The role of Spectral Domain Optical Coherence Tomography in monitoring uncontrolled hypertensive type 2 diabetic patients

Rationale: The pathogenesis of diabetic retinopathy is multifactorial, and a range of hyperglycemia-linked pathways has been implicated in the initiation and progression of this condition. All the cells in the retina are affected by the diabetic milieu, and in view of such disease and tissue complexity, it is unlikely that any single process is solely responsible for the retinal pathophysiology. Dyslipidemia is considered a trigger to rapid worsening of the condition and its treatment is becoming a part of normal diabetes treatment. Nevertheless, as establishing causal mechanisms and related conditions remain an important research goal, also the means to follow up the impact on the retina and other ocular tissues are as important. Objective: this retrospective study shows the progression of diabetic macular edema (DME) in patients with dyslipidemia related to poor glycemic and blood control in subjects with existing DME by measuring the total macular volume (TMV) and thickness through the spectral domain optical coherence tomography (SD- OCT). Methods and results: 30 uncontrolled cases of type 2 diabetes that were measured monthly by SD- OCT through a period of 3 months with correlation to the degree of dyslipidemia and hyperglycemia, were analyzed. Conclusion: The role of OCT in monitoring the progression of DME in patients with uncontrolled type 2 diabetes is essential and the collaboration between the ophthalmologist and endocrinologist is essential to monitor the course of disease in uncontrolled patients.