Premium
Influence of metabolic control in patients with refractory diabetic macular edema treated with Ozurdex
Author(s) -
Sanchez Ramon A.,
Lopez Galvez M.I.,
Ortega Alonso E.,
Hernandez Rodriguez R.,
Portilla Blanco R.R.,
Roberts I.,
Zarzosa Martin E.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.01566
Subject(s) - medicine , glycemic , diabetic macular edema , metabolic control analysis , refractory (planetary science) , visual acuity , diabetes mellitus , ophthalmology , macular edema , blood pressure , observational study , retrospective cohort study , surgery , diabetic retinopathy , endocrinology , physics , astrobiology
Purpose To analyze the relationship between glycemic, lipid, and blood pressure control following the American Diabetes Association( ADA ) goals, and the response of refractory diabetic macular edema ( DME )in patients treated with Ozurdex. Methods A retrospective, descriptive and observational study was conducted on patients with refractory DME treated with Ozurdex ® in the University Hospital of Burgos, Spain, between 2012 and 2015. Results 21 patients were included. Almost all (95%) patients had type 2 diabetes mellitus ( DM ), and 81% were treated with insulin. The mean time of evolution of DM in this series was 16 years (± 12). The mean HbA1c was 7.22 ± 1.06. The mean initial best corrected visual acuity ( BCVA ) was 0.72 (log Mar ±0.33) and improved to 0.58 (log Mar ±0.31) after 6 months of follow up. The initial central macular thickness ( CMT ) was 506 μ ±99, and a reduction to 384 μ ±128 was observed after 6 months of follow up. Taking into account the overall metabolic control of the patient, a statistically significant difference was found in the improvement in BCVA after 3 months of follow up in patients with good metabolic control. A greater central macular thickness reduction was observed in patients with a better metabolic control at six months of follow up. This study also suggests that patients with an optimum HbA1c control have a tendency to achieve a better visual acuity after an Ozurdex implantation. No statistical differences were found between blood pressure and lipid parameters, and the anatomic or functional response to Ozurdex. Conclusions Ozurdex is an effective and safe treatment in the treatment of DME in patients that did not respond or poorly responded to other therapies. The overall metabolic control of the patient following the criteria of the ADA is related to the success of the treatment with Ozurdex.