MACULAR THICKNESS CHANGES EVALUATED BY OPTICAL COHERENCE TOMOGRAPHY IN CORRELATION WITH GLUCOSE AND HBA1C PARAMETERS AFTER SWITCHING DIABETES TREATMENT FROM ORAL HYPOGLYCEMICS TO INSULIN THERAPY IN PATIENTS WITH TYPE 2 DIABETES
Keywords:
type 2 diabetes, diabetic retinopathy, diabetic maculopathy, oral hypoglycemics, insulinAbstract
Introduction: To assess the impact of insulin therapy in the initial period on central macular thickness evaluated by optical coherence tomography (OCT) in patients with type 2 diabetes.
Materials and methods: A prospective observational study including 12 patients (24 eyes) with type 2 diabetes with or without DME was conducted. Patients had been treated only with oral hypoglycemics before inclusion in the study, and all of them were prescribed additional insulin therapy at the time of enrollment in the study. The main outcome parameters were changes in visual acuity (BCVA) and changes in central subfield thickness (CST) measured by optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). Additional variables analyzed included HbA1c, serum glucose, blood pressure, triglycerides, and cholesterol and their correlation with clinical findings. The examinations were performed at 1, 3, and 6 months after initiation of diabetes treatment with insulin.
Results: In all 12 subjects (24 eyes studied), no change in BCVA was observed. The laboratory parameters for glucose and HbA1c were analyzed, and at each follow-up showed a satisfactory reduction and stabilization of the results. From an anatomical point of view, CST showed minimal deterioration in 20 examined eyes - 209.3 μm to 240.21 μm (p<0.001). The mean HbA1c levels showed better results after insulin therapy.
Conclusion: This study suggests that in the initial phase of insulin therapy compared to oral antidiabetic agents, no decrease in visual acuity was observed, but changes in the anatomical structure of the macular region and macular volume occurred.
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