Prevalence and Pattern of Macular Edema in Diabetes

Abstract

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.

Sight-threatening Diabetic Retinopathy and Associated Risk Factors Among Adult Diabetes Patients at Debre Tabor General Hospital, Northwest Ethiopia

“…Our finding demonstrated that, the likelihood of developing STDR was high for both types of DM participants with longer duration of diabetes (≥10 years) and this was consistent with what has been found previously in Norway, 32 Hangzhou, China, 27 mainland China, 20 India, 34 Cameroon, 41 and Malawi 29 that longer duration diabetes was associated with the development of visionthreatening diabetic retinopathy. This might be due the fact that in diabetes there are abnormalities in energy production which are thought to be the major contributor to the development of advanced diabetic complications like STDR, and these abnormalities are considered to occur late in the development of the disease.…”

“…The prevalence of STDR among T2DM participants was 11.9% which was similar to Nepal (8.3%), 33 India (9.5%), 34 and Saudi Arabia (16.3%). 35 Nevertheless, this report was lower than Pakistan (17.6%) 36 and higher than California, USA (0.5%), 37 Pittsburgh, USA (19.0%), 38 and Slovakia (3.35).…”

“…In this regard, our finding was similar to the findings previously reported in Norway, 32 mainland China, 20 and India. 34 A poorly controlled high glucose level instigates a cascade of events leading to retinal vascular endothelial dysfunction eventually leading to advanced diabetic retinopathy. 11 Our study identified that T1DM participants with comorbid hypertension were more likely to develop STDR compared to those without comorbid hypertension, this finding was in accordance with studies in California, USA, 37 mainland China, 20 and Malawi, 29 that comorbid hypertension was positively associated with advanced diabetic retinopathy.…”

“…In this regard, our finding was similar to the findings previously reported in Norway, 32 mainland China, 20 and India. 34 A poorly controlled high glucose level instigates a cascade of events leading to retinal vascular endothelial dysfunction eventually leading to advanced diabetic retinopathy. 11…”