RESUMEN
BACKGROUND AND OBJECTIVE: To determine the efficacy of atorvastatin in reducing hard exudates and diabetic macular edema. PATIENTS AND METHODS: An uncontrolled clinical case series included 18 eyes with diabetic maculopathy and an elevated baseline lipid profile. All patients were treated with atorvastatin. Ophthalmologic evaluation, including fundus photography and fluorescein angiography, was performed at presentation and repeated at 3, 6, and 12 months. Hard exudates, hemorrhages, and fluorescein leakage at 12 months were evaluated and compared with baseline findings. RESULTS: Eighteen subjects with diabetic maculopathy received atorvastatin, and a significant decrease in total cholesterol and low-density lipoprotein cholesterol was seen (P < .05). Hard exudates and fluorescein leakage were decreased. No evidence of an association between change in hemorrhage status and treatment was found. CONCLUSION: Oral atorvastatin therapy in patients with diabetes mellitus and dyslipidemia seems to reduce the severity of hard exudates and fluorescein leakage in diabetic maculopathy and could be useful as an adjuvant therapy in the management of diabetic macular edema.
Asunto(s)
Anticolesterolemiantes/uso terapéutico , Colesterol/sangre , Complicaciones de la Diabetes/sangre , Retinopatía Diabética/complicaciones , Ácidos Heptanoicos/uso terapéutico , Hipercolesterolemia/complicaciones , Edema Macular/tratamiento farmacológico , Pirroles/uso terapéutico , Administración Oral , Anciano , Anticolesterolemiantes/administración & dosificación , Atorvastatina , Retinopatía Diabética/sangre , Retinopatía Diabética/diagnóstico , Femenino , Angiografía con Fluoresceína , Estudios de Seguimiento , Fondo de Ojo , Hemoglobina Glucada/metabolismo , Ácidos Heptanoicos/administración & dosificación , Humanos , Hipercolesterolemia/sangre , Hipercolesterolemia/tratamiento farmacológico , Edema Macular/diagnóstico , Edema Macular/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Pirroles/administración & dosificación , Resultado del Tratamiento , Agudeza VisualRESUMEN
The aim of this pilot study was to investigate the effect of intravitreal administration of etanercept in refractory diabetic macular edema. Seven patients diagnosed with diabetic macular edema, refractory to previous treatment, were enrolled. They all received 2 consecutive intravitreal injections of 2.5 mg (0, 1 ml) of Etanercept (Enbrel), with a two-week interval. In all patients visual acuity assessment, fundoscopy and fluorescein angiography were performed prior to the first injection, weekly for the first month, as well as 2 and 3 months following the first injection. No adverse reactions or adverse events were noticed in any patient. Analysis of the data indicates a trend for improvement of visual acuity, a slight worsening of hard exudates and fluorescein leakage, while hemorrhages remained stable, 3 months after initiation of therapy. However, no statistical significance has been reached. This small pilot study did not reveal any improvement in the clinical course of patients with refractory diabetic macular edema after the intravitreal injection of etanercept. Further research is warranted in order to obtain conclusive results concerning the role of anti-TNF therapy in diabetic macular edema.