To correlate Heidelberg Retina Tomograph (HRT) derived macular edema (DME) index with severity of diabetic retinopathy and systemic factors. A total of 300 diabetic patients were recruited for the study for each of them a value for the macular edema index was obtained using the HRT II. Patients' age, gender, duration and type of diabetes mellitus, latest HbA1c result and presence or absence of co-morbid factors (hypertension, ischemic heart disease, nephropathy) were recorded together with the stage of diabetic retinopathy. These were correlated with DME. Out of 300 patients, HRT defined macula edema was seen in 68 patients (22.6%). There is a wider and higher range (95% percentile) of macula edema index in the severe non proliferative diabetic retinopathy (NPDR) group. Independent samples t test showed significant difference between the severe NPDR group and no DR group (p<0.001), mild NPDR group (p<0.05) and moderate NPDR group (p<0.05). A higher macula edema index was also found to have a low degree of correlation with more advanced stages of retinopathy (r=0.310; p<0.001). Also nephropathy showed a strong and significant correlation with DME. Hypertension had moderately significant correlation with DME. This study found no correlation between ischemic heart disease and DME. HRT derived scanning laser edema index is a reliable objective tool to evaluate diabetic retinopathy and systemic risk factors.
Primary extramedullary plasmacytomas of the eyelid are rare with only five other cases reported in the literature. A 43-year-old Chinese man presented with painless swelling of the left lower eyelid that developed over the past two years. An incisional biopsy and histopathological analysis of the lesion revealed a primary extramedullary plasmacytoma of the eyelid. The tumour was completely excised. There has been no tumour recurrence over the last five years. This tumour should be among those considered when encountering an atypical adnexal lesion. A systemic examination, relevant clinical investigations, as well as life-long monitoring are essential for these patients due to the strong association of extramedullary plasmacytoma with multiple myeloma. When a lesion can be completely resected, surgery provides similar results to radiotherapy.