Researchers identify new way to predict risk of eye problems in diabetics
Toronto, February 7, 2013
By Kate Taylor
Dr. Rajeev Muni
Research led by St. Michael’s Hospital has found a way to predict which diabetic patients are at highest risk for developing eye complications and when.
“High sensitivity C-reactive protein (hsCRP) is a marker of inflammation in the blood that we’ve found to be linked to eye problems in diabetics,” said Dr. Rajeev Muni, a vitreoretinal surgeon at the hospital and the lead author of the paper. “This is very important because if we can measure this marker on initial diagnosis it will help us narrow the focus of the patients who are at highest risk of losing their vision.”
He said diabetic eye disease is the most common complication of diabetes and this information indicates which patients with diabetes should be treated more aggressively and who needs to be checked more regularly by their eye doctor.
Diabetic retinopathy is the leading cause of blindness in working-aged people in North America. Most of the vision loss from diabetic retinopathy is caused by diabetic macular edema, or swelling of the central part of the retina. The high blood sugar levels associated with diabetes causes damage to blood vessels all over the body, including the eye, causing a breakdown of the blood retinal barrier leading to fluid leakage.
The research appeared online today in the journal JAMA Ophthalmology.
Dr. Muni and colleagues reviewed existing studies and found that there were four possible markers of inflammation in the blood that could potentially be linked to eye complications in diabetes.
They found that the presence of one in particular, hsCRP, could predict the development of new cases of diabetic mascular edema, and that higher levels of hsCRP meant patients could develop vision loss sooner.
C-reactive protein is made by the liver when there is inflammation in the body. Dr. Muni said the link between hsCRP and eye complications in diabetes implies that inflammation in the body, including the retina, may play an important role in causing diabetic complications such as severe vision loss.
The association between hsCRP and diabetic macular edema remained significant even after adjusting for other factors such as age, duration of diabetes, blood sugar control, smoking status and BMI.
“The results of this study may improve our ability to appropriately manage diabetic patients by knowing which patients need to be treated more aggressively and see their eye doctor more regularly,” said Dr. Muni, also a clinical epidemiologist at the hospital. “The reality is, a lot of people with diabetes don’t have regular access to an eye doctor, but if we know to measure these markers, we can closely monitor those most at risk.”
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
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