Prophylaxis of macular edema after cataract surgery in diabetic patients, topical Nepafenac versus intravitreal Ranibizumab

2021 ◽  
pp. 112067212110012
Author(s):  
Ahmed Howaidy ◽  
Zeiad H Eldaly ◽  
Mohamed Anis ◽  
Tageldin M Othman
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Study Groups ◽  
Macular Thickness ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Intravitreal Ranibizumab ◽  
Significant Difference ◽  
And Control

Purpose: To compare effect of topical Nepafenac versus intravitreal Ranibizumab on macular thickness after cataract surgery in diabetic patients with no preoperative macular edema. Patients and methods: A prospective randomized controlled study recruited diabetic patients with visually significant cataract and no diabetic macular edema (DME). Patient underwent uncomplicated phacoemulsification with IOL implantation and were randomly assigned to receive post-operative topical Nepafenac, intra-operative intravitreal Ranibizumab, or no prophylactic treatment. Changes in subfoveal and perifoveal macular thickness were assessed by SD-OCT. Results: The mean central macular thickness showed a significant increase in all study groups 1 week and 1 month postoperative when compared to baseline. At 3 months postoperative, there was a significant difference between Nepafenac and Control group ( p = 0.017), Ranibizumab and Control groups ( p = 0.009) with no significant difference between Nepafenac and Ranibizumab group ( p = 0.545) regarding CMT. Comparable results could be detected as regarding peri-foveal macular thickness changes. Concerning BCVA, there was a significant difference between topical Nepafenac/control ( p = 0.001) and intravitreal Ranibizumab/control ( p = 0.004) at 1-week visit. No significant difference in BCVA was observed between Nepafenac and Ranibizumab group throughout the whole study period. In postoperative visits, cystoid macular edema occurred in three patients (7.9%) in Nepafenac group, one patient (2.7%) in Ranibizumab group, and seven patients (17.07%) in control group. Conclusion: Both postoperative topical Nepafenac and intra-operative intra-vitreal Ranibizumab are effective adjunctive to phacoemulsification in diabetic patients for prophylaxis of macular edema.

scholarly journals Effects of Intra-vitreal Injection of Bevacizumab as an Adjunct during Phacoemulsification in Diabetic Maculopathy

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Ali Afzal Bodla ◽  
Syeda Minahil Kazmi ◽  
Noor Tariq ◽  
Ayema Moazzam ◽  
Muhammad Muneeb Aman
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Macular Thickness ◽  
Control Group ◽  
Key Words Diabetes Mellitus ◽  
Diabetic Patients ◽  
Key Words Diabetes ◽  
Post Surgery ◽  
Significant Difference

Purpose:  To study the effects of Intra-vitreal injection of Bevacizumab as an adjunct during phacoemulsification in patients with diabetic retinopathy. Study Design:  Quasi experimental study. Methods:  Hundred diabetic patients who were scheduled to undergo phacoemulsification were included in the study. They were equally divided into two groups; Bevacizumab and control group. Complete ocular examination and macular thickness and volume were determined using an OPTOVUE-OCT machine. The patients in the Bevacizumab group were given intra-vitreal injection of 1.25 mg/0.05ml of Bevacizumab at the time of Phacoemulsification. A written ethical approval was obtained and the study was conducted according to principles of declaration of Helsinki. Results:  The bevacizumab group manifested low value of CMT one month post-surgery as compared to the control group (262.2 ± 32.2 and 288.5 ± 54.1, respectively) with P = 0.01. The Total Macular volume, and Best-corrected visual acuity in the two groups showed no significant difference one month after surgery. Amongst the patients who developed postsurgical macular edema, four patients did not possess a positive history for diabetic retinopathy and 3 of them had Non Proliferative Diabetic Retinopathy. We found no significant relationship between the post-surgical macula edema with the presence of mild Non Proliferative Diabetic Retinopathy. (Fisher's test, P = 0.321). Conclusion:  The ocular anti-VEGF therapy substantially reduces macular edema secondary to post-surgical inflammation in diabetic patients. It effectively reduces the central macular thickness although the results are not found to be statistically significant when compared with the control group. Key Words:  Diabetes mellitus; diabetic macular edema; diabetic retinopathy: Bevacizumab.

scholarly journals Effects of Topical Prostaglandin Analog on Macular Thickness Following Cataract Surgery with Postoperative Topical Bromfenac Treatment

2020 ◽  
Vol 9 (9) ◽  
pp. 2883
Author(s):  
Kee Sup Park ◽  
Kyoung Nam Kim ◽  
Kyeung Min Kim ◽  
Han Min Lee ◽  
Sung Bok Lee ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Controlled Trial ◽  
Perioperative Period ◽  
Macular Thickness ◽  
Control Group ◽  
Study Group ◽  
Prostaglandin Analog ◽  
Postoperative Changes ◽  
Significant Difference

Purpose: To evaluate changes in macular thickness in patients continuing prostaglandin analog (PGA) treatment during the perioperative period involving bromfenac treatment. Methods: Patients with glaucoma who were using a topical PGA were randomly assigned to two groups in this randomized controlled trial: PGA continuing study group and PGA discontinued glaucoma control group. Patients without ocular diseases other than cataract were enrolled into the non-glaucomatous group. After the cataract surgery, the patients used bromfenac twice per day for 4 weeks. Optical coherence tomography was performed in all patients preoperatively and at 1 month postoperatively. Changes in macular thickness were compared among the three groups. Results: There were 32 eyes in the study group, 33 eyes in the glaucoma control group, and 58 eyes in the non-glaucomatous group. We found statistically significant postoperative changes in central macular thickness in all groups (4.30 ± 8.01 μm in the PGA continuing group, 9.20 ± 13.88 μm in the PGA discontinued group, and 7.06 ± 7.02 μm in the non-glaucomatous group, all p < 0.008), but no significant difference among the three groups (p = 0.161). Cystoid macular edema occurred in only one patient in the non-glaucomatous group (p = 0.568). Conclusions: Continuous use of PGAs during the perioperative period was not significantly associated with increased macular thickness after uncomplicated cataract surgery. In the absence of other risk factors (e.g., capsular rupture, uveitis, or diabetic retinopathy), discontinuing PGAs for the prevention of macular edema after cataract surgery with postoperative bromfenac treatment is unnecessary in patients with glaucoma.

Correlation of salivary neopterin and plasma fibrinogen levels in patients with chronic periodontitis and/or type 2 diabetes mellitus

Pteridines ◽  
2017 ◽  
Vol 28 (3-4) ◽  
pp. 177-183 ◽  
Author(s):  
Angel Fenol ◽  
V.R. Swetha ◽  
Sajitha Krishnan ◽  
Jayachandran Perayil ◽  
Rajesh Vyloppillil ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Chronic Periodontitis ◽  
Study Groups ◽  
Control Group ◽  
Diabetic Patients ◽  
Potential Biomarker ◽  
Whole Saliva ◽  
Nonsurgical Periodontal Therapy ◽  
Significant Difference

AbstractNeopterin is a novel predictor for coronary events especially in diabetic patients and also an indicator for the effectiveness of the periodontal treatment. In this study, we assessed whether salivary neopterin can be used as a potential biomarker in evaluating the risk of cardiovascular disease in type 2 diabetic patients with chronic periodontitis. Forty subjects between 25 and 75 years of age and who matched the criteria were selected and divided into four groups. Their periodontal status was evaluated. Stimulated whole saliva and blood were collected for analysis of salivary neopterin and fibrinogen and HbA1c levels, respectively. Nonsurgical periodontal therapy was carried out. Patients were recalled after 3 months, and the same procedure was repeated. A reduction in all the parameters was seen after treatment in all the four groups. Salivary neopterin levels showed significant difference (p<0.001) in the values between the study groups and the control group before treatment. After 3 months of treatment, salivary neopterin levels showed a statistical significant reduction (p<0.001) in all the study groups. Neopterin could serve as an effective tool to assess the inflammatory process related to periodontitis and diabetes mellitus and also predict future cardiovascular events in diabetic patients.

scholarly journals Comparative study of optical coherence tomographic analysis of macula in preoperative and postoperative diabetic patients undergoing small incision cataract surgery

2021 ◽  
Vol 7 (2) ◽  
pp. 352-357
Author(s):  
Shruthi Marati ◽  
Vallabha K
Keyword(s):  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Macular Thickness ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Spectral Domain Oct ◽  
Quantitative Changes

The clinical evaluation of macular edema has been difficult to characterize, but evaluation has become more precise with the help of optical coherence tomography (OCT). This study is undertaken to evaluate the quantitative changes in macular thickness using spectral domain OCT in diabetic patients undergoing cataract surgery pre and post operatively and its relation with diabetic retinopathy (DR). Study participants included 65 diabetic patients irrespective of presence or absence of retinopathy who underwent cataract surgery. Each eye underwent fundus examination with indirect ophthalmoscopy and OCT of macula i.e.,preoperatively and at postoperatively at day 1, 1 week, 4 weeks and at 12 weeks. Best-corrected visual acuity (BCVA) was recorded at each visit. The central subfield macular thickness (CSMT) increased in all patients irrespective of presence or absence of diabetic retinopathy of about 17.4±25.3µm and 29µm±38.8 at 1 month and 3 month follow up. There was a statistically significant increase seen in CSMT after cataract surgery especially in patients with preoperatively diagnosed macular edema. Associated retinopathy also acts as a risk factor. But there was no statistically significant increase in mild and moderate NPDR preoperatively and also in postoperative period after uncomplicated small incision cataract surgery.

scholarly journals Aflibercept or ranibizumab for the treatment of diabetic macular edema; a retrospective study

2019 ◽  
Vol 10 (4) ◽  
pp. 3000-3005
Author(s):  
Khlood M. Aldossary ◽  
Anfal Alruzuq ◽  
Ghady Almohanna ◽  
Hessa Almusallam ◽  
Sara Alamri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Macular Thickness ◽  
P Value ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Injectable Drugs ◽  
Significant Difference ◽  
Intravitreal Aflibercept

Diabetic macular edema (DME) is a significant cause of diabetic retinopathy and a major cause of vision loss. In this study, we aimed to evaluate and compare the efficacy of two injectable drugs; intravitreal Aflibercept and intravitreal Ranibizumab for the treatment of DME of the eyes. A retrospective chart review was conducted for patients diagnosed with DME from March 2014 to January 2019 who received either intravitreal Aflibercept or intravitreal Ranibizumab injection. A total of 57 eyes were included, of which 19 eyes were treated with intravitreal Ranibizumab injection, and 38 eyes were treated with intravitreal Aflibercept injection; all eyes were examined for 3 months. Two outcomes were assessed in this study, namely; visual acuity (VA) and central macular thickness (CMT). The mean age in the Ranibizumab group was 61.1±9.5 vs 64.3±10.2 in the Aflibercept group with no significant difference (p-value=0.25). The ratio of improvement in visual acuity (VA) in the Ranibizumab group was 68.4% vs 44.7% in the Aflibercept group; (p-value=0.038) which demonstrates the superiority of Ranibizumab over Aflibercept concerning visual acuity result. However, there is no statistically significant difference between the ratio of improvement in central macular thickness (CMT) results in both groups; (p-value=1.00). In fact, the ratio of improvement in CMT in both groups was the same 78.9% for both the groups. The pre and post results demonstrated improvement in post-procedural for CMT among both the groups but only Ranibizumab group showed VA improvement post-procedural. Through this study, we concluded that both injectable drugs improve visual acuity (VA) and decrease central macular thickness (CMT) in eyes with DME. However, Ranibizumab is superior in improving visual acuity compared to Aflibercept. Further comparative effectiveness trials between Aflibercept and Ranibizumab are still warranted.

scholarly journals APOPTOSIS INDEX BETWEEN FEMALES AND MALES IN REGULAR HEMODIALYSIS

2016 ◽  
Vol 19 (3) ◽  
pp. 150
Author(s):  
Djoko Santoso
Keyword(s):  
Age Groups ◽  
Microtiter Plate ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Diabetic Patients ◽  
Immunochemical Determination ◽  
Apoptosis Index ◽  
Significant Difference ◽  
And Control ◽  
Esrd Patients

Many reports have documented apoptosis index in hemodialysis patients, but to date, no single study has directly compared the apoptosis index of males to females. Data on mortality rate among hemodialytic patients in the hemodialysis center at the Department of Internal Medicine Dr Soetomo General Hospital, Surabaya, Indonesia show a high number predominated by female patients. Therefore, to answer the question of whether there is a gender difference in apoptosis index, the researcher studied leukocyte responses in male and female hemodialysis patients. The apoptosis index of the sample was measured by indirect immunoassay method. Cell lyses, followed by immunochemical determination of histone-complexed DNA fragments in a microtiter plate wells. The apoptosis quantization was obtained by determining the amount of colored product spectrophotometrically. One hundred and four non-diabetic subjects who received hemodialysis (HD), and 24 normal controls (NC), were evaluated. The apoptosis index in ESRD patients group and control group showed no significant difference (0.6172 vs 0.4008, p=0.114), neither did it vary in both sexes and age groups. When the sex factor was analyzed (after exclusion from the diabetic ESRD patients), females apoptosis index was significantly higher than that of the males (0.7325 vs 0.55175, p<0.05). In conclusion, apoptosis index in females among non-diabetic patients undergoing hemodialysis is higher than that occur in males and controls.

scholarly journals Ocular Rigidity and Outflow Facility in Nonproliferative Diabetic Retinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Theonitsa Panagiotoglou ◽  
Miltiadis Tsilimbaris ◽  
Harilaos Ginis ◽  
Nikos Karyotakis ◽  
Vaggelis Georgiou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Control Group ◽  
Diabetic Patients ◽  
Outflow Facility ◽  
Nonproliferative Diabetic Retinopathy ◽  
Computer Controlled ◽  
And Control

Purpose.To compare ocular rigidity (OR) and outflow facility (C) in patients with nonproliferative diabetic retinopathy (NPDR) and control subjects.Methods. Twenty-four patients with NPDR (NPDR group) and 24 controls (control group) undergoing cataract surgery were enrolled. NPDR group was further divided into patients with mild NPDR (NPDR1-group) and patients with moderate and/or severe NPDR (NPDR2-group). After cannulation of the anterior chamber, a computer-controlled device was used to infuse saline and increase the intraocular pressure (IOP) in a stepping procedure from 15 to 40 mmHg. Ocular rigidity and outflow facility coefficients were estimated from IOP and volume recordings.Results. Ocular rigidity was 0.0205 μL−1in NPDR group and 0.0202 μL−1in control group (P=0.942). In NPDR1-group, OR was 0.017 μL−1and in NPDR2-group it was 0.025μL−1(P=0.192). Outflow facility was 0.120 μL/min/mmHg in NPDR-group compared to 0.153 μL/min/mmHg in the control group at an IOP of 35 mmHg (P=0.151). There was no difference in C between NPDR1-group and NPDR2-group (P=0.709).Conclusions. No statistically significant differences in ocular rigidity and outflow facility could be documented between diabetic patients and controls. No difference in OR and C was detected between mild NPDR and severe NPDR.

scholarly journals A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Iman M. Eissa ◽  
Noha M. Khalil ◽  
Heba A. El-Gendy
Keyword(s):  
Anterior Segment ◽  
Tear Film ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Film Stability ◽  
Duration Of Diabetes ◽  
Significant Difference ◽  
Tear Meniscus ◽  
Tear Meniscus Height

Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls.Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted.Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls.Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P=0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability.Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

scholarly journals Comparison of ox-LDL Levels in Diabetic Patients with Normo-, Micro-, and Macroalbuminuria with Their First Degree Relatives and the Healthy Control Group

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Parisa Behzadi ◽  
Firouzeh Torabi ◽  
Massoud Amini ◽  
Ashraf Aminorroaya
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cross Sectional Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
First Degree Relatives ◽  
Significant Difference ◽  
Healthy Control ◽  
And Control

Oxidized low density lipoprotein (ox-LDL) is a product of oxidative stress. In this cross-sectional study, we compared the ox-LDL concentrations in diabetic patients with normoalbuminuria (n=28), microalbuminuria (n=28), and macroalbuminuria (n=28) with their first degree relatives (n=28) and healthy control people (n=31). They were selected by consecutive patient selection method. The ox-LDL level was assayed using ELISA. We measured blood pressure, lipid profile, fasting plasma glucose (FPG), and HbA1c in all groups. There was no significant difference in ox-LDL concentrations among normoalbuminuric, microalbuminuric, and macroalbuminuric diabetic groups. In diabetic patients with micro- and macroalbuminuria, ox-LDL concentration was higher than their first degree relatives (P=0.04andP=0.03) and control group (P=0.001andP=0.03, resp.). In normoalbuminuric diabetic persons, ox-LDL concentration was just higher than that of healthy people (P=0.02). There was no statistically significant difference in ox-LDL levels between normoalbuminuric diabetic patients and their first degree relatives. In conclusion, the presence and progression of albuminuria in diabetic patients are not related to ox-LDL concentration and genetic predisposition influences the plasma OX-LDL level. Larger sample size is needed to confirm this conclusion in future studies.

scholarly journals The Effect of Wrist Kinesiotaping on Hand Motor Exercise in Fine Motor Skill for Children with Cerebral Palsy

1970 ◽  
Vol 10 (1) ◽  
pp. 1-10
Author(s):  
Erna Setiawati
Keyword(s):  
Cerebral Palsy ◽  
Motor Skill ◽  
Current Method ◽  
Controlled Study ◽  
Fine Motor ◽  
Control Group ◽  
Fine Motor Skill ◽  
Post Intervention ◽  
Significant Difference ◽  
And Control

ABSTRACTIntroduction: Kinesiotaping (KT) is one of current method that being used for hands problems in cerebral palsy. The purpose of this study was to evaluate the effect of kinesiotaping at wrist combined with hand motor exercise in fine motor skill for children with cerebral palsy.Methods: The design was simple randomized controlled study pre and post intervention. There were 18 children who divided into kinesiotaping and control group. Subjects in the KT group received hand motor exercise and wrist kinesiotaping. Subjects in control group received only hand motor exercise.Both groups received the exercise for 4 weeks. There were difference in the MACS score which is used to measure fine motor skills in this study. Pre and posttest scores were collected before applying kinesiotaping and after 4 weeks of intervention.Results: Both groups showed an increase in MACS score after 4 weeks intervention. For MACS score, there was statistically significant difference in KT group (p = 0.025), but not statistically significant in control group (p = 0.083).Conclusion: Wrist kinesiotaping can be used for adjunct therapy combined with conventional hand motor exercise for improving manual ability in the hand and fin e motor skill in cerebral palsy.Keywords: Cerebral palsy, fine motor skill, wrist kinesiotaping.

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