The Association Between Diabetes and Age-Related Macular Degeneration Among the Elderly in Taiwan

He, Ming-Shan; Chang, Fang-Ling; Lin, Hong-Zin; Wu, Jung-Lun; Hsieh, Tsung-Cheng; Lee, Yuan‐Chieh

doi:10.2337/dc18-0707

Cited by 48 publications

(44 citation statements)

References 38 publications

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“…This phenomenon is also important to consider in a clinical context, as GCL thickening and thinning in AMD eyes may mask or exaggerate GCL thinning from other comorbid ocular diseases, such as glaucoma and diabetic retinopathy. 2,3,4,5 As such, the use of local assessment of GCL thickness, as done in this study, may be more effective than summary data for the improved diagnoses and monitoring of GCL-altering pathologies in clinical practice.…”

Section: Proposed Mechanisms For Gcl Changesmentioning

confidence: 91%

“…Emerging evidence, however, suggests the inner retina may also be subject to a host of changes secondary to outer retinal degeneration in AMD. Defining the ganglion cell layer (GCL) thickness profile in intermediate AMD eyes is vital, as nonexudative AMD shows increased rates of comorbidity with other GCL thickness altering 2 , 3 pathologies, such as glaucoma 4 and diabetic retinopathy, 5 potentially obscuring GCL thickness interpretations.…”

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confidence: 99%

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Macula Ganglion Cell Thickness Changes Display Location-Specific Variation Patterns in Intermediate Age-Related Macular Degeneration

Trinh

Tong

Yoshioka

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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Nivison-Smith L. Macula ganglion cell thickness changes display location-specific variation patterns in intermediate age-related macular degeneration. Invest Ophthalmol Vis Sci. 2020;61(3):2. https://doi.org/10.1167/iovs.61.3.2 PURPOSE.The purpose of this study was to examine changes in the ganglion cell layer (GCL) of individuals with intermediate age-related macular degeneration (AMD) using grid-wise analysis for macular optical coherence tomography (OCT) volume scans. We also aim to validate the use of age-correction functions for GCL thickness in diseased eyes. METHODS.OCT macular cube scans covering 30°× 25°were acquired using Spectralis spectral-domain OCT for 87 eyes with intermediate AMD, 77 age-matched normal eyes, and 254 non-age-matched normal eyes. The thickness of the ganglion cell layer (GCL) was defined after segmentation at 60 locations across an 8 × 8 grid centered on the fovea, where each grid location covered 0.74 mm 2 (approximately 3°× 3°) within the macula. Each GCL location of normal eyes (n = 77) were assigned to a specific iso-ganglion cell density cluster in the macula, based on patterns of age-related GCL thickness loss. Analyses were then performed comparing AMD GCL grid-wise data against corresponding spatial clusters, and significant AMD GCL thickness changes were denoted as values outside the 95% distribution limits. RESULTS.Analysis of GCL thickness changes revealed significant differences between spatial clusters, with thinning toward the fovea, and thickening toward the peripheral macula. The direction of GCL thickness changes in AMD were associated more so with thickening than thinning in all analyses. Results were corroborated by the application of GCL thickness age-correction functions.CONCLUSIONS. GCL thickness changed significantly and nonuniformly within the macula of intermediate AMD eyes. Further characterization of these changes is critical to improve diagnoses and monitoring of GCL-altering pathologies.

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Section: Proposed Mechanisms For Gcl Changesmentioning

confidence: 91%

mentioning

confidence: 99%

Macula Ganglion Cell Thickness Changes Display Location-Specific Variation Patterns in Intermediate Age-Related Macular Degeneration

Trinh

Tong

Yoshioka

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…The Charlson Comorbidity Index score has been used commonly in retrospective analysis to match two cohorts of patients with diabetes. [ 19,20 ] The Charlson Comorbidity Index score is a tool to classify prognosis based on comorbid conditions. Factors included in the computation of the score are: age, myocardial infarction, congestive heart failure, peripheral heart disease, cerebrovascular disease, dementia, COPD, peptic ulcer disease, liver disease, diabetes, hemiplegia, renal disease, tumour, leukaemia, lymphoma and AIDS (not HIV).…”

Section: Methodsmentioning

confidence: 99%

Health expenditure and health services utilization comparison of patients with type 2 diabetes on sodium–glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors: evidence from 2015 to 2016 medical expenditure panel survey

Patel

Vaidya

2020

Journal of Pharmaceutical Health Services Research

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Objectives Primary objective of this study was to compare the overall health expenditures of patients with type 2 diabetes on sodium–glucose cotransporter‐2 (SGLT2) inhibitors versus dipeptidyl peptidase‐4 (DPP4) inhibitors. Methods Two cohorts of type 2 diabetes patients receiving either SGLT2 inhibitor with metformin or DPP4 inhibitor with metformin were identified from 2015 to 2016 Medical Expenditure Panel Survey (MEPS) data. Propensity score matching was used to balance cohorts based on socio‐economic status, insulin utilization status, and the Charlson comorbidity score. Patients in SGLT2 inhibitor cohort were matched with patients in DPP4 inhibitor cohort using 1 : 2 ratio on the logit of propensity score using caliper width of 0.1 of the standard deviation of the logit of the propensity score. Expenditure variables were analysed using a generalized linear model with log link function and gamma distribution and adjusted for socio‐economic variables. Unadjusted means were obtained using bootstrap. Results After propensity score matching, 240 patients were left in the sample with 80 patients in SGLT2 inhibitor cohort and 160 patients in DPP4 inhibitor cohort. Unadjusted average annual total health expenditure was significantly higher in the SGLT2 inhibitor cohort versus DPP4 inhibitor cohort ($17,325 versus $15,702; P value <0.0001). After adjusting for socio‐economic factors, overall health expenditure (β = −0.3516; P = 0.0038) was significantly lower in DPP4 inhibitor cohort compared to SGLT2 inhibitor. Conclusion SGLT2 inhibitors were associated with significantly higher overall and prescription expenditures compared to DPP4 inhibitors during the study period evaluated. Future studies need to utilize administrative claims data to assess current comparativeness effectiveness trends.

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“…The choriocapillaris (CC) is a thin, single layer of the capillary plexus located between the Bruch's membrane and Sattler's layer, which gives nourishment and supplies oxygen to the retinal pigment epithelium (RPE) and outer retina [7,12]. According to clinical and histopathological studies, there are different retinal diseases, such as juvenile macular degeneration (JMD) (most commonly known as Stargardt disease) and diabetic retinopathy (DR), which correlates with the CC circulation [7,[13][14][15]. Nevertheless, it is a challenge to take images of the choriocapillaris in vivo using existing technology [16].…”

Section: Introductionmentioning

confidence: 99%

Determination of Referential Rates for Optical Coherence Tomography and Optical Coherence Tomography Angiography Flow Deficits in the Macular Choriocapillaris in Ophthalmologically Healthy Children

et al. 2020

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Background and Objectives: Despite the growing number of new research publications, normative references for children’s optical coherence tomography (OCT) parameters are still not completed. We chose to explore this topic because of the lack of normative parameters that is due to an improvement in different technologies and instruments. Our aim was to determine referential rates of retinal nerve fiber layer (RNFL) thickness and flow deficits (FD%) in the macular choriocapillaris (CC) in normal eyes of ophthalmologically healthy children. Materials and Methods: Ophthalmologically healthy 8- to 14-year-old individuals participated (n = 75) in this study. OCT images were taken using an swept-source-OCT (SS-OCT) instrument (DRI-OCT Triton, Topcon, Tokyo, Japan). The early treatment diabetic retinopathy study (EDTRS) grid (6 × 6 mm) divided the RNFL into the thickness maps. The FD% values of the CC were calculated on the 3 × 3-mm scans in a 1-mm circle (C1), 1.5-mm rim (R1.5), and the entire 2.5-mm circle (C2.5), and on the 6 x 6-mm scans in a 1-mm circle (C1), 1.5-mm rim (R1.5), the entire 2.5-mm circle (C2.5), 2.5-mm rim (R2.5), and 5-mm circle (C5). Results: Both scan quantifications of FD% in the C1, C2.5, and R1.5 sectors were similar, but the 6 × 6-mm scan measurements were statistically significantly smaller than the 3 × 3-mm ones. Significant moderate correlations were found between axial length (AxL) and FD% in the 6 × 6-mm scans, namely C1 (r = −0.347, p = 0.002), C2.5 (r = −0.337, p = 0.003), R1.5 (r = −0.328, p = 0.004), R2.5 (r = −0.306, p = 0.008), and C5 (r = −0.314, p = 0.006). Conclusions: The thinnest RNFL layers were on the temporal and nasal sides. FD% values in the C1, C2.5, and R1.5 sectors were similar between the 3 × 3-mm and 6 × 6-mm scans. The negative moderate correlations between AxL and FD% were found in all C1, C2.5, C5, R1.5, and R2.5 sectors of the 6 × 6-mm scans. Further prospective studies are needed to determine more accurate normative references for children’s OCT parameters.

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The Association Between Diabetes and Age-Related Macular Degeneration Among the Elderly in Taiwan

Abstract: This study provides large-scale, population-based evidence that diabetes with retinopathy is independently associated with an increased risk of subsequent AMD development.

Cited by 48 publications

References 38 publications

Macula Ganglion Cell Thickness Changes Display Location-Specific Variation Patterns in Intermediate Age-Related Macular Degeneration

Macula Ganglion Cell Thickness Changes Display Location-Specific Variation Patterns in Intermediate Age-Related Macular Degeneration

Health expenditure and health services utilization comparison of patients with type 2 diabetes on sodium–glucose cotransporter-2 inhibitors versus dipeptidyl peptidase-4 inhibitors: evidence from 2015 to 2016 medical expenditure panel survey

Determination of Referential Rates for Optical Coherence Tomography and Optical Coherence Tomography Angiography Flow Deficits in the Macular Choriocapillaris in Ophthalmologically Healthy Children

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