Lower Hemoglobin Concentration Is Associated with Retinal Ischemia and the Severity of Diabetic Retinopathy in Type 2 Diabetes

Abstract

Aims. To assess the association of blood oxygen-transport capacity variables with the prevalence of diabetic retinopathy (DR), retinal ischemia, and macular oedema in patients with type 2 diabetes mellitus (T2DM). Methods. Cross-sectional, case-control study (N = 312) with T2DM: 153 individuals with DR and 159 individuals with no DR. Participants were classified according to the severity of DR and the presence of retinal ischemia or macular oedema. Hematological variables were collected by standardized methods. Three logistic models were adjusted to ascertain the association between hematologic variables with the severity of DR and the presence of retinal ischemia or macular oedema. Results. Individuals with severe DR showed significantly lower hemoglobin, hematocrit, and erythrocyte levels compared with those with mild disease and in individuals with retinal ischemia and macular oedema compared with those without these disorders. Hemoglobin was the only factor that showed a significant inverse association with the severity of DR [beta-coefficient = −0.52, P value = 0.003] and retinal ischemia [beta-coefficient = −0.49, P value = 0.001]. Lower erythrocyte level showed a marginally significant association with macular oedema [beta-coefficient = −0.86, P value = 0.055]. Conclusions. In patients with DR, low blood oxygen-transport capacity was associated with more severe DR and the presence of retinal ischemia. Low hemoglobin levels may have a key role in the development and progression of DR.

Comparison of Serum Biochemical and Haematological Analyses in Patients with Age-Related Macular Degeneration and Diabetic Retinopathy

“…All patients received a full ophthalmologic examination that included visual acuity, slit-lamp examination and indirect fundoscopic examination. A diagnosis of PDR, non-PDR or AMD was reached according to fundus fluorescein angiography (FFA) and SD-OCT (Heidelberg Engineering OCT 2 Module 85.000Hz) findings after detailed direct and indirect fundus examinations on dilated pupillae (Ambati et al, 2012;Čolak et al, 2017;Colijn et al, 2019;Paun et al, 2015;Boekhoorn et al, 2007;Prakash et al, 2017;Traveset et al, 2016;Magri et al, 2012). The control group were recruited from employees of the our hospital, their relatives and who were without any signs of AMD, DRP our ophthalmology department out of patients.…”

“…To date, there are cross-sectional studies reporting that there may be a relationship between the variability in serum biochemical parameters, serum lipoproteins, inflammatory markers, CBC parameters and the risk of DR and AMD (Colijn et al, 2019;Paun et al, 2015;Boekhoorn et al, 2017;Prakash et al, 2017;Traveset et al, 2016). However, epidemiological data have been inconsistent regarding the associations of CRP, CBC parameters, serum lipid levels, DR and AMD (Colijn et al, 2019;Paun et al, 2015;Boekhoorn et al, 2007;Prakash et al, 2017;Traveset, et al, 2016).…”

Association between neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and diabetic retinopathy among diabetic patients without a related family history

“…Recently, increasing studies reported that routine blood examination could provide rich and effective information to assist risk strati cation of disease [10][11].The promising index neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) conveyed a systematic in ammatory response in our body and has been evidenced as predictive and prognostic factors for DM and the related complications [12][13][14][15]. Moreover, Hemoglobin (Hb) was also a well-established biomarker for DR [16][17]. However, the association between these factors and DR among patients without diabetes or hypertension family history remains unclear.…”

Ischemic Postconditioning Mitigates Retinopathy in Tree Shrews with Diabetic Cerebral Ischemia

“…Since the metabolism in the retina is profoundly active, the tolerance of retinal cells to ischemia and hypoxia is poor. Therefore, the mechanisms of retinal ischemia and anti-injury protection have always been the hot topics in the field of DR pathogenesis [10,14,15]. Despite a large number of basic experiments and clinical studies at home and abroad, there is still no effective means of prevention, early intervention, and treatment of DR.…”