title: Visual function and morphological changes in the macular area of patients with type 2 diabetes mellitus after intensive insulin therapy.
abstract: BACKGROUND
  Intensive insulin therapy has been found to lessen the progress of diabetic retinopathy (DR) to some extent, while it has also been implicated to be responsible for decrease of DR. We investigated visual function and morphological changes in the macular area in short-term follow-up of patients with type 2 diabetes mellitus after intensive insulin therapy.
  
  
  METHODS
  This was a prospective clinical study of nonproliferative DR patients (102 eyes, 120 patients) undergoing intensive insulin therapy. The Contrast Glare Tester (Takagi CGT-1000) was used to examine contrast sensitivity (CS) and Heidelberg Retina Tomograph (HRT) II and Stratus Model 3000 OCT were used to observe the changes of morphology in the macular area. Follow-up times were pre-intensive therapy, 3 and 6 months post-intensive therapy.
  
  
  RESULTS
  CS at low and middle frequencies was higher at 3 and 6 months post-therapy compared with pre-therapy (P < 0.05). Significant differences in CS at low frequency were found between 6 and 3 months post-therapy (P < 0.05). Macular edema index was lower in the first, second, and third rings of the macular area after intensive therapy compared with pre-therapy (P < 0.05). Compared with 3 months post-therapy, the macular edema index was lower in the first, second, and third rings of the macular area at 6 months post-therapy (P > 0.05). No significant differences in the thickness of the first, second, and third rings of the macular area were detected between 3 and 6 months post-therapy and pre-therapy (P > 0.05).
  
  
  CONCLUSIONS
  CS and macular edema indexes were significantly improved in nonproliferative diabetic retinopathy patients after intensive insulin therapy, but thickness of the macular area was unchanged.
authors.affiliation: Department of Ophthalmology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
authors.forename: Zhenguo
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
authors.forename: Jiayu
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Ophthalmology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
authors.forename: Chunjie
authors.initials: C
authors.lastname: Lu
authors.affiliation: Department of Ophthalmology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
authors.forename: Sisi
authors.initials: S
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
authors.forename: Jiawei
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Ophthalmology, Ruian People's Hospital, Ruian, Zhejiang 325200, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zhong
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China. Email: trtianbei@163.com.
authors.forename: Bei
authors.initials: B
authors.lastname: Tian
authors.affiliation: Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Wei
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D008266:Macula Lutea / Q000473:pathology*; D008875:Middle Aged; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D014785:Vision, Ocular / Q000502:physiology*
chemical_list: D007328:Insulin