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Sickle Cell Trait or Sickle Cell Disease Associated with Increased Diabetic Retinopathy Risk.

Christina M Ambrosino1, Jacinta A McDonald2, Ximin Li3,4

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Patients with diabetes mellitus and sickle cell disease or trait have higher rates of diabetic retinopathy and macular edema. This indicates an increased ocular treatment burden in this patient group.

Keywords:
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Area of Science:

  • Ophthalmology
  • Hematology
  • Endocrinology

Background:

  • Diabetic retinopathy (DR) is a leading cause of vision loss in patients with diabetes mellitus (DM).
  • Sickle cell disease (SCD) and sickle cell trait (SCT) are inherited blood disorders that can affect various organs.
  • The combined impact of DM with SCD or SCT on DR and its treatment is not well understood.

Purpose of the Study:

  • To investigate the association between comorbid diabetes mellitus (DM) and sickle cell disease (SCD) or sickle cell trait (SCT).
  • To evaluate the impact of SCD/SCT on the prevalence of diabetic retinopathy (DR) and diabetic macular edema (DME).
  • To assess the ocular treatment burden in patients with DM and SCD/SCT.

Main Methods:

  • A cross-sectional study using the American Academy of Ophthalmology IRIS® Registry.
  • Included 3742 patients with DM and SCD/SCT, and 3742 controls with DM alone.
  • Analyzed clinical outcomes (PDR, DME) and ocular procedure frequency using descriptive statistics, chi-square tests, and multivariate logistic regression.

Main Results:

  • Patients with DM and SCD/SCT showed higher frequencies of all measured clinical outcomes compared to DM alone.
  • Five of seven studied ocular procedures were more common in the DM with SCD/SCT group (P < 0.001).
  • DM patients with SCD/SCT had significantly greater odds of proliferative diabetic retinopathy (7.36x) and diabetic macular edema (4.22x).

Conclusions:

  • Comorbid SCD or SCT in patients with DM is associated with an increased likelihood of microvascular pathology.
  • These patients face a higher ocular treatment burden.
  • Further prospective studies are needed to elucidate the relationship between DM and SCD/SCT.