Clinical Relevance Of Body Fluid Volume Status In Diabetic Patients With Macular Edema

Objective:To investigate body fluid status in diabetic macular edema(DME)patients and the extent to which it is affected by renal function.Methods:One hundred and thirty-two eyes from 132 patients with diabetes mellitus(DM)were prospectively collected in this cross-sectional,observational study.Thirty-five were DM patients without diabetic retinopathy(DR),31 were DR patients without DME,and 66 were DME patients.The fluid status of each participant was quantified with extracellular water-to-total body water ratio(ECW/TBW)using a body composition monitor.Central subfield thickness(CST)and macular volume(MV)were obtained using optical coherence tomography(OCT).Urine albumin-to-creatinine ratio(UACR),estimated glomerular filtration rate(e GFR),and albumin was obtained using serum and urine laboratory data.Results:ECW/TBW was significantly increased in DME patients(39.2±0.9,%)compared to DM(38.1±0.7,%,P=0.003)and DR patients without DME(38.7±0.9,%,P<0.001).In multilinear regression,fluid overload was positively related to DME and UACR(DME vs.DM: β=2.418,P<0.001;DME vs.DR: β=1.641,P=0.001;UACR,per 10^2,β=1.017,P=0.01).In the binary logistic regression for DME risk,the area under the receiver operating characteristic curve(AUROC)increased significantly by adding ECW/TBW along with UACR and age(AUC: 0.826 vs.0.768).Conclusions:DME patients had elevated body fluid volume independent of kidney functions.The assessment of extracellular fluid status may help in the management of DME.