ISSN: 2578-465X
Authors: Mary R*, Giovanna V, Andrea G Luigi P, Michele T, Alessandro R and Jose LV2
Diabetic macular edema (DME) represents the most common cause of sight loss in diabetic patients. It is characterized by swelling and thickening of the macula due to sub- and intra-retinal fluid accumulation in the macula, triggered by the breakdown of the inner blood-retinal barrier due to vessel glycosylation and inflammation. Therefore, antioxidant agents like nutraceuticals as adjuvant or prophylactic tools to standard therapies can become another weapon in the therapy of DME. Curcumin and Bromelain have shown in vitro and in vivo antioxidant, anti-inflammatory, and antiproliferative activity. This study aimed to explore the effectiveness of curcumin-based drugs in oral administration followed by SMLP in diabetic patients with clinically significant DME. Methods: We enrolled 24 eyes, both naïve or not naïve, patients, older than 50 years old, with clinically significant DME and a central macular thickness (CMT) of 350 um or more measured by optical coherence tomography with a minimum follow-up of 6 months. Fifteen patients were assigned to subthreshold micropulse laser photocoagulation (SMLP); the other nine patients were assigned to subthreshold micropulse laser photocoagulation associated with oral administration of a curcumin-based drug. Results: At the 4-month follow-up, the group of patients treated with sub- threshold micropulse laser associated with curcumin-based drug showed a lower mean CMT at OCT, compared to the group treated with laser alone. We found the same at the 6-month follow-up, with statistical significance. Conclusions: Our study found no retreatment was necessary for patients who underwent SMLP and oral curcumin-based therapy. These patients experienced a significant decrease in CMT, confirmed at the OCT fovea B-scan at 4 and 6 months. Patients who underwent SMLP alone instead were found to have developed an increase in CMT, and retreatments were performed.
Keywords: Diabetes; Retinopathy; Macula Edema; Curcumin; Bromelain; Micro Pulse
