Persistent diabetic macular edema is associated with elevated hemoglobin A1c

• Published in: American journal of ophthalmology Vol. 139; no. 4; pp. 620 - 623
• Main Authors: Do, Diana V., Shah, Syed Mahmood, Sung, Jennifer U., Haller, Julia A., Nguyen, Quan Dong
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.04.2005; Elsevier; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes. Impaired glucose tolerance; Diabetic retinopathy; Diabetic Retinopathy - blood; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - surgery; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Fluorescein Angiography; Glucose; Glycated Hemoglobin A - metabolism; Glycemic Index; Hemoglobin; Humans; Hyperglycemia - blood; Hypertension; Laser Coagulation; Lasers; Macular Edema - blood; Macular Edema - diagnosis; Macular Edema - surgery; Male; Medical imaging; Medical personnel; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Patients; Physicians; Retrospective Studies; Standard deviation; Womens health; Endocrinopathy; Macula; Edema; Association; Diabetes mellitus; Hemoglobin; Ophthalmology
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2004.10.063

To assess the correlation between persistent diabetic macular edema and hemoglobin A1c (HbA1C). Retrospective study. Records of type 2 diabetic patients who received eye care for persistent clinically significant macular edema (CSME) from January 2002 to January 2004 were reviewed. Subjects who met one of two criteria were identified: 1) persistent CSME, detected by contact lens biomicroscopy and fluorescein angiography, despite at least two focal laser photocoagulations (FLP) performed at least 3 months before the current diagnosis, or 2) a history of CSME with resolution of macular edema at the time of examination. Patients also needed to have had their HbA1C measured at the Johns Hopkins Hospitals within 3 months of meeting these criteria. The study identified 92 patients (152) eyes with persistent CSME and 32 patients (56 eyes) with resolved CSME. HbA1C values ranged from 5.3% to 15.6% (mean, 8.9%; median, 8.7%) and 5.3% to 9.7% (mean, 6.7%; median, 6.6%) among patients with persistent and resolved edema ( P = .0005). Among the 32 patients with persistent unilateral CSME, mean HbA1C was 8.6% (median 8.5%), and among the 60 patients with bilateral CSME, mean HbA1C was 9.1% (median, 8.9%). Of patients with persistent CSME, 74% had HbA1C greater than 7.5% compared with 12.5% of the patients with resolved CSME ( P = .0005). Persons with type 2 diabetes and persistent CSME have higher HbA1C at time of their disease than patients with resolved CSME. Patients with bilateral disease have more elevated HbA1C than those with unilateral disease.