scholarly journals Morphological and visual acuity outcomes associated with single intravitreal injection of Anti- VEGF versus macular photocoagulation for diabetic macular edema

2020 ◽  
Vol 08 (01) ◽  
Author(s):  
Dr Vijay Gupta
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Anti Vegf

scholarly journals Intravitreal Ranibizumab Injection As A Treatment For Diabetic Macular Edema

2020 ◽  
Vol 3 (2) ◽  
pp. 51-57
Author(s):  
Defayudina Dafilianty Rosataria ◽  
Ramzi Amin
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Early Stage ◽  
Hard Exudates ◽  
Anti Vegf ◽  
History Of

ABSTRACT Introduction : In general, diabetic retinopathy is classified into early stage, namely non proliferative diabetic retinopathy (NPDR), and advanced stage, proliferative diabetic retinopathy (PDR). Diabetic macular edema is the most common cause of visual impairment in cases of early stage or NPDR. Purpose : To describe Diabetic Macular Edema (DME) with intravitreal injection of anti-VEGF as a treatment. Case report : 43 old female, came with chief complaint of blurred vision on her right eye since six months ago. Blurring is felt slowly. Patient has a history of uncontrolled diabetes since 10 years and a history of hypercholesterolemia since 1 year ago. visual acuity of the right eye is 4/60. On posterior segment examination, neovascularization of the papilla was found. Decreased foveal reflex (+), hard exudates (+) within 500 µm from the central macula. Microaneurism (+), dot hemorrhage (+), blot (+) in 4 quadrants, hard exudates (+) in 2 quadrants in her right eye. The patient was planned for intravitreal injection of anti-VEGF on her right eye. Conclusion : Intravitreal injection of anti-VEGF can improve visual acuity and reduce exudate and hemorrhage in retina from ophthalmoscope and fundus photography examination. In addition, the investigation with OCT was found to improve with reduced macular thickness.  

scholarly journals Multifocal Electroretinogram, Central Macula Thickness and Visual Acuity in Diabetic Macular Edema Following Intravitreal Injection of anti-VEGF

2021 ◽  
Vol 4 (2) ◽  
pp. 150
Author(s):  
Syntia Nusanti ◽  
Kirana Sampurna ◽  
Ari Djatikusumo ◽  
Anggun Rama Yudantha ◽  
Joedo Prihartono
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Post Injection ◽  
Anti Vegf ◽  
Sd Oct

Introduction :  Diabetic Retinopathy (DR) is one of the major cause of visual acuity deterioration in diabetic patients. The loss of central visual acuity in diabetic patients are mainly due to macula edema, which is found in 29% diabetic patients with the over 20 years duration of disease. The aim of this study is to evaluate and investigate the possible correlation among changes of visual acuity (VA), central macular thickness (CMT) using Spectral Domain Optical Coherence Tomography (SD-OCT). Electrophysiological responses using multifocal electroretinography (MfERG) in diabetic macular edema (DME) following intravitreal injection of bevacizumab. Methods: Single arm clinical trial. Thirty-three eyes of 33 DME patients (16 non-proliferative diabetic retinopathy and 17 non-high-risk proliferative diabetic retinopathy), receives intravitreal bevacizumab 1,25mg. All patients underwent complete ophthalmic examination including ETDRS VA testing, Sixty-one scaled hexagon MfERG and SD-OCT scan at baseline, 1-week and 1-month post-injection. Components of the first order kernel (N1, N2 and P1) in central 2o were measured. Result : MfERG showed reduced P1 amplitude (P<0.05) at 1-week after injection followed by increased P1 amplitude (P>0.05) at 1-month after treatment as compared to the baseline in all subjects. There was 19% improvement CMT and 0.2Logmar VA improvement in 1-month post-injection compared to the baseline (P<005). This study showed no serious ocular adverse effects. There was no significant correlation between changes in visual acuity with changes in CMT or other MfERG parameters. Conclusion: Intravitreal injection bevacizumab resulting in improved VA, reduction in CMT and mild improvement in the MfERG responses. Although VA changes did not correlate with reduced CMT nor with improved responses of MfERG, the combined use of SD-OCT and MfERG may be used to evaluate macular function in DME patient with worsened visual acuity post anti-VEGF injection.

Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Syeda Rushda Zaidi
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Rank Test ◽  
P Value ◽  
Central Macular Thickness ◽  
Anti Vegf ◽  
Quasi Experimental

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.

scholarly journals Pharmacological Management of Diabetic Macular Edema in Real-Life Observational Studies

2018 ◽  
Vol 2018 ◽  
pp. 1-16 ◽  
Author(s):  
Laurent Kodjikian ◽  
David Bellocq ◽  
Thibaud Mathis
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Observational Studies ◽  
Real Life ◽  
Pharmacological Management ◽  
Anti Vegf ◽  
Pubmed Database ◽  
Baseline Visual Acuity

Objectives of the Study. Summary of observational studies concerning the pharmacological management of diabetic macular edema (DME). Methods. A literature review was conducted using the PubMed database on 1 February 2018 to identify studies evaluating the efficacy of anti-VEGF and dexamethasone (DEX) implants for DME. Studies with more than 10 patients and follow-up of more than 6 months were selected. Analyses were carried out on the overall population and on subgroups defined according to baseline visual acuity (BVA) and the patients’ naïve or non-naïve status. Results. Thirty-two studies evaluating the efficacy of anti-VEGF and 31 studies evaluating the efficacy of DEX-implants were retained, concerning 6,842 and 1,703 eyes, respectively. A mean gain of +4.7 letters for a mean of 5.8 injections (mean follow-up: 15.6 months) and +9.6 letters for a mean of 1.6 injections (10.3 months) was found in the anti-VEGF and DEX-implant studies, respectively. Final VA appears to be similar for both treatment (62 letters for anti-VEGF, 61.2 letters for DEX-implant), and BVA appears lower for DEX-implant, which may partially explain the greater visual gain. The DEX-implant studies show greater gains in VA compared to the anti-VEGF studies, especially for higher BVA. Indeed, mean gains for the subgroups of patients with BVA<50 letters, 50<BVA<60 letters, and BVA>60 letters are +4.3, +5.8, and +3.1 letters, respectively, in the anti-VEGF studies and +10.5, +9.3, and +8.8 letters, respectively, in the DEX-implant studies. Regarding the patient’s initial status, only naïve status appears to confer the best functional response in DEX-implant studies. Conclusion. Observational studies investigating DEX-implant report clinically similar final VA when compared to anti-VEGF, but superior visual gains in real-life practice. This latter difference could be due to the better BVA, but also to the fact that less injections were administered in the anti-VEGF observational studies than in the interventional studies.

scholarly journals Comparative characteristics of the outcomes of the use of multidirectional intravitreal pharmacotherapy in the treatment of diabetic macular edema

2021 ◽  
pp. 39-45
Author(s):  
М.М. Bikbov ◽  
◽  
K.I. Kudoyarova ◽  
R.M. Zainullin ◽  
T.R. Gilmanshin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Angiogenesis Inhibitor ◽  
Standard Technique ◽  
Macular Area ◽  
Dexamethasone Implant ◽  
Biodegradable Implant ◽  
Inflammatory Reactions

Purpose. To conduct a comparative analysis of the effectiveness of intravitreal injection of dexamethasone-containing implant and aflibercept in macular edema in patients with diabetes mellitus. Material and methods. The study involved 80 patients (80 eyes) with macular edema. The group 1 included 38 patients (38 eyes) who underwent a single intravitreal injection of dexamethasone-containing biodegradable implant «Ozurdex» in a dose of 0.7 mg according to the standard technique. In the group 2, 42 patients (42 eyes) received 5 loading doses of aflibercept with an interval of one month. All patients underwent monthly spectral optical coherence tomography (OCT) of the macular area, as well as visometry and tonometry during the observation period. Results. One month after intravitreal injection of the studied drugs in both groups, no inflammatory reactions were detected in any case. According to OCT data, cystic edema of the macular area with a tendency to decrease the thickness in the fovea was preserved. After treatment with aflibercept, the average retinal thickness in the macula was 186.4±15.1 µm, and visual acuity averaged 0.48±0.05 in 85.7% of patients. During therapy with intravitreal injection of Ozurdex, an increase in visual acuity was noted in 89.4% of patients. Conclusion. This study found that intravitreal pharmacotherapy with an angiogenesis blocker and a dexamethasone implant in patients with diabetic macular edema are comparable in its effectiveness – 85.7 and 89.4% respectively. If systematic anti-angiogenesis therapy is not possible for a number of reasons, it is advisable to use a prolonged dexamethasone implant. Key words: macular edema, intravitreal pharmacotherapy, angiogenesis inhibitor, implant with dexamethasone.

scholarly journals EFFECT OF ANTI-VEGF THERAPY ON THE STRUCTURAL STATE OF THE RETINA IN DIABETIC MACULAR EDEMA

2016 ◽  
Vol 1 (6) ◽  
pp. 24-27
Author(s):  
Бикбов ◽  
Mukharram Bikbov ◽  
Файзрахманов ◽  
Rinat Fayzrakhmanov ◽  
Зайнуллин ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Density ◽  
Structural State ◽  
Central Area ◽  
Macular Pigment ◽  
Optical Coherence ◽  
Macular Pigment Optical Density ◽  
Anti Vegf

Objective: to analyze the structural state of the central area of the retina in diabetic macular edema in the background anti-VEGF therapy.Methods. The study included 38patients (40eyes) with diabetic macular edema. All patients received anti-VEGF-ranibizumab therapy at a dose of 0.05ml. The results were analyzed after three intravitreal injections with 1month interval. We assessed visual acuity, morphological and anatomical structure of the macular area, the sensitivity of the retina and macular pigment optical densityResults. Analyzing optical density of the macular pigment we revealed a significant increase of all parameters in 73% of patients after the therapy. The average value of the optical density before treatment was at 0.102±0.01du, on the background of anti-VEGF-therapy this figure went up to 0.213±0.01 (p&#60;0.05). According to the optical coherence to-mography average retinal thickness before treatment made 404.62±15.23μm, after the treatment – 300.91±6.43μm (р&#60;0,05). When comparing data of optical coherence tomography and macular pigment optical density we revealed more pronounced decrease in the macular pigment optical density in the area of the retinal edema and a significant increase in the basic parameters on the background of the therapy.Conclusion. Anti-VEGF-therapy significantly improves visual acuity, the recovery profile of macular edema and reduces the zone in patients with diabetic macular edema.

scholarly journals Anti-VEGF agents in the treatment of diabetic macular edema

2013 ◽  
Vol 16 (4) ◽  
pp. 78-84
Author(s):  
Vladimir Iosifovich Konenkov ◽  
Vadim Valerievich Klimontov ◽  
Valeriy Vyacheslavovich Chernykh ◽  
Nadezhda Viktorovna Tjan
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Randomized Clinical Trials ◽  
Diabetic Patients ◽  
Vegf Inhibitors ◽  
Vascular Endothelium Growth Factor ◽  
Future Studies ◽  
Anti Vegf ◽  
New Treatment

Diabetic macular edema (DME) is a common complication associated with the loss of visual acuity in diabetic patients. Intravitreal injections of vascular endothelium growth factor (VEGF) inhibitors (anti-VEGF therapy) have been proposed recently as a new treatment option for patients with DME. In this review we summarized results of randomized clinical trials of VEGF inhibitors in DME patients. The results indicate that all studied inhibitors (ranibizumab, bevacizumab, pegaptanib and aflibersept) reduce the retinal thickness and improve of visual acuity in DME when are used as a monotherapy or in combination with the laser treatment. Optimal course duration and effectiveness predictors of anti-VEGF therapy in DME should be elucidate in the future studies.

scholarly journals Ellipsoid Zone Integrity and Visual Acuity Changes during Diabetic Macular Edema Therapy: A Longitudinal Study

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Lucy J. Kessler ◽  
Gerd U. Auffarth ◽  
Dmitrii Bagautdinov ◽  
Ramin Khoramnia
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Visual Outcome ◽  
Long Term Results ◽  
First Year ◽  
Ellipsoid Zone ◽  
Anti Vegf ◽  
Potential Biomarker

Purpose. Ellipsoid zone (EZ) integrity is identified as a potential biomarker for therapy surveillance and outcome prediction of visual acuity (VA). However, only a few studies report long-term results of over 1 year of clinical and anatomical changes in patients with diabetic macular edema (DME). This study is aimed at describing the long-term VA and anatomical outcomes in spectral domain optical coherence tomography (OCT) (relative ellipsoid zone reflectivity ratio, central macular thickness, and volume) in patients with DME treated with antivascular endothelial growth factor (anti-VEGF) therapy. Furthermore, we studied the correlation between EZ integrity and changes in visual acuity. Methods. 71 eyes of 71 patients were included in this retrospective study. Clinical characteristics were reviewed yearly. OCT data were assessed at baseline and after 1, 3, and 5 years. EZ parameters were quantified automatically. OCT parameters and visual outcome were correlated and analyzed in multivariable regression models. Results. EZ reflectivity ratio correlated with functional outcome in DME patients from baseline to fifth year at all time points (for all p < 0.05 ). EZ reflectivity improved the most in the first year of treatment (0.68 to 0.75; p < 0.05 ) and declined gradually until year 5 of therapy (0.71; compared to baseline p > 0.05 ). Similarly, best VA was achieved after 1 year (0.40 logarithm of the minimum angle of resolution (logMAR) to 0.28 logMAR; p < 0.001 ) and declined gradually until year 5. Final VA in year 5 was comparable to baseline (0.45 logMAR, compared to baseline p > 0.05 ). Together with baseline VA, baseline EZ parameters did predict VA outcome after 1 year ( p < 0.05 ). Concordantly, VA and EZ parameters from year 1 were associated with VA outcome in year 2. Conclusion. This study described the long-term course of EZ changes during anti-VEGF treatment in DME patients. In addition, our results underlined the potential of EZ parameters as novel OCT biomarkers for prediction of VA outcomes during therapy.

scholarly journals Intravitreal Anti Vascular Endothelial Growth Factor Agents in The Management of Retinal Diseases: An Audit

2017 ◽  
Vol 11 (1) ◽  
pp. 315-321 ◽  
Author(s):  
Bassey Fiebai ◽  
Victor Odogu
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Diabetic Macular Edema ◽  
Age Related Macular Degeneration ◽  
Retinal Diseases ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Anti Vegf ◽  
Treatment Type

Purpose: The study aimed to describe our initial experience with the use of anti vascular endothelial growth factors (anti-VEGFs) in the treatment of retinal diseases. Methods: The case records of all patients who had received at least 3 doses of intravitreal anti- VEGF injections between January 2012 to December 2016 were reviewed. Information culled from the data was age, sex, indications for treatment, type of injection, presenting visual acuity, post injection visual acuity, systemic and ocular co morbidities. Results were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software Results: A total of 190 injections were given during the study period, to 58 eyes of 50 patients. Twenty-eight females (56.00%) and twenty-two males (44.00%) were seen with a mean age of 59.6± 11.66. Bevacizumab was the most frequently administered anti- VEGF, 142 (74.74%) while only 48(25.26%) injections of Ranibizumab were given. Three eyes had both bevacizumab and ranibizumab (1.58%). Retinal vein occlusion 61(32.11%) was the commonest indication for the injections followed by diabetic macular edema 43(22.63%) and proliferative diabetic retinopathy 42(22.11%). Others were neovascular age related macular degeneration, neovascular glaucoma, vitreous hemorrhage, myopic choroidal neovascularization and cystoid macular edema. There was an association between age and disease, (p = 0.001). There was an improvement in visual acuity after intervention in cases with retinal vein occlusion and diabetic macular edema, and this was statistically significant. Hypertension was the commonest systemic disorder in this series 81(42.36%) and the supero-temporal quadrant 131(68.95%) was the most preferred position to administer the injection. Floaters was the commonest complication seen. Conclusion: Anti VEGFs have become an invaluable tool in the management of a number of retinal diseases in our center. However, the cost implications are a hindrance to an increased uptake of this form of treatment. Cheaper alternative preparations should be made available to encourage the uptake. Government in developing countries should be encouraged to bear the health burden of the old aged pensioner (OAP).

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