Circadian Rhythm Types in Individuals with Diabetic Macular Edema


  • Matthew T. Cory Indiana University School of Medicine
  • Janvi S. Patel Indiana University-Purdue University Indianapolis
  • Denis Jusufbegovic Department of Opthalmology, Indiana University School of Medicine
  • Ashay Bhatwadekar Department of Opthalmology, Indiana University School of Medicine



Background and Hypothesis:Diabetic Retinopathy (DR) is the leading cause of vision loss in patients with diabetes. Diabeticmacular edema (DME) can be associated with any stage of DR, causing thickening and swelling of  the  macula,  leading  to  vision  impairment.  Circadian  rhythm,  the  body’s  natural  clock  thatgoverns physiological processes and dictates our sleep-wake cycle, is known to be affected by DR and DME. This study hypothesizes that DME will be associated with a more extreme circadian rhythm type.

Methods:Individuals 18 years or older with a diagnosis of type I or type II diabetes complicated by DMEwere given a 19-item Morningness-Eveningness Questionnaire (MEQ) to determine their circadian rhythm and sleep  patterns. Information regarding demographics, metabolic parameters, diabetes, visual acuity and DME severity was collected.

Results:In  this ongoing study, we compiled data from 54 individuals out of a targeted enrollment of 160.  Overall,  the  MEQ  scores  characterized  more  individuals  as  morning  types,  followed  by  intermediate  and  evening  types.  The  preliminary  analysis shows  a  weak,  insignificant  positive correlation with retinal thickness in the right eye and a weak, insignificant negative in the left eye. In addition, a weak, insignificant negative correlation was also observed between MEQ and right eye visual acuity, with the opposite trend occurring in the left eye. DME variables such as mean central foveal thickness decreased insignificantly in right eyes from morning to evening groups but increased in the left eye.

Conclusion and Potential Impact:  Our study suggests DME individuals are mostly morning type instead of evening type. However, there is no strong relationship between MEQ scores and DME parameters. As we recruit more individuals in the future, we hope to establish a more significant relationship that could improve our understanding of how circadian rhythms and DME are interconnected and could lead to new treatments.