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Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22.

Abstract

OBJECTIVE

To evaluate the relationship between serum lipid levels, retinal hard exudate, and visual acuity in patients with diabetic retinopathy.

DESIGN

Observational data from the Early Treatment Diabetic Retinopathy Study.

PARTICIPANTS

Of the 3711 patients enrolled in the Early Treatment Diabetic Retinopathy Study, the first 2709 enrolled had serum lipid levels measured.

MAIN OUTCOME MEASURES

Baseline fasting serum lipid levels, best-corrected visual acuity, and assessment of retinal thickening and hard exudate from stereoscopic macular photographs.

RESULTS

Patients with elevated total serum cholesterol levels or serum low-density lipoprotein cholesterol levels at baseline were twice as likely to have retinal hard exudates as patients with normal levels. These patients were also at higher risk of developing hard exudate during the course of the study. The risk of losing visual acuity was associated with the extent of hard exudate even after adjusting for the extent of macular edema.

CONCLUSIONS

These data demonstrate that elevated serum lipid levels are associated with an increased risk of retinal hard exudate in persons with diabetic retinopathy. Although retinal hard exudate usually accompanies diabetic macular edema, increasing amounts of exudate appear to be independently associated with an increased risk of visual impairment. Lowering elevated serum lipid levels has been shown to decrease the risk of cardiovascular morbidity. The observational data from the Early Treatment Diabetic Retinopathy Study suggest that lipid lowering may also decrease the risk of hard exudate formation and associated vision loss in patients with diabetic retinopathy. Preservation of vision may be an additional motivating factor for lowering serum lipid levels in persons with diabetic retinopathy and elevated serum lipid levels.

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  • Authors+Show Affiliations

    ,

    National Eye Institute, National Institutes of Health, Bethesda, Md, USA.

    , , , , , ,

    Source

    MeSH

    Adult
    Anti-Inflammatory Agents
    Aspirin
    Blood-Retinal Barrier
    Capillary Permeability
    Diabetes Complications
    Diabetes Mellitus
    Diabetic Retinopathy
    Exudates and Transudates
    Female
    Humans
    Laser Coagulation
    Lipids
    Male
    Middle Aged
    Retina
    Risk Factors
    Steroids
    Visual Acuity

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    8790092

    Citation

    Chew, E Y., et al. "Association of Elevated Serum Lipid Levels With Retinal Hard Exudate in Diabetic Retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22." Archives of Ophthalmology (Chicago, Ill. : 1960), vol. 114, no. 9, 1996, pp. 1079-84.
    Chew EY, Klein ML, Ferris FL, et al. Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Arch Ophthalmol. 1996;114(9):1079-84.
    Chew, E. Y., Klein, M. L., Ferris, F. L., Remaley, N. A., Murphy, R. P., Chantry, K., ... Miller, D. (1996). Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Archives of Ophthalmology (Chicago, Ill. : 1960), 114(9), pp. 1079-84.
    Chew EY, et al. Association of Elevated Serum Lipid Levels With Retinal Hard Exudate in Diabetic Retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Arch Ophthalmol. 1996;114(9):1079-84. PubMed PMID: 8790092.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. AU - Chew,E Y, AU - Klein,M L, AU - Ferris,F L,3rd AU - Remaley,N A, AU - Murphy,R P, AU - Chantry,K, AU - Hoogwerf,B J, AU - Miller,D, PY - 1996/9/1/pubmed PY - 2001/3/28/medline PY - 1996/9/1/entrez SP - 1079 EP - 84 JF - Archives of ophthalmology (Chicago, Ill. : 1960) JO - Arch. Ophthalmol. VL - 114 IS - 9 N2 - OBJECTIVE: To evaluate the relationship between serum lipid levels, retinal hard exudate, and visual acuity in patients with diabetic retinopathy. DESIGN: Observational data from the Early Treatment Diabetic Retinopathy Study. PARTICIPANTS: Of the 3711 patients enrolled in the Early Treatment Diabetic Retinopathy Study, the first 2709 enrolled had serum lipid levels measured. MAIN OUTCOME MEASURES: Baseline fasting serum lipid levels, best-corrected visual acuity, and assessment of retinal thickening and hard exudate from stereoscopic macular photographs. RESULTS: Patients with elevated total serum cholesterol levels or serum low-density lipoprotein cholesterol levels at baseline were twice as likely to have retinal hard exudates as patients with normal levels. These patients were also at higher risk of developing hard exudate during the course of the study. The risk of losing visual acuity was associated with the extent of hard exudate even after adjusting for the extent of macular edema. CONCLUSIONS: These data demonstrate that elevated serum lipid levels are associated with an increased risk of retinal hard exudate in persons with diabetic retinopathy. Although retinal hard exudate usually accompanies diabetic macular edema, increasing amounts of exudate appear to be independently associated with an increased risk of visual impairment. Lowering elevated serum lipid levels has been shown to decrease the risk of cardiovascular morbidity. The observational data from the Early Treatment Diabetic Retinopathy Study suggest that lipid lowering may also decrease the risk of hard exudate formation and associated vision loss in patients with diabetic retinopathy. Preservation of vision may be an additional motivating factor for lowering serum lipid levels in persons with diabetic retinopathy and elevated serum lipid levels. SN - 0003-9950 UR - https://www.unboundmedicine.com/medline/citation/8790092/full_citation L2 - https://jamanetwork.com/journals/jamaophthalmology/fullarticle/vol/114/pg/1079 DB - PRIME DP - Unbound Medicine ER -