Remote Ischemic Preconditioning and Diabetic Macular Edema

Abstract

Objective: Remote Ischemic Preconditioning (RIPC) as the transient ischemia and reperfusion of the arm is a promising method for protecting different tissue from future ischemia. These effects might be mediated through vascular and endothelial growth factor (VEGF) pathway. We investigated the influence of RIPC on diabetic macular edema (DME) as a chronic ischemic condition in patients who were candidate to receive anti-VEGF therapy. Materials and Methods: In this Single blinded, randomized controlled trial, 40 eligible type 2 diabetes mellitus (T2DM) patients with macular edema who were candidate to receive anti-VEGF therapy randomized into intervention (CP) and sham controlling (SP). The CP received RIPC in three consecutive days before anti-VEGF injection. Data of optical cochrane tomography (OPC) before and 10 days after procedure were compared as outcomes. Results: Central foveal volume and visual acuity mean difference before and after intra-vitral anti-VEGF injection in both groups was significant. There were no significant mean differences in central macular thickness in case groups. Comparing the mean between two groups did not show a significant difference in visual acuity, central foveal volume (P-value: 0.69) and central macular thickness (P-value: 0.62). There were no significant differences in the desired changes pattern of DME between two groups (P-value: 1.00). Conclusion: This pilot study did not show any additive positive effect of RIPC on retinal outcomes especially visual acuity in T2DM patients with DME who were received anti-VEGF treatment.

Keywords

• Ischemic preconditioning
• Type 2 diabetes mellitus
• Macular edema
• anti-VEGF