Investigative Ophthalmology Science, vol.52, no.14, pp.1298, 2011 (Journal Indexed in SCI Expanded)
Purpose: : To investigate the effect of octreotide, a somatostatine analogue, in experimental diabetes model and persistent clinical cystoid macular edema
Methods: : Three groups of rabbits including control group (10 rabbits), diabetes group (10 rabbits with alloxan-induced diabetes), and treatment group (10 rabbits with alloxan-induced diabetes and treatment with subcutaneous octreotide 2,5mg, twice a day) were studied with light and transmission electron microscopy after 3 months of follow-up. Clinical treatment arm included retrospective review of charts of 4 patients who had persistent cystoid macular edema, unresponsive to all interventions including antiVEGFs treated with posterior subtenon octreotide (Sandostatin-LAR®,10mg). They had BCVA of less than 20/200, and OCT(StratusTM)-based central macular thickness (CMT) of more than 600 micron.
Results: : When compared to treatment group, diabetes group had leukocyte infiltration nearby the capillary loss, extensive loss of the pericytes, severe disruption in the basal membrane, and significant degree of the endothelial edema. When compared to control group, treatment group had only significant degree of capillary dilation. Three patients completed 6 months follow-up after 1 injection. Relative changes in CMT ranged from 10 to 35 percent, and 2 eyes obtained BCVA of 20/100. No adverse effects including laboratory parameters was recorded.
Conclusions: : With its long-acting release formula, octreotide may provide a novel treatment option for cases suffering from otherwise untreatable clinically significant diabetic macular edema. Further studies are needed.