–37.47) for overall diabetic macular edema, 25.49% (95% Ci, 20.14–30.84) for non-CSME, and 6.27% (95% Ci, 3.29–9.24) for CSME. Univariate analysis identified macroalbuminuria and microalbuminuria, poor glycemic control, high total serum cholesterol, high serum low-density lipoprotein (LDL) cholesterol, and high serum non–high-density lipoprotein (HDL) cholesterol related to non-CSME and CSME (trend chi-square test, P<0.05). Logistic regression analysis (after adjusting variables such as age, gender, body mass index, duration, smoking, hypertension, glycosylated hemoglobin, macroalbuminuria and microalbuminuria, and insulin use) revealed high serum LDL cholesterol (odds ratio [OR], 2.72], high serum non-HDL cholesterol (OR, 1.99), and high cholesterol ratio (OR, 3.08) related to non-CSME, and poor glycemic control (OR, 8.06), microalbuminuria (OR, 14.23), and high serum total cholesterol (OR, 9.09) related to CSME. Conclusions One third of the subjects had diabetic macular edema, and 6% of them showed evidence of CSME necessitating laser photocoagulation. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article. To estimate the prevalence of diabetic macular edema, both clinically significant macular edema (CSME) and nonclinically significant macular edema (non-CSME), and report the associations of dyslipidemia on them. A population-based cross-sectional study in India. After all exclusions, 1414 subjects with diabetes underwent an examination. The CSME was defined according to the Early Treatment Diabetic Retinopathy Study (ETDRS) guidelines; stereo digital fundus pairs were studied. The dyslipidemia cases were classified according to the National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III). Prevalence of CSME and non-CSME and association of serum lipids with them. The prevalence was 31.76% (95% confidence interval [CI], 26.04–37.47) for overall diabetic macular edema, 25.49% (95% Ci, 20.14–30.84) for non-CSME, and 6.27% (95% Ci, 3.29–9.24) for CSME. Univariate analysis identified macroalbuminuria and microalbuminuria, poor glycemic control, high total serum cholesterol, high serum low-density lipoprotein (LDL) cholesterol, and high serum non–high-density lipoprotein (HDL) cholesterol related to non-CSME and CSME (trend chi-square test, P<0.05). Logistic regression analysis (after adjusting variables such as age, gender, body mass index, duration, smoking, hypertension, glycosylated hemoglobin, macroalbuminuria and microalbuminuria, and insulin use) revealed high serum LDL cholesterol (odds ratio [OR], 2.72], high serum non-HDL cholesterol (OR, 1.99), and high cholesterol ratio (OR, 3.08) related to non-CSME, and poor glycemic control (OR, 8.06), microalbuminuria (OR, 14.23), and high serum total cholesterol (OR, 9.09) related to CSME. One third of the subjects had diabetic macular edema, and 6% of them showed evidence of CSME necessitating laser photocoagulation.

Epidemiology of diabetic macular edema in patients with type 2 diabetes in the Beixinjing District of Shanghai

To investigate the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME) in Beixinjing District, and analyze the image characteristics of their Optical coherence tomography (OCT), so as to evaluate the correlation among DME and the grade of DR as well as posterior vitreous detachment (PVD). In a prospective study, OCT was performed in 151 eyes of 100 type 2 diabetes patients with DR and 102 normal eyes as control subjects. 795 cases were examined, and 215 of them were diagnosed to have DR. The average thickness of macular fovea was 195.56 microm in 151 eyes from 100 random sampling. 46 eyes had macular thickening. Three characteristics were found in the images of OCT in the patients with DME: sponge-like retinal swelling in 35 eyes (76.1%), macular cystoid edema in 8 eyes (17.4%), and serous retinal detachment in 3 eyes (6.5%). The statistical analysis showed that there was a positive correlation between the thickness of macular fovea and negative correlation with best-corrected visual acuity (r = 0.2869, P = 0.0004). There was statistic significance between the severity of DR and DME (P = 0.0003). But there was no statistic significance between DME and PVD. The prevalence of DME is 37.1% in this district. Three type images of OCT were demonstrated in DME. The macular thickness is correlated with the severity of DR regardless of PVD.

Intravitreal injection of triamcinolone: an emerging treatment for diabetic macular edema.

Editor’s comment: From time to time, treatments for diabetes and its complications are promulgated, which seem to have sufficient nonrandomized clinical data to support their consideration for use in our patients. Rather than wait for randomized clinical trials to be published (and in some cases, this is unlikely to occur), descriptions of these treatments, their effectiveness, and their side effects will be published in Diabetes Care as a Commentary. In many situations, these therapeutic approaches would only be considered after more conventional therapy has been ineffective. Intraocular injections of glucocorticoids for macular edema fit these criteria. Diabetic retinopathy is a major cause of visual impairment in the U.S. (1–3). Diabetic macular edema is a manifestation of diabetic retinopathy that produces loss of central vision and is commonly diagnosed by ophthalmologists. The Wisconsin Epidemiologic Study of Diabetic Retinopathy estimated that after 15 years of known diabetes, the prevalence of diabetic macular edema is ∼20% in patients with type 1 diabetes, 25% in patients with type 2 diabetes who are taking insulin, and 14% in patients with type 2 diabetes who do not take insulin (1). Diabetic macular edema, because of the frequency with which it is seen, is a condition that has considerable public health importance. Currently, the only demonstrated means to reduce the risk of vision loss from diabetic macular edema are intensive glycemic control, as demonstrated by the Diabetes Control and Complications Trial (DCCT) (4) and the U.K. Prospective Diabetes Study (5), and laser photocoagulation, as demonstrated by the Early Treatment Diabetic Retinopathy Study (ETDRS) (6). In the DCCT, intensive glucose control reduced the risk of onset of diabetic macular edema by 23% compared with conventional treatment. Long-term follow-up of patients in the DCCT show a sustained effect of intensive glucose control, with a 58% …