Kasturba Medical College Mangalore, Mangalore, India.
Manipal Academy of Higher Education, Manipal, India.
Int Ophthalmol. 2024 Aug 2;44(1):338. doi: 10.1007/s10792-024-03263-x.
Diabetic macular edema is one of the leading causes of vision loss across the world. Hard exudates at the macula can lead to structural abnormalities in the retina leading to irreversible vision loss. Systemic dyslipidemia and other modifiable risk factors when identified and treated early may help prevent substantial vision loss. The purpose of this study was to study the association between serum lipid levels and other systemic risk factors like hemoglobin, HbA1c, and serum creatinine with hard exudates and macular edema in patients with diabetic retinopathy.
It is a prospective cross-sectional study conducted in a tertiary health care center in South India. 96 patients having diabetic retinopathy with hard exudates were included. Modified Airlie house classification was used to grade the hard exudates. Blood investigations including serum lipid profile, hemoglobin, HbA1c, and serum creatinine were carried out. Central subfield macular thickness was measured using optical coherence tomography.
96 patients of type II DM with diabetic retinopathy were divided into three groups of hard exudates. A statistically significant correlation was observed between the severity of hard exudates and total cholesterol (p = 0.00), triglycerides (p = 0.00), LDL (p = 0.00), and VLDL (p = 0.00). HbA1c levels showed a statistically significant correlation with the severity of hard exudates (p = 0.09), no significant correlation was noted between hard exudates and hemoglobin levels (p = 0.27) and with serum creatinine (p = 0.612). A statistically significant association between CSMT and hard exudates (p = 0.00) was noted.
In our study, we concluded that the severity of hard exudates is significantly associated with increasing levels of serum total cholesterol, triglycerides, LDL, VLDL, and HbA1c levels in type II DM patients presenting with diabetic retinopathy. The increasing duration of diabetes is significantly associated with increasing severity of hard exudates. Central subfield macular thickness increases with increasing severity of hard exudates in diabetic retinopathy.
糖尿病性黄斑水肿是全球导致视力丧失的主要原因之一。黄斑区硬性渗出物可导致视网膜结构异常，进而导致不可逆转的视力丧失。如果能早期识别和治疗系统性血脂异常和其他可改变的危险因素，可能有助于防止严重的视力丧失。本研究旨在研究血清脂质水平与血红蛋白、HbA1c 和血清肌酐等其他系统性危险因素与糖尿病性视网膜病变患者硬性渗出物和黄斑水肿之间的关系。
这是在印度南部一家三级保健中心进行的前瞻性横断面研究。纳入了 96 例伴有硬性渗出物的糖尿病性视网膜病变患者。采用改良的 Airlie 屋分类法对硬性渗出物进行分级。进行了包括血清脂质谱、血红蛋白、HbA1c 和血清肌酐在内的血液检查。使用光学相干断层扫描测量中央视网膜黄斑区厚度。
将 96 例 2 型糖尿病合并糖尿病性视网膜病变患者分为三组硬性渗出物。在硬性渗出物的严重程度与总胆固醇（p=0.00）、三酰甘油（p=0.00）、LDL（p=0.00）和 VLDL（p=0.00）之间观察到有统计学意义的相关性。HbA1c 水平与硬性渗出物的严重程度呈统计学显著相关性（p=0.09），但与血红蛋白水平（p=0.27）和血清肌酐（p=0.612）之间无显著相关性。中央视网膜黄斑区厚度与硬性渗出物之间存在统计学显著相关性（p=0.00）。
在我们的研究中，我们得出结论，在患有糖尿病性视网膜病变的 2 型糖尿病患者中，硬性渗出物的严重程度与血清总胆固醇、三酰甘油、LDL、VLDL 和 HbA1c 水平的升高显著相关。糖尿病病程的延长与硬性渗出物严重程度的增加显著相关。中央视网膜黄斑区厚度随糖尿病性视网膜病变硬性渗出物严重程度的增加而增加。
