Statins and fibrates as the treatment of nonproliferative diabetic retinopathy in type 2 diabetes mellitus; [Statine und Fibrate als Therapie der nichtproliferativen diabetischen Retinopathie bei Typ-2-Diabetes]

Background: Diabetic retinopathy is the result of microvascular retinal changes. Hyperglycemia-induced intramural pericyte death and thickening of the basement membrane lead to incompetence of the vascular walls. The purpose was to improve medication for nonproliferative diabetic retinopathy in patients with type 2 diabetes mellitus using statins and fibrates. Methods: A total of 47 patients (94 eyes) with nonproliferative diabetic retinopathy (moderate stage) in type 2 diabetes mellitus took part in the research. All patients received standard treatment using angioprotectors and antioxidants. Additionally, correctors of dyslipidemia were prescribed – statins (atorvastatin 20 mg per a day) and fibrates (lipofen 250 mg per a day) – to 21 of the patients. The quantity of microaneurysms, hemorrhages, hard and soft exudates, areas of macular edema were determined by perimetry, optical coherence tomography (OCT), and fluorescein angiography (FA). The patients were observed for 1 year. Results: After using statins and fibrates, macular disease (MD) decreased from −3.5 to −4.5 dB, and in the control group (without using correctors of dyslipidemia) it increased from −3.7 to −8.1 dB (p < 0.01). The quantity of local defects in visual fields in both research groups increased from 11.9 to 16.5 points, but increased significantly in the control group from 12.3 to 20.6 points (p < 0.01) compared with the treated group. On FA and OCT there were more intraretinal hemorrhages and hard exudates in control patients than in the research group. Conclusions: Correctors of dyslipidemia are useful for patients with nonproliferative diabetic retinopathy in type 2 diabetes mellitus. The treatment slows down the progression of diabetic retinopathy. © 2016, Springer-Verlag Wien.