Effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus

Abstract

Purpose: To investigate the effect of microalbuminuria on macular thickness in patients with type-2 diabetes mellitus with no or mild diabetic retinopathy and to investigate the relationship between macular thickness and metabolic parameters. Materials and methods: Fifty eight eyes of 58 patients without diabetic retinopathy (group 1) in microalbuminuria stage, 42 eyes of 42 patients with mild diabetic retinopathy (group 2) in microalbuminuria stage, and 50 eyes of 50 patients without diabetic retinopathy and microalbuminuria (group 3) were included in this study. After detailed ophthalmologic examination, all patients underwent spectral domain-optical coherence tomography measurements. Macular thickness was noted from nine different areas (fovea, four parafoveal, and four perifoveal areas) and compared between groups. The correlations between macular thickness and age, duration of diabetes mellitus, microalbuminuria, serum urea, creatinine, glycosylated hemoglobin (HbAIc), albumin, sodium (Na), and urinary Na were evaluated. Results: The mean age was 53.29 ± 6.49 in group 1, 55.86 ± 6.97 in group 2, and 52.98 ± 5.66 years in group 3 (p = 0.06). The macular thickness values of superior, inferior, and nasal parafoveal areas were significantly different between groups (p = 0.001, p = 0.006, and p = 0.03, respectively). Bonferroni post test revealed that this difference originated from the difference between group 2 and 3 (p < 0.05 for all values). There were significant negative correlations between the macular thickness values of parafoveal areas and serum urea, HbA1c, albumin, microalbuminuria levels (p < 0.05 for all values). Conclusion: In this study, a significantly decreased parafoveal macular thickness was measured in patients with mild diabetic retinopathy and microalbuminuria compared to patients without diabetic retinopathy and microalbuminuria.

Early retinal neurodegeneration in preclinical diabetic retinopathy: a multifactorial investigation

“…In our study, MA (+) diabetic patients had similar SD-OCT measurements when compared with MA (−) diabetic subjects and nondiabetic healthy controls. Ucgul Atilgan et al [11] presented the only similar study to ours and they found significant differences in superior, inferior and nasal parafoveal thickness values among patients without DR in MA stage (group 1), patients with mild DR in MA stage (group 2) and patients without DR and MA (group 3). However, they also stated that significance was originated from differences between group 2 (had lower values) and group 3.…”

“…The main objective of the current study was to demonstrate effects of MA, HT and/or HL, DM duration and HbA1c level on neuroretinal alterations in macular and peripapillary regions in patients with preclinical DR. On the other hand, there is only one study reporting effect of MA on retinal layers in preclinical DR [11]. In our study, MA (+) diabetic patients had similar SD-OCT measurements when compared with MA (−) diabetic subjects and nondiabetic healthy controls.…”

“…The rationale of this current study was to present an extensive multifactorial analysis including MA, hyperlipidaemia (HL) and/or hypertension (HT) coexistence, DM duration and HbA1c level on neuroretinal alterations in macular and peripapillary regions using SD-OCT in diabetic patients without DR (preclinical DR). At present, there is only one specific study investigating relations between MA and retinal layers in the current literature to best of our knowledge [11].…”

Association of Microalbuminuria and Bevacizumab Therapy Outcomes in Diabetic Retinopathy Patients

“…Moreover, in diabetic patients, HbA1c was significantly higher in DR patients than non-DR patients (13). Ucgul Atilgan et al showed that central macular thickness is significantly higher in DR patients with microalbuminuria than diabetic patients without retinopathy and microalbuminuria (7). Lunetta et al introduced microalbuminuria as a potent risk factor for retinopathy (14).…”

“…Furthermore, the hyperglycemic status in DR patients plays a dual role in the progression of nephrological diseases (e.g., albuminuria), along with DR, due to the preceded systemic inflammation (4). Therefore, numerous DR patients suffer from albuminuria (5)(6)(7).…”