Influence of retinopathy on macular edema after cataract phacoemulsification in diabetic cataract patients and analysis of related factors / 中国医师杂志

ABSTRACT

Objective:To investigate the effect of diabetic retinopathy (DR) on macular edema (ME) after cataract phacoemulsification in diabetic cataract patients and its risk factors.Methods:A total of 170 diabetic cataract patients (170 eyes) who underwent cataract phacoemulsification in the department of ophthalmology, BenQ Medical Center Affiliated to Nanjing Medical University from June 2017 to June 2019 were selected. All patients underwent monocular cataract phacoemulsification. They were divided into DR group (100 cases) and non diabetic retinopathy group (NDR group, 70 cases) according to whether or not DR was combined. The improvement of visual acuity and fundus lesions were compared between the two groups, the correlation between the severity of DR and the incidence of macular fovea retinal thickness and ME was analyzed, and the risk factors of DR were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of diabetes course, vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) on ME.Results:Compared with NDR group, the DR group had better postoperative best corrected visual acuity (BCVA), larger area of vascular leakage and bleeding. The retinal thickness of fovea was significantly thickened, and the incidence of ME in DR group was significantly higher than that in NDR group (all P<0.05). The severity of DR was positively correlated with the retinal thickness of fovea and the incidence of ME (all P<0.05). The duration of diabetes, VEGF and IL-6 were independent risk factors for DR (all P<0.05). The best critical values for predicting me were 4.7 years, 127.82 pg/ml and 136.45 pg/ml, respectively. The combination of the three has higher diagnostic value. Conclusions:DR can accelerate the postoperative ME of diabetic cataract patients, and is positively correlated with the severity of DR. The duration of diabetes, VEGF and IL-6 are not only independent risk factors of DR, but also have high predictive value for the occurrence of ME.