First Author: T.Pilkevych UKRAINE
Co Author(s): V. Naumenko N. Pasyechnikova
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To study the effect of recombinant erythropoietin on the progression of diabetic retinopathy and diabetic macular edema in patients with diabetes mellitus.
The Filatov Institute of Eye Diseases and Tissue Therapy, NAMS Ukraine, Ukraine, Odessa
In our study, 34 patients (67 eyes) participated. All patients were diagnosed with diabetes mellitus with the presence of diabetic retinopathy, a proliferative stage of 3 and 4 degrees of severity, with diffuse or complicated diabetic macular edema. All patients were previously treated for diabetes mellitus and diabetic retinopathy, as well as laser coagulation of the retina. All patients included in the study were examined by an endocrinologist, nephrologist. An additional examination of patients with related specialists showed that all patients had diabetic nephropathy of 3-4 degrees of severity and anaemia (haemoglobin below 100 g / l), and therefore a recombinant erythropoietin was administered according to the standard regimen (60 U / kg body weight 3 times a day).
After 8 months of observation in control group, total hemophthalm and detachment of reticular membrane occurred in 8 eyes (30.6%), whereas in the main group, hemophthalm and retinal detachment developed in 4 eyes (9.6%), (p = 0, 03). In the control group, after 8 months of observation, visual acuity decreased in 69.2% of cases - 18 eyes and only 2 eyes (15.4%) experienced an increase in visual acuity. In the main group of patients, visual acuity was observed in 10 eyes (22.0%), visual acuity decreased in 9 eyes (24.4%), with stable visual acuity was 22 eyes (53.7%). When assessing the dynamics of the course of diabetic macular edema with OCT, in patients of the control group at 8 months, regression of both diffuse and complicated diabetic macular edema was not detected. In the patients of the main group, after 8 months of follow-up, diffuse diabetic macular edema was absent in 18 of the 22 eyes, and complicated diabetic macular edema was absent in 6 of the 14 eyes. That is, a statistically significant improvement in the state of the retina in the macular area was established (p = 0.0009). Complications with the introduction of recombinant erythropoietin, we did not observe.
The use of recombinant erythropoietin promotes increased visual acuity in patients with diabetes mellitus (in 75.5%), regression of diabetic macular edema (in 48.7%), and also prevents the development of complications of diabetic retinopathy.