https://doi.org/10.31288/oftalmolzh201352429

Changes in the general immune status in diabetic macular edema (complicated and diffuse) in patients with diabetes type II after treatment

Zborovskaya O, Preys N

SI «The Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine», Odessa

Introduction. Diabetic macular edema (DME) is the most common cause of de creased vision in patients with type II diabetes. It can accompany any stage of the disease and occurs on average 10 % of patients with diabetes. A key element of the pathogenesis of DME is the accumulation of extra fluid in the space of cellular degeneration due to imbalance of blood-retinal barrier. The basic principles of treatment of diabetic retinopathy at present considered to be stable compensation of diabetes, normalizing blood pressure and treating the diseased retina.

Material and methods. General ophthalmic examination, OCT, FFA and immu-nological studies were performed on all patients. The study included patients with diabetes type II with diabetic macular edema of various kinds. Total 64 patients (128 eyes), including 28 women (43.8 %) and 36 men (56.3 %); whose average age was '58 (SD 10); from 24 to 78years old. Diabetic macular edema was studied including diffuse (occlusal and unocclusal kind) and complicated (occlusal and unocclusal) ones. There were 33 cases of diffuse occlusal DME, 35 cases of diffuse unocclusal DME; 28 cases of complicated occlusal DME, and 32 — complicated unocclusal DME,. Statistical analysis was performed in the program Statistica.

Results. After cikloferon and cytoflavin combined treatment there was found a positive trend of the immune status indicators in the form of lowering relative percent-age levels of T-lymphocytes — CD-3 in diffuse and complicated DME of different kinds, reducing sensitization to AG-retinal in diffuse and complicated (occlusual and unocclusal) DME (p = 0,0001). For indicators of humoral immunitythere is a tend to reduce the concentration of immunoglobulin A, G, M in diffuse and complicated DME of different kinds. 

Conclusions: The data obtained enable to suggest the use of cytoflavin and cykloferon appropriate and reasonable in the treatment of patients with diabetes type II in diffuse and complications (occlusion and unocclusion) DME.

Key words: diabetic macular edema, humoral immunity, cellular immunity, immune status.    

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