Influence of Segmental Supply of Cilioretinal Artery on Morphology of Diabetic Macular Edema

Abstract Background The supply of Cilioretinal artery (CRA) to different layers of retina influences retinal pathologies like diabetic retinopathy. Since the supply of CRA is segmental, Our aim is to analyze the location of CRA) with non center-involving and center-involving diabetic macular edema (DME) and to evaluate the supply of CRA with segments of macular edema based on Early Treatment of Diabetic Retinopathy Study (ETDRS) scale using optical coherence tomography (OCT). Design Retrospective study Methods and Materials A retrospective study in which forty-three patients at various stages of diabetic retinopathy with the presence of CRA were identified. Presence and location of CRA was recognized using fundus fluorescein angiography. Diabetic retinopathy was graded based on ETDRS classification using OCT. Results Evaluation of 26 men and 17 women of various groups of diabetic retinopathy revealed unilateral CRA in 40 subjects and bilateral CRA in 3 subjects. When CRA supplied the central area, maximum retinal thickness was noted at the temporal quadrant (271.67±164.02 μm) and had noncenter-involving DME (194.87±121.06 μm), when CRA supplied the lower area, maximum retinal thickness was noted at the superior quadrant (293.64±159.36 μm) and had center-involving DME (395±285.75 μm), and when it supplied the upper area, maximum retinal thickness was noted at the nasal quadrant (293.49±176.18μm) with center-involving DME (292±192.79 μm). Conclusion The presence of CRA seems to alter the morphology and influences the segment involved in DME. However, further studies with larger sample size are warranted to prove this association.

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Influence of Segmental Supply of Cilioretinal Artery on Morphology of Diabetic Macular Edema

10.21203/rs.2.21876/v2 ◽

2020 ◽

Author(s):

Rehana Khan ◽

Mahesh Shanmugam ◽

Rajesh Ramanjulu ◽

Jay Chablani ◽

Niharika Singh ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Retrospective Study ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Central Area ◽

Fundus Fluorescein Angiography ◽

Cilioretinal Artery ◽

Temporal Quadrant ◽

Retinal Pathologies

Abstract Background: The supply of Cilioretinal artery (CRA) to different layers of retina influences retinal pathologies like diabetic retinopathy. Since the supply of CRA is segmental, Our aim is to analyze the location of CRA) with non center-involving and center-involving diabetic macular edema (DME) and to evaluate the supply of CRA with segments of macular edema based on Early Treatment of Diabetic Retinopathy Study (ETDRS) scale using optical coherence tomography (OCT).Design: Retrospective studyMethods: A retrospective study in which forty-three patients at various stages of diabetic retinopathy with the presence of CRA were identified. Presence and location of CRA was recognized using fundus fluorescein angiography. Classification of DME was based on ETDRS subfields on OCT.Results: Evaluation of 26 men and 17 women of various groups of diabetic retinopathy revealed unilateral CRA in 40 subjects and bilateral CRA in 3 subjects. When CRA supplied the central area, maximum retinal thickness was noted at the temporal quadrant (271.67±164.02 mm) and had non center-involving DME (194.87±121.06 mm), when CRA supplied the lower area, maximum retinal thickness was noted at the superior quadrant (293.64±159.36 mm) and had center-involving DME (395±285.75 mm), and when it supplied the upper area, maximum retinal thickness was noted at the nasal quadrant (293.49±176.18mm) with center-involving DME (292±192.79 mm).Conclusion: The presence of CRA seems to alter the morphology and influences the segment involved in DME. However, further studies with larger sample size are warranted to prove this association.

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Influence of segmental supply of Cilioretinal artery on morphology of diabetic macular edema

BMC Ophthalmology ◽

10.1186/s12886-021-01812-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Rehana Khan ◽

Mahesh Shanmugam ◽

Rajesh Ramanjulu ◽

Jay Chablani ◽

Niharika Singh ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Central Area ◽

Fundus Fluorescein Angiography ◽

Cilioretinal Artery ◽

Temporal Quadrant ◽

Retinal Pathologies

Abstract Background The supply of Cilioretinal artery (CRA) to different layers of the retina influences retinal pathologies such as diabetic retinopathy (DR). Since the supply of CRA is segmental, our aim was to analyze the location of CRA with respect to non – center involving diabetic macular edema (DME) differentiated by various segments and center involving DME based on Early Treatment of Diabetic Retinopathy Study (ETDRS) scale using optical coherence tomography (OCT). Methods A retrospective study was conducted in which forty-three patients with various stages of DR and the presence of CRA were identified. Presence and location of CRA was recognized using fundus fluorescein angiography. Classification of DME was based on ETDRS subfields on OCT. Results Evaluation of 26 men and 17 women with varying degrees of severity involving DR revealed the presence of unilateral CRA in 40 subjects and bilateral CRA in 3 subjects. When CRA supplied the central area, maximum retinal thickness was noted at the temporal quadrant (271.67 ± 164.02 μm) along with non - center involving DME (194.87 ± 121.06 μm); when CRA supplied the lower area, maximum retinal thickness was noted at the superior quadrant (293.64 ± 159.36 μm) along with center involving DME (395 ± 285.75 μm) and when it supplied the upper area, maximum retinal thickness was noted at the nasal quadrant (293.49 ± 176.18 μm) along with center involving DME (292 ± 192.79 μm). Conclusion The presence of CRA seems to influence the morphology of the retina amongst patients diagnosed with DR by altering the segments involved in DME based on its supply location. However, further studies with a larger sample size are warranted to strenghten this association.

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Intravitreal Injection for Diabetic Macular Edema as Adjunctive Therapy for Proliferative Diabetic Retinopathy: A Retrospective Study

Clinical Ophthalmology ◽

10.2147/opth.s346065 ◽

2022 ◽

Vol Volume 16 ◽

pp. 135-143

Author(s):

Wissam Aljundi ◽

Shady Suffo ◽

Cristian Munteanu ◽

Achim Langenbucher ◽

Berthold Seitz ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Retrospective Study ◽

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Proliferative Diabetic Retinopathy ◽

Adjunctive Therapy

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Anatomical and visual outcome of intravitreal bevacizumab (Avastin) in patients with diabetic macular edema

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v8i1.16157 ◽

2016 ◽

Vol 8 (1) ◽

pp. 54-61

Author(s):

Shyam Vyas ◽

Raba Thapa ◽

Sanyam Bajimaya ◽

Eli Pradhan ◽

Govinda Paudyal

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Intravitreal Bevacizumab ◽

Visual Outcome ◽

Central Retinal Thickness ◽

Post Injection ◽

Macular Volume

Background: Intravitreal bevacizumab has been shown to be an effective treatment of diabetic macular edema. Objective: To assess the anatomical and visual outcome of intravitrealbevacizumab (Avastin) in patients of diabetic macular edema. Materials and methods: 52 eyes of 33 patients with diabetic retinopathy with CSME were included in this study. Detailed ophthalmic examination, including best-corrected visual acuity(BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by Optical coherence tomography (OCT), was done at baseline and at each follow- up visit. All patients were treated with 0.05 mL intravitreal injection containing 1.25 mg of bevacizumab and repeat injection was given in cases of recurrent/persistent subretinal or intraretinal fluid shown by OCT and deterioration of BCVA. Results: All patients completed 6 months of follow-up with mean number of 2.78 intravitreal injections per eye.The mean BCVA at baseline was 0.80 log MAR, with significant changes 0.68 (p=0.012), 0.63 (p=<0.001) and 0.60 log MAR (p=<0.001) at 6 weeks, 3 months, and 6 months respectively. Final BCVA analysis demonstrated that 25 eyes (48.07%) remained stable and 22 (42.30%) improved ≥2 lines on BCVA. The mean central retinal thickness was 449.03 μm at baseline and it decreased significantly to 410.09 (p<0.001),345.76(p<0.001), 344.55(p<0.001) and 326.51(p<0.001) at 1st day, 6 weeks, 3 months and 6 months post injection, respectively. Mean macular volume changed significantly from baseline of 10.77 μm to 10.33μm (p<0.001) 8.97 (p<0.001), 8.82 (p<0.001), 8.95 (p<0.001) at 1st day, 6 weeks, 3 months and 6 months post injection respectively. Conclusion: Intravitreal bevacizumab injection resulted in significant improvement in BCVA, central retinal thickness and total macular volume in patients with diabetic retinopathy with CSME, and this beneficial effect is maximum at 6 weeks. Also, slight reduction in these parameters at 3 month follow up suggests that visual improvement and stable macular thickness can be maintained longer with injection frequency of probably 6-12 weeks. Nepal J Ophthalmol 2016; 8(15): 54-61

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Panretinal photocoagulation after or prior to intravitreal conbercept injection for diabetic macular edema: a retrospective study

BMC Ophthalmology ◽

10.1186/s12886-021-01920-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wei Zhang ◽

Guiyang Zhao ◽

Weijie Fan ◽

Taihong Zhao

Keyword(s):

Diabetic Retinopathy ◽

Retrospective Study ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Panretinal Photocoagulation ◽

Significant Difference ◽

Photocoagulation Treatment ◽

The Mean ◽

The Difference

Abstract Background Panretinal photocoagulation treatment (PRP) have been known as a standard treatment for proliferative diabetic retinopathy (PDR) or severe nonproliferative diabetic retinopathy (sNPDR). However, there is no consensus on when PRP should be administrated if anti-VEGF treatment is needed for the concurrent diabetic macular edema (DME). This study is to evaluate the difference between two groups of PRP prior to, or after intravitreal conbercept (IVC) for patients with PDR or sNPDR combined with DME. Methods This was a retrospective study. Fifty-eight eyes with DME secondary to PDR or sNPDR were divided into two groups; the PRP after (PRP-after group), or prior to (PRP-prior group), IVC. Changes in number of IVC injections, best corrected visual acuity (BCVA), and central subfield macular thickness (CSMT) were compared after 4 weeks, 12 weeks, 1 year, and 2 years from the first IVC injection. Results The mean number of injections in PRP-after group was 4.8 (1 year) and 6.4 (2 year), lower than 6.4 (1 year) and 8.5 (2 year) in PRP-prior group (both p = 0.002). There was no significant difference in change in BCVA and CSMT between two groups after each follow-up. Conclusion PRP after IVC requires less injections but also yields similar visual and anatomic outcome comparing with PRP prior to IVC in patients with diabetic retinopathy combined with DME.

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A study of therapeutic effects of 670 nm irradiation in different types of diabetic macular edema

Biomedical Photonics ◽

10.24931/2413-9432-2020-9-4-15-22 ◽

2021 ◽

Vol 9 (4) ◽

pp. 15-22

Author(s):

S. Ramin ◽

M. Ahadi ◽

A. Ebrahimi

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Central Retinal Thickness ◽

Diabetic Patients ◽

Therapeutic Effects ◽

Positive Effects ◽

The Mean

The purpose of this study was to investigate the therapeutic effects of 670 nm irradiation in patients with diabetic macular edema. In several studies, positive effects of red/near-infrared irradiation showed in a range of ocular diseases such as macular degeneration, macular edema, and retinitis pigmentosa. This study was conducted on forty five eyes of 26 diabetic patients with macular edema between the ages of 51 and 80.Measurement of visual acuity and slit lamp examination, funduscopy, and optical coherence tomography were performed in all subjects. None of the patients had proliferative retinopathy. We used a portable LED device (Warp 10, Quantum Devices) for treatment. Patients held this device at a distance of 3 cm from their eyes for 240 seconds for three months. Full ophthalmic examinations were repeated 1, 2, and 3 months after treatment.After 3 months, the mean visual acuity improved from 0.44 ± 0.38 log MAR to 0.27 ± 0.24 log MAR and vision increased by 1.52 ± 1.16 lines post treatment (р<0.001). The mean central macula thickness decreased from 381.49 ± 144.40 μm to 359.72 ± 128.84 μm (р=0.050). In patients with mild and moderate nonproliferative diabetic retinopathy, the mean central retinal thickness decreased 52.06 ± 67.78 μm and 39.27 ± 44.69 μm, respectively, but patients with severe type showed an increase of 34.93 ± 65.65 μm in the mean central retinal thickness (р<0.001). Also, the severity of macular edema had no effect on final outcomes (р>0.05). Photobiomodulation can positively affect diabetic macular edema, especially in patients with mild to moderate diabetic retinopathy.

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Fundus fluorescein angiographic assessment of patients with proliferative Diabetic Retinopathy and Macular Edema before and after intravitreal injection of Bevacizumab

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20194976 ◽

2019 ◽

Vol 7 (11) ◽

pp. 4111

Author(s):

Ankur . ◽

Yogesh Kumar ◽

Deepesh Arora ◽

Rupali Tyagi ◽

Sanjeev Kumar Mittal

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Proliferative Diabetic Retinopathy ◽

Intravitreal Bevacizumab ◽

Fundus Fluorescein Angiography ◽

Intravitreal Bevacizumab Injection ◽

Department Of Ophthalmology ◽

Leakage Area ◽

Before And After

Background: To assess the role of intravitreal bevacizumab (1.25 mg) in patients with proliferative diabetic retinopathy with macular edema in terms of change in leakage area and best-corrected visual acuity.Methods: This prospective randomized interventional study was conducted in the Department of Ophthalmology from September 2013 to August 2015 and included thirty eyes of twenty patients.After a detailed history and ocular examination, diagnosed cases of proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) underwent sequential fundus fluorescein angiography. Bevacizumab was administered intravitreally. Patients were assessed two hours after injection for anterior chamber reaction and intraocular pressure and were advised follow-ups at 24 hours and then at 1, 4, 8 and 12 weeks. For the outcome, the change of retinal new vessels by assessment of leakage area using Quantitative Planimetric Analysis (QPA) of photographs as well as the change in best-corrected visual acuity (BCVA) from baseline to the 12 weeks follow-up, were done. Results were analyzed statistically by applying t-test.Results: Intravitreal bevacizumab injection lead to a significant decrease in leakage in DME and PDR, and improvement in mean BCVA. The effect was maximum at 4 weeks which weaned off as the study progressed through it remains statistically significant at the end of 12 weeks.Conclusions: Intravitreal bevacizumab plays a major role in treating and reducing visual deterioration in patients with proliferative diabetic retinopathy and diabetic macular edema.

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