TY - JOUR
T1 - Clinically Significant Macular Edema in Type I Diabetes
T2 - Incidence and Risk Factors
AU - Vitale, Susan
AU - Maguire, Maureen G.
AU - Murphy, Robert P.
AU - Hiner, Cheryl J.
AU - Rourke, Lillian
AU - Sackett, Catherine
AU - Patz, Arnall
N1 - Funding Information:
Originally received: September 13, 1994. Revision accepted: April 3, 1995. From the Wilmer Eye Institute, Johns Hopkins Medical Institutions, Baltimore. Dr. Maguire currently is affiliated with Scheie Eye Institute, Philadelphia. Dr. Murphy and Ms. Hiner currently are affiliated with the Retina Institute of Maryland, Baltimore. Presented in part at the ARVO Annual Meeting, Sarasota, May 1994. Supported in part by NEI grants R03 EY09870 and EY 01765 and by NIH Shared Instrument grant SS04060, Bethesda, Maryland. The authors have no financial interest in any aspect of this research.
PY - 1995
Y1 - 1995
N2 - Purpose: To examine incidence of and risk factors for clinically significant macular edema in persons with type I diabetes. Methods: A group of 189 persons with type I diabetes, recruited from a summer camp for children with diabetes and from practices of local physicians, were participants in a longitudinal study with annual follow-up visits which included physical and ophthalmologic examinations and color stereo fundus photographs of each eye, centered on the disc and macula. Subjects were free of proliferative retinopathy at study baseline. Ages ranged from 3 to 40 years, duration of diabetes ranged from 0 to 12 years, mean glycosylated hemoglobin (Hgb A1 c) was 12.2% (range, 6.4%–21.5%), and average follow-up was 6.1 years. Presence of clinically significant macular edema was defined as in the Early Treatment Diabetic Retinopathy Study. Results: In a total of 41 persons (62 eyes), clinically significant macular edema developed during study follow-up. Cumulative risk of clinically significant macular edema was 0 until 7 years' duration of diabetes. The cumulative risk of clinically significant macular edema increased linearly for each year of duration between 10 and 20 years, with an average annual increase of approximately 6.7%. Significant risk factors for clinically significant macular edema were older age at diagnosis, male sex, and higher Hgb A1 c level. Systolic and diastolic blood pressure, proteinuria, body mass index, race, initial presence of retinopathy, and use of anti hypertensives did not significantly affect the risk of clinically significant macular edema. Conclusion: Older age at diagnosis of diabetes, male sex, and higher Hgb A1 c levels (poorer control of blood glycemic levels) significantly increase the risk of clinically significant macular edema in persons with type I diabetes. These data extend the evidence implicating worse glycemic control as a cause of clinically significant macular edema, even within a population with relatively loose control.
AB - Purpose: To examine incidence of and risk factors for clinically significant macular edema in persons with type I diabetes. Methods: A group of 189 persons with type I diabetes, recruited from a summer camp for children with diabetes and from practices of local physicians, were participants in a longitudinal study with annual follow-up visits which included physical and ophthalmologic examinations and color stereo fundus photographs of each eye, centered on the disc and macula. Subjects were free of proliferative retinopathy at study baseline. Ages ranged from 3 to 40 years, duration of diabetes ranged from 0 to 12 years, mean glycosylated hemoglobin (Hgb A1 c) was 12.2% (range, 6.4%–21.5%), and average follow-up was 6.1 years. Presence of clinically significant macular edema was defined as in the Early Treatment Diabetic Retinopathy Study. Results: In a total of 41 persons (62 eyes), clinically significant macular edema developed during study follow-up. Cumulative risk of clinically significant macular edema was 0 until 7 years' duration of diabetes. The cumulative risk of clinically significant macular edema increased linearly for each year of duration between 10 and 20 years, with an average annual increase of approximately 6.7%. Significant risk factors for clinically significant macular edema were older age at diagnosis, male sex, and higher Hgb A1 c level. Systolic and diastolic blood pressure, proteinuria, body mass index, race, initial presence of retinopathy, and use of anti hypertensives did not significantly affect the risk of clinically significant macular edema. Conclusion: Older age at diagnosis of diabetes, male sex, and higher Hgb A1 c levels (poorer control of blood glycemic levels) significantly increase the risk of clinically significant macular edema in persons with type I diabetes. These data extend the evidence implicating worse glycemic control as a cause of clinically significant macular edema, even within a population with relatively loose control.
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U2 - 10.1016/S0161-6420(95)30894-9
DO - 10.1016/S0161-6420(95)30894-9
M3 - Article
C2 - 9097743
AN - SCOPUS:0029121107
SN - 0161-6420
VL - 102
SP - 1170
EP - 1176
JO - Ophthalmology
JF - Ophthalmology
IS - 8
ER -