Wydanie 1/2019
str. 41 - 45

Cukrzycowy obrzęk plamki – patofizjologia i leczenie

Diabetic Macular Edema – Pathophysiology and Treatment

Magdalena Durajczyk, Michał Post, Wojciech Lubiński

II Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie Kierownik: prof. dr hab. n. med. Wojciech Lubiński

Summary: Aim: Prolonged hyperglycemia entails damage, malfunction and failure of various organs, especially eyes, kidneys, nerves, heart and blood vessels. Complications related to diabetes affect almost every anatomical structure in sight organ. Diabetic macular edema is a major cause of vision impairment. This disease affects 18 million people all over the world.
Purpose: The purpose of this thesis is to summarize the state of current knowledge in the field of pathophysiology and treatment of diabetic macular edema.
Material and Methods: Overview of “Pubmed” publications from 2012 to 2019, literature, diabetology and ophthalmic guidelines on the subject of diabetic macular edema.
Results: Pathophysiology of diabetic macular edema has multiple factors and is complex, the key role is played by the duration of diabetes and hyperglycemia, but also by metabolic control. Reduction of glycated hemoglobin by 1% (from 9 to 8 percent) results in reduced risk of microangiopathy progression by 30–40%. Diabetic macular edema characterises itself by a complete morphology disorder of central part of retina. Edema of the fundus of the eye often comes with a presence of microaneurysms, sometimes surrounded by a yellowish, incomplete ring of hard exudates. Spectral optical coherence tomography is extremely useful for diagnosing this disease. Topical treatment methods of diabetic macular edema are intravitreal injections of anti vascular endothelial growth factor, drugs, injections and implants of corticosteroids, laser therapy and vitrectomy.
Conclusions: The key factor to diabetic macular edema treatment is systemic diabetes therapy and normalization of blood pressure. Ophthalmic treatment is just a supplementary treatment, in which the anti-VEGF injections play the crucial role. Only interdisciplinary cooperation might yield the results hoped for in terms of stopping the progression of the disease and improvement in visual acuity of patients with diabetic macular edema.

Słowa kluczowe: cukrzycowy obrzęk plamki, retinopatia cukrzycowa, patofizjologia, leczenie.

Keywords: diabetic macular edema, diabetic retinopathy, pathophysiology and treatment.