109
EW RETINA
September 2017
Contact information
Chen: rc2631@cumc.columbia.edu
Chung: nfarano@youreyes.org
Mendelsohn: karensuedennis@gmail.com
Splaver: karensuedennis@gmail.com
which leads to diabetic retinopa-
thy and macular edema as well as
atherosclerosis and coronary artery
disease," he said. However, he does
see the results as a good prompt to
refer patients to cardiologists when
necessary. "An ophthalmologist who
encounters a patient with diabetes
and manifestations of end-organ
damage such as retinopathy and
macular disease should have the
patient see a clinical cardiologist and
vice versa," he said.
Although it may not be the oph-
thalmologist's role to analyze the
overall health of a patient with dia-
betes, Alan Mendelsohn, MD, Eye
Surgeons & Consultants, Hollywood,
Florida, has found that patients who
are followed by an endocrinologist
(instead of a primary care doctor)
tend to have better ocular health.
"Anecdotally, the same diabetics
seemingly have been healthier with
a decrease in prevalence and sever-
ity of cardiovascular events when
followed medically by a cardiolo-
gist," he said. Dr. Mendelsohn has
made several recommendations for
patients to see endocrinologists as
well as cardiologists. He also makes
a point to ask for quarterly results
from hemoglobin A1C results,
which indicate blood sugar control
over about a 3-month period. "On
each visit, we discuss this lab find-
ing with encouragement for strict
diabetic control so as to achieve as
low of a hemoglobin A1C level as
possible," he said. He thinks this
number can help provide clues for
both ocular and CVD health.
Royce W.S. Chen, MD, Helen
and Martin Kimmel Assistant Pro-
fessor of Ophthalmology, Columbia
University Medical Center, and
attending ophthalmologist, New
York-Presbyterian Hospital, New
York, observed that the study results
are generalizable to white, African
American, and Hispanic popula-
tions but that Asians are generally
underrepresented in these studies.
He thinks it would be interesting to
see the study results segregated by
ethnicities. However, he still sees an
important message in the study.
"The conclusions are valid and
should serve to remind the ophthal-
mologist that he is a physician and
should remember to take care of the
whole person in front of him, not
just his retinas," he said. EW
Reference
1. Xie J, et al. Association of diabetic macular
edema and proliferative diabetic retinopathy
with cardiovascular disease: A systematic
review and meta-analysis. JAMA Ophthalmol.
2017;135:586–93.
Editors' note: The physicians have
no financial interests related to their
comments.
