MODERN ASPECTS OF DIABETIC RETINOPATHY AND DIABETIC MACULAR OEDEMA TREATMENT

Cover Page


Cite item

Full Text

Abstract

Main reasons of eyesight deterioration in diabetic patients are diabetic retinopathy (DR) and diabetic macular oedema (DMO). International multicenter studies have shown that retinal laser coagulation in the event of DMO decreases the risk of eyesight loss in 50% , though only in 16% patients it was also possible to improve their eyesight. Use of vascular endothelial growth factor inhibitor – Ranibizumab – have opened a new era in DMA treatment. It’s efficacy and safety have been proven in several international studies. This article contains our own data upon the use of Lucentis in patients with DMO. Intravitreal Lucentis injections and subsequent retinal lasercoagulation in the macular zone were performed on 43 eyes; follow up period – 6 months. Additional injections were required in 19 cases, average amount of injections – 1,4. Mean corrected visual acuity before the treatment was 0,37±0,06, after7 days, 1, 3 and 6 months - respectively 0,41±0,06, 0,49±0,06, 0,51±0,07 and 0,52±0,07 (р<0,05). Mean retina thickness in central zone was 428±25 mkm before treatment, 391±24 mkm 7 days after the last injection 349±23, 313±21 and 308±20mkm (р<0,05) after 1, 3 and 6 months. In addition to that Lucentis use in preoperative period in patients with non-complicated proliferative DR allowed to decrease the risk of hemorrhagic complications. Thereby, intravitreal injections of Lucentis improve functional result of treatment of patients with DMO, increase efficacy and safety of surgical interventions in patients with complicated forms of proliferating DR.


About the authors

V. V. Neroev

FSBI Helmholtz Moscow Scientific-research institute of eye diseases

Author for correspondence.
Email: sekr@igb.ru
профессор, доктор медицинских наук, директор ФГБУ «Московский НИИ глазных болезней им. Гельмгольца» Минздравсоцразвития России, главный внештатный специалист-офтальмолог Минздравсоцразвития России Адрес: 105062, Москва, ул. Садовая-Черногрязская, 14/19 Тел.: (495) 607-73-31 Russian Federation

References

  1. Dedov I.I., Shestakova M.V., Ametov A.S. et al. Saharnyi diabet = Diabetes. 2011; 1: 95–105.
  2. American Diabetes Association: Diabetes Retinopathy. Diabetes Care. 2002; 25 (1): 590–593.
  3. Klein R., Klein B.E., Moss S.E. Visual impairment in diabetes. Ophthalmology. 1984; 91: 1–9.
  4. Sjolie A.K., Stephenson J., Aldington S. Retinopathy and vision loss in insulin-dependent diabetes in Europe. Ophthalmology. 1997; 104: 252–260.
  5. Early Treatment Diabetic Retinopathy Study research group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology. 1991; 98: 767–785.
  6. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings. Ophthalmology. 1978; 85 (1): 82–106.
  7. Klein R., Klein B.E.K., Moss S.E. et al. The Wisconsin epidemiologic study of diabetic retinopathy III. Diabetic macular edema. Ophthalmology. 1984; 91 (12): 1464–1474.
  8. Bandello F., Parodi M.B., Lanzetta P. et al. Diabetic macular edema. Dev. Ophthalmol. 2010; 47: 73–110.
  9. Hirai F.E. et al. Clinically significant macular edema and survival in type 1 and type 2 diabetes. Am. J. Ophthalmol. 2008; 145 (4): 700–706.
  10. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 1. Arch. Ophthalmol. 1985; 103: 1796–1806.
  11. Neroev V.V., Ryabina M.V., Azim Zade A.A. Glaukoma = Glaucoma. 2006; 4: 38–40.
  12. Massin P.G. Intravitreal triamcinolone acetonide for diabetic diffuse macular edema. Program and abstracts of the American Academy of Ophthalmology. 2002 Annual Meeting; October 20–23, 2002; Orlando, Florida.
  13. Mitchell P. Ranibizumab alone or adjunctive to laser vs. laser monotherapy in diabetic macular edema: twelve-month results of the RESTORE study. American Academy of Ophthalmology. 2010; PA026.
  14. Mitchell P., Bandello F., Schmidt-Erfurth U. et al. Ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema (RESTORE study). Ophthalmology. 2011; 118 (4): 615–625.
  15. The Diabetic Retinopathy Clinical Research Network. Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2010; 117 (6): 1064–1077.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2012 "Paediatrician" Publishers LLC



Этот сайт использует файлы cookie и сервис сбора персональных данных (Яндекс.Метрика), чтобы анализировать трафик, а также улучшать работу сайта. Нажимая кнопку «Я согласен/согласна», вы даете согласие на обработку ваших данных. Подробности — в нашей Политике конфиденциальности.