急性進行性糖尿病性網膜症のreversibility

Reversibility of acute diabetic retinopathy

　糖尿病治療を契機として急性網膜症の発症を見るも，光凝固は施行せず，引き続き血糖コントロールと抗血小板薬の内服投与により眼底病変の改善をみた5例7眼を観察することにより，急性網膜症は早期に病変がとらえられれば，即座に光凝固を施行せずとも，血糖のコントロールと血小板薬の併用で眼底病変の可逆的改善をみる例のあることが判明した．

A rapid and strict glycemic control exaggerates the retinopathy in poorly controlled or untreated diabetes mellitus with a longer history, resulting in acute diabetic retinopathy, or ADR. We observed 5 patients (7 eyes) of ADR and treated them with control of glycemia and medications without resort-ing to panretinal photocoagulation.

All the cases were non-insulin-dependent diabet-ics. The ages ranged from 49 to 65 years. Simple diabetic retinopathy was present in all before initia-tion of conventional diabetic control. ADR devel-oped within 15 days to 8 months after start of therapy. Acceleration of platelet aggregation devel-oped in 3 out 5 patients. Through a sustained strict glycemic control and additional oral administra-tion of anti-platelet drugs over 8 to 13 months, funduscopic and fluorescein angiographic findings showed marked improvement of ADR in 7 eyes in the series.

These findings indicate that ADR may improve without the aid of panretinal photocoagulation when adequately treated.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(8) : 992-997, 1988