Association between fluid volume in inner nuclear layer and visual acuity in diabetic macular edema

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

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Predictors for 2-year functional and morphological outcomes of a treat and extend regimen with ranibizumab in patients with diabetic macular edema

Ophthalmic Research ◽

10.1159/000514721 ◽

2021 ◽

Author(s):

Helena Giannakaki-Zimmermann ◽

Alexandra Behrndt ◽

Laura Hoffmann ◽

Maria-Magdalena Guichard ◽

Cengiz Tuerksever ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Loading Dose ◽

Treatment Frequency ◽

Treat And Extend ◽

Free Treatment ◽

Younger Age ◽

One Year ◽

Treat And Extend Regimen

Abstract Purpose: To investigate longer-term functional and morphological outcomes and their predictors in diabetic macular edema (DME) following a treat and extend regimen (TER) without loading dose under ranibizumab. Methods: Patient data were reviewed and analyzed retrospectively over a period of 24 months after initiation of TER. Best-corrected visual acuity (BCVA), treatment frequency as well as quantitative and qualitative Spectral-domain Optical Coherence Tomography parameters were assessed. Results: 118 eyes of 87 patients were included. A mean of 9.742.13 injections in the first and 7.632.29 in the second year were applied. There were significant gains of BCVA and reductions in central retinal thickness from baseline to month 12 and 24 (all p<0.001). Percentage of eyes with an intact inner-/outer segment (IS/OS) junction increased from 15.3% at baseline to 42.1% at month 24 (p<0.001). An intact IS/OS junction at baseline increased the probability of having a dry retina after 12 months by 79.3% (p=0.017) and after 24 months by 88.1% (p=0.040). Less IS/OS disruption at baseline predicted longer maximum recurrence-free treatment intervals at 2 years (r=-0.345, p<0.001) and better BCVA at one year (r=-0.347, p<0.001). Baseline bigger intraretinal cysts were associated with more IS/OS disruption at 24 months (r=0.305, p=0.007). Younger age and lower BCVA at baseline were predictive for a higher BCVA gain at 24 months (p=0.046, p<0.001). Conclusion: Ranibizumab applied in a TER without loading dose in DME significantly improves visual acuity and retinal anatomical structure throughout two years. The evaluated predictors might help to guide routine clinical treatment in DME.

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Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

Author(s):

Yoshito Koyanagi ◽

Shigeo Yoshida ◽

Yoshiyuki Kobayashi ◽

Yuki Kubo ◽

Muneo Yamaguchi ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Option ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

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Micropulse laser in patients with refractory and treatment-naïve center–involved diabetic macular edema: short terms visual and anatomic outcomes

Therapeutic Advances in Ophthalmology ◽

10.1177/2515841420979112 ◽

2021 ◽

Vol 13 ◽

pp. 251584142097911

Author(s):

Diego Alejandro Valera-Cornejo ◽

Marlon García-Roa ◽

Jaime Quiroz-Mendoza ◽

Alejandro Arias-Gómez ◽

Paulina Ramírez-Neria ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

Thickness Change ◽

Macular Volume ◽

Naive Group ◽

Micropulse Laser ◽

Refractory Diabetic Macular Edema ◽

Treatment Naïve

Purpose: The purpose of the study is to describe visual and anatomic outcomes of 5774nm micropulse laser photocoagulation in eyes with either treatment-naïve or refractory diabetic macular edema (DME) at 3 months. Methods: This was a prospective case series that recruited 23 consecutive patients (33 eyes) with center-involved DME that was either treatment-naïve or had not responded to prior treatment. Micropulse therapy was performed with the Easy Ret 577 (Quantel Medical, Cournon d’Auvergne, France) diode laser in a high-density manner in eyes with treatment-naïve or refractory DME. The primary outcome was the change of best-corrected visual acuity (BCVA; logMAR) at 1 and 3 months. Secondary outcomes were changes in the central macular thickness (CMT), thickness area, macular volume, and macular capillary leakage at 1 and 3 months. Results: There were no significant changes in BCVA at 3 months, with mean ± standard deviation (SD) of −0.08 ± 0.01 ( p = 0.228) and + 0.01 ± 0.01 ( p = 0.969) for treatment-naïve and refractory groups, respectively. The change in CMT at 3 months was statistically but not clinically significant in the treatment-naïve group only (mean ± SD; –30 ± 130 µm; p = 0.011). The macular volume and area thickness change were not statistically significant ( p = 0.173 and p = 0.148 for macular volume and area thickness, respectively) in the treatment-naïve group. There was no difference concerning the leakage area in both groups. No adverse events were reported. Conclusion: We concluded that micropulse 577nm laser therapy maintained the visual acuity and macular thickness at 3 months in both treatment-naïve and refractory DME.

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ASSOCIATION OF THE EXTENT OF DIABETIC MACULAR EDEMA AS ASSESSED BY OPTICAL COHERENCE TOMOGRAPHY WITH VISUAL ACUITY AND RETINAL OUTCOME VARIABLES

Retina ◽

10.1097/iae.0b013e318194995d ◽

2009 ◽

Vol 29 (3) ◽

pp. 300-305 ◽

Cited By ~ 20

Author(s):

DAVID J. BROWNING ◽

RAJENDRA S. APTE ◽

SUSAN B. BRESSLER ◽

KAKARLA V. CHALAM ◽

RONALD P. DANIS ◽

...

Keyword(s):

Optical Coherence Tomography ◽

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Optical Coherence

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SAFETY OF TRANSFOVEAL SUBTHRESHOLD DIODE MICROPULSE LASER FOR FOVEA-INVOLVING DIABETIC MACULAR EDEMA IN EYES WITH GOOD VISUAL ACUITY

Retina ◽

10.1097/iae.0000000000000177 ◽

2014 ◽

Vol 34 (10) ◽

pp. 2010-2020 ◽

Cited By ~ 40

Author(s):

Jeffrey K. Luttrull ◽

Stephen H. Sinclair

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Micropulse Laser ◽

Good Visual Acuity

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EFFICACY OF INTRAVITREAL TRIAMCINOLONE ACETONIDE FOR DIABETIC MACULAR EDEMA

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v3i2.14288 ◽

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

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