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It is also contraindicated in acute metabolic acidosis, severe hepatic impairment, or conditions predisposing to tissue hypoxia (such as decompensated heart failure, acute myocardial infarction, or severe respiratory disease)
Patients who had either mild or moderate NPDR with DME at baseline were the most likely to experience worsening: 13 patients with mild NPDR and DME, and 16 patients with moderate NPDR and DME went on to develop PDR
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