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The Efficacy of Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors for the treatment of chronic diabetic macular oedema in vitrectomised eyes: a retrospective study
  1. Hiroki Mieno1,
  2. Kazuhito Yoneda1,
  3. Masahiro Yamazaki2,
  4. Ryosuke Sakai2,
  5. Chie Sotozono1,
  6. Michiaki Fukui2
  1. 1 Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  2. 2 Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Kyoto, Japan
  1. Correspondence to Dr Kazuhito Yoneda; kazuyone{at}


Objective To investigate the change of chronic diabetic macular oedema (DMO) in vitrectomised eyes when the administration of sodium–glucose cotransporter 2 (SGLT2) inhibitors is initiated as a systemic medical treatment.

Methods and analysis This study involved 10 eyes of five patients with chronic DMO lasting more than 6 months who had previously undergone vitrectomy and whose systemic medical treatments were newly changed to SGLT2 inhibitors. In this study, chronic DMO was defined as persistent diffuse macular oedema despite ophthalmic treatment in patients with diabetes. Patients who received antivascular endothelial growth factor therapy or steroids administration, or change of eye-drop medication from at 3 months before and after the initiation of SGLT2 inhibitors, were excluded. In this study, visual acuity (VA) and central retinal thickness (CRT, μm) prior to and at 3, 6 and 12 months after the initiation of SGLT2 inhibitors were retrospectively compared. The Wilcoxon signed-rank test was used for statistical analysis.

Results In the 10 treated eyes, from at baseline to at 3, 6 and 12 months after the initiation of SGLT2 inhibitor, median VA (logMAR) improved from 0.35 to 0.15 (p=0.038), 0.2 (p=0.157) and 0.2 (p=0.096), respectively, and median CRT significantly reduced from 500.5 µm to 410 µm (p<0.01), 378 µm (p<0.01) and 339 µm (p<0.01), respectively.

Conclusion Although this study involved only five patients, our findings indicate that SGLT2 inhibitors might have structural efficacy for chronic DMO in vitrectomised eyes.

  • Macula
  • Retina

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  • Contributors HM contributed to study design, researched ophthalmological data and wrote the manuscript. KY contributed to study design, performed ophthalmological examinations and wrote the manuscript. MY contributed to study design, performed physical examinations and reviewed the manuscript. RS researched physical data and reviewed the manuscript. CS and MF acted as the study coordinators and reviewed the manuscript. All authors contributed to the review of the data and discussion of the results, and gave approval of the final version of the manuscript submitted for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Kyoto Prefectural University of Medicine ERB-C-816-1.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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