Оценка динамики резорбции диабетического макулярного отека на фоне стероидной терапии

Abstract

Purpose. To identify the dominant topographic resorption zones of diabetic macular edema, as well as their hierarchy, which determines a favorable postoperative outcome. Material and methods. We examined 21 patients (27 eyes) aged 26 to 79 years (mean age 64.4±11.2 years) with a diagnosis of diabetic retinopathy, diabetic macular edema. All patients underwent a standard ophthalmological examination, as well as a segment-by-segment analysis of optical coherence tomography scans (OCT Spectralis Heidelberg, Germany) before and 1 month after steroid therapy. The retinal thickness (RT) and volume (RV) were analyzed in 9 segments of the macular region with a diameter of 6 mm. Statistical processing of the obtained material was carried out using the IBM SPSS Statistics v. 21 program, using standard methods of descriptive statistics. Results. During the analysis of optical coherence tomography data, the following results were obtained: the average maximum corrected visual acuity after steroid therapy significantly increased from 51.5±14.7 to 65±9 letters ETDRS (p<0.0001). The percentage ratio of macular edema regression in the analyzed segments revealed the following proportional pattern of changes in RT and RV: in the fovea zone – a decrease of 31%; 4 segments of a concentric circle with a diameter of 3 mm – on average by 20.6±1.2% and 21.0±1.8%; 4 segments of a concentric circle with a diameter of 6 mm – on average by 10%. Conclusion. The present study revealed the absence of dominant topographic zones of resorption, against the background of steroid therapy, while the proportionality and uniformity of the reduction of macular edema was observed. Key words: diabetic retinopathy, diabetic macular edema, optical coherence tomography, steroid therapy, ozurdex.