A influência do controle metabólico nos resultados anatômicos e funcionais do tratamento do edema macular diabético com um anti-VEGF

• Ano de defesa: 2015
• Autor(a) principal: Matsuda, Simone [UNIFESP]
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Retinopatia diabética; Diabetes mellitus tipo 2; Edema macular diabético; Inibidores da angiogênese; Fator A de crescimento do endotélio vascular
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=2576349; https://repositorio.unifesp.br/handle/11600/48889

Artigo 1 OBJECTIVES: To evaluate the impact of insulin therapy on the outcomes of diabetic macular edema (DME) treatment with vascular endothelial growth factor (VEGF) inhibitors in type 2 diabetics. METHODS: A retrospective consecutive case series of 95 type 2 diabetic patients with DME treated with antiVEGF therapy. Two cohorts were examined—patients taking only oral antidiabetic agents (NIDDM) and patients on insulin therapy (IDDM). The main outcome measures were change in visual acuity (VA) and change central subfield macular thickness (CST) measured by spectraldomain optical coherence tomography (SDOCT). Additional variables analyzed included HbA1c, creatinine, blood pressure and body mass index and theirs correlation with clinical findings. RESULTS: Both groups had a statistical significant improvement in VA (IDDM: 20/61 to 20/49, p=0.003; NIDDM: 20/76 to 20/56, p=0.005). There was no difference between groups at initial or 12 month examination (p=0.239 and p=0.489, respectively). From an anatomic standpoint, CST also improved significantly in both groups [454.7 μm to 354.9 μm (p<0.001) in the NIDDM and 471.5 μm to 368.4 μm (p<0.001) in the IDDM group]. Again, there was no significant difference between groups at initial or 12 month followup examination (p= 0.586 and p=0.591,respectively). Mean HBA1c levels remained relatively stable during the followup in both groups. CONCLUSION: This study suggests that insulin therapy in type 2 diabetic does not appear to impact the visual or anatomic effectiveness of DME treatment with antiVEGF inhibitors over a 1 year follow up.