Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep;59(9):1179-1188.
doi: 10.1007/s00592-022-01901-3. Epub 2022 Jun 24.

Nomogram-based prediction of clinically significant macular edema in diabetes mellitus patients

Zijing Li #  1   2 , Xiaowen Deng #  2 , Lijun Zhou  1 , Tu Lu  1 , Yuqing Lan  3 , Chenjin Jin  4
Affiliations

Nomogram-based prediction of clinically significant macular edema in diabetes mellitus patients

Zijing Li et al. Acta Diabetol. 2022 Sep.

Abstract

Aims: The aim of the study was to construct and validate a risk nomogram for clinically significant macular edema (CSME) prediction in diabetes mellitus (DM) patients using systemic variables.

Methods: In this retrospective study, DM inpatients who underwent routine diabetic retinopathy screening were recruited and divided into training and validation sets according to their admission date. Ninety-three demographic and systemic variables were collected. The least absolute shrinkage and selection operator was used to select the predictive variables from the training set. The selected variables were used to construct the CSME prediction nomogram. Internal and external validations were performed. The C-index, calibration curve and decision curve analysis (DCA) were reported.

Results: A total of 349 patients were divided into the training set (240, 68.77%) and the validation set (109, 31.23%). The presence of diabetic peripheral neuropathy (DPN) symptoms, uric acid, use of insulin only or not for treatment, insulin dosage, urinary protein grade and disease duration were chosen for the nomogram. The C-index of the prediction nomogram was 0.896, 0.878 and 0.837 in the training set, internal validation and external validation, respectively. The calibration curves of the nomogram showed good agreement between the predicted and actual outcomes. DCA demonstrated that the nomogram was clinically useful.

Conclusions: A nomogram with good performance for predicting CSME using systemic variables was developed. It suggested that DPN symptoms and renal function may be crucial risk factors for CSME. Moreover, this nomogram may be a convenient tool for non-ophthalmic specialists to rapidly recognize CSME in patients and to transfer them to ophthalmologists for early diagnosis and treatment.

Keywords: Clinically significant macular edema; Diabetes mellitus; Least absolute shrinkage and selection operator; Nomogram; Prediction; Systemic.

PubMed Disclaimer

References

    1. Cho NH, Shaw JE, Karuranga S et al (2018) IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 138:271–281 - PubMed - DOI
    1. Tan GS, Cheung N, Simó R et al (2017) Diabetic macular oedema. Lancet Diabetes Endocrinol 5(2):143–155 - PubMed - DOI
    1. Flaxel CJ, Adelman RA, Bailey ST et al (2020) Diabetic retinopathy preferred practice pattern®. Ophthalmology 127(1):P66-p145 - PubMed - DOI
    1. Vié AL, Kodjikian L, Agard E et al (2019) Evaluation of obstructive sleep apnea syndrome as a risk factor for diabetic macular edema in patients with type II diabetes. Retina 39(2):274–280 - PubMed - DOI
    1. Merante D, Menchini F, Truitt KE et al (2010) Diabetic macular edema: correlations with available diabetes therapies–evidence across a qualitative review of published literature from MEDLINE and EMBASE. Drug Saf 33(8):643–652 - PubMed - DOI

LinkOut - more resources