Macular oedema as manifestation of diabetic retinopathy
Abstract
Diabetes mellitus is the third most dangerous disease of our time preceded by cardiovascular diseases and oncologic pathology.
According to the International Diabetes Federation (January 1, 2016), worldwide approximately 415 million people aged 20–79 years suffer from diabetes.
The most significant manifestations of diabetes mellitus are lesions of the retina and blood vessels, which manifest as diabetic retinopathy and macular oedema, which lead to the inevitable loss of vision and disability in patients of working age. The existence of multile diagnostic methods and a broad classification provide an evidence of the complex nature of the pathological process of the macular zone in diabetes mellitus. However, to date, a single, generalised and accepted classification does not exist. Difficulties in the treatment of diabetic maculopathy are attributed to various forms of retinal lesions and ambiguities in the approach used to choose the disease management.
It determines the importance of the development of diagnostic methods for the further correction of the standard treatment approach. New directions of surgical treatment allow relying on the best results of diabetic maculopathy treatment.
About the Authors
Mukharram M. BikbovUfa Eye Research Institute
Russian Federation
MD, PhD, Professor
Competing Interests:
No conflict of interests
Rinat R. Fayzrakhmanov
Ufa Eye Research Institute
Russian Federation
MD, PhD
Competing Interests:
No conflict of interests
Rinat M. Zaynullin
Ufa Eye Research Institute
Russian Federation
research associate
Competing Interests:
No conflict of interests
Artur F. Zaynetdinov
Ufa Eye Research Institute
Russian Federation
junior research associate
Competing Interests:
No conflict of interests
Timur R. Gilmanshin
Ufa Eye Research Institute
Russian Federation
MD, PhD, senior research associate
Competing Interests:
No conflict of interests
Marat R. Kalanov
Ufa Eye Research Institute
Russian Federation
research associate
Competing Interests:
No conflict of interests
References
1. Дедов И.И., Шестакова М.В. Сахарный диабет и артериальная гипертензия. — М.: ООО «Медицинское информационное агентство»; 2006. [Dedov II, Shestakova MV. Sakharnyi diabet i arterial'naya gipertenziya. Moscow: OOO «Meditsinskoe informatsionnoe agentstvo»; 2006. (in Russ.)]
2. Демидова Т. Ю., Трахтенберг Ю.А. Современные возможности терапии диабетической ретинопатии // Сахарный диабет. – 2014. – Т. 17. – №3 – C. 122-128. [Demidova TY, Trakhtenberg YA. Current approaches to the management of diabetic retinopathy. Diabetes mellitus. 2014;17(3):122-128. (in Russ.)]. doi: 10.14341/DM20143122-128
3. Klein R, Lee KE, Gangnon RE, Klein BE. The 25-Year Incidence of Visual Impairment in Type 1 Diabetes. Ophthalmology. 2010;117:63-70. doi: 10.1016/j.ophtha.2009.06.051
4. Кирилюк М.Л. Медикаментозное лечение и профилактика диабетической ретинопатии при сахарном диабете типа 1 Обзор литературы и клинических исследований // Международный эндокринологический журнал. – 2012. – Т. 8. – №5 – С. 70-75. [Kirilyuk ML. Medication and Prevention of Diabetic Retinopathy in Type 1 Diabetes Mellitus Review of the Literature and Clinical Trials. International journal of endocrinology. 2012;8(5):70-75. (in Russ.)]
5. Щуко А.Г., Волкова Н.В., Самсонова Ю.С. Глазные проявления сахарного диабета: учебное пособие. – Иркутск: ИГМУ; 2015. [Shchuko AG, Volkova NV, Samsonova YuS. Glaznye proyavleniya sakharnogo diabeta: uchebnoe posobie. Irkutsk: IGMU; 2015. (in Russ.)]
6. Wilkinson-Berka JL, Tan G, Jaworski K, Miller AG. Identification of a retina aldosterone system and the protective effects of mineralocorticoid receptor antagonism on retinal vascular pathology. Circ. Res. 2009;104:124-133. doi: 10.1161/circresaha.108.176008
7. ACCORD Study Group. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010;363(3):233-244. doi: 10.1056/NEJMoa1001288
8. Zhang X, Saaddine JB, Chou CF et al. Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA. 2010;304(6):649-656. doi:10.1001/jama.2010.1111
9. Шадричев Ф.Е. Практические аспекты офтальмологического ведения пациентов с пролиферативной диабетической ретинопатией // Офтальмологические ведомости. – 2008. – Т.1. – №. 1. – C. 58-64. [Shadrichev FE. Practical Aspects of Ophthalmologic Care for Patients with Proliferative Diabetic Retinopathy. Ophthalmologic vedomosti. 2008;1(1):58-64. (in Russ.)]
10. Измайлов А.С. Диабетическая ретинопатия и макулярный отек: Дис. д-ра мед. наук. – СПб.; 2004. [Izmailov AS. Diabeticheskaya retinopatiya i makulyarnyi otek. [dissertation] SPb; 2004. (in Russ.)]
11. Трахтенберг Ю.А., Аметов А.С., Демидова Т.Ю., Воробьева И.В. Антиоксидантная терапия непролиферативной диабетической ретинопатии // Врач. — 2006. — №11. — С. 15-18. [Trakhtenberg YA, Ametov AS, Demidova TY, Vorob'eva IV. Antioksidantnaya terapiya neproliferativnoi diabeticheskoi retinopatii. Vrach. 2006;(11):15-18. (in Russ.)]
12. White NH, Sun W, Cleary PA, et al. Effect of prior intensive therapy in type 1 diabetes on 10-year progression of retinopathy in the DCCT/EDIC: comparison of adults and adolescents. Diabetes. 2010;59(5):1244-1253. doi: 10.2337/db09-1216
13. Bhagat N, Grigorian R, Tutela A, Zarbin M. Diabetic macular edema: pathogenesis and treatment. Survey of ophthalmology. 2009;54(1):1-32. doi: 10.1016/j.survophthal.2008.10.001
14. Haller JA, Schachat AP. Update on the pathophisiology, molecular biology, and treatment of macular edema. Advanced studies in ophthalmology. 2007;4(7):178–190.
15. Bernardes R, Dias J, Cunha-Vaz J. Mapping the human blood-retinal barrier function. IEEE Transactions on Biomedical Engineering. 2005;52(1):106-116. doi: 10.1109/TBME.2004.839801
16. Gardner TW, Aiello LP. Pathogenesis of diabetic retinopathy. In: Flynn HW, Smiddy WE. Diabetes and ocular disease: past, present and future therapies. Ophthalmology monographs. N-Y; 2000:49–70.
17. Soheilian M, Ramezani A, Obudi A, et al. Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema. Ophthalmology. 2009;116(6):1142-1150. doi: 10.1016/j.ophtha.2009.01.011
18. Stefánsson E. Ocular oxygenation and the treatment of diabetic retinopathy. Survey of ophthalmology. 2006;51(4):364-380. doi: 10.1016/j.survophthal.2006.04.005
19. Bhagat N, Grigorian R, Tutela A, Zarbin N. Diabetic macular edema: pathogenesis and treatment. Survey of ophthalmology. 2009;54(1):1-32. doi: 10.1016/j.survophthal.2008.10.001
20. Yun JS, Ko S, Kim J, et al. Diabetic retinopathy and endothelial dysfunction in patients with type 2 diabetes mellitus. Diabetes Metab J. 2013;37(4):262-269. doi: 10.4093/dmj.2013.37.4.262
21. Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA. 2007;298(8):902-916. doi: 10.1001/jama.298.8.902
22. Астахов Ю.С., Шадричев Ф.Е., Лисочкина А.Б. Диабетическая ретинопатия (тактика ведения пациентов) // Клиническая офтальмология. 2004. — Т. 5. – №2. — С. 85-88. [Astakhov YS, Shadrichev FE, Lisochkina AB. Diabeticheskaya retinopatiya (taktika vedeniya patsientov). Klinicheskaya oftal'mologiya. 2004;5(2):85-88. (in Russ.)]
23. Rotsos TG, Moschos MM. Cystoid macular edema. Clin Ophthalmol. 2008;2(4):919-930. doi: 10.2147/OPTH.S4033
24. Figueira J, Khan J, Nunes S, et al. Prospective randomised controlled trial comparing sub-threshold micropulse diode laser photocoagulation and conventional green laser for clinically significant diabetic macular oedema. Br J Ophthalmol. 2009;93(10):1341-1344. doi: 10.1136/bjo.2008.146712
25. Girach A, Lund-Andersen H. Diabetic macular oedema: a clinical overview. Int J Clin Pract. 2007;61(1):88-97. doi: 10.1111/j.1742-1241.2006.01211.x
26. Peyman GA, Lad EM, Moshfeghi DM. Intravitreal injection of therapeutic agents. Retina. 2009;29(7):875-912. doi: 10.1097/IAE.0b013e3181a94f01
27. Шадричев Ф.Е., Астахов Ю.С., Григорьева Н.Н., Шкляров Е.Б. Сравнительная оценка различных методов диагностики диабетического макулярного отека // Вестник офтальмологии. — 2008. — №4. — С. 25-27. [Shadrichev FE, Astakhov YS, Grigor'eva NN, Shklyarov EB. Sravnitel'naya otsenka razlichnykh metodov diagnostiki diabeticheskogo makulyarnogo oteka. Vestnik oftal'mologii. 2008;(4):25-27. (In Russ).]
28. Бикбов М.М., Файзрахманов Р.Р., Ярмухаметова А.Л., Зайнуллин Р.М. Структурно-функциональный анализ центральной зоны сетчатки у пациентов с диабетическим макулярным отеком // Сахарный диабет. – 2015. – Т. 18. – №4. – С. 99-104. [Bikbov ММ, Fayzrakhmanov RR, Yarmukhametova АL, Zainullin RM. Analysis of the central zone of the retina in patients with diabetic macular edema. Diabetes mellitus. 2015;18(4):99-104. (in Russ.)] doi: 10.14341/DM7624
29. Бикбов М.М., Файзрахманов Р.Р., Ярмухаметова А.Л., Зайнуллин Р.М. Анатомическое картирование диабетического макулярного отека по данным оптической когерентной томографии при проведении антивазопролиферативной терапии // Современные технологии в офтальмологии. – 2015. – №1. – С. 31-33. [Bikbov ММ, Fayzrakhmanov RR, Yarmukhametova АL, Zainullin RM. Anatomicheskoe kartirovanie diabeticheskogo makulyarnogo oteka po dannym opticheskoi kogerentnoi tomografii pri provedenii antivazoproliferativnoi terapii. Sovremennye tekhnologii v oftal'mologii. 2015;(1):31-33. (in Russ.)]
30. Бикбов М.М., Файзрахманов Р.Р., Зайнуллин Р.М. Синдром витреомакулярной тракции. Обзор // Катарактальная и рефракционная хирургия. – 2014. – Т. 14. – №2. – С. 15-17. [Bikbov MM, Fayzrakhmanov RR, Zainullin RM. Sindrom vitreomakulyarnoi traktsii. Obzor. Kataraktal'naya I refraktsionnaya khirurgiya. 2014;14(2):15-17. (in Russ.)]
31. Zysk AM, Nguyen FT, Oldenburg AL, et al. Optical coherence tomography: a review of clinical development from bench to bedside. J Biomed Opt. 2007;12(5):051403. doi:10.1117/1.2793736
32. Гацу М.В., Байбородов Я.В. Клинико-топографическая классификация диабетических макулопатий // Офтальмология. – 2008 – Т. 5. – №3. – C. 20-22. [Gatsu MV, Baiborodov YV. Kliniko-topograficheskaya klassifikatsiya diabeticheskikh makulopatii. Oftal'mologiya. 2008;5(3):20-22. (in Russ.)]
33. Diabetes Control and Complications Trial, Lacin JM, Genuth S, et al. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med. 2000;342(6):381-389. doi: 10.1056/NEJM200002103420603
34. Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33(13):1635-1701. doi: 10.1093/eurheartj/ehs092
35. Sjoelie AK, Dodson P, Hobbs FRR. Does renin-angiotensin system blockade have a role in preventing diabetic retinopathy? A clinical review. Int J Clin Pract. 2011;65(2):148-153. doi: 10.1111/j.1742-1241.2010.02552.x
36. Kurihara T, Ozawa Y, Nagai N, et al. Angiotensin II type 1 receptor signaling contributes to synaptophysin degradation and neuronal dysfunction in the diabetic retina. Diabetes. 2008;57(8):2191-2198. doi: 10.2337/db07-1281
37. Шестакова М.В. Роль тканевой ренин-ангиотензин-альдостероновой системы в развитии метаболического синдрома, сахарного диабета и его сосудистых осложнений // Сахарный диабет. – 2010. – Т. 13. – №3. – C. 14-19. [Shestakova MV. The role of the tissue renin-angiotensin-aldosterone system in the development of metabolic syndrome, diabetes mellitus and itsvascular complications. Diabetes mellitus. 2010;13(3):14-19. (in Russ.)] doi: 10.14341/2072-0351-5481
38. Баутина Ю.Е., Липатов Д.В., Чистяков Т.А., и др. Внутриглазное и системное содержание ангиотензина II и сосудистого эндотелиального фактора роста при диабетической ретинопатии / VI Всероссийский конгресс эндокринологов. Сборник тезисов. 2012. – С. 66. [Bautina YE, Lipatov DV, Chistyakov TA et al. Vnutriglaznoe i sistemnoe soderzhanie angiotenzina II i sosudistogo enotelial'nogo faktora rosta pri diabeticheskoy retinopatii. In: Proceedings of VI Vserossiyskiy kongress endokrinologov. Sbornik tezisov. 2012:66. (in Russ.)]
39. Diabetic Retinopathy Clinical Research Network, Scott IU, Edwards AR, et al. A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology. 2007;114(10):1860-1867. doi: 10.1016/j.ophtha.2007.05.062
40. Ford JA, Lois N, Royle P, et al. Current treatments in diabetic macular oedema: systematic review and meta-analysis. BMJ Open. 2013;3:e002269. doi: 10.1136/bmjopen-2012-002269
41. Schwartz SG, Flynn HW Jr, Scott IU. Intravitreal corticosteroids in the management of diabetic macular edema. Curr Ophthalmol Rep. 2013;1(3):144–149. doi: 10.1007/s40135-013-0015-3
42. Jonas JB, Libondi T, Golubkina L, et al. Combined intravitreal bevacizumab and triamcinolone in exudative age-related macular degeneration. Acta ophthalmol. 2010;88(6):630-634. doi: 10.1111/j.1755-3768.2008.01502.x
43. Mirshahi A, Shenazandi H, Lashay A, et al. Intravitreal triamcinolone as an adjunct to standard laser therapy in coexisting high-risk proliferative diabetic retinopathy and clinically significant macular edema. Retina. 2010;30(2):254-259. doi: 10.1097/IAE.0b013e3181b4f125
44. Kang SW, Sa HS, Cho HY, Kim JI. Macular grid photocoagulation after intravitreal triamcinolone acetonide for diffuse diabetic macular edema. Arch. Ophthalmol. 2006;124:653-658. doi: 10.1001/archopht.124.5.653
45. Aydin E, Demir HD, Yardim H, Erkorkmaz U. Efficacy of intravitreal triamcinolone after or concomitant with laser photocoagulation in nonproliferative diabetic retinopathy with macular edema. Eur J Ophthalmol. 2009;19:630-637.
46. Казайкин В.Н. Диабетическая ретинопатия: клиника, диагностика и лечение. – М.: ООО «НПЦ Мединформ», 2016. [Kazaikin VN. Diabeticheskaya retinopatiya: klinika, diagnostika i lechenie. Moscow: OOO «NPTs Medinform»; 2016. (in Russ.)]
47. Haller JA, Kuppermann BD, Blumenkranz MS, et al. Randomized controlled trial of an intravitreous dexamethasone drug delivery system in patients with diabetic macular edema. Arch Ophthalmol. 2010;128(3):289–296. doi: 10.1001/archophthalmol.2010.21
48. Boyer DS, Faber D, Gupta S, et al. Dexamethasone intravitreal implant for treatment of diabetic macular edema in vitrectomized patients. Retina. 2011;31(5):915–923. doi: 10.1097/IAE.0b013e318206d18c
49. Jaffe GJ, Martin D, Callanan D, et al. Fluocinolone acetonide implant (Retisert) for noninfectious posterior uveitis: thirty-four-week results of a multicenter randomized clinical study. Ophthalmology. 2006;113(6):1020–1027. doi: 10.1016/j.ophtha.2006.02.021
50. Kane FE, Burdan J, Cutino A, Green KE. Iluvien: a new sustained delivery technology for posterior eye disease. Expert Opin Drug Deliv. 2008;5(9):1039–1046. doi:10.1517/17425247.5.9.1039
51. Campochiaro PA, Brown DM, Pearson A, et al. Sustained delivery fluocinolone acetonide vitreous inserts provide benefit for at least 3 years in patients with diabetic macular edema. Ophthalmology. 2012;119(10):2125–2132. doi: 10.1016/j.ophtha.2012.04.030
52. Nakamura S, Iwasaki N, Funatsu H, et al. Impact of variants in the VEGF gene on progression of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2009;247(1):21-26. doi: 10.1007/s00417-008-0915-3
53. Simo R, Hernandez C. Intravitreous anti-VEGF for diabetic retinopathy: hopes and fears for a new therapeutic strategy. Diabetologia. 2008;51(9):1574-1580. doi: 10.1007/s00125-008-0989-9
54. Massin P, Bandello F, Garweg JG, et al. Safety and Efficacy of Ranibizumab in Diabetic Macular Edema (RESOLVE Study) A 12-month, randomized, controlled, double-masked, multicenter phase II study. Diabetes care. 2010;33(11):2399-2405. doi:10.2337/dc10-0493
55. Do DV. Intravitreal afliberept injection (IAI) for diabetic macular edema (DME): 12-month results of VISTA-DME and VIVIDDME. Proceedings of the Annual Meeting of the American Academy of Ophthalmology; 2013 November 16–19; New Orleans, USA.
56. Щуко А.Г., Бурий В.В., Новолодский А.И., Зайцева Н.В. Пилинг внутренней пограничной мембраны в лечении диабетического макулярного отека // Клиническая офтальмология. – 2012. – №1 – C. 1-2. [Shchuko AG, Buriy VV, Novolodskiy AI, Zaytseva NV. Piling vnutrenney pogranichnoy membrany v lechenii diabeticheskogo makulyarnogo oteka. Klinicheskaya oftal'mologiya. 2012;(1):1-2. (in Russ.)]
57. Шадричев Ф.Е. Диабетическая ретинопатия и макулярный отек. Алгоритмы диагностики и лечения клинически значимых форм // Фарматека. – 2012. – № 16 – C. 34-41. [Shadrichev FE. Diabeticheskaya retinopatiya i makulyarnyy otek. Algoritmy diagnostiki i lecheniyaklinicheski znachimykh form. Farmateka. 2012;(16):34-41. (in Russ.)]
58. Файзрахманов Р.Р., Каланов М.Р., Зайнуллин Р.М. Витрэктомия в сочетании с пилингом внутренней пограничной мембраны при диабетическом макулярным отеке (обзор литературы) // Вестник Оренбургского государственного университета. – 2015. – №. 12 – С. 257-259. [Fayzrakhmanov RR, Kalanov MR, Zaynullin RM. Vitrectomy combined with peeling of the internal limiting membrane in diabetic macular edema (literature review). Vestnik Orenburgskogo gosudarstvennogo universiteta. 2015;(12):257-259. (in Russ.)]
Supplementary files
Review
For citations:
Bikbov M.M., Fayzrakhmanov R.R., Zaynullin R.M., Zaynetdinov A.F., Gilmanshin T.R., Kalanov M.R. Macular oedema as manifestation of diabetic retinopathy. Diabetes mellitus. 2017;20(4):263-269. (In Russ.)