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Glitazone use associated with diabetic macular edema
Donald S Fong1, Richard Contreras
1Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, California and Clinical Trials Research, Pasadena, California 91101, USA. donald.s.fong@kp.org
American Journal of Ophthalmology
|February 3, 2009
Summary
Glitazone use in diabetic patients is linked to an increased risk of developing macular edema (ME). Even after accounting for other factors, this association persists, suggesting ophthalmologists should consider glitazones when treating ME.
Area of Science:
- Ophthalmology
- Endocrinology
- Pharmacology
Background:
- Diabetes mellitus is a prevalent condition associated with numerous microvascular complications.
- Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
- Glitazones are a class of antidiabetic medications.
Purpose of the Study:
- To investigate the ocular safety of glitazones.
- To determine the association between glitazone use and the development of diabetic macular edema (DME).
Main Methods:
- Prospective cohort study involving approximately 170,000 individuals with diabetes.
- Glitazone use identified through pharmacy databases.
- Macular edema (ME) development as the primary outcome measure.
- Logistic regression analysis used to adjust for confounding variables.
Main Results:
- Glitazone users showed a higher likelihood of developing ME (OR, 2.6; 95% CI, 2.4 to 3.0).
- Even after adjusting for factors like drug benefit, eye exams, and glycemic control (HbA1c <7.0), glitazone use remained associated with increased ME risk (OR, 1.6; 95% CI, 1.4 to 1.8).
Conclusions:
- The glitazone class of drugs appears to be associated with DME.
- Glitazones show a modest association with DME even after adjusting for age, glycemic control, and insulin use.
- Ophthalmologists should consider the potential role of glitazones when managing patients with DME.
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