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D. S. Fong, R. Contreras; Glitazone Use Associated With Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4418.
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A few reports have suggested an association between glitazones and macular edema. To determine its ocular safety, we investigate the association of diabetic macular edema in a large population of glitazone users.
The study was conducted at Kaiser Permanente Southern California. About 170,000 persons with diabetes were identified using the Diabetes Case Identification Database. Glitazone drug use was obtained from the pharmacy database. The main outcome measure was the development of macular edema. Chi-square test was used to compare proportions and t-tests were used for means. Logistic regression analyses was used to adjust for potential confounding variables.
In 2006, there were 996 new cases of macular edema. Glitazone users were more likely to develop macular edema in 2006 (OR: 2.6, 95% CI: 2.4 to 3.0). After excluding patients who did not have the drug benefit, did not have an eye exam and had a HgA1c <7.0, glitazone use was still associated with an increase risk of developing macular edema ( OR: 1.6, 95% CI: 1.4 to 1.8).
The current study appears to show that the glitazone class of drug is associated with diabetic macular edema. After adjusting for confounding factors of age, glycemic control and insulin use, glitazones are still modestly associated with diabetic macular edema. A more in-depth study will need to be done to evaluate the role of other confounding factors. When treating patients with diabetic macular edema, ophthalmologists should consider the role of the glitazones.
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