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Factors associated with diabetic macular edema in patients with proliferative diabetic retinopathy

  • Retinal Disorders
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Abstract

Purpose

To identify factors associated with diabetic macular edema (DME) and to characterize the types of DME present in eyes with proliferative diabetic retinopathy (PDR).

Methods

Observational, retrospective case series of PDR patients reviewed for demographic information, general medical history, ophthalmologic history, optical coherence tomography (OCT), and fluorescein angiogram image characteristics. DME and vitreomacular interface (VMI) status were determined using OCT images. DME was defined as center-involving DME (CI-DME) and noncenter-involving DME (NCI-DME). VMI was defined as vitreomacular adhesion (VMA), vitreomacular traction (VMT), or macular posterior vitreous detachment (PVD).

Results

A total of 293 eyes of 210 screened patients with PDR were included. Of the eyes, 194/293 (66.2%) had DME, and 99/293 (33.8%) had no DME; in univariable analysis, there were no significant differences in VMI status (p = 0.4) or epiretinal membrane (ERM, p = 0.1) between them. Of 194 eyes with DME, 90/194 (46.4%) had CI-DME, and 104/194 (53.6%) had NCI-DME. In univariable analysis, CI-DME eyes were significantly more likely than NCI-DME eyes to have a PVD (p = 0.029) and ERM (p < 0.001). In multivariable analysis, the presence of younger age (p = 0.028) and presence of ERM (p = 0.001) were significantly more likely to be observed in eyes with CI-DME.

Conclusion

In this exploratory study focused on diabetic patients with PDR, we determined that VMI status did not have a significant association with DME in general, but VMI status, younger age, and presence of ERM may be associated with CI-DME.

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Data availability

The datasets during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

The code during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

Funded in party by a Dean’s Research Scholarship (John R. O’Fee) from the Keck School of Medicine of the University of Southern California (Los Angeles, CA) and an unrestricted grant to the Department of Ophthalmology at USC Keck School of Medicine from Research to Prevent Blindness (New York, NY).

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Authors and Affiliations

  1. Department of Ophthalmology, Keck School of Medicine, USC Roski Eye Institute, University of Southern California, 1450 San Pablo St., Suite 4703, Los Angeles, CA, 90033, USA

    John R. O’Fee, Joseph Juliano & Andrew A. Moshfeghi

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Contributions

John O’Fee: conception and design, literature search, data collection, data interpretation, writing, and figures. Joseph Juliano: conception and design, literature search, data analysis, data interpretation, and writing. Andrew A. Moshfeghi: conception and design, literature search, data interpretation, and writing.

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Correspondence to Andrew A. Moshfeghi.

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Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The study involved human participants and was determined to be exempt from review by the University of Southern California Institutional Review Board (08/20/2020, HS-20–00538).

Consent to participate

The study was retrospective in nature so it would not have been feasible to obtain informed consent from each participant.

Human and animal rights

The research involved human participants and was determined to be exempt from review by the University of Southern California Institutional Review Board; the study was retrospective, so it would not have been feasible to obtain informed consent from each participant.

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The authors declare no competing interests.

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John O’Fee and Dr. Juliano do not have financial disclosures to report.

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Meeting presentations

Presented, in part, at the Association of Research in Vision and Ophthalmology Annual Meeting on May 1, 2021, in virtual format. An abstract related to this work was presented at the 54th Annual Scientific Meeting of the Retina Society on September 30, 2021, in Chicago, IL.

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O’Fee, J.R., Juliano, J. & Moshfeghi, A.A. Factors associated with diabetic macular edema in patients with proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol 260, 2191–2200 (2022). https://doi.org/10.1007/s00417-022-05595-9

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