Associations between chronic glycosylated haemoglobin (HbA1c) level and macular volume in diabetes patients without macular oedema

Abstract

Acta Ophthalmol. 2010: 88: 753–758 Abstract. Purpose: This study aimed to examine the correlation between glycosylated haemoglobin (HbA1c) level and macular volume in diabetes patients without diabetic macular oedema (DMO). Methods: We carried out an observational, cross‐sectional study. Patients who had diabetes mellitus (DM) of ≥ 10 years duration without DMO were included. Only one eye of each patient was selected for analysis. Eyes with proliferative diabetic retinopathy were excluded. Central subfield thickness (CST), central subfield volume (CSV) and total macular volume (TMV) were measured by optical coherence tomography (OCT). Chronic HbA1c level was defined as the mean HbA1c value in the year prior to enrolment. Results: We included 97 eyes from 97 patients (47 women, 50 men; mean age 62.2 years). They included eight type 1 and 89 type 2 DM patients. The mean duration of DM was 15.5 years. Forty‐two (43%) eyes had no diabetic retinopathy and 55 (57%) eyes had non‐proliferative diabetic retinopathy. In statistical analysis, CST (mean 188.80 ± 27.64 μm; r = 0.220, p = 0.030), CSV (mean 0.149 ± 0.021 mm3; r = 0.213, p = 0.036) and TMV (mean 6.497 ± 0.715 mm3; r = 0.299, p = 0.003) positively correlated with chronic HbA1c level (7.95 ± 1.29%). The linear regression model showed that chronic HbA1c level (standardized coefficient 0.253; p = 0.013) and age (standardized coefficient − 0.206; p = 0.040) were factors significantly related to TMV. Conclusions: Chronic HbA1c level positively correlates with macular thickness and volume in patients with DM of ≥ 10 years duration without DMO. Our results suggest that subclinical macular volume and thickness changes may occur before DMO becomes clinically evident. Early tight glycaemic control prior to the onset of DMO may play an important role in preventing the deterioration of macular function by altering macular haemodynamics.

RETRACTED ARTICLE: Cental macular thickness in patients with type 2 diabetes mellitus without clinical retinopathy

“…Moon, at al [20] suggested that a high baseline HbA1c and a large reduction in HbA1c were risk factors for increase in macular thickness. Yeung, et al [21], showed that HbA1c level positively correlated with macular thickness in patients with type1 and 2 diabetes of10 or more years’ duration without diabetic macular edema. Chou, Moreira at al [22].…”

“…Yeung, http://at al. [21]–[23] concluded that meticulous diabetes control may slow the progression of early diabetic retinopathy and may play an important role in preventing macular dysfunction. In type 1 and 2 diabetes patients, strict follow-up of plasma glucose level could reduce the progression and development of diabetic retinopathy.…”

Influence of diabetes on macular thickness measured using optical coherence tomography: the Singapore Indian Eye Study

“…42 In our study, the duration of diabetes and HbA1 C levels did not significantly affect macular thickness measurements. In contrast, previous studies have reported increased macular thickness with higher HbA1 C levels, 43,44 whereas a longer duration of diabetes was associated with thinner macula measurements in the absence of macula oedema. 45,46 However, these studies were not population-based, hence were susceptible to selection bias.…”

Central Macular Thickness in Diabetic Retinopathy- A Comparative Study

“…Alterations in glucose metabolism lead to changes in the capillary walls of retinal vessels. This leads to breakdown of blood retinal barrier causing haemorrhages and seepage of exudates, which in turn present as detectable retinal thickening in OCT. [13][14][15] In contrast to our study, few researchers [16][17][18][19] reported early macular thickening in diabetic eyes, however, the difference was not statistically significant. In certain patients they observed significantly higher macular thickness in diabetics without clinical retinopathy when compared with controls.…”