Intensive Glycemic Management Is Associated With Reduced Retinal Structure Abnormalities on Ocular Coherence Tomography in the DCCT/Epidemiology of Diabetes Interventions and Complications (EDIC) Study
Authors' conclusion
Early intensive glycemic management in T1D is associated with a decreased risk of DRIL. This important morphological abnormality was associated with a history of macular edema, a history of ocular surgery, and worse VA. This study reveals benefits of intensive glycemic management on the retina beyond features detected by fundus photographs and ophthalmoscopy.
Study context
- Population
- Individuals with T1D in EDIC; mean age 61 years, diabetes duration 39 years, HbA1c 7.6%; Optical coherence tomography (OCT) in study years 25–28 (2019–2022)54% intensive (INT), 46% conventional (CONV)
- Participants
- 937 individuals
- Comparison
- Original intensive vs conventional glycemic management
Methodological detailsobservational follow-up
- Observational follow-up
Primary result
As reported in the abstract
Disorganization of retinal inner layers (DRIL) on OCT · study years 25-28
P = 0.0003
Further findings
Intraretinal fluid · more likely with CONV
P = 0.0222
Intraretinal cysts · more likely with CONV
P = 0.0471
Multivariable associations
- Sex, age, smoking, mean updated systolic BP, history of clinically significant" macular edema (CSME) and of anti-VEGF treatment independently associated with central subfield thickness changes
- HbA1c, BMI, history of CSME and of ocular surgery associated with disorganization of retinal inner layers (DRIL)
- Visual acuity (VA) decline associated with significant thinning of all retinal subfields except central and inner nasal
Original publication
Intensive Glycemic Management Is Associated With Reduced Retinal Structure Abnormalities on Ocular Coherence Tomography in the DCCT/EDIC Study. Diabetes Care. Published 29 March 2024. doi:10.
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