Ophthalmology (Eye & Ear Hospital) - Theses

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    Association of serum lipids with diabetic retinopathy, macular edema and macular thickness in adults with diabetes: the Diabetes Management Project (DMP)
    Benarous, Rehab ( 2011)
    PURPOSE: To assess the association of serum lipids with diabetic retinopathy (DR), diabetic macular edema (DME), and macular thickness in adults with diabetes. RESEARCH DESIGN AND METHODS: Diabetic patients aged 18 years or older were prospectively recruited from eye clinics at the Royal Victorian Eye and Ear Hospital, Melbourne, Australia. Fasting total-C [cholesterol], HDL-C, non-HDL-C, triglyceride and LDL-C were assessed. DR was graded from fundus photographs (dilated) as mild, moderate and severe non-proliferative and proliferative; and separately graded for presence of DME, including clinically significant macular edema (CSME). Macular thickness was assessed using optical coherence tomography (OCT). RESULTS: A total of 500 participants (median age = 65 years) were examined. DR, DME and CSME were present in 321 (66.2%), 149 (33.0%), and 68 (15.0%) patients, respectively. In multivariate models adjusting for traditional risk factors and lipid medications, persons with higher total-, LDL-, and non-HDL-C were more likely to have CSME (odds ratio of 1.54, 1.49, and 1.63 per 1 SD increase, respectively; all P<0.05). Serum lipid levels were not related to DR, DME or macular thickness. CONCLUSION: Serum lipids are independently associated with the CSME, but not with DR, mild or moderate DME or macular thickness. These data reflect the impact of hyperlipidaemia in the pathogenesis of severe macular edema and suggest that differential dyslipidemia therapies targeting DR and CSME may be needed.