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Randomized Controlled Trial
. 2010 Mar;128(3):312-8.
doi: 10.1001/archophthalmol.2009.310.

Lack of association between thiazolidinediones and macular edema in type 2 diabetes: the ACCORD eye substudy

Walter T Ambrosius  1 , Ronald P Danis, David C Goff Jr, Craig M Greven, Hertzel C Gerstein, Robert M Cohen, Matthew C Riddle, Michael E Miller, John B Buse, Denise E Bonds, Kevin A Peterson, Yves D Rosenberg, Letitia H Perdue, Barbara A Esser, Lea A Seaquist, James V Felicetta, Emily Y Chew; ACCORD Study Group
Affiliations
Randomized Controlled Trial

Lack of association between thiazolidinediones and macular edema in type 2 diabetes: the ACCORD eye substudy

Walter T Ambrosius et al. Arch Ophthalmol. 2010 Mar.

Abstract

Objective: To assess the cross-sectional association of thiazolidinediones with diabetic macular edema (DME).

Methods: The cross-sectional association of DME and visual acuity with thiazolidinediones was examined by means of baseline fundus photographs and visual acuity measurements from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Visual acuity was assessed in 9690 participants in the ACCORD trial, and 3473 of these participants had fundus photographs that were centrally read in a standardized fashion by masked graders to assess DME and retinopathy from October 23, 2003, to March 10, 2006.

Results: Among the subsample, 695 (20.0%) people had used thiazolidinediones, whereas 217 (6.2%) people had DME. Thiazolidinedione use was not associated with DME in unadjusted (odds ratio [OR], 1.01; 95% confidence interval [CI], 0.71-1.44; P = .95) and adjusted (OR, 0.97; 95% CI, 0.67-1.40; P = .86) analyses. Significant associations with DME were found for retinopathy severity (P < .001) and age (OR, 0.97; 95% CI, 0.952-0.997; P = .03) but not for hemoglobin A(1c) (P = .06), duration of diabetes (P = .65), sex (P = .72), and ethnicity (P = .20). Thiazolidinedione use was associated with slightly greater visual acuity (0.79 letter; 95% CI, 0.20-1.38; P = .009) of uncertain clinical significance.

Conclusions: In a cross-sectional analysis of data from the largest study to date, no association was observed between thiazolidinedione exposure and DME in patients with type 2 diabetes; however, we cannot exclude a modest protective or harmful association. Trial Registration clinicaltrials.gov Identifier: NCT00542178.

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Figures

Figure 1
Figure 1
ACCORD-Eye recruitment flow chart. ACCORD-Eye began recruitment after initiation of the main trial.
See this image and copyright information in PMC

Comment in

  • Macular edema and thiazolidinediones.
    Colucciello M, Ryan E. Colucciello M, et al. Arch Ophthalmol. 2010 Dec;128(12):1630-1; author reply 1631-2. doi: 10.1001/archophthalmol.2010.287. Arch Ophthalmol. 2010. PMID: 21149797 No abstract available.

References

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