Title: Effect of Pioglitazone therapy on Early Non Proliferative Diabetic Retinopathy
Authors: Swati Agarwal, Shikha Agarwal, Sanjiv Gupta, Navendu Rai
DOI: https://dx.doi.org/10.18535/jmscr/v7i5.151
Abstract
Background: Thiazolidinediones are oral hypoglycemic drugs that have been recently used for patients of Type 2 diabetes. Their side effect of systemic fluid retention aggravates diabetic macular edema. This research work was designed to study the change in macular thickness in diabetic patients are Pioglitazone.
Method: A prospective study was undertaken. Metabolically stable Type 2 diabetes were taken up for study and followed for three months who fulfilled the inclusion criteria. Group I included patients with no diabetic retinopathy. Group II included patient with mild / moderate retinopathy without macular edema. Two groups were further randomized into subgroups ‘A’ & ‘B’. ‘A’ received standard systemic medical therapy for diabetes and second subgroup received 30mg pioglitazone in addition to standard treatment. Spectral domain Optical Coherence Tomography was used to measure central foveal thickness at baseline, 6 weeks and 12 weeks.
Result: 66 cases were included. The increase in central foveal thickness (baseline-1200) in groups on pioglitazone (18-9.00±5.41µ, 2B-9.29±3.18µ) was statistically higher than without pioglitazone (1A-0.39±2.86µ,2A-1.56±4.27µ) (P<0.001).
Conclusion: Pioglitazone therapy is related to statistically significant increase in macular thickness at three month follow up. Optical Coherence Tomography (OCT) is an important tool for picking up subclinical changes in macular thickness that do not reflect in visual acuity.
Keywords: Non proliferative diabetic retinopathy, Diabetic retinopathy, Piogliazone, Macular thickness.
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