The role of fractalkine in the development of diabetic macular edema in patients with type 2 diabetes mellitus
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Abstract
Background. Diabetic macular edema (DME) is a severe complication of type 2 diabetes mellitus (DM) and a leading cause of vision loss in the working age population of most developed countries. The gold standard for DME treatment should be based on a good control of glycemia along with control of lipids and renal function. However, despite the systemic metabolic control values being essential for patients with diabetic retinopathy, it has proven to be insufficient for DME if it appears. In these patients, additional measures are needed in order to avoid the subsequent loss of vision. The aim of the work was to assess the content of blood fractalkine in patients with type 2 DM and DME in conjunction with the indicators of the thickness of the macula layers. Materials and methods. The study involved 82 patients with type 2 DM (145 eyes), divided into 4 groups in accordance with the DME form. The average age of patients was 65.25 ± 10.85 years, the average duration of DM — 14.00 ± 7.05 years, the average level of HbA1c — 8.40 ± 1.58 %. Results. Using analysis of variance and regression analysis, methods for constructing logistic regression models, we have shown that fractalkine is not associated with the risk of not low values (> QI) of nerve fiber layer, ganglion cell layer, inner plexiform layer, central sector of macula, thickness of fovea. Conclusions. Fractalkine may be a promising new therapeutic method for the treatment of diabetic retinal diseases. DME tends to be a chronic disease, although spontaneous recovery is not uncommon. It is important to recognize that 35 % of patients with macular edema had spontaneous resolution after 6 months if untreated.
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References
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AAO. Diabetic Retinopathy PPP - Updated 2017. Available from: https://www.aao.org/preferred-practice-pattern/diabetic-retinopathy-ppp-updated-2017. Accessed: Dec 2017.