|Year : 1987 | Volume
| Issue : 4 | Page : 216-217
Reversibility of Diabetic Maculopathy with Sulindac - A Case Report
YR Sharma, Mohan Madan, RB Vajpayee, HE Tewari, RV Azad
|Date of Web Publication||20-Dec-2008|
Y R Sharma
Source of Support: None, Conflict of Interest: None
A patient of diabetic maculopathy was observed to achieve both subjective and objective improvement with short term sulindac therapy. No other such report in the literature is available regarding treatment of diabetic maculopathy with sulindac.
|How to cite this article:|
Sharma Y R, Madan M, Vajpayee R B, Tewari H E, Azad R V. Reversibility of Diabetic Maculopathy with Sulindac - A Case Report. Indian J Ophthalmol 1987;35:216-7
|How to cite this URL:|
Sharma Y R, Madan M, Vajpayee R B, Tewari H E, Azad R V. Reversibility of Diabetic Maculopathy with Sulindac - A Case Report. Indian J Ophthalmol [serial online] 1987 [cited 2020 Feb 17];35:216-7. Available from: http://www.ijo.in/text.asp?1987/35/4/216/26176
| Introduction|| |
Diabetic maculopathyis the commonest cause of visual loss in Diabetics. There is no known medical therapy. Photocoagulation has shown to be effective in diabetic exudative maculopathy  . Sulindac has been suggested as a potential drug in treating certain diabetic complications like cataracts and retinopathyr  . Cunahvaz et al  demonstrated reversibility of retinal capillary leakage in early diabetic retinopathy using vitreous photofluorometry. We recently had an opportunity to use sulindac in a patient of diabetic maculopathy. Striking beneficial results obtained in this case are reported herein:
| Case Report|| |
A 57 year old female school teacher with a history of diabetes for fourteen years controlled with Glibenclamide, presented with complaints of diminution of vision of six months duration Her best correctea vision was 6/18 OD and 6/9 OS. Over the next six months her vision deteriordted to 6/24 OD 6/12 OS. Fundus photography and fluorescein angiography revealed bilateral moderate diabetic maculopathy with microaneurysms, exudates, haemorrhages and focal leakage areas [Figure 1] Because of her profession she was greatly distressed specially on account of reading difficulties She was advised Argon Laser focal macular photocoagulation but she declined this and requested for any possible medical treatment Because of our interest in sulindac which we were using topically in cataract studies , we tried this drug on this patient The drug was imported by the patient as it was not available in India. She was explained the experimental nature of the therapy and her consent was obtained She was put on 200 mgm bid.
After a months treatment her vision had improved to 6/12 OD 6/9 OS Near vision was N/5 in both eyes Repeat fundus photography and fluorescein angiography demonstrated objective improvement with lessening of microaneurysms, macular edema and exudates [Figure 2]. She continued to use Sulindac over the next two months and her vision recorded last was 6/12 OD and 6/6 OS. Thus there has been an objective improvement of two lines on Snellen's chart in each eye. Her near vision now is N/5 in both eyes.
| Discussion|| |
We think it worthwhile to report this case because of striking rapid visual improvement on short term sulindac therapy and because improvement was both subjective and objective It does not seem to us that visual recovery could be coincidental. Her diabetes control remained unaffected during sulindac therapy. How sulindac might be beneficial in diabetic complications has been speculated , and we suggest that it is worthwhile studying the use of sulindac in diabetic complications like retinopathy and cataracts in large double blind studies This is the only potent aldose reductase inhibitor which is already in clinical use  .
| References|| |
Patz A, Schatz Ft Berkew JW etal : 1973 Trans Am Acaed Ophthalmol Otolaryngeol. 77: 34-39.
Sharma Y. R and Cotlier E: 1982 Exp. Eye Research. 35: 21-27.
Cunah-vaz J.G, Mota CC, Laite EC et al: 1985 Arch Ophthalmol 103: 1307-1311.
[Figure 1], [Figure 2]