ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Association of Types of Diabetic Macular Edema with Different Anti-Diabetic Therapies
Farklı Antidiyabetik Tedavilerle Diyabetik Makuler Ödem Tiplerinin İlişkisi
Received Date : 03 Feb 2020
Accepted Date : 26 Jun 2020
Available Online : 31 Aug 2020
Doi: 10.25179/tjem.2020-74091 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:198-205
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: To evaluate and assess the association of diabetic macular edema with different anti-diabetic therapy regimens. Material and Methods: We recruited 340 patients with prediagnosed Type 2 diabetes mellitus attending the ophthalmology and medicine outpatient department. Patients were older than 30 years with Type 2 diabetes mellitus and on a specific anti-diabetic regimen (monotherapy/combination therapy) for ≥6 months, and who underwent macular edema assessment by using spectral domain optical coherence tomography. The patterns of macular edema per retinal morphology were grouped as diffuse retinal thickening, cystoid macular edema, and serous retinal detachment. Results: No significant association was found between edema pattern and dual therapy regimen (metformin+1 other oral hypoglycemic agent) (p=0.685) in the 680 eyes of the 340 patients. In patients on all the other triple therapy regimens (metformin+2 other oral hypoglycemic agents), diffuse retinal thickening was the most common type, except in patients on thiazolidinediones and insulin in conjunction with metformin in which cystoid macular edema was the most common. However, the difference between different triple therapy regimens was statistically significant (p=0.053). Conclusion: The most common form of macular edema was diffuse retinal thickening irrespective of the type and regimen of anti-diabetic therapy. Increased incidence of cystoid macular edema was observed in patients on triple therapy, including insulin. Because of the difference in the patterns, it is imperative to evaluate patients for different types of edema due to ongoing anti-diabetic treatment.
ÖZET
Amaç: Diyabetik makuler ödemin farklı antidiyabetik tedavi rejimleriyle ilişkisinin değerlendirilmesi. Gereç ve Yöntemler: Oftalmoloji ve medikal oftalmoloji polikliniğine başvuran, önceden tanı almış Tip 2 diabetes mellituslu 340 hasta çalışmaya alındı. Otuz yaşından büyük, Tip 2 diabetes mellituslu ve ≥6 aydır spesifik bir antidiyabetik rejim (monoterapi/kombinasyon terapisi) alan hastalar, spektral alan optik koherens tomografisi kullanılarak makuler ödem değerlendirmesine tabi tutulmuşlardır. Her bir retina morfolojisi için makuler ödem paternleri; diffüz retina kalınlaşması, sistoid makuler ödem ve seröz retina dekolmanı olarak gruplandırıldı. Bulgular: Toplam 340 hastadaki 680 gözde ödem paterni ve ikili tedavi rejimleri (metformin+diğer 1 oral hipoglisemik ajan) (p=0,685) arasında anlamlı bir ilişki bulunmadı. Diğer tüm üçlü tedavi rejimlerindeki (metformin+diğer 2 oral hipoglisemik ajan) hastalarda, kistoid makuler ödemin en yaygın olduğu tiazolidindionlar ve metformin ile birlikte insülin kullanan hastalar hariç, diffüz retinal kalınlaşma en yaygın tipti. Bununla birlikte, farklı üçlü tedavi rejimleri arasındaki fark istatistiksel olarak anlamlıydı (p=0,053). Sonuç: Makuler ödemin en yaygın formu, antidiyabetik tedavinin tipi ve rejimine bakılmaksızın diffüz retinal kalınlaşma idi. İnsülin de dâhil olmak üzere üçlü tedavi gören hastalarda artmış kistoid makuler ödem insidansı gözlenmiştir. Paternlerdeki farklılık nedeni ile devam eden antidiyabetik tedaviye bağlı olarak hastaları farklı ödem tipleri açısından değerlendirmek zorunludur.
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