Impact of estimated glomerular filtration rate on diabetic macular edema

Abstract

Comorbidities are more common and more severe in patients with DME. However, eGFR as a marker was not useful in predicting either the severity or pattern of DME. eGFR, in its present form, may not be useful in the evaluation and management of patients with DME.

Correlating the patterns of Diabetic macular edema, Optical Coherence Tomography Biomarkers and Grade of Diabetic Retinopathy With Stage of Renal Disease

“…Also, eGFR is possibly the earliest marker for nephropathy and albuminuria is an inconsistent marker that may regress or progress. [20,23] In our group of patients, the average duration of diabetes was 12 years or more with stage 3,4 or 5 CKD and the proportion of different morphological patterns of DME on OCT did not signi cantly vary across various CKD stages. However, the most common morphological pattern found in the study cohort was cystoid pattern 42% (95% CI: 36-49) followed by mixed pattern 31% (95% CI: 24-38) and then the spongiform pattern in 16% (95% CI: [11][12][13][14][15][16][17][18][19][20][21][22].…”

“…[20,23] In our group of patients, the average duration of diabetes was 12 years or more with stage 3,4 or 5 CKD and the proportion of different morphological patterns of DME on OCT did not signi cantly vary across various CKD stages. However, the most common morphological pattern found in the study cohort was cystoid pattern 42% (95% CI: 36-49) followed by mixed pattern 31% (95% CI: 24-38) and then the spongiform pattern in 16% (95% CI: [11][12][13][14][15][16][17][18][19][20][21][22]. This is in contrast to what has been reported by Koo et al in their retrospective study on 93 korean patients of DME with renal dysfunction.…”

“…Very few studies have been conducted to determine the correlation of non-ocular factors such as CKD secondary to diabetes with various morphological patterns of DME seen on OCT. [12,20,21] Also the previous studies conducted were single centre studies with a relatively small sample size. None of the studies performed have demonstrated the impact of CKD on the recently described visual prognostic biomarkers in DME and correlated them.…”

Proteinuria as a Potential Biomarker for the Efficacy of Intravitreal Bevacizumab Injection in Patients with Diabetic Macular Edema

“…This tendency was also noted by previous studies. Impaired renal function assessed using glomerular filtration rate was associated with increased prevalence of DR, severe DR, and severe visual impairment, while no significance was noted with DME [16,17]. Similarly, secondary analysis of a randomized clinical trial comparing different anti-VEGF agents reported no treatment group differences in UACR as a reflection of kidney function in patients with DME [38].…”

“…A recent study identified a significant association between DN and DME [15], and there are also reports that impaired renal function is not associated with DME [16,17]. Urinary albumin-to-creatinine ratio (UACR) calculated from a random urine sample has been introduced as a marker with a good correlation to absolute urinary protein or albumin excretion collected over 24 hours [18,19].…”