The diabetic macular edema (DME) results from many factors, among which donenates hyperglycemia, but dyslipidemia is also a contributing factor. It leads to a worse visual acuity, or if long standing, even to a permanent visual loss caused by the impaired layer of the junction of internal and external segments of photoreceptors (IS/OS junction) by edema.
According to the FIELD study, the DME may be favourably influenced by a noninvasive treatment with fibrates. Our case reports compare the use of fibrates and statins in the treatment of the DME.
In a patient treated with fibrates all symptoms of the DME resolved (disappearing of macular edema and detachment of IS/OS photoreceptors, reduction of hard exudates and the improvement of visual acuity of affected eye of 4 lines of ETDRS charts. We assume certain conditions for a succesful treatment with fibrates, especially a prompt initiation immediately after the diagnosis of diabetic macular edema without diabetic nephropathy.
The benefit of the treatment with fibrates is a non-invasive management of the DME, the prerequisite is a good cooperation between the diabetologist and the ophthalmologist.