title: Microaneurysm number and distribution in the macula of Chinese type 2 diabetics with early diabetic retinopathy: a population-based study in Kinmen, Taiwan.
abstract: To explore the number and distribution of microaneurysms (MA) in the macula of type 2 diabetics in Kinmen, Taiwan and associated risks for early diabetic retinopathy (DR). A baseline mass screening extracts 971 type 2 diabetics between 1991 and 1993 and follow-up eye screening at 1999 was then done. Number of MA was counted and associated systemic factors collected from a centered 45 degrees color fundus photograph of dilated eyes of type 2 diabetics (Topcon-NW5). Thirty-three (6.2%, n = 527) had MA retinopathy. Those with one eye involved (n = 26) had two mean MA; those with bilateral involvement (n = 7) had four mean per eye. Most MA were located temporally (mean MA = 0.79), then superiorly (mean = 0.58), inferiorly (mean = 0.46) and nasal (mean = 0.28). MA occurred at the 6,000-microm outermost ring (mean = 1.51), then the 3,000-microm ring (mean = 0.35), the 1,500-microm ring (mean = 0.26) and center 500 microm circle (mean = 0.01). After adjusting for confounding factors, early DR with MA was associated with longer duration of type 2 diabetes [odds ratios (OR) = 1.10, 95% confidence interval (CI) 1.00-1.21], higher glycosylated hemoglobin (OR = 1.36, 95%CI 1.11-1.66) and wider waist circumference (OR = 1.04, 95%CI 1.01-1.07). Our photograph grading system suggests that MA number and distribution at the macula may reflect severity of early DR and is a valid tool for predicting the progression of DR. Identifying those factors associated with MA only DR is important in developing prevention strategies for this early microvascular complication of type 2 diabetes.
authors.affiliation: Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Chen
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.forename: An-Fei
authors.initials: AF
authors.lastname: Lee
authors.forename: Fenq-Lih
authors.initials: FL
authors.lastname: Lee
authors.forename: Wen-Ming
authors.initials: WM
authors.lastname: Hsu
authors.forename: Jorn-Hon
authors.initials: JH
authors.lastname: Liu
authors.forename: Tao-Hsin
authors.initials: TH
authors.lastname: Tung
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000783:Aneurysm / Q000453:epidemiology*; D001794:Blood Pressure; D001806:Blood Urea Nitrogen; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D005451:Fluorescein Angiography; D007839:Functional Laterality; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008266:Macula Lutea / Q000503:physiopathology*; D008875:Middle Aged; D012044:Regression Analysis; D012164:Retinal Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D013624:Taiwan / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin; D014280:Triglycerides