Study On The Relationship Between Type D Personality And Macular Edema Of Proliferative Diabetic Retinopathy

Objective: To explore the correlation between Type D personality and the occurrence and severity of diabetic macular edema(DME).Methods:A case-control study was conducted to randomly select 140 proliferative diabetic retinopathy patients diagnosed in the ophthalmic inpatient and outpatient department of the First Affiliated Hospital of China Medical University from June 2021 to December 2021.Among them,95 patients with DME are the case group,and the 45 patients without DME are the control group of NDME(non-diabetic macular edema).The demographic characteristics and clinical data of the two groups were collected.Ophthalmic examination includes best corrected visual acuity(BCVA),intraocular pressure,optical coherence tomography(OCT),fundus photography,and B-type ultrasound.DS14 scale was used to evaluate type D personality(TDP)in the two groups.According to the 2002 International Clinical Grading Standards for diabetic retinopathy and macular edema,According to the severity,the DME patients was divided into mild,moderate and severe subgroup.Statistical software SPSS25.0 was used for data analysis.Logistic regression model was used to match the demographic characteristics of baseline data with 1∶1 propensity score matching(PSM).Univariate and multivariate logistic regression analysis were used to analyze the relevant influencing factors of DME and DME severity.Receiver Operating Characteristics(ROC)was used to analyze the predictive effects of type D personality DS14 scale score,negative affectivity(NA)score and social inhibition(SI)score on the occurrence of DME.Results: Before PSM,In the DME group and the non-DME group,patients with TDP accounted for 63% and 27% respectively.Univariate analysis shows that Hb A1 c are the related factors affecting the occurrence of DME(P <0.05).Univariate analysis and multivariate logistic regression analysis both showed that type D personality(Univariate analysis P <0.001,multivariate analysis P=0.001)and the duration of DM(Univariate analysis P <0.05,multivariate analysis P <0.05)are the relevant influencing factors of DME.the area under the curve(AUC)of DS14 score,NA score and SI score in DME and NDME groups is 0.706(95% CI 0.616-0.796,P < 0.05),0.697(95% CI 0.607-0.786,P < 0.05)and 0.651(95% CI 0.550-0.752,P < 0.05)respectively.Before PSM,Univariate analysis showed that the best corrected visual acuity(BCVA)is a relevant influencing factor of DME severity(P <0.05),Univariate analysis and multivariate logistic regression analysis both showed that the duration of DM is an independent factor influencing the severity of DME(P < 0.05).After PSM,In the DME group and the non-DME group,patients with TDP accounted for 60% and 29% respectively.Univariate analysis and multivariate logistic regression analysis both showed that type D personality was the relevant factor influencing the occurrence of DME(univariate analysis P = 0.004,multivariate analysis P=0.016).The area under the curve(AUC)of DS14 score,NA score and SI score in DME and NDME groups is 0.682(95% CI 0.577-0.788,P < 0.05),0.671(95% CI0.567-0.774,P < 0.05),0.630(95% CI 0.516-0.743,P < 0.05)respectively.After PSM.Univariate analysis and multivariate logistic regression analysis both showed that DM family history(univariate analysis P = 0.011,multivariate analysis P < 0.05)was the correlation factor of DME severity,and the difference between groups was statistically significant.Conclusion: 1.In PDR patients,compared with NDME patients,type D personality accounts for a higher proportion in DME patients,type D personality was significantly correlated with the occurrence of DME,but type D personality was not significantly correlated with the severity of DME.2.DS14 score,NA score and SI score of type D personality have a good predictive effect on the occurrence of DME.Applying DS14 scale to assess type D personality provides a new idea for the treatment of diseases.Clinical psychological intervention should be carried out as early as possible for people with potential risk of type D personality,to reducing the risk of DME and improving the prognosis and quality of life of DME patients.