Association of dyslipidaemia with macular oedema and hard exudates in diabetic maculopathy

Diabetic retinal changes, diabetic maculopathy and prolixferative retinopathy are major causes of loss of vision worldwide in people of working age. In addition to oedema in the area of the macula lutea, diabetic maculopathy is often characterized by white changes termed hard exudates. It has been observed that the appearance of hard exudates is consistent with the appearance of dyslipidaemia, which is typical for diabetic patients. The aim of this paper was to underline the role of elevated serum lipids in the onset of macular oedema and hard exudates.

The examined group comprised 38 patients with diabetes mellitus type 2 who had medioretinal changes of the eye fundus as well as changes in the macular area manifested by retinal oedema and the presence of hard exudates. The control group consisted of type 2 diabetic patients without changes associated with diabetic maculopathy.

The examined group of diabetic patients that manifested diabetic maculopathy had significantly higher values of total lipids (9.49 +/- 2.02 g/L vs. 8.06 +/- 0.84 g/L), triglycerol (2.02 +/- 1.23 mmol/l vs. 1.24 +/- 0.37 mmol/l), total cholesterol (6.03 +/- 1.13 mmol/l vs. 5.21 +/- 0.62 mmol/l) and cholesterol ester (4.02 +/- 0.72 mmol/l vs. 3.48 +/- 0.46 mmol/l) as compared to the control group. Although values of HDL (1.39 +/- 1.01 mmol/l) and LDL (3.69 +/- 1.0 mmol/l) cholesterol were higher in the examined group than in the control one, there were no statistically significant differences (1.39 +/- 1.01 mmol/l vs. 1.30 +/- 0.33 mmol/l) and (3.69 +/- 1.0 mmol/l vs. 3.60 +/- 0.72 mmol/l) respectively. The analysis of the severity of hard exudates and oedema in relation to lipid fractions in the examined group showed that total lipids, total cholesterol and cholesterol were significantly higher than in the subjects where exudates were less severe.

Hyperlipidaemia is a risk factor for the development of hard exudates in diabetic maculopathy.