Retina. 2022 Feb 7. doi: 10.1097/IAE.0000000000003424. Online ahead of print.
ABSTRACT
PURPOSE: To determine the association of uric acid (UA) and glucose in aqueous humor with diabetic macular edema (DME) in patients with type 2 diabetes.
METHODS: Patients with DME or diabetes mellitus without retinopathy were enrolled from August 2016 to December 2020. Non-diabetic patients with age-related cataract or age-related macular degeneration were included as controls.
RESULTS: A total of 585 eyes from 585 patients were included for this study. Statistical analysis showed that aqueous UA was associated with central retinal thickness (r=0.39, P<0.0001), with higher levels of UA in severe DME and lower levels in mild DME, suggesting an ocular source of UA from the diabetic retina. Aqueous UA (odds ratio [OR], 6.88 [95% CI, 2.61-18.12]), but not aqueous glucose (0.95 [95% CI, 0.73-1.23]) or serum UA (0.90 [95% CI, 0.66-1.23]), was a stronger predictor for DME than duration of DM (1.26 [95% CI, 1.12-1.42]) or hemoglobin A1c (1.35 [95% CI, 0.99-1.83]). If aqueous UA (<2.46 mg/dl) and aqueous glucose (<6.43 mmol/L) were used as reference, high UA (≥2.46 mg/dl) alone was associated with 5.83-fold increase in risk of DME, but high glucose (≥6.43 mg/dl) alone was not associated with DME.
CONCLUSIONS: Increased aqueous UA, but not glucose, is an independent risk factor for DME. These data suggest that an intravitreal UA-lowering therapy could be beneficial for DME.
PMID:35174802 | DOI:10.1097/IAE.0000000000003424