Diabetic Retinopathy and Diabetic Macular Edema in People With Early-Onset Diabetes
Diabetic macular edema (DME) and retinal neovascular proliferation are common consequences of diabetic retinopathy (DR). There can be differences between the characteristics, risk factors, treatment response, visual outcome predictors of DME in people with early-onset diabetes as compared to people diagnosed in older age. There is a lack of data to address different aspects of DME in younger patients. Hence, Nikitha Gurram Reddy and colleagues conducted a study under the title “Diabetic Retinopathy and Diabetic Macular Edema in People With Early-Onset Diabetes” published in the Clinical Diabetes Journal. The summary of this study is mentioned below:
Objective:
To investigate the clinical profile, treatment strategies, optical coherence tomography (OCT) characteristics, and visual acuity changes of younger people diagnosed with diabetes and DME. This study highlights the need to closely follow young people with diabetes and to consider early and aggressive management in such eyes.
Method:
For this retrospective study, a database of all patients with early-onset diabetes (type 1 & 2) who had reported to the retina clinic of a tertiary eye care hospital for the first time were collected for DR
Evaluation between January 2013 and December 2020. Eyes belonging to group 1 [showing nontractional center-involving DME (CI-DME)] and group 2 (scans showing either no DME or non tractional, non–CI-DME) as per OCT scan were included. The severity of DR was categorized based on the Early Treatment Diabetic Retinopathy Study as mild, moderate, or severe nonproliferative DR and proliferative DR as early or high-risk stage.
The corrected visual acuity was recorded in Snellen units and converted to logarithm of the minimum angle of resolution (logMAR) for statistical analyses.
Findings:
The analysis suggests the existence of differences in severity, prevalence, and pathogenesis of DR in individuals diagnosed with diabetes at a young age as compared to patients diagnosed after 40 years of age. There is a higher prevalence of DME in young patients with diabetes and DME is seen in more severe stages of DR. Retinal capillary nonperfusion and elevated VEGF production seem to be responsible for the DME in these patients. The high prevalence of DME and of proliferative DR can be a reason for severe vision loss.
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