Intravitreal propranolol in patient with persistent clinically significant diabetic macular edema: A single Armed Clinical Trial

Abstract

Diabetic Macular Edema (DME) is one of the most important causes of vision loss in diabetic patients. Propranolol is a non-selective beta-adrenergic receptor blocking agent that specifically competes with beta-receptor agonists such as epinephrine and norepinephrine at β1- or β2-AR sites. Propranolol suppresses angiogenesis in vitro. The aim of this study is to evaluation efficacy of intravitreal propranolol in patient with persistent clinically significant diabetic macula edema. Materials and Methods: This research is a befor-and-after-study and have been included patients with CSME who have been referred to Nikokari Medical Education Center in Tabriz during a period of one year from 2023 to 2024 and were treated with Avastin; 10 patients have been included in the study as a pilot. Sampling was done as census among patients with treatment-resistant CSME. These patients were first subjected to complete ophthalmological examination, and best corrected vision; then, in Nikukari Hospital in Tabriz, OCT was prepared by the relevant operators under the same conditions and exclusively by an OCT device. Then, after preparation, the patients underwent intravitreal injection of 50 micrograms of propranolol with a volume of 0.05 ml. 1 week after the injection, the patients underwent a visit and full examinations, and determination of corrected vision and OCT imaging. In examinations, the thickness of the macula was re-checked and compared before and after surgery. Results: In this study, the mean (standard deviation) age of the subjects was 65.30 (±3.9) years. The highest frequency of gender in the subjects of this study was male with 7 cases (70.0%). The mean (SD) of macular thickness before and after propranolol injection in the studied subjects was 556 and 491.8, respectively. Also, the mean (SD) of visibility before and after propranolol injection in the studied subjects was 1.22 logmar and 1.08 logmar, respectively. In this study, the centrl thickness of the macula shows a statistically significant difference between before and after injection(p=0.032) visibility in this study, therevis no significant difference in the variable of vision before and after injection(P=0.12).