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International Ophthalmology

, Volume 39, Issue 10, pp 2237–2243 | Cite as

Hyperglycemia potentiates the effect of ionic calcium in photoreceptor ellipsoid zone disruption in diabetic retinopathy

  • Ankita
  • Jana Stefanickova
  • Sandeep SaxenaEmail author
  • Dwividendra K. Nim
  • Kaleem Ahmad
  • Abbas A. Mahdi
  • Apjit Kaur
  • Shashi K. Bhasker
  • Jela Valaskova
  • Peter KruzliakEmail author
Original Paper

Abstract

Purpose

To study the association of serum ionic calcium and glycated hemoglobin (HbA1c) with retinal photoreceptor ellipsoid zone (EZ) disruption in diabetic retinopathy (DR).

Methods

This is a tertiary care center-based observational cross-sectional study. Sixty-three consecutive cases, divided into 21 cases each with no diabetic retinopathy, non-proliferative diabetic retinopathy and proliferative diabetic retinopathy were included. Twenty-one healthy controls were also included. Ellipsoid zone disruption was assessed using spectral-domain optical coherence tomography. Serum ionic calcium and HbA1c were measured using standard protocol. Patient data from cases were divided into two groups according to their HbA1c levels: group 1 (HbA1c < 7, n = 26) and group 2 (HbA1c > 7, n = 37). Data were analyzed statistically.

Results

Mean ionic calcium levels in group 1 and group 2 were 1.131 ± 0.073 mmol/dL and 1.170 ± 0.070 mmol/dL, respectively. In group 1, 11 out of 26 had EZ disruption (42.3%). Similarly, in group 2, 29 out of 37 had EZ disruption (78.4%). On logistic regression analysis, as compared to group 1, ellipsoid zone disruption was found to be positively associated with serum ionic calcium (p = 0.01) in group 2 cases.

Conclusion

Increased levels of serum ionic calcium are associated with increased EZ disruption in patients with HbA1c > 7 in DR.

Keywords

Diabetic retinopathy Glycated hemoglobin Serum calcium Spectral-domain optical coherence tomography Ellipsoid zone 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  1. 1.Department of OphthalmologyKing George’s Medical UniversityLucknowIndia
  2. 2.Department of Ophthalmology, Faculty of MedicineComenius University in Bratislava and University HospitalBratislavaSlovakia
  3. 3.Department of PharmacologyLady Hardinge Medical CollegeNew DelhiIndia
  4. 4.Department of BiochemistryKing George’s Medical UniversityLucknowIndia
  5. 5.2nd Department of Internal Medicine, Faculty of MedicineComenius University and University HospitalBratislavaSlovakia
  6. 6.2nd Department of Surgery, Faculty of MedicineMasaryk University and St. Anne’s University HospitalBrnoCzech Republic
  7. 7.Department of Internal MedicineBrothers of Mercy HospitalBrnoCzech Republic

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