Ocular risk markers good predictors for vision-threatening complications in T2DM: Study

A complete eye examination, which included best-corrected visual acuity, slit-lamp examination, intraocular pressure measurement, digital seven-field colour fundus photography, and optical coherence tomography, was performed annually. Additionally, 45°/50° field-2 images were obtained for microaneurysm turnover (MAT) analyses using RetmarkerDR. Of the 212 eyes included in the study, 172 individuals with type 2 diabetes, one eye per person, completed the study. Fourteen eyes developed CSME (8%) and 10 developed CIME (6%), whereas 4 eyes developed PDR (2%), with 1 of these eyes showing both CSME and PDR (3).

The results of the study are:

• Development of macular oedema, either CSME or CIME, and PDR is associated with ocular risk markers such as baseline MAT, CRT, and GCL+IPL thickness metrics.
• They can help better predict the development of complications than systemic markers of metabolic control.
• Eyes with mild retinopathy in individuals with type 2 diabetes with MAT <6 and with HbA1c measurements <8% (64 mmol/mol) showed a very low likelihood of developing CSME or PDR (3 of 88 [3%]) in a period of 5 years.
• On the other hand, an eye with mild retinopathy in a patient with type 2 diabetes, with MAT ≥6, and with HbA1c ≥8% (64 mmol/mol), showed high likelihood of developing CSME and PDR (9 of 25 [36%]).

Thus, the researchers concluded that ocular risk markers are more informative than systemic risk markers for prediction in eyes of patients with well-controlled diabetes with mild retinopathy which ones are at risk for developing vision-threatening complications.

Reference:

Ocular and Systemic Risk Markers for Development of Macular Edema and Proliferative Retinopathy in Type 2 Diabetes: A 5-Year Longitudinal Study by António C.-V. Martinho et al published in the Diabetes Care.

https://doi.org/10.2337/dc20-1125