Early DMO: a predictor of poor outcomes following cataract surgery in diabetic patients. The DICAT-II study.

Autor: Panozzo G; Ophthalmology Unit, Clinica San Francesco, Verona, Italy. g.panozzo@iol.it.; ESASO, European School of Advanced Studies in Ophthalmology, Lugano, Switzerland. g.panozzo@iol.it., Mura GD; ESASO, European School of Advanced Studies in Ophthalmology, Lugano, Switzerland., Franzolin E; Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy., Giannarelli D; UOSD Clinical Trial Center, Biostatistics and Bioinformatics, Regina Elena National Cancer Institute IRCCS, Rome, Italy., Albano V; Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy., Alessio G; Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy., Arrigo A; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Casati S; Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy., Cassottana P; Department of Ophthalmology, San Martino University Hospital, IRCCS, Genova, Italy., Contardi C; Department of Ophthalmology, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy., D'Aloisio R; Department of Ophthalmology, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy., Fasce F; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Gusson E; Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy., Marchini G; Ophthalmology Unit, Department of Neurosciences, Biomedicine and Movement, University of Verona, Verona, Italy., Mastropasqua L; Department of Ophthalmology, G. d'Annunzio University of Chieti-Pescara, Chieti, Italy., Niccolò M; Department of Ophthalmology, University of Genova, Genova, Italy., Palmisano C; Department of Medical Science, Neuroscience and Sense Organs, Eye Clinic, University of Bari, Bari, Italy., Pastore MR; Department of Medical Surgical Sciences and Health, Eye Clinic, University of Trieste, Trieste, Italy., Saviano S; Department of Medical Surgical Sciences and Health, Eye Clinic, University of Trieste, Trieste, Italy., Tognetto D; Department of Medical Surgical Sciences and Health, Eye Clinic, University of Trieste, Trieste, Italy., Bandello F; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Jazyk: angličtina
Zdroj: Eye (London, England) [Eye (Lond)] 2022 Aug; Vol. 36 (8), pp. 1687-1693. Date of Electronic Publication: 2021 Aug 03.
DOI: 10.1038/s41433-021-01718-4
Abstrakt: Background: The prospective DIabetes and CATaract Study II (DICAT II) was performed to characterise the risks of cataract surgery to the retinae of patients with early diabetic macular oedema (E-DMO).
Methods: DICAT II was a prospective, comparative, multicentre, observational study involving six Italian clinics. Patients were aged ≥55 years, had type 1 or 2 diabetes with spectral-domain optical coherence tomography evidence of ESASO classification Early DMO. Group 1 eyes (78 eyes, 78 patients) underwent phacoemulsification-based cataract surgery. Group 2 eyes (65 eyes, 65 patients) had E-DMO and either clear media or had undergone uncomplicated cataract surgery ≥1 year previously. Central subfield thickness (CST) and best-corrected visual acuity (BCVA) were assessed in both groups.
Results: The negative impact of surgery on CST was evident after the first postoperative week; CST peaked during the first month, then rapidly decreased. CST worsening ≥10 µm was observed in 63/78 eyes (80.7%) and 29/65 eyes (44.6%) in Groups 1 and 2, respectively (p < 0.0001). CST worsening of ≥50 µm was observed in 51 eyes (65.4%) and 10 eyes (15.4%) in Groups 1 and 2, respectively (p < 0.0001). Mean CST worsening was lower in Group 2 than in Group 1 (38.6 ± 30.4 µm vs 85.5 ± 55.3 µm, p < 0.0001) with a lower BCVA loss (-2.6 ± 3.5 letters vs -8.2 ± 6.2 letters, p < 0.0001). Higher glycaemic levels and HBA1c levels were significantly associated with the risk of >50 μm CST worsening in eyes from both groups.
Conclusion: Early DMO is associated with poorer outcomes after cataract surgery and requires close pre- and postoperative monitoring.
(© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)
Databáze: MEDLINE
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