The Efficacy of Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors for the treatment of chronic diabetic macular oedema in vitrectomised eyes: a retrospective study

Abstract

ObjectiveTo investigate the change of chronic diabetic macular oedema (DMO) in vitrectomised eyes when the administration of sodium–glucose cotransporter 2 (SGLT2) inhibitors is initiated as a systemic medical treatment.Methods and analysisThis study involved 10 eyes of five patients with chronic DMO lasting more than 6 months who had previously undergone vitrectomy and whose systemic medical treatments were newly changed to SGLT2 inhibitors. In this study, chronic DMO was defined as persistent diffuse macular oedema despite ophthalmic treatment in patients with diabetes. Patients who received antivascular endothelial growth factor therapy or steroids administration, or change of eye-drop medication from at 3 months before and after the initiation of SGLT2 inhibitors, were excluded. In this study, visual acuity (VA) and central retinal thickness (CRT, μm) prior to and at 3, 6 and 12 months after the initiation of SGLT2 inhibitors were retrospectively compared. The Wilcoxon signed-rank test was used for statistical analysis.ResultsIn the 10 treated eyes, from at baseline to at 3, 6 and 12 months after the initiation of SGLT2 inhibitor, median VA (logMAR) improved from 0.35 to 0.15 (p=0.038), 0.2 (p=0.157) and 0.2 (p=0.096), respectively, and median CRT significantly reduced from 500.5 µm to 410 µm (p<0.01), 378 µm (p<0.01) and 339 µm (p<0.01), respectively.ConclusionAlthough this study involved only five patients, our findings indicate that SGLT2 inhibitors might have structural efficacy for chronic DMO in vitrectomised eyes.

Cardiorenal protection with SGLT2: Lessons from the cardiovascular outcome trials

“…Mieno et al studied five patients and performed visual acuity testing along with measuring CRT from baseline at 3, 6, and 12 months. They retrospectively compared the results and found CRT significantly improved after 1 year of treatment, with improvements first seen after 3 months of treatment (Figures and ) . However, it should be noted that this work constituted a retrospective analysis with a small number of patients (five), with no significant available statistical data to be reported therein.…”

“…They retrospectively compared the results and found CRT significantly improved after 1 year of treatment, with improvements first seen after 3 months of treatment ( Figures 6 and 7). 66 However, it should be noted that this work constituted a retrospective analysis with a small number of patients (five), with no significant available statistical data to be reported therein. Increased CRT is seen in conditions that compromise the integrity of the bloodretinal barrier, such as macular edema and diabetic retinopathy.…”

“…With the administration of ranibizumab monotherapy, a reduction in central retinal thickness (CRT) by 61.3 μm was observed at a 12‐month assessment time point . Trials involving SGLT2 inhibitors showing potential benefits in improving vision in patients with diabetic retinopathy, with evaluation of patients with the use of optic coherence tomography (OCT) to assess ocular changes, have recently been conducted …”

“…64 Trials involving SGLT2 inhibitors showing potential benefits in improving vision in patients with diabetic retinopathy, with evaluation of patients with the use of optic coherence tomography (OCT) to assess ocular changes, have recently been conducted. 66 Mieno et al studied five patients and performed visual acuity testing along with measuring CRT from baseline at 3, 6, and 12 months. They retrospectively compared the results and found CRT significantly improved after 1 year of treatment, with improvements first seen after 3 months of treatment ( Figures 6 and 7).…”

PREVENTION AND MANAGEMENT OF Diabetes-Related Eye Disease

“…Reprinted with permission from ref. 29. regard to DME (34, 35). Thiazolidinediones have been reported to increase the risk of DME (32, 36), but not all studies have supported this finding (37).…”