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Hyperglycemia potentiates the effect of ionic calcium in photoreceptor ellipsoid zone disruption in diabetic retinopathy

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Abstract

Purpose

To study the association of serum ionic calcium and glycated hemoglobin (HbA1c) with retinal photoreceptor ellipsoid zone (EZ) disruption in diabetic retinopathy (DR).

Methods

This is a tertiary care center-based observational cross-sectional study. Sixty-three consecutive cases, divided into 21 cases each with no diabetic retinopathy, non-proliferative diabetic retinopathy and proliferative diabetic retinopathy were included. Twenty-one healthy controls were also included. Ellipsoid zone disruption was assessed using spectral-domain optical coherence tomography. Serum ionic calcium and HbA1c were measured using standard protocol. Patient data from cases were divided into two groups according to their HbA1c levels: group 1 (HbA1c < 7, n = 26) and group 2 (HbA1c > 7, n = 37). Data were analyzed statistically.

Results

Mean ionic calcium levels in group 1 and group 2 were 1.131 ± 0.073 mmol/dL and 1.170 ± 0.070 mmol/dL, respectively. In group 1, 11 out of 26 had EZ disruption (42.3%). Similarly, in group 2, 29 out of 37 had EZ disruption (78.4%). On logistic regression analysis, as compared to group 1, ellipsoid zone disruption was found to be positively associated with serum ionic calcium (p = 0.01) in group 2 cases.

Conclusion

Increased levels of serum ionic calcium are associated with increased EZ disruption in patients with HbA1c > 7 in DR.

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Author information

Author notes

  1. Ankita Ankita and Jana Stefanickova: Co-first/Co-equal authorship.

Authors and Affiliations

  1. Department of Ophthalmology, King George’s Medical University, Shah Mina Road, Lucknow, Uttar Pradesh, 226003, India

    Ankita, Sandeep Saxena, Apjit Kaur & Shashi K. Bhasker

  2. Department of Ophthalmology, Faculty of Medicine, Comenius University in Bratislava and University Hospital, Bratislava, Slovakia

    Jana Stefanickova & Jela Valaskova

  3. Department of Pharmacology, Lady Hardinge Medical College, New Delhi, India

    Dwividendra K. Nim

  4. Department of Biochemistry, King George’s Medical University, Lucknow, India

    Kaleem Ahmad & Abbas A. Mahdi

  5. 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia

    Peter Kruzliak

  6. 2nd Department of Surgery, Faculty of Medicine, Masaryk University and St. Anne’s University Hospital, Brno, Czech Republic

    Peter Kruzliak

  7. Department of Internal Medicine, Brothers of Mercy Hospital, Polni 3, 639 00, Brno, Czech Republic

    Peter Kruzliak

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  1. Ankita
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Correspondence to Sandeep Saxena or Peter Kruzliak.

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Ankita, Stefanickova, J., Saxena, S. et al. Hyperglycemia potentiates the effect of ionic calcium in photoreceptor ellipsoid zone disruption in diabetic retinopathy. Int Ophthalmol 39, 2237–2243 (2019). https://doi.org/10.1007/s10792-018-01063-8

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  • DOI: https://doi.org/10.1007/s10792-018-01063-8

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