Diabetes und Augenerkrankungen

2020 ◽  
Vol 15 (02) ◽  
pp. 122-133
Author(s):  
Rainer Guthoff

AbstractThe frequency of diabetic retinopathy increases and is a leading cause of blindness in the working population. Recommended exams are testing of the visual acuity, ophthalmoscopy with dilated pupils, fundus fluorescein angiography and optical coherence tomography (OCT). By OCT the diagnosis and monitoring of diabetic macular edema has vastly improved. By intravitreal medications such as intravitreal anti-VEGF or intravitreal steroids macular edema can be treated successfully. Panretinal laser photocoagulation is the gold-standard in the therapy of proliferative diabetic retinopathy. Patients benefit from good co-working of general practitioner and ophthalmologist concerning screening and treatment.

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M E B Samaan ◽  
A H Saad ◽  
T H Mohammed ◽  
Y A Elzankalony

Abstract Background Behçet disease is an obliterative and necrotizing systemic vasculitis that involves different organ systems. It affects both arteries and veins, mainly the veins. Ocular affection is one of the major criteria of Behçet disease; the most common ocular presentation is bilateral non-granulomatous panuveitis with retinal vasculitis. Purpose To identify early, evaluate and follow-up properly the posterior segment involvement in Behçet disease cases with the help of Fundus fluorescein angiography and Optical coherence tomography. Patients and Methods This is a descriptive cross sectional study involved 40 eyes. All patients had a complete ophthalmological examination, a comprehensive history taking as well as review of systems and the laboratory tests. This is followed by pupillary dilatation and retinal imaging by fundus fluorescein angiography and optical coherence tomography. Results On ophthalmological examination, 35 eyes had retinal affection due to Behçet disease and 5 eyes are retina-free. The most common retinal affection was vasculitis in 29 eyes, followed by optic nerve affection in 10 eyes then less common was retinitis in 6 eyes. Regarding visual acuity (VA) 14 eyes had low visual acuity of less than (6/60), 21 eyes had VA between (6/60 – 6/12) and 5 eyes had good visual acuity of more than (6/12). Fluorescein angiograms showed that, 36 eyes representing 90% of the total eyes had abnormal angiogram; vascular leakage was the commonest abnormality in 29 eyes, less common was optic disc edema in 12 eyes, then retinitis in 6 eyes. Macular edema was present in the angiogram of 6 eyes. About OCT, there were abnormalities in 33 eyes; macular edema was the most common in 21 eyes, epiretinal membrane (ERM) in 9 eyes, then neurosensory detachment (NSD) and macular hole each was seen in 4 eyes. Conclusion This study demonstrated that posterior pole involvement, retinal vascular leakage, optic disc hyperfluorescence, and macular leakage are significantly associated with worse VA in Behçet retinal vasculitis. This suggests that, use of Fundus Fluorescein Angiography and Optical Coherence Tomography in evaluation of Behçet retinal vasculitis is clinically significant in predicting visual prognosis and determining of treatment efficacy.


2019 ◽  
Vol 2 ◽  
pp. 1 ◽  
Author(s):  
Anibal Martin Folgar ◽  
Jorge Oscar Zarate

We present a 57-year-old referred reduced visual acuity who was in treatment with paclitaxel for developing metastatic breast adenocarcinoma. Ophthalmoscopic examination, optical coherence tomography, and autofluorescence show the cystoid macular edema, but fluorescein angiography is normal, without leakage of dye in the late times. The patient responds well 8 weeks after stopping antineoplastic. Paclitaxel can cause cystoid macular edema and lifting a recovery both anatomical and functional of the macula.


Diabetic retinopathy is an important public health issue as its prevalence has been increasing every year. It is one of the major causes of visual loss which can be preventable with early diagnosis and appropriate treatment. The fundus examination must be done in detail using mydriatics, and digital images must be recorded in all diabetic patients with special emphasis on the disease type (type I and type II), duration, and prognosis. Fluorescein angiography (FA) is a gold standard invasive retinal imaging technique for the diagnosis, monitoring, and evaluating the response of the treatment in diabetic patients, but FA has limitations due to possible side effects. Optical coherence tomography angiography (OCTA) is a recent, non-invasive, dye-free imaging technique that can be used in every visit. It has the capability to image all retinal and choroidal vascular layers (segmentation) and quantify macular ischemia in a short period of time which is beneficial for the patient, and the ophthalmologist. The aim of this review is to address the findings, advantages, and disadvantages of FA and OCTA in patients with diabetic retinopathy and diabetic macular edema.


2012 ◽  
Vol 93 (6) ◽  
pp. 985-989 ◽  
Author(s):  
A N Samoilov ◽  
R H Khafizjanova ◽  
R F Gainutdinova ◽  
A R Gilyazova ◽  
M G Tukhbatullin

Aim. To study the properties of eye vessels Doppler sonography and retinal optical coherence tomography in assessing the treatment effectiveness in patients with diabetic retinopathy. Methods. 122 patients (244 eyes) with type 2 diabetes mellitus and nonproliferative diabetic retinopathy aged 41 to 55 years were examined. The disease duration ranged from 2 to 15 years. All patients were treated with glibenclamide and supportive therapy: eye drops of 1% methylethylpiridinol - 1 drop 3 times a day, 20% pyracetam solution - 5 ml intravenously for 14 days. Patients were divided into 4 groups: 1st group included 30 patients who were administered with Hirudo powder, 2nd group consisted of 32 patients treated with Hirudo powder in combination with laser photocoagulation, 3rd group included 30 patients treated by laser photocoagulation and 4th group consisted of 30 patients who were treated with glibenclamide and supportive therapy only. All patients were examined before and 4 days after treatment, examination included standard ophthalmic examination, retinal optical coherence tomography and eye vessels pulsed color Doppler sonography. Results. Improvement of circulation parameters resulting in increased blood flow speed and decrease of vascular resistance index, as well as visual acuity improvement, reduction of macular edema were registered in the first group after the treatment. In the 2nd group, significant improvement of circulation parameters as increased blood flow speed and decrease of vascular resistance index, visual acuity increase, reducing of the area and height of macular edema were observed. In the 3rd group, deterioration of circulation parameters as decreased blood flow speed and increase of vascular resistance index, slight visual acuity increase and reducing of the area and macular edema height were observed. In the 4th group improvement of circulation parameters was non-significant as well as visual acuity change and retinal condition. Thus, combination of Hirudo powder and retinal laser photocoagulation was the most effective method, leading to improvement of circulation parameters, visual acuity increase, reduction of macular edema. Conclusion. Quantitative analysis of retinal optical coherence tomography and eye vessels Doppler sonography parameters and their link to visual acuity testing allows to assess completely the effectiveness of conducted treatment.


2003 ◽  
Vol 66 (6) ◽  
pp. 771-774 ◽  
Author(s):  
Somaia Mitne ◽  
Augusto Paranhos Júnior ◽  
Ana Paula Silvério Rodrigues ◽  
Tércio Guia ◽  
Arnaldo Bordon ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Nishant Radke ◽  
Charudutt Kalamkar ◽  
Amrita Mukherjee ◽  
Snehal Radke

Purpose. To study the effect and outcome of intravitreal Ziv-Aflibercept (IVZ) in treatment of Chronic Central Serous Chorioretinopathy (CSCR) related Choroidal Neovascular Membrane (CNVM). Methods. A case report of 48-year-old male patient treated with 1.25 mg/0.05 ml IVZ (total 3 doses at monthly intervals) in CSCR related CNVM. Pre- and posttreatment fundus fluorescein angiography (FFA) and Optical Coherence Tomography (OCT) were done to document response along with improvement in visual acuity. Patients. Single eye of a 48-year-old male patient. Results. Regression of CNVM was noted with improvement of macular contour and thickness on OCT and cessation of leakage on FFA. Visual acuity improved from 3/60, <N36 to 6/12, N12. Discussion. Anti-VEGF injections have shown benefit in treatment of CNVM. There is very little information about benefit of IVZ in CSCR related CNVM. Conclusion. IVZ is effective in regression of CSCR related CNVM and is associated with better macular anatomy and improved visual function.


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