Intraocular Risk Factors in the Primary Formation of Diabetic Macular Edema in Patients with Diabetes Mellitus Type II
https://doi.org/10.18008/1816-5095-2019-1-63-69
Abstract
Purpose. Revealing of the intraocular risk factors in the diabetic macular edema (ME) formatis in diabetes mellitus type II (DM2). Patients and methods. A 3.5-year research of 80 patients (160 eyes) with DM2 without signs of ME at the beginning of the research was performed. The main group consisted of 46 patients with ME symptoms on one or both eyes during the research period, the comparison group included 34 patients without ME symptoms to the end of the research. The initial ocular characteristics were retrospectively compared in groups. Results. The mean value of the axial lengths (AL) in the eyes of the main group was 23.12 ± 0.75 mm compared to 23.82 ± 0.62 mm in the comparison group (significant difference, p < 0.01). AL was less than 23.5 mm in 66 % eyes in the main group and only in 22 % of the eyes in the comparison group (p < 0.01). The mean value of the initial macular retina volume in the main group was significantly higher than in the comparison group — 7.51 ± 0.22 mm3 and 7.21 ± 0.12 mm3, respectively (p < 0.01). Initial background diabetic retinopathy (DR) was noted in 73 % eyes in the main group, which significantly differed from the comparison group, where this index was noted only in 13 % of the eyes (p < 0.01). Conclusion. Significant ocular risk factors for the formation of ME in patients with DM2 are: the initial macular retina volume more than 7.3 mm3, the value of the AL less than 23.5 mm; the initial background DR. The use of the detected morphometric parameters of eye and retina in combination with an adequate assessment of the risk factors in human organism makes it possible to assume a high risk of the primary formation of diabetic ME in patients with DM2 with high degree of probability.
About the Authors
M. V. Pshenichnov
Khabarovsk branch IRTC “Eye Microsurgery” named after Acad. S.N. Fyodorov
Russian Federation
Russian Federation
Ph.D., ophthalmologist of the laser surgery department
Tikhookeanskaya str., 211, Khabarovsk, 680033, Russia
O. V. Kolenko
Khabarovsk branch IRTC “Eye Microsurgery” named after Acad. S.N. Fyodorov
Postgraduate Institute for Public Health Workers
Russian Federation
Russian Federation
Ph.D., assistant professor, deputy head of medical part; assistant professor of the department of ophthalmology
Tikhookeanskaya str., 211, Khabarovsk, 680033, Russia
Krasnodarskaya str., 9, Khabarovsk, 680000, Russia
E. L. Sorokin
Khabarovsk branch IRTC “Eye Microsurgery” named after Acad. S.N. Fyodorov
Far-Eastern State Medical University
Russian Federation
Russian Federation
doctor of medical sciences, professor, deputy head on science work; professor of the general and clinical surgery department
Tikhookeanskaya str., 211, Khabarovsk, 680033, Russia
Muraviev-Amurskii str., 35, Khabarovsk, 680000, Russia
Yu. E. Pashentcev
Khabarovsk branch IRTC “Eye Microsurgery” named after Acad. S.N. Fyodorov
Russian Federation
Russian Federation
junior researcher
Tikhookeanskaya str., 211, Khabarovsk, 680033, Russia
References
1. Gonzalez-Clemente J.M., Esmatjes E., Adan A., Raitieri J.C., Levy I., Gomis R., Vilardell E. Retinopathy in patients with insulin-dependent diabetes mellitus of short duration. Rev. Clin. Esp. 1996;196(4);228–233.
2. Sorokin E.L., Egorov V.V., Pshenichnov M.V., Kolenko O.V. The estimation of the condition of macular area diabetes mellitus type II patients referred to laser treatment of diabetic retinopathy; the prospects to vision preservation. Far East Medical Journal = Dalnevostochnyi meditsinskii jurnal. 2007;3:86–88 (In Russ.).
3. Moshetova L.K., Golubeva I.V. Screening of diabetic retinopathy in a city polyclinic. Advances in theoretical and clinical medicine = Uspekhi teoreticheskoy i klinicheskoy meditsiny. 1999;3:326–327 (In Russ.).
4. Akduman L., Olk R.J. Laser photocoagulation of diabetic macular edema. Ophthalmic. Surg. Lasers. 1997;28(5):387–408.
5. Nguyen H.T., Luzio S.D., Dolben J., West J., Beck L., Coates P.A., Owens D.R. Dominant risk factors for retinopathy at clinical diagnosis in patients with type II diabetes mellitus. J. Diabetes Complications. 1996;10(4):211–219. DOI: 10.1016/1056-8727(95)00059-3
6. Sorokin E.L., Kolenko O.V., Pshenichnov M.V., Moskovchenko A.A. Clarification of sequence of diffuse diabetic macular edema formation at diabetes mellitus type 2. Annals of Orenburg State University = Vestnik Orenburgskogo gosudarstvennogo universiteta. 2012;11:187–190 (In Russ.).
7. Sorokin E.L., Pshenichnov M.V. The value of morphometric parameters of the retina in predicting the debut of diabetic macular edema in patients with type 2 diabetes mellitus. Diabetes Mellitus = Sakharnyi diabet. 2008;3:18–19 (In Russ.).
8. Sorokin E.L., Kolenko O.V., Pshenichnov M.V., Moskovchenko A.A. Morphometric indicators of retina in diffuse diabetic macular edema in patients with diabetes mellitus type 2. Far East Medical Journal = Dalnevostochnyi meditsinskii jurnal. 2013;2:73–75 (In Russ.).
9. Sorokin E.L., Kolenko O.V., Moskovchenko A.A., Pshenichnov M.V. Share of diffuse macular edema in patients with type 2 diabetes mellitus at first visit laser surgery department. Modern technologies in ophthalmology = Sovremennye tekhnologii v oftalmologii. 2014;2:81–83 (In Russ.).
10. Sorokin E.L., Moskovchenko A.A., Danilov O.V. The study of morphometric and functional features of diffuse diabetic macular edema in patients with type 2 diabetes mellitus. Modern technologies in ophthalmology = Sovremennye tekhnologii v oftalmologii. 2014;2:83–85 (In Russ.).
11. Astahov Yu.S., Shadrischev F.E. Diabetologic centers — a new step in creation of specialized help for patients with diabetic retinopathy. Russian Medical Journal. Clinical Ophthalmology = ossijskij medicinskij zhurnal. Klinicheskaya oftal’mologiya. 2001;4:148–153 (in Russ.).
12. Klein R., Marino E.K., Kuller L.H., Polak J.F., Tracy R.P., Gottdiener J.S., Burke G.L., Hubbard L.D., Boineau R. The relation of atherosclerotic cardiovascular disease to retinopathy in people with diabetes in the Cardiovascular Health Study. Br. J. Ophthalmol.
13. 2002;86(1):84–90. DOI: 10.1136/bjo.86.1.84
14. Klein R., Klein B.E., Moss S.E., Davis M.D., DeMets D.L. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: IV Diabetic macular edema. Ophthalmology. 1984;105(10):1464–1474.
15. Gatsu M.V., Balashevich L.I. The classification of diabetic maculopathies. Ophthalmology journal = Oftalmologicheskie vedomosti. 2009;2(4):52–58 (in Russ.).
16. Henricsson M., Nilsson A., Janzon L., Groop L. The effect of glycaemic control and the introduction of insulin therapy on retinopathy in non-insulin-dependent diabetes mellitus. Diabet. Med. 1997;14(2):123–131. DOI: 10.1002/(SICI)1096-9136(199702)14:2 < 123::AID-DIA306>3.0.CO;2-U
17. Ferris F.L., Podgor M.J., Davis M.D. Macular edema in diabetic retinopathy study patients. Diabetic retinopathy study report number 12. Ophthalmology. 1987;94(7):754–760. DOI: 10.1016/s0161-6420(87)33526-2
18. Aroca P.R., Salvat M., Fernandez J., et al. Risk factors for diffuse and focal macular edema. J. Diabetes Complications. 2004;18(4):211–215. DOI: 10.1016/S1056-8727(03)00038-2
Review
For citations:
Pshenichnov M.V., Kolenko O.V., Sorokin E.L., Pashentcev Yu.E. Intraocular Risk Factors in the Primary Formation of Diabetic Macular Edema in Patients with Diabetes Mellitus Type II. Ophthalmology in Russia. 2019;16(1):63-69. (In Russ.) https://doi.org/10.18008/1816-5095-2019-1-63-69
Views:
835
Email this article 