Role of brimonidine in the treatment of clinically significant macular edema with ischemic changes in diabetic maculopathy.
To evaluate the role of brimonidine (BMD), an alpha-2 agonist, in the management of clinically significant macular edema (CSME) in diabetic maculopathy with ischemic changes. A prospective, randomized controlled trial including 30 eyes of 30 metabolically stable diabetic patients with CSME showing fundus fluorescein angiography documented ischemic changes. Group I included 17 eyes of patients who received topical BMD (0.2 %) twice daily for 6 months while Group II included 13 eyes of age-matched patients who were kept under observation and acted as controls. The mean change in logMAR visual acuity and any change in the grade of the foveal avascular zone (FAZ) size, outline, capillary non-perfusion, or capillary dilatation was noted in the two groups and compared at the end of 6 months. The FAZ area and radius was significantly less in the study group than the control group. However, no significant difference in FAZ capillary outline, FAZ capillary loss, FAZ capillary dilatation and overall grade of ischemia between the two groups was seen. There was improvement in visual acuity from baseline to 6 months but it was comparable between the two groups (p = 0.02). BMD may have a role in the treatment of ischemic macula in CSME since the FAZ area and radius were significantly less in the study group. However, a larger sample size and a longer follow-up are needed to further authenticate the results of this pilot study.
Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India, pcgpgi@gmail.com.
Parul Chawla
PC
Gupta
Sunandan
S
Sood
Subina
S
Narang
Parul
P
Ichhpujani
D058647:Adrenergic alpha-2 Receptor Agonists / Q000627:therapeutic use*; D000368:Aged; D000068438:Brimonidine Tartrate; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000473:pathology; D008269:Macular Edema / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011810:Quinoxalines / Q000627:therapeutic use*; D012171:Retinal Vessels / Q000187:drug effects; D014792:Visual Acuity
D058647:Adrenergic alpha-2 Receptor Agonists; D011810:Quinoxalines; D000068438:Brimonidine Tartrate