Correlation of retinal nerve fibre layer and macular thickness with serum uric acid among type 2 diabetes mellitusReport as inadecuate

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BMC Ophthalmology

, 17:91



BackgroundUric acid is a final breakdown product of purine catabolism in humans. It’s a potent antioxidant and can also act as a pro-oxidant that induces oxidative stress on the vascular endothelial cells, thus mediating progression of diabetic related diseases. Various epidemiological and experimental evidence suggest that uric acid has a role in the etiology of type 2 diabetes mellitus. We conducted a cross-sectional study to evaluate the correlation of retinal nerve fibre layer RNFL and macular thickness with serum uric acid in type 2 diabetic patients.

MethodsA cross-sectional study was conducted in the Eye Clinic, Hospital Universiti Sains Malaysia, Kelantan between the period of August 2013 till July 2015 involving type 2 diabetes mellitus patients with no diabetic retinopathy and with non-proliferative diabetic retinopathy NPDR. An evaluation for RNFL and macular thickness was measured using Spectralis Heidelberg optical coherence tomography. Six ml of venous blood was taken for the measurement of serum uric acid and glycosylated haemoglobin HbA1C.

ResultsA total of 180 diabetic patients were recruited 90 patients with no diabetic retinopathy and 90 patients with NPDR into the study. The mean level of serum uric acid for both the groups was within normal range and there was no significance difference between the two groups. Based on gender, both male and female gender showed significantly higher level of mean serum uric acid in no diabetic retinopathy group p = 0.004 respectively. The mean serum uric acid was significantly higher in patient with HbA1C < 6.5% p < 0.031. Patients with NPDR have thicker RNFL and macular thickness compared to patients with no diabetic retinopathy. However, only the RNFL thickness of the temporal quadrant and the macular thickness of the superior outer, inferior outer and temporal outer subfields were statistically significant p = 0.038, p = 0.004, 0.033 and <0.001 respectively. There was poor correlation between RNFL and macular thickness with serum uric acid in both the groups.

ConclusionSerum uric acid showed a poor correlation with RNFL and macular thickness among type 2 diabetic patients.

KeywordsDiabetic retinopathy Retinal nerve fibre layer thickness Macular thickness Serum uric acid Glycosylated haemoglobin AbbreviationsCIConfidence interval

DRDiabetic retinopathy


ETDRSEarly Treatment Diabetic Retinopathy Study

HbA1CGlycosylated haemoglobin

NPDRNon-proliferative diabetic retinopathy

OCTOptical coherence tomography

RNFLRetinal nerve fibre layer

SDStandard deviation

SD-OCTSpectral-Domain Optical Coherence Tomography

SPSSStatistical Package for Social Sciences

Author: Munisamy-Naidu Vinuthinee-Naidu - Embong Zunaina - Anuar Azreen-Redzal - Naing Nyi-Nyi


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