Anterior Diabetic Retinopathy Studied by Ultra-widefield Angiography
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Purpose: To evaluate the prevalence of anterior type diabetic retinopathy (DR) using ultra-widefield fluoresceinangiography and to identify the factors associated with anterior type DR incidence. Methods: A retrospective case review was used in this study. Patients with non-proliferative diabetic retinopathy(NPDR) underwent examination by ultra-widefield fluorescein angiography, and were classified into anterior,posterior, or diffuse DR groups. Anterior DR was defined if diabetic retinal changes were noted only at thelocation anterior to the imaginary circle bordered by the Early Treatment Diabetic Retinopathy Study seven-standard fields. Correlations between demographic data, as well as systemic and ocular factors, and theincidence of NPDR types were evaluated. Results: Among the 234 eyes of 234 patients with NPDR, 25 eyes (10.7%) demonstrated anterior DR. AnteriorDR was observed in 10 eyes (30.3%) of patients having mild NPDR, three eyes (4.8%) of moderate NPDRpatients, and in 12 eyes (7.1%) of severe NPDR patients (p < 0.001). The incidence of anterior DR positivelycorrelated with lower hemoglobin A1c levels and with greater high-density lipoprotein levels following multiplelogistic regression analysis (p < 0.001). The mean hemoglobin A1c level was 7.03 ± 0.99% in anterior DR, 7.99± 1.74% in posterior DR, and 7.94 ± 1.39% in diffuse DR patients (p = 0.003). The mean high-density lipoproteinlevel was 51.2 ± 12.5 mg/dL in anterior, 49.7 ± 15.2 mg/dL in posterior, and 45.2 ± 13.1 mg/dL in diffuse DRpatients (p = 0.010). Conclusions: Diabetic retinal changes confined to an anterior location were more frequently noted in earlierstages of NPDR. The incidence of DR sparing posterior retinal involvement was related to favorable bloodsugar and lipid profiles.
Abstract
Purpose: To evaluate the prevalence of anterior type diabetic retinopathy (DR) using ultra-widefield fluoresceinangiography and to identify the factors associated with anterior type DR incidence. Methods: A retrospective case review was used in this study. Patients with non-proliferative diabetic retinopathy(NPDR) underwent examination by ultra-widefield fluorescein angiography, and were classified into anterior,posterior, or diffuse DR groups. Anterior DR was defined if diabetic retinal changes were noted only at thelocation anterior to the imaginary circle bordered by the Early Treatment Diabetic Retinopathy Study seven-standard fields. Correlations between demographic data, as well as systemic and ocular factors, and theincidence of NPDR types were evaluated. Results: Among the 234 eyes of 234 patients with NPDR, 25 eyes (10.7%) demonstrated anterior DR. AnteriorDR was observed in 10 eyes (30.3%) of patients having mild NPDR, three eyes (4.8%) of moderate NPDRpatients, and in 12 eyes (7.1%) of severe NPDR patients (p < 0.001). The incidence of anterior DR positivelycorrelated with lower hemoglobin A1c levels and with greater high-density lipoprotein levels following multiplelogistic regression analysis (p < 0.001). The mean hemoglobin A1c level was 7.03 ± 0.99% in anterior DR, 7.99± 1.74% in posterior DR, and 7.94 ± 1.39% in diffuse DR patients (p = 0.003). The mean high-density lipoproteinlevel was 51.2 ± 12.5 mg/dL in anterior, 49.7 ± 15.2 mg/dL in posterior, and 45.2 ± 13.1 mg/dL in diffuse DRpatients (p = 0.010). Conclusions: Diabetic retinal changes confined to an anterior location were more frequently noted in earlierstages of NPDR. The incidence of DR sparing posterior retinal involvement was related to favorable bloodsugar and lipid profiles.
참고문헌 (18)
- "Fundus photographic risk factors for progression of diabetic retinopathy: ETDRS report number 12. Early Treatment Diabetic Retinopathy Study Research Group", Ophthalmology, 98(5 Suppl), pp.823~833 (1991)
- Manivannan A, "Ultra-wide-field fluorescein angiography of the ocular fundus", Am J Ophthalmol, 140, pp.525~527 (2005)
- Patel RD, "Characterization of ischemic index using ultra-widefield fluorescein angiography in patients with focal and diffuse recalcitrant diabetic macular edema", Am J Ophthalmol, 155, pp.1038~1044 (2013)
- Wessel MM, "Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy", Retina, 32, pp.785~791 (2012)
- Ruilope LM, "Losartan and other angiotensin II antagonists for nephropathy in type 2 diabetes mellitus: a review of the clinical trial evidence", Clin Ther, 25, pp.3044~3064 (2003)
- Malaguarnera G, "Lipoprotein(a) serum levels in diabetic patients with retinopathy", Biomed Res Int, 2013, pp.943505~ (2013)
- Lyons TJ, "Diabetic retinopathy and serum lipoprotein subclasses in the DCCT", EDIC cohort, 2004, pp.45, 910~918
- "The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus: the Diabetes Control and Complications Trial Research Group", N Engl J Med, 329, pp.977~986 (1993)
- "The absence of a glycemic threshold for the development of long-term complications: the perspective of the Diabetes Control and Complications Trial", Diabetes, 45, pp.1289~1298 (1996)
- "The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial", Diabetes, 44, pp.968~983 (1995)
- Klein R, "Relation of glycemic control to diabetic microvascular complications in diabetes mellitus", Ann Intern Med, 124(1 Pt 2), pp.90~96 (1996)
- Toth PP, "The impact of serum lipids on risk for microangiopathy in patients with type 2diabetes mellitus", Cardiovasc Diabetol, 11, pp.109~ (2012)
- ACCORD Study Group, "Effects of medical therapies on retinopathy progression in type 2 diabetes", N Engl J Med, 363, pp.233~244 (2010)
- Knowler WC, "Increased incidence of retinopathy in diabetics with elevated blood pressure:a six-year follow-up study in Pima Indians", N Engl J Med, 302, pp.645~650 (1980)
- Rand LI, "Factors influencing the development of visual loss in advanced diabetic retinopathy: Diabetic Retinopathy Study (DRS) report No. 10", Invest Ophthalmol Vis Sci, 26, pp.983~991 (1985)
- Janka HU, "Risk factors for progression of background retinopathy in long-standing IDDM", Diabetes, 38, pp.460~464 (1989)
- Chew EY, "Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy: Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22", Arch Ophthalmol, 114, pp.1079~1084 (1996)
- Kaneko Y, "Areas of nonperfusion in peripheral retina of eyes with pathologic myopia detected by ultra-widefield fluorescein angiography", Invest Ophthalmol Vis Sci, 55, pp.1432~1439 (2014)