Systemic and ocular diseases associated with the development of diabetic macular edema among Japanese patients with diabetes mellitus

Abstract

Background: Diabetic macular edema (DME) causes severe vision loss among patients with diabetes mellitus (DM). We aimed to investigate systemic and ocular diseases associated with the development of DME in a Japanese population. Methods: A total of 3.11 million Japanese subjects who were registered in the database of the Japan Medical Data Center from 2005 to 2014 were analyzed. Subjects with DM were defined as individuals who had been prescribed any therapeutic medications for DM, and associated diseases were analyzed. The periods assessed were one year before the development of DME among patients with DME and one year before the last visit to an ophthalmic clinic among patients without DME. Results: A total of 17,403 patients with DM satisfied the inclusion and exclusion criteria, and 420 patients developed DME. Univariate analysis revealed significant associations between 55 diseases, including 39 systemic and 16 ocular diseases, and DME development. Logistic analysis identified 21 systemic diseases and 10 ocular diseases as significant factors associated with DME development. Conclusion: Various types of systemic and ocular diseases are associated with DME development. Subjects with DM who present these risk factors must be carefully monitored to prevent visual impairment.

Variations in Electronic Health Record-Based Definitions of Diabetic Retinopathy Cohorts

“…After screening for lack of relevance (N = 28 articles) and applying our exclusion criteria, (N = 109), 42 articles were included in this study ( Fig 1 ). Table 3 8 , 9 , 10 , 11 , 12 , 13 , 14 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 lists the included studies (N = 42) in this literature review. The articles included published studies from 2008 to 2022.…”

Association between the response of intravitreal antivascular endothelial growth factor injection and systemic factors of diabetic macular edema

“…Jeng et al [ 18 ], however, suggests that diabetic nephropathy is related to the aggravation of diabetic retinopathy rather than the development of diabetic macular edema. However, Kume et al [ 19 ] recently published a study on systemic factors associated with diabetic macular edema in the Japanese population which reported a significant relationship between diabetic nephropathy and diabetic macular edema. They explain that oxidative stress and decreased osmotic control ability following hyperglycemia deteriorates not only the kidney function but also the function of the blood-retinal barrier and retinal pigment epithelium of the eye.…”

Bibliometric and visualized analysis of DME from 2012 to 2022

“…[ 4 , 32 ] The patients with DME were mainly elderly, so the age was also one of the factors affecting DME. [ 33 ] Fluorescein fundus angiography, as a diagnostic method for DME, can be used to identify non-perfusion areas, leakage microaneurysms, and diffuse leakage areas. When injecting fluorescein into the circulatory system, the image was captured by the fundus camera to observe the changes in the intensity of fluorescein and identify the leakage area.…”

“…[ 32 ] Optical coherence tomography angiography (OCTA) can observe the superficial and (or) deep capillary plexus of diabetes retinopathy, such as microangioma, vascular loop, nonperfusion, neovascularization, expansion of the microvascular zone in the fovea of the macula, and beaded veins in several different capillary beds. [ 33 ] In addition, OCTA has been used for quantitative tracking of intravitreal injection of anti-VEGF and laser coagulation therapy currently. [ 34 ] According to the above keyword analysis, the elderly people with DM should be of high concern.…”