EVALUATION OF MACULAR THICKNESS IN TYPE -2 DIABETICS ON PIOGLITAZONE

Thiazolidinediones are oral hypoglycemic drugs that have been recently used for patients of type 2 diabetes. Review of literature shows that their side effect of systemic fluid retention aggravates diabetic macular edema. This research work was designed to see the effect of Thiazolidinediones (Pioglitazone) on early diabetic retinopathy. Optical Coherence Tomography (OCT) was used to measure average and central foveal thickness. 122 consecutive eyes of metabolically stable Type 2 diabetes were taken up for study and followed for three months who fulfilled the exclusion criteria. Patients were divided in two groups. Group one included patients with no diabetic retinopathy. Group two included patient with mild / moderate retinopathy without macular edema. As group two was further randomized into two subgroups. First subgroup received standard systemic medical therapy for diabetes and second subgroup received 30mg Pioglitazone in addition to standard treatment. All subjects underwent complete ocular systemic examination including Optical Coherence Tomography (OCT) at baseline, 6 weeks and 3 months. In this study, there was increase in central foveal thickness and average cube thickness in both the subgroups on Pioglitazone. Pioglitazone therapy is related to statistically significant increase in macular thickness at three month follow up. Optical Coherence Tomography (OCT) is an important tool for picking up subclinical changes in macular thickness that do not reflect in visual acuity.