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Severe macular edema induced by pioglitazone in a patient with diabetic retinopathy: a case study

Toshiyuki Oshitari1, Noriko Asaumi, Masaru Watanabe

  • 1Department of Ophthalmology, Kimitsu Central Hospital, Kisarazu City, Chiba, Japan. tarii@aol.com

Vascular Health and Risk Management
|February 3, 2009
PubMed

Insights

Pioglitazone use in a patient with proliferative diabetic retinopathy led to severe diabetic macular edema (DME). Prompt consultation with an ophthalmologist is recommended if vision decreases in patients taking pioglitazone.

Area of Science:

  • Ophthalmology
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus management
  • Diabetic retinopathy progression
  • Pioglitazone therapy indications

Observation:

  • A 30-year-old woman with poorly controlled diabetes and proliferative diabetic retinopathy developed severe diabetic macular edema (DME) after initiating pioglitazone.
  • Ophthalmological examination revealed decreased visual acuity and severe DME in both eyes within weeks of starting pioglitazone.
  • Discontinuation of pioglitazone led to partial visual improvement, but DME persisted on optical coherence tomography.

Findings:

  • Pioglitazone therapy was associated with the onset of severe diabetic macular edema (DME) in a patient with pre-existing proliferative diabetic retinopathy.
  • Spironolactone treatment successfully resolved the macular edema and improved visual acuity.
  • The case highlights a potential adverse effect of pioglitazone on diabetic retinopathy complications.

Implications:

  • Physicians should consider the potential for pioglitazone to exacerbate or induce diabetic macular edema (DME) in patients with diabetic retinopathy.
  • Prompt ophthalmological consultation is crucial for patients on pioglitazone experiencing decreased vision.
  • This case underscores the importance of monitoring visual function in diabetic patients undergoing treatment with pioglitazone.
Keywords:
diabetic macular edemaoptical coherence tomographypioglitazonespironolactone

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