Influence of Serum Lipid Fractions on the Course of Diabetic Macular Edema after Photocoagulation

Kremser, B.; Falk, Michael C.; Kieselbach, G.

doi:10.1159/000310581

Cited by 14 publications

(5 citation statements)

References 8 publications

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“…[26] Another prospective study concluded that serum lipid fraction may affect the success of laser treatment and also the course of macular edema. [29] Our study failed to show any statistically significant relationship between presence or absence of hypercholesterolemia with a positive visual outcome. However, there appears to be a trend towards better visual improvement in patients without hyperlipidemia.…”

Section: Discussioncontrasting

confidence: 64%

Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema

Zaidi

Jacob

2009

Oman J Ophthalmol

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Background:The aim of this study was to determine the effect of macular laser treatment on the visual acuity (VA) of Omani diabetic patients with clinically significant macular edema (CSME). Visual outcome was also correlated with duration and control of diabetes and presence or absence of hypertension and hyperlipidemia.Materials and Methods:This is a retrospective noncomparative cohort study involving 101 eyes of 72 Omani diabetic patients. Change in VA was determined using Snellen′s VA chart. The mean duration of follow-up was approximately 21 months (range, 16-24 months).Results:29.7% of the patients maintained their vision, 35.6% showed improvement, whereas 34.7% showed a decrease in their vision. Positive visual outcome showed a statistically significant direct relationship with tight control of diabetes and absence of hypertension and an inverse relationship with the duration of diabetes. Presence of hyperlipedemia did not show a statistically significant relationship with positive visual outcome. However, it showed a trend to better visual outcome in the absence of hyperlipedemia. Peak incidence of macular edema was seen at the age of 52.3 years.Conclusion:Macular photocoagulation was found to be an effective method of treatment for CSME among Omani diabetic patients, which has resulted in a positive visual outcome in 65.3% of the patients (stable and improved vision). Effective control of diabetes, duration of diabetes, and hypertension are the factors which influence the postlaser visual outcome.

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Section: Discussioncontrasting

confidence: 64%

Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema

Zaidi

Jacob

2009

Oman J Ophthalmol

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“…However, the complications were also associated with the degree of macular oedema prior to photocoagulation with a worse outcome for oedema with hard exudates compared to diffuse oedema. Several studies (ETDRS No 22; Klein et al 1991;Kremser et al 1995) have reported an association of elevated serum cholesterol levels and hard exudates, whereas no such relationship was found in the UKPDS study (UKPDS 1998). As high levels of blood triglycerides and low HDL cholesterol more often are seen in patients with insulin resistence (ADA 1993) this could be one explanation for the higher frequency of severe hard exudates in the type 2 diabetic patients.…”

Section: Discussionmentioning

confidence: 94%

Photocoagulation of diabetic macular oedema; complications and visual outcome

Lövestam-Adrian

Agardh²

2000

Acta Ophthalmologica Scandinavica

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“…Similarly, the risk of hard exudate increased more than twofold for subjects in the highest quintile of total cholesterol, LDL cholesterol, or total-to-HDL cholesterol ratio and more than threefold for subjects in the highest quintile of triglycerides. In contrast, no lipid parameters were asso- Several previous studies of lipids and DR did not control for HbA 1c (7,(17)(18)(19). In the DCCT (20), as well as in other epidemiological studies, HbA 1c was a strong predictor of diabetic macular edema (21).…”

Section: Discussionmentioning

confidence: 98%

A Prospective Study of Serum Lipids and Risk of Diabetic Macular Edema in Type 1 Diabetes

et al. 2004

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We evaluated the relationships between serum lipid levels and clinically significant macular edema (CSME), hard exudates, and other diabetic retinopathy (DR) end points in a population with type 1 diabetes. We studied data from serum lipids that were measured annually among the 1,441 Diabetes Control and Complications Trial (DCCT) participants. We used proportional hazards regression models to examine the relationship of the cumulative average of lipid levels (total, LDL, and HDL cholesterol, total-to-HDL cholesterol ratio, and triglycerides) with development of CSME, hard exudate, DR progression, and development of proliferative DR (PDR). In models controlling for primary prevention versus secondary intervention subgroup, randomized treatment assignment, HbA 1c , and other risk factors, both total-to-HDL cholesterol ratio and LDL predicted development of CSME (rate ratio [RR] for extreme quintiles 3.84, P for trend ‫؍‬ 0.03 for total-to-HDL cholesterol ratio, and RR 1.95, P for trend ‫؍‬ 0.03 for LDL) and hard exudate (RR 2.44, P for trend ‫؍‬ 0.0004 for total-to-HDL cholesterol ratio, and RR 2.77, P for trend ‫؍‬ 0.002 for LDL). Relationships of lipids with progression of DR and development of PDR were weaker and not significant after adjustment for HbA 1c . Higher serum lipids are associated with increased risk of CSME and retinal hard exudate. Lipid-lowering treatment among type 1 diabetic subjects, recommended to prevent cardiovascular disease, may also decrease risk of CSME, an important cause of vision loss.

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Influence of Serum Lipid Fractions on the Course of Diabetic Macular Edema after Photocoagulation

Cited by 14 publications

References 8 publications

Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema

Effect of macular photocoagulation on visual acuity of Omani patients with clinically significant macular edema

Photocoagulation of diabetic macular oedema; complications and visual outcome

A Prospective Study of Serum Lipids and Risk of Diabetic Macular Edema in Type 1 Diabetes

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