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S. B. Jyothi, G. B. Arden, Y. F. Lee, M. Richardson, E. Pearce, S. Sivaprasad; Light Adaptation Improves Diabetic Maculopathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5847.
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We determined if light adaptation during sleep would slow the progression or reverse diabetic maculopathy by reducing rod dark current.
40 patients with diabetic maculopathy were recruited. Inclusion criteria included type 1 or 2 diabetics with maculopathy or clinically significant macular edema too close to the fovea to treat. Exclusion criteria included previous eye treatment of any form for diabetic retinopathy. Baseline and follow-up assessments include best corrected visual acuity in ETDRS letters, microaneurysm count and area of exudates in fundus photographs, number and size of cysts and macular thickness on Cirrus OCT, contrast sensitivity, color vision with computerised ChromaTest, microperimetry thresholds and HbA1c levels. Light emitting diodes emitting ≥80 cd/m2 (505nm) were held against one eyelid in a soft transparent plastic cushion that rested on the closed eye lids all night. The fellow eye served as control.
At 3 months, 4 were excluded from the study: one for non compliance, one was hospitalised for stroke, one was lost to follow-up and one deceased. 50% showed morphological improvement of the macula with disappearance of all retinal cystic changes, 40% showed no change and 10% worsened (p=0.03). The exudates disappeared in 32%, persisted in 25% and none developed new exudates (p=0.002). The mean threshold in MP1 (microperimetry) improved from 13.69 db to 15.38 db (p=0.04). Whilst in the other eye retinal edema and exudates got worse( p=0.04 and p=0.02 by t-test). There were no significant change in visual acuity, contrast sensitivity and colour vision and average macular thickness. There were no report of any sleep disturbance and none of the subjects have complained of any side-effects.
The use of lightmasks is a promising treatment or preventive option in diabetic maculopathy.
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