RISK FACTOR ANALYSIS OF DIABETIC MACULAR OEDEMA
Background : Diabetic retinopathy is the most common cause of newly diagnosed legal blindness amongst the working population in the industrialized world today.The common cause of visual impairment in diabetic retinopathy include macular oedema & complication due to proliferative retinopathy. The majority of diabetics have type II disease, wherein macular oedema is commoner, it follows that overall, macular oedema accounts for more vision impairment than proliferative retinopathy. Hence evaluating possible relationship between diabetic macular oedema & various risk factor helps as preventive measure for progression of disease.
Methodology:
Eyes were diagnosed with diabetic macular oedema according to ETDRS guidelines. Best corrected visual acuity with Smelled vision drum, slit lamp examination of anterior segments, and fund us evaluation with slit lamp bio microscopy using + 90 Volk lens was done. Fasting plasma samples after at least an 8 -h overnight fast were collected for lipid analysis in blood . Other investigation blood sugar, haemoglobin, serum creatinine were assessed. Existing of hypertension noted. Ocular risk factor like cataract surgery was included.
Results: Most cases presented with vision between 6/18 to 6/60 constituting 35 eyes (43.75%) followed by 22 eyes (27.5%) had normal vision 6/6 to 6/18 , 10 eyes (12.5%) low vision category 2, 6/60 to 3/60 and remaining 13 eyes (16.25%) were in blindness category 3, 3/60 to 1/60 . Males 37 (74 % ) were affected more than females 13 (26%) . Mean duration of DM was 9.28=6.15 years. The P value of 0.019 for serum cholesterol to diabetic macular oedema is statically significant . P value for LDL , HDL ,triglycerides, haemoglobin serum creatinine and surgery was not significant . Chi square test was used to see the association between groups for categorical variables. Results were considered significant at 'p' < 0.05 .
Conclusions:
Total serum cholesterol appears as an important risk factor for incidence and progression of diabetic macular oedema. Most of the cases were in age group of 51 to 60 years. Male were predominantly affected .The maximum patient had low vision category 1 constituting 35 eyes (43.75%) . Duration of diabetes mellitus and diabetic macular oedema was not related indicating perhaps DME can occur at any stage of diabetic retinopathy. Cataract surgery , hypertension , serum creatinine, haemoglobin were not significantly related to diabetic macular oedema. As the study was carried out in small number of patient , further study with large number of patient is needed .
