Kahtani Eman Saeed Al
King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Clin Ophthalmol. 2015 May 25;9:929-33. doi: 10.2147/OPTH.S80850. eCollection 2015.
Kidney failure provoked by glomerulosclerosis leads to fluid filtration deficits and other disorders of kidney function. Refractory diabetic macular edema (DME) can be another warning sign of glomerulosclerosis in diabetic patients.
A 40-year-old Saudi male presented with macular edema that was refractory to all possible medical and surgical ophthalmic interventions in both eyes. The macular edema significantly improved once the patient began systemic treatment for newly diagnosed diabetic glomerulosclerosis. This case report is presented with optical coherence tomography (OCT) documentation of before and after each medical and surgical intervention.
Considerable improvement occurred after treatment with a systemic angiotensin-converting enzyme inhibitor and diuretic treatment due to newly diagnosed diabetic glomerulosclerosis.
Refractory DME can be secondary to diabetic glomerulosclerosis. This case indicates the possibility that systemic intervention may be warranted in cases of refractory DME, and the importance of collaboration between ophthalmologists, endocrinologists, and internists in these cases.
肾小球硬化引发的肾衰竭会导致液体滤过功能障碍及其他肾功能紊乱。难治性糖尿病性黄斑水肿（DME）可能是糖尿病患者肾小球硬化的另一个警示信号。
一名40岁沙特男性患者，双眼黄斑水肿，对所有可能的眼科药物及手术治疗均无反应。在患者开始对新诊断的糖尿病性肾小球硬化进行全身治疗后，黄斑水肿明显改善。本病例报告展示了每次药物及手术干预前后的光学相干断层扫描（OCT）记录。
由于新诊断的糖尿病性肾小球硬化，在使用全身血管紧张素转换酶抑制剂及利尿剂治疗后有显著改善。
难治性DME可能继发于糖尿病性肾小球硬化。该病例表明，在难治性DME病例中进行全身干预具有可能性，以及眼科医生、内分泌科医生和内科医生在这些病例中协作的重要性。
