Furosemide is a potent diuretic which is an anthranilic acid derivative. Chemically, it is 4-chloro-N-furfuryl-5-sulfamoylanthranilic acid. Furosemide is indicated for the treatment of oedema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome.

Here I report a case of a diabetic patient, with nephrotic syndrome, who experienced marked improvement in diabetic macular oedema after systemic treatment with furosemide.

Case report

A 41 year old woman with type II insulin dependent diabetes mellitus was referred for decrease in vision in both eyes over the past 2 months. Besides the diabetes, her past medical history was positive for irregular menstrual cycle and gastroparesis. The patient had also noticed a gain in weight of about 30 lb (13.5 kg) over the same period of time, from 154 lb (69.3 kg) to 196 lb (88.2 kg). She was treated with insulin for the diabetes and Regulin Forte for the irregular menstrual cycle. Her glycosylated haemoglobin was 9.5%.

On examination her best corrected visual acuity (VA) was 20/400 in both eyes. Anterior segment examination was normal. Dilated biomicroscopic examination of the retina of both eyes revealed diffuse macular oedema. There were also a few microaneurysms scattered throughout the posterior pole, but no hard exudates. Fluorescein angiography …