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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
1Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
Objective:
This study aimed to understand the impact of sickle cell disease (SCD) or sickle cell trait (SCT) on diabetic retinopathy and retinopathy treatment burden.
Design:
Cross-sectional study.
Subjects And Controls:
Utilizing the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight), 3742 patients with comorbid diabetes mellitus (DM) and either SCD or SCT were included in the analytic sample. A race-stratified group of 3742 patients with DM and no known SCD was included as controls.
Methods:
Data analysis was performed using R (R Project 4.2.0). Descriptive statistics summarized demographic data among patients with comorbid SCD or SCT and among controls. Chi-square tests compared clinical outcomes (proliferative diabetic retinopathy [PDR], diabetic macular edema [DME]) and ocular procedure frequency across patients with DM and SCD or SCT and across controls. Multivariate logistic regression models examined the likelihood of clinical outcomes and ocular procedures across patients with and without comorbid SCD or SCT while adjusting for insurance, smoking status, and demographic factors.
Main Outcome Measures:
Frequency of clinical outcomes and ocular procedures.
Results:
All measured clinical outcomes were more frequently documented among patients with DM and either SCD or SCT as compared with those with DM alone. Of the 7 ocular procedures studied, 5 were more common among the DM with SCT or SCD group as compared with controls (P < 0.001). On regression analysis, DM patients with comorbid SCD or SCT had 7.36 and 4.22 times greater odds of PDR and DME, respectively (confidence interval for PDR: 6.36-8.54, confidence interval for DME: 3.68-4.85).
Conclusions:
This analysis suggests that DM patients with comorbid SCD or SCT have an increased likelihood of DM-related microvascular pathology and a higher ocular treatment burden. Prospective studies are needed to further characterize the relationship between DM and SCT or SCD.
Financial Disclosures:
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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