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

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-28 DOI:10.1016/j.xops.2025.100756

Christina M. Ambrosino BS , Jacinta A. McDonald MD , Ximin Li ScM , Ann Nampomba MSc , Adrienne W. Scott MD

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Abstract

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 Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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镰状细胞特征或镰状细胞病与糖尿病视网膜病变风险增加相关

目的了解镰状细胞病（SCD）或镰状细胞性状（SCT）对糖尿病视网膜病变及视网膜病变治疗负担的影响。DesignCross-sectional研究。研究对象和对照组利用美国眼科学会IRIS®注册表（Intelligent Research in Sight），将3742例合并糖尿病（DM）和SCD或SCT的患者纳入分析样本。一个种族分层的3742例糖尿病患者，没有已知的SCD作为对照组。方法采用R软件（R Project 4.2.0）进行数据分析。描述性统计总结了合并SCD或SCT患者和对照组的人口统计数据。卡方检验比较了糖尿病合并SCD或SCT患者和对照组的临床结果（增殖性糖尿病视网膜病变[PDR]、糖尿病性黄斑水肿[DME]）和眼部手术频率。在调整保险、吸烟状况和人口统计因素的同时，多因素logistic回归模型检查了有无合并症SCD或SCT患者的临床结果和眼科手术的可能性。主要观察指标：临床结果和眼科手术的频率。结果：与单独患有糖尿病的患者相比，糖尿病合并SCD或SCT患者的所有临床结果都更频繁地记录下来。在研究的7种眼部手术中，与对照组相比，糖尿病合并SCT或SCD组中有5种更为常见(P <；0.001)。在回归分析中，合并SCD或SCT的DM患者PDR和DME的几率分别是前者的7.36倍和4.22倍（PDR的置信区间：6.36-8.54，DME的置信区间：3.68-4.85）。结论：该分析提示合并SCD或SCT的DM患者发生DM相关微血管病变的可能性增加，眼部治疗负担加重。需要前瞻性研究来进一步表征糖尿病与SCT或SCD之间的关系。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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