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Journal of Medical Sciences

Year: 2007 | Volume: 7 | Issue: 1 | Page No.: 81-87
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Authors

Tarek A. Moustafa

Hayam S. Kamel

Mohamed A. El Malt

Keywords

Research Article

High Dietary Fibre Intake (Talbina) as Adjunct in the Management of Diabetic Macular Edema

Tarek A. Moustafa, Hayam S. Kamel and Mohamed A. El Malt
To determine the efficacy of the lipid-lowering high dietary fibre (Talbina) in reducing retinal hard exudates and subfoveal lipid migration after focal/grid laser photocoagulation in clinically significant macular edema in patients with diabetes with elevated serum lipids. Thirty patients with type 2 diabetes with clinically significant macular edema, dyslipidemia and hard exudates of grade 4 and above were assessed in our study. Patient were subjected to strict metabolic control within 4 to 6 weeks of enrollment. In addition, 15 patients in group A received Talbina (Oats high dietary fibre); 15 patients in group B did not receive any lipid-lowering therapy. All received laser photocoagulation after a metabolic control period and were followed up for a minimum of 18 weeks. The outcome measures were reduction in hard exudates, subfoveal lipid migration, status of macular edema and visual acuity. The study included 19 men and 11 women with non insulin-dependent diabetes mellitus who could achieve good metabolic control within 4 to 6 weeks of inclusion in the study. All patients had elevated serum lipids at baseline. Ten (66.6%) of 15 patients in treatment group A and two (13.3%) of 15 patients in control group B showed reduction in hard exudates (p = 0.007). None of the patients in group A showed subfoveal lipid migration after laser photocoagulation, while five (33.3%) of 15 in group B showed subfoveal lipid migration (p = 0.04). Regression of macular edema was seen in nine eyes in group A and five in group B (p = 0.027). None of the eyes in group A showed worsening of visual acuity (p = 0.22). The use of high dietary fibre (Talbina) in patients with type 2 diabetes with dyslipidemia reduces the severity of hard exudates and subfoveal lipid migration in clinically significant macular edema and could be an important adjunct in the management of clinically significant macular edema.
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