The Use of Optical Coherence Tomography to Determine the Effect of Thiazolidinediones on Retinal Thickness in Patients with Type 2 Diabetes

Tarbett, Aaron K.; VanRoekel, R.C.; Howard, Robin S.; Vigersky, Robert A.

doi:10.1177/193229681100500418

Cited by 10 publications

(7 citation statements)

References 19 publications

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“…Our findings are in keeping with two prior cross-sectional studies of optical coherence tomography that showed no association between TZD use and increased macular thickness. 18,19 These findings are important given that TZD remains an important line of therapy. 20 …”

Section: Discussionmentioning

confidence: 99%

Lack of Longitudinal Association Between Thiazolidinediones and Incidence and Progression of Diabetic Eye Disease: The ACCORD Eye Study

Gower¹,

Lovato²,

Ambrosius³

et al. 2018

American Journal of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

Lack of Longitudinal Association Between Thiazolidinediones and Incidence and Progression of Diabetic Eye Disease: The ACCORD Eye Study

Gower¹,

Lovato²,

Ambrosius³

et al. 2018

American Journal of Ophthalmology

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“…In contrast, smaller population-based studies have demonstrated no association between TZD and DME. Studies using OCT measurement have revealed no evidence of fluid retention in the macula and no difference in central retinal thickness [48][49][50]. Moreover, the ACCORD Eye study observed no association between TZD exposure and DME but could not exclude modest protective or harmful associations [51].…”

Section: Thiazolidinedionesmentioning

confidence: 96%

New anti-hyperglycaemic agents for type 2 diabetes and their effects on diabetic retinopathy

Saw

Wong

et al. 2019

Eye

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There has been an increase in the range of non-insulin anti-hyperglycaemic agents used to treat type 2 diabetes. With the globally rising rates of type 2 diabetes and complications such as diabetic retinopathy, it is important for ophthalmologists to be aware of these new agents and their impacts on diabetic retinopathy and diabetic macular oedema. We conducted a review of the literature to determine if there were any beneficial or harmful effects of the currently used anti-hyperglycaemic agents on diabetic retinopathy or diabetic macular oedema. Our review of the current literature found that apart from thiazolidinediones, anti-hyperglycaemic agents have been reported to have beneficial or neutral effects on diabetic eye complications. Thiazolidinediones (pioglitazone is the only one currently available) have been linked to incident or worsening diabetic macular oedema, although the rate is believed to be low. Glucagon-like peptide 1 (GLP1) agonists (incretins) in general are beneficial except semaglutide which is associated with increased rates of diabetic retinopathy complications. These results have implications for selection of anti-hyperglycaemic agents for patients with diabetic retinopathy or macular oedema. Further studies need to be conducted to identify if reported beneficial effects are independent of the impact of glycaemic control. Early worsening of retinopathy with tight glycaemic control should also be noted in interpretation of future studies.

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“…Several authors have studied the possibility of OCT for the early diagnosis of ME and have suggested criteria to detect so-called subclinical macular edema. Among anti-diabetic medications, thiazolidineiones (12)(13)(14) and insulin (3,4,5,15) have been implicated in the rise of macular thickness, which may be due to the side effect of drugs or due to its role progression of retinopathy. However, the evidence obtained is not conclusive.…”

Section: Discussionmentioning

confidence: 99%

Association of Types of Diabetic Macular Edema with Different Anti-Diabetic Therapies

Singh¹,

Yadav²,

Karoli³

et al. 2020

Turk J Endocrinol Metab

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Objective: To evaluate and assess the association of diabetic macular edema with different anti-diabetic therapy regimens. Material and Methods: We recruited 340 patients with prediagnosed Type 2 diabetes mellitus attending the ophthalmology and medicine outpatient department. Patients were older than 30 years with Type 2 diabetes mellitus and on a specific anti-diabetic regimen (monotherapy/combination therapy) for ≥6 months, and who underwent macular edema assessment by using spectral domain optical coherence tomography. The patterns of macular edema per retinal morphology were grouped as diffuse retinal thickening, cystoid macular edema, and serous retinal detachment. Results: No significant association was found between edema pattern and dual therapy regimen (metformin+1 other oral hypoglycemic agent) (p=0.685) in the 680 eyes of the 340 patients. In patients on all the other triple therapy regimens (metformin+2 other oral hypoglycemic agents), diffuse retinal thickening was the most common type, except in patients on thiazolidinediones and insulin in conjunction with metformin in which cystoid macular edema was the most common. However, the difference between different triple therapy regimens was statistically significant (p=0.053). Conclusion: The most common form of macular edema was diffuse retinal thickening irrespective of the type and regimen of anti-diabetic therapy. Increased incidence of cystoid macular edema was observed in patients on triple therapy, including insulin. Because of the difference in the patterns, it is imperative to evaluate patients for different types of edema due to ongoing anti-diabetic treatment.

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The Use of Optical Coherence Tomography to Determine the Effect of Thiazolidinediones on Retinal Thickness in Patients with Type 2 Diabetes

Cited by 10 publications

References 19 publications

Lack of Longitudinal Association Between Thiazolidinediones and Incidence and Progression of Diabetic Eye Disease: The ACCORD Eye Study

Lack of Longitudinal Association Between Thiazolidinediones and Incidence and Progression of Diabetic Eye Disease: The ACCORD Eye Study

New anti-hyperglycaemic agents for type 2 diabetes and their effects on diabetic retinopathy

Association of Types of Diabetic Macular Edema with Different Anti-Diabetic Therapies

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