title: Systemic oxygen therapy versus oral enalapril for treatment of diabetic macular ischemia: a randomized controlled trial.
abstract: The purpose of this study was to evaluate the structural and functional effects of systemic oxygen therapy and enalapril in patients with diabetic macular ischemia (DMI). This randomized clinical trial consisted of 105 eyes with DMI divided into three groups. Group I received systemic oxygen by face mask at a flow rate of 10 L/min; Group II received 5 mg enalapril daily; and Group III received placebo tablets for 3 months. Best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by optical coherence tomography (OCT), extent of foveal avascular zone (FAZ) on fluorescein angiograms, and electroretinograms (ERG) were obtained at baseline and after 3 and 6 months. Overall, 102 patients completed the study. Baseline characteristics were not significantly different among groups. Significant improvement in BCVA and decrease in CMT and FAZ occurred at months 3 and 6 in oxygen group compared to deterioration in enalapril and control groups (All P values <0.001). ERG parameters were significantly better in oxygen group compared to enalapril group at months 3 and 6 and better than those in control group at month 3. Normobaric oxygen therapy for 3 months in DMI decreased CMT and FAZ and improved BCVA and ERG parameters. Enalapril did not show any favorable effect.
authors: Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., 16666, Tehran, Iran.|Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors: Farideh
authors: F
authors: Sharifipour
authors: Negah Eye Hospital, Tehran, Iran.
authors: Mohammadreza
authors: M
authors: Razzaghi
authors: Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., 16666, Tehran, Iran.|Negah Eye Hospital, Tehran, Iran.|Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors: Alireza
authors: A
authors: Ramezani
authors: Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., 16666, Tehran, Iran.|Negah Eye Hospital, Tehran, Iran.
authors: Mohsen
authors: M
authors: Azarmina
authors: Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran.
authors: Mehdi
authors: M
authors: Yaseri
authors: Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., 16666, Tehran, Iran.
authors: Roham
authors: R
authors: Soheilian
authors: Department of Ophthalmology and Ophthalmic Research Center, Labbafinejad Medical Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Pasdaran Ave. Boostan 9 St., 16666, Tehran, Iran. masoud_soheilian@yahoo.com.|Negah Eye Hospital, Tehran, Iran. masoud_soheilian@yahoo.com.
authors: Masoud
authors: M
authors: Soheilian
mesh_terms: D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D004656:Enalapril / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D008266:Macula Lutea / Q000098:blood supply; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000627:therapeutic use*; D012164:Retinal Diseases / Q000628:therapy*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D010100:Oxygen
keywords: Diabetic macular ischemia; Enalapril; Ischemic maculopathy; Oxygen therapy