Impact of estimated glomerular filtration rate on diabetic macular edema

Int Ophthalmol. 2018 Jun;38(3):1043-1050. doi: 10.1007/s10792-017-0557-8. Epub 2017 May 18.

Abstract

Purpose: Diabetic macular edema (DME) is a major cause of visual impairment in patients with diabetes and is influenced by various systemic factors. This study evaluates the effect of renal status on DME using estimated glomerular filtration rate (eGFR) as a study marker.

Methods: This was a prospective observational cross-sectional study. One hundred and ninety-five patients of diabetic retinopathy (DR) were included. Group 1 had patients of DR without DME (n = 100), and group 2 had patients of DR with DME (n = 95). All patients were evaluated for DR/DME-related risk factors. eGFR was calculated in all patients. Spectral domain optical coherence tomography (SDOCT) was done to identify the various patterns and severity of DME.

Results: Group 2 patients had significantly higher comorbidities than those in group 1 (p < 0.001). Hba1c, total cholesterol, triglycerides, LDL/HDL ratio, systolic and diastolic blood pressures were significantly higher in group II (p < 0.001 in each). There was no significant difference between the groups in terms of blood urea, serum creatinine or eGFR. eGFR did not show a significant association with a specific SDOCT pattern or severity of DME.

Conclusion: 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.

Keywords: Diabetic macular edema; Diabetic nephropathy; Diabetic retinopathy; Estimated glomerular filtration rate.

Publication types

  • Observational Study

MeSH terms

  • Cross-Sectional Studies
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / physiopathology*
  • Diabetic Retinopathy / complications*
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / physiopathology
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Macular Edema / diagnosis
  • Macular Edema / etiology
  • Macular Edema / physiopathology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Tomography, Optical Coherence / methods*
  • Visual Acuity