Petteri Ylinen1, Ilkka Laine1, Juha-Matti Lindholm1, Raimo Tuuminen2. 1. From the Department of Ophthalmology (Ylinen, Lindholm), Helsinki University Hospital, the Helsinki Retina Research Group (Ylinen, Laine, Lindholm, Tuuminen), University of Helsinki, the Department of Automation and Electrical Engineering (Laine), Aalto University, Patient Insurance Centre (Tuuminen), Helsinki, and the Kymenlaakso Central Hospital (Laine, Tuuminen), Unit of Ophthalmology, Kotka, Finland. 2. From the Department of Ophthalmology (Ylinen, Lindholm), Helsinki University Hospital, the Helsinki Retina Research Group (Ylinen, Laine, Lindholm, Tuuminen), University of Helsinki, the Department of Automation and Electrical Engineering (Laine), Aalto University, Patient Insurance Centre (Tuuminen), Helsinki, and the Kymenlaakso Central Hospital (Laine, Tuuminen), Unit of Ophthalmology, Kotka, Finland. Electronic address: hrrg-group@helsinki.fi.
Abstract
PURPOSE: To specify the risk factors for pseudophakic cystoid macular edema (CME) in patients with diabetes. SETTING: Kymenlaakso Central Hospital, Unit of Ophthalmology, Kotka, Finland. DESIGN: Prospective case series. METHODS: Patients with type 1 or type 2 diabetes having routine cataract surgery were evaluated. Spectral-domain optical coherence tomography imaging was performed before surgery and 1 month postoperatively. RESULTS: The study comprised 93 patients (95 eyes). The central retinal thickness increase was 9.7 μm ± 1.7 (SEM) in diabetic patients with no retinopathy, 22.7 ± 8.6 μm in those who had nonproliferative retinopathy, and 73.8 ± 37.4 μm in those who had proliferative retinopathy (P < .001). The central retinal thickness increase was greater in the eyes of diabetic patients with insulin dependence than in eyes of patients using noninsulin medication (21.9 ± 5.9 μm versus 8.3 ± 1.8 μm, P = .017). Serum hemoglobin A1c concentration and inversely, patient age, were associated with central retinal thickness increase, even after adjustment for confounding factors (r = 0.607, P < .001 and r = 0.417, P = .001, respectively). The central retinal thickness change was smaller in the eyes of patients who had a nonsteroidal antiinflammatory drug (NSAID) as their postoperative antiinflammatory medication than in eyes of patients who were not prescribed NSAID medication when retinopathy was analyzed as a covariant (8.2 ± 3.6 μm versus 13.6 ± 2.9 μm, P = .016). CONCLUSIONS: Young patient age and poor glycemic control were risk factors for postoperative central retinal thickness increase. This study showed it is necessary to identify, effectively treat, and follow-up with patients with diabetes who are at a greater risk for pseudophakic CME.
PURPOSE: To specify the risk factors for pseudophakic cystoid macular edema (CME) in patients with diabetes. SETTING: Kymenlaakso Central Hospital, Unit of Ophthalmology, Kotka, Finland. DESIGN: Prospective case series. METHODS:Patients with type 1 or type 2 diabetes having routine cataract surgery were evaluated. Spectral-domain optical coherence tomography imaging was performed before surgery and 1 month postoperatively. RESULTS: The study comprised 93 patients (95 eyes). The central retinal thickness increase was 9.7 μm ± 1.7 (SEM) in diabeticpatients with no retinopathy, 22.7 ± 8.6 μm in those who had nonproliferative retinopathy, and 73.8 ± 37.4 μm in those who had proliferative retinopathy (P < .001). The central retinal thickness increase was greater in the eyes of diabeticpatients with insulin dependence than in eyes of patients using noninsulin medication (21.9 ± 5.9 μm versus 8.3 ± 1.8 μm, P = .017). Serum hemoglobin A1c concentration and inversely, patient age, were associated with central retinal thickness increase, even after adjustment for confounding factors (r = 0.607, P < .001 and r = 0.417, P = .001, respectively). The central retinal thickness change was smaller in the eyes of patients who had a nonsteroidal antiinflammatory drug (NSAID) as their postoperative antiinflammatory medication than in eyes of patients who were not prescribed NSAID medication when retinopathy was analyzed as a covariant (8.2 ± 3.6 μm versus 13.6 ± 2.9 μm, P = .016). CONCLUSIONS: Young patient age and poor glycemic control were risk factors for postoperative central retinal thickness increase. This study showed it is necessary to identify, effectively treat, and follow-up with patients with diabetes who are at a greater risk for pseudophakic CME.
Authors: C J Doncel-Fernández; M L Alferez-Asenjo; A Quereda-Castañeda; G Castro-Luna Journal: Graefes Arch Clin Exp Ophthalmol Date: 2020-08-11 Impact factor: 3.117
Authors: Alexander Aaronson; Claudia Taipale; Asaf Achiron; Vesa Aaltonen; Andrzej Grzybowski; Raimo Tuuminen Journal: Transl Vis Sci Technol Date: 2021-06-01 Impact factor: 3.283