Three Different Phenotypes of Mild Nonproliferative Diabetic Retinopathy With Different Risks for Development of Clinically Significant Macular Edema

2013 ◽  
Vol 54 (7) ◽  
pp. 4595 ◽  
Author(s):  
Sandrina Nunes ◽  
Luisa Ribeiro ◽  
Conceição Lobo ◽  
José Cunha-Vaz
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 1) describes the findings in the subgroup of eyes in the ETDRS that were identified as having mild to moderate nonproliferative diabetic retinopathy and macular edema. The analysis showed that immediate focal argon laser photocoagulation of “clinically significant” diabetic macular edema substantially reduced the risk of visual loss, increased the chance of visual improvement, decreased the frequency of persistent macular edema, and caused only minor visual field losses. The authors recommended immediate focal argon laser photocoagulation for all eyes with clinically significant macular edema and mild or moderate nonproliferative diabetic retinopathy, regardless of the level of visual acuity.


2016 ◽  
Vol 7 (2) ◽  
pp. 142-147
Author(s):  
Barsha Suwal ◽  
Jeevan Kumar Shrestha ◽  
Sagun Narayan Joshi ◽  
Ananda Kumar Sharma

Introduction: Diabetic retinopathy is the commonest micro vascular complication in patients with diabetes and remains a leading cause of blindness in people of working age group. Objective: to determine the prevalence of clinically significant macular edema (CSME) and the influence of systemic risk factors Materials and methods: It is a hospital based comparative study conducted in 220 eyes of 110 diabetic patients. DR was graded according to International Clinical Diabetic Retinopathy Severity Scale and CSME was defined according to Early Treatment Diabetic Retinopathy Study (ETDRS) system. The patients were grouped as 1) CSME group (DR and CSME in one or both eyes) and 2) Non- CSME group(CSME in none of the eyes but with any grade of DR).Level of glycosylated hemoglobin (HbA1C), serum total cholesterol, triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and urine for albumin were studied in both groups. Results: CSME was present in 36% of 110 patients. Poor glycemic control and high total cholesterol level showed positive association with CSME (p<0.05). LDL and TG levels were higher and HDL lower in CSME group. However, no statistical significance was found. Conclusion: The CSME is significantly associated with poorer glycemic control and elevated total cholesterol level.


Author(s):  
Marieta Dumitrache ◽  
Rodica Lascu

Management in D.R. through prophylactic treatment (maintaining a glycemic level as close as possible to normal, control hypertension <150/85 mmHg, hyperlipidemia) and curative treatment of D.R. does not cure the disease, but may slow the evolution of D.M. and D.R. AntiVEGF agents are indicated as adjuvant therapy in pan-photocoagulation laser and / or vitrectomy in patients with DR to block angiogenesis by inhibiting VEGF. All antiVEGF agents are an effective treatment for the clinically significant macular edema. Photocoagulation laser is a treatment of choice in preproliferative and proliferative DR and an effective treatment of diabetic macular edema. The indications for laser treatment in diabetic retinopathy are related to the incidence, evolution of neovessels, duration of diabetes, HbA1c level, presence of macular edema, stage of DR. The laser for macular lesions reduces the risk of vision loss in the eyes with incipient and moderate non-proliferative DR and macular edema concomitant; the laser should be applied to all patients with clinically significant macular edema. Vitrectomy in proliferative DR is indicated in vitreous hemorrhage, tractional retinal detachment in order to remove the vitreous hermorrhage and excision of tractional preretinal membranes.


Author(s):  
Dewi Adnya Swari ◽  
Ni Luh Diah Pantjawati

Introduction: The increase in diabetics has an impact incidence of diabetic retinopathy and Diabetic Macular Edema (DME). DME due to changes in the blood retina barrier (BRB), causes fluid accumulation in the macula. This study aims to evaluate the functional outcome visual acuity and structure with optical coherence tomography (OCT) intravitreal bevacizumab (IVB) injection in DME with Clinically Significant Macular Edema (CSME). Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Opthalmology, Bali Mandara Eye Hospital, Denpasar. Data were obtained from the medical records of all diabetic retinopathy patients with clinically significant macular edema who treated with IVB at Bali Mandara Eye Hospital in Denpasar January - December 2018. Result: Of the 52 subjects, improvement in best corrected visual acuity (BCVA) occurred in 26 (50.0%) subjects at the first month evaluation, 21 (40.4%) subjects at the third month, and 10 (19.2%) subjects at the sixth month evaluation. OCT decreased in 44 (84.6%) subjects at the first month evaluation, 16 (30.8%) subjects at the third month, and 14 (26.9%) subjects at the sixth month evaluation. Conclusion: There are visual acuity improvement and central retinal thickness reduction at 6 months after IVB injection. These results strengthen IVB injection to be an alternative therapy in DME with CSME.   


Sign in / Sign up

Export Citation Format

Share Document