Macular ischaemia as a marker for nephropathy in diabetic retinopathy.
OBJECTIVE
To determine whether diabetic macular ischaemia is associated with ischaemic heart disease (IHD), hyperlipidaemia, hypertension (HTN) and nephropathy.


METHODS
Prospective case-control study from January to December 2001, involving 102 type 2 diabetic patients (aged 40-80 years), 59 with unilateral / bilateral macular ischaemia and 43 concurrent controls. Diabetic retinopathy was graded and macular ischaemia assessed by fundus examination, central fundus photography and fluorescein angiography. Systemic examination and laboratory investigations were done to evaluate systemic diseases. The associations were analysed by Chi-square test and Student's t-test. The significance of the variables as independent risk factors was tested by logistic regression analysis.


RESULTS
Macular ischaemia was not associated with IHD (P=1.00); HTN (P=1.00) and hyperlipidaemia (P=0.30). Nephropathy was significantly associated with macular ischaemia (P=0.025; odds ratio [OR]: 2.62; 95% confidence interval [CI]: 1.16-5.9). The association remained significant after controlling for age, gender, duration of diabetes, severity of retinopathy, HTN, IHD and hyperlipidaemia. Further, the association with nephropathy was not affected by the presence of macular isachaemia in one or both the eyes (P=0.39).


CONCLUSIONS
Macular ischaemia may serve as a marker for nephropathy in type 2 diabetes mellitus irrespective of the severity of retinopathy.
Shukla
Dhananjay
D
Aravind Eye Hospital & Postgraduate Institute of Ophthalmology, 1 Anna Nagar, Madurai 625 020, Tamil Nadu, India. daksh@aravind.org
Kolluru
Chandra Mohan
CM
Singh
Jatinder
J
John
Rajesh K
RK
Soman
Manoj
M
Gandhi
Banushree
B
Kim
R
R
Perumalsamy
Namperumalsamy
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D003930:Diabetic Retinopathy / Q000150:complications*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008266:Macula Lutea / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies