Diabetic macular edema. Epidemiology, pathogenesis, diagnosis, clinical features, treatment

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Abstract

The article reviews domestic and international publications addressing the features of spectral optic coherence tomography in patients with diabetes mellitus and diabetic macular edema. Modern concepts of pathogenesis, epidemiology, diagnostic techniques and treatment of diabetic macular edema are described. Diabetes mellitus is one of the World’s most important medical and social problems. The significance of the problem is due to the prevalence of diabetes. The incidence is increasing annually in all countries, and the catastrophic positive trend can be treated as non-infective epidemics. Diabetic retinopathy is considered as one of the most severe specific eye diseases in diabetes. Despite significant advances and new directions of medical and surgical treatment in the last years, macular edema is the most common cause of central visual acuity reduction in diabetes. The most common and informative method of diagnosis of diabetic macular edema is optical coherence tomography. This non-invasive and precise method, allowing to obtain an cross section images of studied tissues in vivo, to estimate the thickness of the retina in micrometers, the volume in cubic millimeters and its structure. Introduction of this method induced revolutionary changes in the diagnosis and treatment of diabetic retinopathy. Treatment of diabetic macular edema requires compensating the set of biological and pathophysiological local and systemic changes in the eye, occurring in diabetes. Currently treatments for diabetic retinopathy include laser surgery, surgical techniques (vitrectomy), intravitreal injections of corticosteroids and anti-vascular endothelial growth factor medications. Despite the results achieved it diagnosis and treatment of diabetic macular edema, these questions require further research.

About the authors

A N Amirov

Kazan State Medical Academy, Kazan, Russia

Author for correspondence.
Email: Raudi87@inbox.ru

E A Abdulaeva

Kazan State Medical Academy, Kazan, Russia

Email: Raudi87@inbox.ru

E L Minkhuzina

Kazan State Medical Academy, Kazan, Russia

Email: Raudi87@inbox.ru

References

  1. Балашевич Л.И. Глазные проявления диабета. - СПб.: МАПО, 2004. - 282 с.
  2. Балашевич Л.И., Измайлов А.С. Диабетическая офтальмопатия - СПб.: Человек, 2012. - 336 с.
  3. Воробьёва И.В., Меркушенкова Д.А. Анализ влияния антиангиогенной терапии на диабетический макулярный отёк при сахарном диабете 2-го типа // РМЖ. Клин. офтальмол. - 2013. - Т. 14, №1. - С. 10-12.
  4. Деев Л.А., Каманин Е.И., Назирова А.В. и др. Распространённость сахарного диабета и диабетической ретинопатии на территории Смоленской области. Эффективность лазерного лечения в зависимости от стадии диабетической ретинопатиии, задачи по повышению качества офтальмологической помощи. - VII Всероссийск. школа офтальмол.: Сб. науч. тр. - М., 2008. - С. 247-258.
  5. Зуева М.В., Цапенко И.В., Нероев В.В. и др. Роль электроретинографии в диагностике и изучении патогенеза диабетической ретинопатии. В кн.: Клиническая физиология зрения. - М.: МБН, 2002. - C. 347-358.
  6. Кондратьева Л.В. Бигуаниды в терапии сахарного диабета / Под ред. А.С. Аметова. - М.: Планида, 2013. - 48 с.
  7. Лисочкина А.Б., Нечипоренко П.А. Микропериметрия - преимущества метода и возможности практичес-кого применения // Офтальмол. ведомости. - 2009. - Т. 2, №1. - С. 18-22.
  8. Лумбросо Б., Рисполи М. Оптическая когерентная томография. Практическое руководство. Перевод с англ. - М.: Издательство Панфилова, БИНОМ, Лаборатория знаний, 2014. - 208 c.
  9. Мошетова Л.К., Аржиматова Г.Ш., Комаров А.В. Клинико-функциональные характеристики органа зрения при сахарном диабете // Врач. - 2012. - №5. - С. 24-27.
  10. Мошетова Л.К., Аржиматова Г.Ш., Туркина К.И., Комаров А.В. Изменения морфометрии сетчатки при СД 1 типа // Офтальмол. ведомости. - 2013. - Т. 6, №3. - С. 16-21.
  11. Пасечникова Н.В. Лазерное лечение при патологии глазного дна. - Київ: Науково-виробниче підприємство «Видавництво ”Наукова думка” НАН України», 2007. - 207 c.
  12. Романенко И.А., Черкасова В.В., Егоров Е.А. Диабетический макулярный отёк. Классификация, клиника, лечение // РМЖ. Клин.офтальмол. - 2010. - Т. 11, №1. - С. 30-32.
  13. Рожко Ю.И., Марченко Л.Н. Связь между томографическими параметрами сетчатки и зрительной функцией при диабетическом макулярном отёке // Офтальмол. Восточная Европа. - 2011. - №4 (15). - С. 34-42.
  14. Хаппе В. Офтальмология. Перевод с нем. / Под ред. А.Н. Амирова.2-е изд. - М.: МЕДпресс-информ, 2005. - 643 с.
  15. Чиж Л.В. Диабетический маулярный отёк (обзор литературы) // Офтальмохир. и терап. - 2004. - Т. 4, №3. - С. 47-54.
  16. Шадричев Ф.Е., Астахов Ю.С., Григорьева Н.Н., Шкляров Е.Б. Сравнительная оценка различных методов диагностики диабетического макулярного отёка // Вестн. офтальмол. - 2008. - Т. 124, №4. - С. 25-28.
  17. Шамшинова A.M. Электроретинография в офтальмологии. - М.: МБН, 2009. - 303 c.
  18. Alkuraya H., Kangave D., Abu El-Asrar A.M. The correlation between optical coherence tomographic features and severity of retinopathy, macular thickness and visual acuity in diabetic macular edema // Int. Ophthalmol. - 2005. - Vol. 26, N 3. - P. 93-99.
  19. Aydin E., Demir H.D., Yardim H. Erkorkmaz of intravitreal triamcinolone after or concomitant with laser photocoagulation in nonproliferative diabetic retinopathy with macular edema // Eur. J. Ophthalmol. - 2009. - Vol. 19. - P. 630-637.
  20. Biallosterski C., van Velthoven M.E., Michels R.P. et al. Decreased optical coherence tomography-measured pericentral retinal thickness in patients with diabetes mellitus type 1 with minimal diabetic retinopathy // Br. J. Ophthalmol. - 2007. - Vol. 91, N 9. - P. 1135-1138.
  21. Brasil O.F. Predictive factors for short-term visual outcome after intravitreal triamcinolone acetonide injection for diabetic macular oedema: an optical coherence tomography study // Br. J. Ophthalmol. - 2007. - Vol. 91. - P. 761-765.
  22. Bressler N.M., Edwards A.R., Antoszyk A.N. et al. Diabetic retinopathy clinical research network. Retinal thickness on Stratus optical coherence tomography in people with diabetes and minimal or no diabetic retinopathy // Am. J. Ophthalmol. - 2008. - Vol. 145, N 5. - P. 894-901.
  23. Byeon S.H., Chu Y.K., Lee H. et al. Foveal ganglion cell layer damage in ischemic diabetic maculopathy: correlation of optical coherence tomographic and anatomic changes // Ophthalmology. - 2009. - Vol. 116, N 10. - P. 1949-1959.
  24. Ciresi A., Amato M.C., Morreale D. et al. OCT is not useful for detection of minimal diabetic retinopathy in type 1 diabetes // Acta Diabetol. - 2010. - Vol. 47, N 3. - P. 259-263.
  25. Cornut P.L., Bieber J., Beccat S. et al. Spectral domain OCT in eyes with retinal artery occlusion // J. Fr. Ophtalmol. - 2012. - Vol. 35, N 8. - P. 606-613.
  26. Deák G.G., Bolz M., Ritter M. et al. Diabetic Retinopathy Research Group Vienna. A systematic correlation between morphology and functional alterations in diabetic macular edema // Invest. Ophthalmol. Vis. Sci. - 2010. - Vol. 51, N 12. - P. 6710-6714.
  27. De Marco R., Capasso L., Magli A. et al. Measuring contrast sensitivity in aretinopathic patients with insulin dependent diabetes mellitus // Doc. Ophthalmol. - 1996. - Vol. 93, N 3. - P. 199-209.
  28. Dolar-Szczasny J., Swiech-Zubilewicz A., Oleszczuk A., Mackiewicz J. Optical Coherence Tomography (OCT) examination in patients with central retinal artery occlusion // Klin. Oczna. - 2012. - Vol. 114, N 1. - P. 26-28.
  29. Esmaeelpour M., Brunner S., Ansari S.S. et al. Choroidal thinning in diabetes type 1 detected by 3D - 1060nm-OCT // Invest. Ophthalmol. Vis. Sci. - 2012. - Vol. 53, N 11. - P. 6803-6809.
  30. Hirai F.E., Knudtson M.D., Klein B.E., Klein R. Clinically significant macular edema and survival in type 1 and type 2 diabetes // Am. J. Ophthalmol. - 2008. - Vol. 145. - P. 700-706.
  31. International Diabetes Federation. Diabetes atlas 6th edition. - 2013. - http://www.idf.org/diabetesatlas (дата обращения: 01.12.14).
  32. Ikeda F., Kishi S. Inner neural retina loss in central retinal artery occlusion // Jpn. J. Ophthalmol. - 2010. - Vol. 54, N 5. - P. 423-429.
  33. Kang S.W., Sa H.S., Cho H.Y., Kim J.I. Macular grid photocoagulation after intravitreal triamcinolone acetonide for diffuse diabetic macular edema // Arch. Ophthalmol. - 2006. - Vol. 124. - P. 653-658.
  34. Kelly D.H. Frequency doubling in visual responses // J. Opt. Soc. Am. - 1966. - Vol. 56, N 11. - P. 1628-1633.
  35. Luo X., Frishman L.J. Retinal Pathway Origins of the Pattern Electroretinogram (PERG) // Invest. Ophthalmol. Vis. Sci. - 2011. - Vol. 52, N 12. - P. 8571-8584.
  36. Marta V., Ciudin A., Hernández C., Simó R. Neurodegeneration: an early event of diabetic retinopathy // World J. Diabetes. - 2010. - Vol. 1, N 2. - P. 57-64.
  37. Nakamura S., Iwasaki N., Funatsu H., Kitano S. Impact of variants in the VEGF gene on progression of proliferative diabetic retinopathy // Graefes. Arch. Clin. Exp. Ophthalmol. - 2009. - Vol. 247, N 1. - P. 21-26.
  38. Park H.Y., Kim I.T., Park C.K. Early diabetic changes in the nerve fibre layer at the macula detected by spectral domain optical coherence tomography // Br. J. Ophthalmol. - 2011. - Vol. 95, N 9. - P. 1223-1228.
  39. Peng P.H., Lin H.S., Lin S. Nerve fibre layer thinning in patients with preclinical retinopathy // Can. J. Ophthalmol. - 2009. - Vol. 44, N 4. - Р. 417-422.
  40. Querques G., Lattanzio R., Querques L. et al. Enhanced depth imaging optical coherence tomography in type 2 diabetes // Invest. Ophthalmol. Vis. Sci. - 2012. - Vol. 53, N 10. - P. 6017-6024.
  41. Quigley H.A., Dunkelberger G.R., Green W.R. Retinal ganglion cell atrophy correlated with automated perimetry in human eyes with glaucoma // Am. J. Ophthalmol. - 1989. - Vol. 107. - P. 453-464.
  42. Sakata K., Funatsu H., Harino S. et al. Relationship of macular microcirculation and retinal thickness with visual acuity in diabetic macular edema // Ophthalmology. - 2007. - Vol. 114, N 11. - P. 2061-2069.
  43. Saishin Y., Takahashi K., Melia M. et al. Inhibition of protein kinase С decreases prosta-glandin-induced breakdown of the blood-retinal barrier // J. Cell. Physiol. - 2003. - Vol. 195, N 2. - P. 210-219.
  44. Shin H.J., Lee S.H., Chung H., Kim H.C. Association between photoreceptor integrity and visual outcome in diabetic macular edema // Graefes Arch. Clin. Exp. Ophthalmol. - 2012. - Vol. 250, N 1. - P. 61-70.
  45. Simo R., Hernandez C. Intravitreous anti-VEGF for diabetic retinopathy: hopes and fears for a new therapeutic strategy // Diabetologia. - 2008. - Vol. 51. - P. 1574-1580.
  46. Soliman W., Hasler P., Sander B., Larsen M. Local retinal sensitivity in relation to specific retinopathy lesions in diabetic macular oedema // Acta Ophthalmol. - 2010. - Vol. 90, N 3. - P. 248-253.
  47. Sugimoto M., Sasoh M., Ido M., Narushima C. Retinal nerve fiber layer decrease during glycemic control in type 2 diabetes // J. Ophthalmol. - 2010. - http://www.hindawi.com/journals/joph/2010/569215/ (дата: обращения 01.12.14).
  48. UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKDPS 38 // BMJ. - 1998. - Vol. 317. - P. 703-713.
  49. Verma A., Rani P.K., Raman R. et al. Is neuronal dysfunction an early sign of diabetic retinopathy. Microperimetry and spectral domain optical coherence tomography (SD-OCT) study in individuals with diabetes, but no diabetic retinopathy // Eye (London). - 2009. - Vol. 23, N 9. - P. 1824-1830.
  50. Verma A., Raman R., Vaitheeswaran K. et al. Does neuronal damage precede vascular damage in subjects with type 2 diabetes mellitus and having no clinical diabetic retinopathy? // Ophthalmic Res. - 2012. - Vol. 47, N 4. - P. 202-207.
  51. Virgili G., Menchini F., Murro V. et al. Optical coherence tomography (OCT) for detection of macular oedema in patients with diabetic retinopathy // Cochrane Database Syst Rev. - 2011. - Issue. 7. - CD008081. - doi: 10.1002/14651858.CD008081.pub2.
  52. Vujosevic S., Midena E., Pilotto E. et al. Diabetic macular edema: correlation between microperimetry and optical coherence tomography findings // Invest. Ophthalmol. Vis. Sci. - 2006. - Vol. 47, N 7. - P. 3044-3051.
  53. Vujosevic S., Pilotto E., Bottega E. et al. Retinal fixation impairment in diabetic macular edema // Retina. - 2008. - Vol. 28, N 10. - P. 1443-1450.
  54. Vujosevic S., Casciano M., Pilotto E. et al. Diabetic macular edema: fundus autofluorescence and functional correlations // Invest. Ophthalmol. Vis. Sci. - 2011. - Vol. 52, N 1. - P. 442-448.
  55. Wirostko B., Wong T.Y., Simo R. Vascular endothelial growth factor and diabetic complications // Prog. Retin. Eye Res. - 2008. - Vol. 27 - P. 608-621.
  56. Wolff B.E., Bearse M.A.Jr, Schneck M.E. et al. Multifocal VEP (mfVEP) reveals abnormal neuronal delays in diabetes // Doc. Ophthalmol. - 2010. - Vol. 121. - P. 189-196.
  57. Yamaguchi Y., Otani T., Kishi S. Resolution of diabetic cystoids macular edema associated with spontaneous vitreofoveal separation // Am. J. Ophthalmol. - 2003. - Vol. 135, N 1. - P. 116-118.

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