Details
Category: Volume 08 Issue 04 April 2020
Hits: 990

Title: Clinical and Optical Coherence Tomography Profile of Diabetic Maculopathy in Patients with and without Diabetic Nephropathy

Authors: Nethaji Sellaram S, Dalia S

 DOI: https://dx.doi.org/10.18535/jmscr/v8i4.41

Abstract

   

Purpose: To compare the clinical profile and morphological pattern of Diabetic maculopathy using Optical Coherence Tomography (OCT) in Diabetes mellitus patients with and without Diabetic Nephropathy.

Design: Comparative cross sectional study.

Materials and Methods: 150 patients were enrolled, their clinical profile and diabetic retinopathy status were assessed. Quantitative analysis and morphological pattern of macular edema was compared between the patient having diabetic nephropathy and without nephropathy. Diabetic nephropathy was determined by patient having microalbuminuria, detected by doing spot urine albumin creatinine ratio.

Results: Out of 150 patients 66.7% patients with Diabetic Nephropathy and 33.3% without microalbuminuria. 50% had moderate NPDR, 22.7% with severe NPDR, 22.7% with PDR, 4.7% with mild NPDR changes. Statistical significant difference was seen in better visual acuity (6/6 to 6/18) in patient with (28%) and without diabetic nephropathy group (46%). No significant difference was observed in maculopathy status between two groups. Duration of diabetes and hypertension showed no significant difference with the maculopathy severity. OCT pattern in macular edema between two groups showed no significant differences. Mean central foveal thickness in diabetic nephropathy group was 312.62  85.915 and without diabetic nephropathy was 289  73.748, No significant difference was observed.

Conclusion: Patient without diabetic nephropathy had good vision. Early stage of diabetic nephropathy in the form of microalbuminuria showed no increase in the central foveal thickness. Diabetic nephropathy did not influence the morphological pattern of macular edema.

Keywords: Clinical profile; OCT pattern; Diabetic Maculopathy; Diabetic Nephropathy.

References

  1. Teiko Yamamoto, Satoshi Iimuro et.al Prevalence and risk factors for diabetic maculopathy, and its relationship to diabetic retinopathy in elderly Japanese patients with type 2 diabetes mellitus. Geriatr Gerontol Int 2012; 12 (Suppl. 1): 134–140g
  2. Klein R, Klein BEK, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy IV. Diabetic macular edema. Ophthalmology 1984;91:1464–74g
  3. Cugati S, Kifley A, Mitchell P, Wang JJ: Temporal trends in the age-specific prevalence of diabetes and diabetic retinopathy in older persons: Population-based survey findings.  Diabetes Res. Clin. Pract.2006
  4. Diabetes Control and Complications trial Research Group. The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus. Arch Ophthalmol 1995; 113: 36–51
  5. Klein R, Moss SE, Klein BE, Davis MD, DeMets DL. The Wisconsin epidemiological study of diabetic retinopathy. XI. The incidence of macular edema. Ophthalmology 1989; 96: 1501–1510
  6. Klein R, Klein BEK, Moss SE, et al. Th e Wisconsin Epidemiologic Study of Diabetic Retinopthy XIV. Ten-year incidence and progression of diabetic retinopathy. Arch Ophthalmol 2008; 112:1217–28.
  7. Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy, II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol1984; 102: 520–526.
  8. Stratton IM, Kohner EM, Aldington SJ et al. UKPDS 50: risk factors for incidence and progression of retinopathy in type II diabetes over 6 years from diagnosis. Diabetologia2001; 44: 156
  9. Cahill M, Halley A, Codd M et al. Prevalence of diabetic retinopathy in patients with diabetes mellitus diagnosed after the age of 70 years. Br J Ophthalmol 1997; 81: 218–222
  10. Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. Is blood pressure a predictor of the incidence or progression of diabetic retinopathy? Arch Intern Med 1989; 149: 2427– 2432
  11. Erasmus RT, Oyeyinka G, Arije A: Microalbuminuria in non-insulin- dependent (type 2) Nigerian diabetics: relation to glycaemic control, blood pressure and retinopathy. Postgrad Med J 1992, 68:638-42
  12. Klein R, Klein BEK, Moss SE, et al. Th e Wisconsin Epidemiologic Study of Diabetic Retinopthy XIV. Ten-year incidence and progression of diabetic retinopathy. Arch Ophthalmol 2008; 112:1217–28
  13. Lattanzio R, Brancato R, Pierro L, Bandello F, Iaccheri B, Fiore T, Maestranzi G. Macular thickness measured by optical coherence tomography (OCT) in diabetic patients. Eur J Ophthalmol. 2002;12:482–7.
  14. Browning DJ, Fraser CM, Clark S. The relationship of macular thickness to clinically graded diabetic retinopathy severity in eyes without clinically detected diabetic macular edema. Ophthalmology. 2007;115:533–9.
  15. Nam Kyun Koo, Hyun Cheol Jin, Kwang Soo Kim, Yu Cheol Kim Relationship between the Morphology of Diabetic Macular Edema and Renal Dysfunction in Diabetes. Korean journal of ophthamol.  2013;27(2): ISSN: 1011-8942 . 98-102.

Corresponding Author

Nethaji Sellaram S

Department of Ophthalmology, Govt. TD Medical College, Alappuzha, Kerala – 688005, India