scholarly journals Intravitreal Corticosteroid Implantation in Diabetic Macular Edema: Updated European Consensus Guidance on Monitoring and Managing Intraocular Pressure

2022 ◽  
Author(s):  
Francisco J. Goñi ◽  
Keith Barton ◽  
José António Dias ◽  
Michael Diestelhorst ◽  
Julián Garcia-Feijoo ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
European Consensus ◽  
Consensus Guidance

scholarly journals EFFICACY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE FOR DIABETIC MACULAR EDEMA

2016 ◽  
Vol 3 (2) ◽  
pp. 30-34
Author(s):  
Prachand Gautam ◽  
Koshal Shrestha ◽  
Gyanendra Lamichhane ◽  
Sushila Patel
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Intravitreal Triamcinolone ◽  
Hard Exudates ◽  
Intravitreal Triamcinolone Acetonide ◽  
Diffuse Diabetic Macular Edema

INTRODUCTION: Diabetic retionopathy is a microangilpathy. The present study was done to investigate results of Intravitreal Triamcinolone Acetonide injection for the treatment diffuse diabetic macular edema. MATERIAL AND METHODS: The study included 40 eyes of 40 patients with clinically significant diffuse diabetic macular edema. Eyes were diagnosed with diabetic macular edema according to Early Treatment Diabetic Retinopathy Study guidelines. An Intravitreal injection of Triamcinolone Acetonide at the dose of 4 mg/0.2 ml was administered. Best corrected visual acuity was measured as the logarithm of the minimum angle of resolution (logMAR) and snellen vision drum and size of macular edema (hard exudates) was obtained by slit lamp biomicroscopy using +90 D Volk lens at each visit. Intraocular pressure (IOP) and other complications related with steroid and injection related complications were also evaluated. Subsequently patients were followed up on 1st day, 2nd week and 3rd month. RESULTS: All patients were completed second follow up at 3 months. The mean size of macular edema, which obtained at 3 months postoperatively, was significantly different from the baseline measurement from 1.4125 to 0.9474 DD. Mean visual acuity improved significantly from baseline at 3 months of follow up was 0.7421 LogMAR (≈ 6/30 in Snellen chart). Eleven eyes developed intraocular pressure higher than 21 mmHg at 2nd week postoperatively. Other drug and injection related complications were not developed. Increased IOP were controlled with anti glaucoma drugs. CONCLUSIONS: Intravitreal Triamcinolone was a promising therapeutic method for diabetic macular edema. TriamcinoloneAcetonide effectively reduces size of macular edema and improves visual acuity in the short term.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10 Page: 30-34

scholarly journals Elevated Intraocular Pressure After Intravitreal Steroid Injection in Diabetic Macular Edema: Monitoring and Management

2016 ◽  
Vol 5 (1) ◽  
pp. 47-61 ◽  
Author(s):  
Francisco J. Goñi ◽  
Ingeborg Stalmans ◽  
Philippe Denis ◽  
Jean-Philippe Nordmann ◽  
Simon Taylor ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Steroid Injection ◽  
Elevated Intraocular Pressure

INTRAOCULAR PRESSURE IN PATIENTS WITH DIABETIC MACULAR EDEMA TREATED WITH DEXAMETHASONE INTRAVITREAL IMPLANT IN THE 3-YEAR MEAD STUDY

Retina ◽  
2016 ◽  
Vol 36 (6) ◽  
pp. 1143-1152 ◽  
Author(s):  
Raj K. Maturi ◽  
Ayala Pollack ◽  
Harvey S. Uy ◽  
Monica Varano ◽  
Andre M. V. Gomes ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Dexamethasone Intravitreal Implant ◽  
Intravitreal Implant

Dexamethasone Implants in Patients with Naïve or Refractory Diffuse Diabetic Macular Edema

2015 ◽  
Vol 233 (3-4) ◽  
pp. 176-185 ◽  
Author(s):  
José Juan Escobar-Barranco ◽  
Begoña Pina-Marín ◽  
Manel Fernández-Bonet
Keyword(s):  
Intraocular Pressure ◽  
Prospective Study ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Central Macular Thickness ◽  
Naive Group ◽  
Good Safety Profile ◽  
Diffuse Diabetic Macular Edema ◽  
Treatment Naïve ◽  
A Prospective Study

Purpose: To assess the effect of dexamethasone (DEX) 0.7 mg (Ozurdex™) on refractory and treatment-naïve diffuse diabetic macular edema. Methods: A prospective study was conducted in 76 patients (40 refractory and 36 naïve) with visual acuities (VA) of 15-72 ETDRS letters, central macular thickness (CMT) >300 µm and intraocular pressure (IOP) <25 mm Hg. After the DEX implant (±photocoagulation), VA, CMT and total macular volume (TMV) were assessed monthly for 6 months. Results: At every visit, VA improved significantly from baseline (p < 0.001) in both groups, but values were significantly better in the naïve group, while CMT and TMV decreased significantly (p < 0.001) and similarly in both groups. The naïve group received more photocoagulations (p = 0.001). There were 7.9% transient IOP increases >10 mm Hg. Conclusions: Substantial improvements in VA and CMT were achieved in both groups, and a gain of 1 ETDRS line was observed in the treatment-naïve group as compared to the refractory group, with a good safety profile in both.

scholarly journals Repeated Intravitreous Ranibizumab Injections for Diabetic Macular Edema and the Risk of Sustained Elevation of Intraocular Pressure or the Need for Ocular Hypotensive Treatment

2015 ◽  
Vol 133 (5) ◽  
pp. 589 ◽  
Author(s):  
Susan B. Bressler ◽  
Talat Almukhtar ◽  
Anjali Bhorade ◽  
Neil M. Bressler ◽  
Adam R. Glassman ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Macular Edema ◽  
Diabetic Macular Edema

Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency

2020 ◽  
pp. 112067212090169 ◽  
Author(s):  
Olufemi E Adams ◽  
Sidney A Schechet ◽  
Seenu M Hariprasad
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Fluocinolone Acetonide ◽  
Central Retinal Thickness ◽  
Corrected Visual Acuity ◽  
Persistent Diabetic Macular Edema ◽  
Best Corrected Visual Acuity

Objective: To evaluate, in the setting of persistent diabetic macular edema, the impact that continuous fluocinolone acetonide delivery has on treatment burden, visual acuity, central retinal thickness, and intraocular pressure. Materials and methods: A single-center, retrospective, cohort study of patients with persistent diabetic macular edema, previously treated with anti–vascular endothelial growth factor injections, dexamethasone implants, or focal laser, who were subsequently treated with fluocinolone acetonide was conducted. All retinal visits were analyzed prior to fluocinolone acetonide, until the most recent follow-up visit. Primary outcomes were pre– and post–fluocinolone acetonide changes in the best-corrected visual acuity and number of treatments required for diabetic macular edema. Secondary outcomes included changes in the central retinal thickness and intraocular pressure. Results: A total of 19 eyes with persistent diabetic macular edema were included and followed for a mean (SD) of 399.3 (222.9) days. Post–fluocinolone acetonide, the mean best-corrected visual acuity improved by 0.4 ETDRS letters for all eyes ( p = 0.895) and the central retinal thickness decreased by 34.2 µm ( p = 0.077). After fluocinolone acetonide, the number of treatments decreased from an average of one treatment every 2.7 months to one every 6 months ( p = 0.009). Furthermore, post–fluocinolone acetonide, 10/19 eyes (52.6%) did not require additional treatment due to a dry macula, and those who did experienced a non-statistically significant reduction of treatments, from one every 2.6 months pre–fluocinolone acetonide, to one every 2.8 months post–fluocinolone acetonide ( p = 0.622). Conclusions: In the setting of persistent diabetic macular edema, fluocinolone acetonide significantly reduces the therapeutic burden, while maintaining best-corrected visual acuity and improving the central retinal thickness. In patient-centered discussions, judiciously employing fluocinolone acetonide should be performed to mitigate this therapeutic burden for patients.

scholarly journals Treatment of Intractable Diabetic Macular Edema with Pegaptanib Versus Bevacizumab, Both in Combination with Dexamethasone

2012 ◽  
Vol 5 (3) ◽  
pp. 83-93
Author(s):  
Diana M Leitner ◽  
David M Chacko ◽  
Philip Twumasi-Ankrah ◽  
Elizabeth Ablah
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Adverse Effects ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outcome Measures ◽  
Post Treatment ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Dexamethasone Group

BACKGROUND: Diabetic macular edema is a significant cause of vision loss, and some patients do not respond optimally to existing treatments. This study compared the response of intractable diabetic macular edema to intravitreal injection of two anti-VEGF drugs, bevacizumab and pegaptanib, both in combination with dexamethasone. METHODS: A retrospective chart review was conducted to examine patients from an ophthalmology practice in one year with diabetic macular edema (DME), recurrent or persistent, after focal laser or intravitreal bevacizumab. Patients received bevacizumab/dexamethasone or pegaptanib/dexamethasone. Outcome measures were improvement in best corrected visual activity (converted to LogMAR) and central macular thickness (CRT). Data on adverse effects also were collected. RESULTS: The bevacizumab/dexamethasone group included 25 eyes which had pre-treatment LogMAR = 0.69 ± 0.49 (mean ± SD) and CRT = 419 ± 131. Post-treatment LogMAR was 0.70 ± 0.48 and CRT = 377 ± 107. The pegaptanib/dexamethasone group included 14 eyes; pretreatment LogMAR = 0.80 ± 0.55 and CRT = 520 ± 108. Post-treatment LogMAR was 0.77 ± 0.49 and CRT = 46 4 ± 106. Neither treatment had a significant effect on visual acuity. Both groups experienced a significant decrease in CRT over time (p = 0.006). The pegaptanib/ dexamethasone group had higher CRT at all times (p = 0.020), but the trend in CRT decrease was not different between the two groups. Intraocular pressure increased in both groups (p = 0.038). No other adverse effects were reported. CONCLUSIONS: Neither bevacizumab/dexamethasone or pegaptanib/dexamethasone significantly improved visual acuity in intractable DME, but both decreased central macular thickness. Differences in outcome measures between the two treatment groups were not significant. The only adverse effect seen was a small increase in intraocular pressure.

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