Correlation between Diabetic Macular Edema and Best Corrected Visual Acuity in Different Categories of Diabetic Retinopathy

Objective: To determine the visual outcome in Diabetic Macular Edema patients after 3rd Avastin injections attending a tertiary eye care hospital. Materials and methods: This was a cross sectional study with Non probability convenient sampling technique. The study was carried out at Diabetic clinic of Al-Ibrahim Eye Hospital, Isra Postgraduate Institute of Ophthalmology, Karachi-Pakistan. Ethical approval was taken from the institutional review board of Institute. Data collection were done retrospectively from January 2017 to June 2019. Data were retrieved for DME patients who have completed three follow-ups with Avastin injection. Inclusion Criteria were patients with age 30 to 60 years, Patient with PDR and NPDR with diabetic macular edema after 3rd injection. Data Analysis was done using SPSS version 23.0. Results: A total of 40 eyes of 40 patients were included in this study after getting information from the record sheet. Analysis were done in 30 eyes of 30 patients because 10 patients were missed their follow-up due to certain reason which were observed from record sheet. Mean age of patients was found to be 41.25±10.24.Pre-operative Avastin injection best corrected visual acuity (BCVA) was noticed by using Log MAR without glasses was 0.49 and with glasses was 0.40. Post-operative best corrected visual acuity Log MAR without glasses 0.51 and with glasses 0.42 after Avastin injection. Improvement of visual acuity was classified as Improved, worsen and Stable. There were 22 (73.33%) patients observed with improvement in visual acuity, 5 (16.66%) patients retained their vision stable and only 3 (10%) patients worsen their visual acuity after all three Avastin injections. Conclusion: The most common cause of diabetic macular edema is non-proliferative diabetic retinopathy and proliferative Diabetic Retinopathy. The Intravitreal injection play vital role, the timely treatment would improve prognosis of visual outcomes in Diabetic macular edema. So the study significantly shows the improvement in best corrected visual acuity before and after three visits.

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Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

Author(s):

Yoshito Koyanagi ◽

Shigeo Yoshida ◽

Yoshiyuki Kobayashi ◽

Yuki Kubo ◽

Muneo Yamaguchi ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Option ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

The Mean ◽

The Difference ◽

Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

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Real-world outcomes of two-year Conbercept therapy for diabetic macular edema

International Journal of Ophthalmology ◽

10.18240/ijo.2021.03.14 ◽

2021 ◽

Vol 14 (3) ◽

pp. 416-422

Author(s):

Yong Cheng ◽

◽

Ming-Wei Zhao ◽

Tong Qian ◽

◽

...

Keyword(s):

Visual Acuity ◽

Adverse Events ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Vision Loss ◽

Retinal Thickness ◽

Corrected Visual Acuity ◽

The Mean ◽

Number Of Injections ◽

Best Corrected Visual Acuity

AIM: To evaluate the two-year outcomes of patients treated for diabetic macular edema (DME) with intravitreal Conbercept (IVC). METHODS: The clinical data of 30 DME patients (36 eyes) were retrospectively reviewed. The patients were treated with IVC for 3mo. Additional IVC was given at subsequent monthly visits, if needed (3+PRN). The patients were followed up for 24mo. RESULTS: The best-corrected visual acuity (BCVA) at 24mo significantly increased (66.7±15.3 letters) in comparison with the baseline (54.4±15.4 letters, P<0.0001). The mean improvement in BCVA was 11.0±2.9 letters. At 24mo, 44.1% of the eyes surveyed gained ≥15 letters, 52.9% of the eyes gained ≥10 letters, and 70.6% of the eyes gained ≥5 letters. No vision loss was noted in 96.8% of the eyes, and 5.9% of the eyes lost ≥5 letters, but ≤10 letters. The central retinal thickness (CRT) at 24mo was significantly reduced (277.1±122.9 μm) in comparison with the baseline (510.9±186.1 μm, P<0.0001). At 24mo, 43.3% of the patients had a CRT ≤250 μm. The mean number of injections over 24mo was 10.6±2.0. No severe eye or systemic adverse events related to either the drug or injection were noted. CONCLUSION: IVC is safe and effective for the treatment of DME.

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Comparison of aflibercept and ranibizumab in diabetic macular edema associated with subretinal detachment

European Journal of Ophthalmology ◽

10.1177/1120672119827855 ◽

2019 ◽

Vol 30 (2) ◽

pp. 363-369 ◽

Cited By ~ 1

Author(s):

Abdullah Ozkaya ◽

Gokhan Demir ◽

Asli Kirmaci

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Secondary Outcome ◽

Intravitreal Ranibizumab ◽

Corrected Visual Acuity ◽

Intravitreal Aflibercept ◽

Best Corrected Visual Acuity

Purpose: To compare the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular edema associated with subfoveal retinal detachment. Methods: This is a retrospective, comparative study. The treatment-naïve diabetic macular edema patients who had diabetic macular edema associated with subfoveal retinal detachment and underwent intravitreal aflibercept or intravitreal ranibizumab treatment were included. The patients were treated on a pro re nata treatment regimen after a loading dose of 3-monthly injections and the follow-up time was 12 months. The primary outcome measure of this study was the presence of subfoveal retinal detachment after treatment at different time points. The secondary outcome measures were the change in best corrected visual acuity and central retinal thickness. Results: A total of 46 eyes of 46 patients were included. The aflibercept group consisted of 20 and the ranibizumab group consisted of 26 eyes. During the follow-up period of 12 months, subfoveal retinal detachment was completely resolved in 75% versus 57.7% of the eyes at month 3 (p = 0.2), 90% versus 76.9% at month 6 (p = 0.2), 90% versus 65.4% at month 9 (p = 0.05), and 100% versus 80.8% at month 12 (p = 0.03) in the intravitreal aflibercept versus intravitreal ranibizumab groups. The change in best corrected visual acuity was not statistically different between the groups at months 3, 6, 9, and 12, respectively (p > 0.05 for all). Conclusion: Both intravitreal aflibercept and intravitreal ranibizumab were effective in regards to anatomical and functional outcomes of diabetic macular edema patients associated with subfoveal retinal detachment. Interestingly, intravitreal aflibercept seemed more effective than intravitreal ranibizumab in the resolution of subfoveal retinal detachment at month 12.

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Comparison of outcomes between intravitreal ranibizumab and intravitreal aflibercept for diabetic macular edema with “Treat-and-Extend” regimen

10.21203/rs.2.16775/v1 ◽

2019 ◽

Author(s):

Masahiko Sugimoto ◽

Shinichiro Chujo ◽

Taku Sasaki ◽

Atsushi Ichio ◽

Ryohei Miyata ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Ranibizumab ◽

Treat And Extend ◽

Corrected Visual Acuity ◽

Intravitreal Aflibercept ◽

Number Of Injections ◽

Best Corrected Visual Acuity ◽

Treat And Extend Regimen

Abstract Background To compare the effectiveness of intravitreal ranibizumab (IVR) and aflibercept (IVA) with the Treat-and-Extend (TAE) regimen for diabetic macular edema (DME).Patients and methods Thirteen eyes received an intravitreal injection of 0.5 mg ranibizumab (mean age, 70.9±6.0 years) and 13 eyes received 2 mg aflibercept (65.9±8.6 years). After 3 consecutive monthly injections, they received additional injections with the TAE regimen. The changes in the best-corrected visual acuity (BCVA), CRT, and total number of injections were compared.Results No significant differences were detected in the baseline demographics. The BCVA was significantly improved for both groups; 0.31±0.19 to 0.10±0.12 logMAR units for IVR and 0.41±0.19 to 0.16±0.28 logMAR units for IVA at 24 months ( P <0.01). The CRT was significantly reduced in both groups; 440.9±69.3 to 307.5±66.4 μm for IVR and 473.9±71.5 to 317.8±71.2 μm for IVA at 24 months ( P <0.01). No significant differences were detected in the improvements of the BCVA and reduction in the CRT between them. The total number injections were significant fewer for the IVA group (11.0±1.2) than the IVR group (12.0±1.0) at 24 months ( P =0.02).Conclusion The results showed that the TAE regimen was effective. The IVA group required fewer injections to attain the same improvements.

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Early versus late switch: How long should we extend the anti-vascular endothelial growth factor therapy in unresponsive diabetic macular edema patients?

European Journal of Ophthalmology ◽

10.1177/1120672119848257 ◽

2019 ◽

Vol 30 (5) ◽

pp. 1091-1098 ◽

Cited By ~ 1

Author(s):

Adrian Hernández Martínez ◽

Ernesto Pereira Delgado ◽

Guillermo Silva Silva ◽

Luis Castellanos Mateos ◽

José Lorente Pascual ◽

...

Keyword(s):

Vascular Endothelial Growth Factor ◽

Visual Acuity ◽

Growth Factor ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Vascular Endothelial ◽

Corrected Visual Acuity ◽

Endothelial Growth Factor ◽

Switch Group ◽

Best Corrected Visual Acuity

Purpose: To compare the results of early versus late switch to the dexamethasone intravitreal implant Ozurdex® in patients with diabetic macular edema who had a poor response to vascular endothelial growth factor inhibitors. Methods: Retrospective and single-center study conducted, in a real setting, on consecutive diabetic macular edema patients who were switch to an intravitreal dexamethasone implant after a poor response to anti-vascular endothelial growth factor treatment. Study sample was divided into two groups: (1) early-switch group, included those eyes who received three anti-vascular endothelial growth factor injections before switch and (2) late-switch group, included those eyes that received six or more anti-vascular endothelial growth factor injections before switch. The primary end-point was the difference in mean change in best-corrected visual acuity and in central subfoveal thickness. Results: A total of 69 (31 early-switch group and 38 late-switch group) eyes were included. In the early-switch group, median (25–75 quartile range) best-corrected visual acuity significantly increase from 0.2 (0.2–0.5) at baseline to 0.4 (0.3 –0.7) at month 24 (p = 0.0043). Whereas, in the late-switch group, best-corrected visual acuity did not increase (p = 0.8602). Central subfoveal thickness was significantly reduced in both early- and late-switch groups, p = 0.0002 and 0.0038, respectively. The proportion of eyes obtaining a central subfoveal thickness reduction ⩾ 10% was significantly greater in the early-switch group than in the late-switch group (71.0% vs 47.4%, respectively, p = 0.0498). Three (9.7%) and 10 (26.3%) eyes have developed ocular hypertension during the study in the early- and late-switch groups, respectively, p = 0.0816. Conclusion: Early switch to Ozurdex in patients who did not adequately respond to anti-vascular endothelial growth factor therapy provided better functional and anatomical outcomes.

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Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency

European Journal of Ophthalmology ◽

10.1177/1120672120901691 ◽

2020 ◽

pp. 112067212090169 ◽

Cited By ~ 1

Author(s):

Olufemi E Adams ◽

Sidney A Schechet ◽

Seenu M Hariprasad

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Retinal Thickness ◽

Fluocinolone Acetonide ◽

Central Retinal Thickness ◽

Corrected Visual Acuity ◽

Persistent Diabetic Macular Edema ◽

Best Corrected Visual Acuity

Objective: To evaluate, in the setting of persistent diabetic macular edema, the impact that continuous fluocinolone acetonide delivery has on treatment burden, visual acuity, central retinal thickness, and intraocular pressure. Materials and methods: A single-center, retrospective, cohort study of patients with persistent diabetic macular edema, previously treated with anti–vascular endothelial growth factor injections, dexamethasone implants, or focal laser, who were subsequently treated with fluocinolone acetonide was conducted. All retinal visits were analyzed prior to fluocinolone acetonide, until the most recent follow-up visit. Primary outcomes were pre– and post–fluocinolone acetonide changes in the best-corrected visual acuity and number of treatments required for diabetic macular edema. Secondary outcomes included changes in the central retinal thickness and intraocular pressure. Results: A total of 19 eyes with persistent diabetic macular edema were included and followed for a mean (SD) of 399.3 (222.9) days. Post–fluocinolone acetonide, the mean best-corrected visual acuity improved by 0.4 ETDRS letters for all eyes ( p = 0.895) and the central retinal thickness decreased by 34.2 µm ( p = 0.077). After fluocinolone acetonide, the number of treatments decreased from an average of one treatment every 2.7 months to one every 6 months ( p = 0.009). Furthermore, post–fluocinolone acetonide, 10/19 eyes (52.6%) did not require additional treatment due to a dry macula, and those who did experienced a non-statistically significant reduction of treatments, from one every 2.6 months pre–fluocinolone acetonide, to one every 2.8 months post–fluocinolone acetonide ( p = 0.622). Conclusions: In the setting of persistent diabetic macular edema, fluocinolone acetonide significantly reduces the therapeutic burden, while maintaining best-corrected visual acuity and improving the central retinal thickness. In patient-centered discussions, judiciously employing fluocinolone acetonide should be performed to mitigate this therapeutic burden for patients.

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Correlation between optical coherence tomographic patterns and visual acuity in eyes with diabetic macular edema

QJM ◽

10.1093/qjmed/hcaa058.034 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

HA A A Mansour ◽

A A Mohamed ◽

H M Abdeldayem ◽

A F Mahmoud

Keyword(s):

Diabetes Mellitus ◽

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Diabetic Patients ◽

Optical Coherence ◽

Patients Âgés ◽

Corrected Visual Acuity ◽

High Prevalence ◽

Best Corrected Visual Acuity

Abstract Background Diabetes mellitus is a disease of high prevalence as well as incidence and consequence worldwide. An approximate 387 million people have been found to be affected by diabetes mellitus worldwide in 2013. It is presumed that the number of people with diabetes will almost double the current numbers by 2035. Aim of the work To determine what is the most important predictor assessed by spectral domain optical coherence tomographic tomography (SD-OCT) correlates with best corrected visual acuity (BCVA) in eyes with untreated diabetic macular edema (DME). Patients and Methods Sixty eyes of forty three diabetic patients were included in this observational ,non intervention study. The patients’ ages ranged from 50 to 70 years. All cases had DM type2. This study was conducted at ophthalmic clinic of Al Mataria teaching Hospital from January 2018 till November 2018. Informed consent was obtained from all participants before enrolment. All applicable institutional regulations concerning the ethical use of human volunteers were followed during this research. Results In this study, we observed statistically significant correlation between best corrected visual acuity (BCVA) and central subfield thickness (C. S. T), moreover this study detect that the most important OCT pattern affecting vision is the presence of central macular edema. Conclusion In untreated diabetic macular edema cystoid macular edema was the most common OCT pattern and has worest vision during 1st ophthalmic examination

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How to Achieve Near-Normal Visual Acuity with Bevacizumab in Diabetic Macular Edema Patients

Journal of Clinical Medicine ◽

10.3390/jcm10163572 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3572

Author(s):

Bogumiła Sędziak-Marcinek ◽

Adam Wylęgała ◽

Elżbieta Chełmecka ◽

Edward Wylęgała ◽

Sławomir Teper

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Wide Field ◽

Swept Source ◽

Normal Visual Acuity ◽

Corrected Visual Acuity ◽

Central Subfield Thickness ◽

Before And After

Patients suffering from diabetic retinopathy (DR) and diabetic macular edema (DME) are inherently interested in achieving normal or near-normal visual acuity. The study aimed to investigate factors influencing the visual acuity achieved by DME patients after bevacizumab (IVB) treatment. 98 patients (98 eyes) diagnosed with DR and DME underwent IVB treatment (9 injections/12 months). Patients were diagnosed and monitored using swept-source optical coherence tomography (SS-OCT), ultra-wide-field fluorescein angiography (UWFFA) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart testing. We assessed macular central subfield thickness (CST), non-proliferative diabetic retinopathy (NPDR) indicators and best-corrected visual acuity (BCVA). After the treatment, patients were divided into BCVA£75 and BCVA>75 groups. The IVB therapy increased the number of ETDRS letters read by about 9 and 8 in the BCVA£75 and the BCVA>75 group, respectively. Before and after treatment, the BCVA>75 group had lower CST than the BCVA£75 group. The treatment reduced macular CST by 177 μm in the BCVA£75 group and only by 93 μm in the BCVA>75 group. Total non-perfusion area (NPA) decreased in both BCVA score groups after IVB therapy. Normal or near-normal vision can be achieved with IVB treatment, provided it starts when visual acuity is not significantly reduced yet. The ophthalmic screening of DR patients should also target those with relatively high visual acuity.

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Pengaruh Bevacizumab Intravitreal terhadap Best Corrected Visual Acuity dan Central Macular Thickness pada Diabetic Macular Edema

Jurnal Kesehatan Andalas ◽

10.25077/jka.v8i4.1094 ◽

2020 ◽

Vol 8 (4) ◽

Author(s):

Arini Ghaisa Atsari ◽

Weni Helvinda

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Central Macular Thickness ◽

Corrected Visual Acuity ◽

Anti Vegf ◽

One Way Anova ◽

Best Corrected Visual Acuity

Diabetic Macular Edema (DME) adalah penyebab utama kebutaan pada populasi diabetes. Salah satu patogenesis pada DME adalah karena peningkatan ekspresi VEGF. Bevacizumab adalah anti-VEGF yang dapat meningkatkan Best Corrected Visual Acuity (BCVA) dan mengurangi Central Macular Thickness (CMT) pada pasien DME. Tujuan: Mengetahui persentase jenis kelamin, usia, durasi DM tipe II, BCVA dan CMT sebelum dan setelah injeksi pada bulan pertama dan bulan ketiga pada pasien DME serta menganalisis pengaruh intravitreal bevacizumab anti-VEGF terhadap BCVA dan CMT pada DME di Rumah Sakit M Djamil Padang. Metode: Penelitian ini adalah studi retrospektif analitik berdasarkan rekam medis dari 16 pasien DME yang telah injeksi bevacizumab intravitreal pada tahun 2017. Data dianalisis secara statistik menggunakan uji one way Anova dengan p < 0,05 dianggap signifikan. Hasil: Pasien terdiri dari 11 wanita (68,8%) dan 5 pria (31,2%). Jumlah usia pasien terbanyak antara 51-55 tahun (43,8%) dan durasi terlama yang diketahui DM tipe II adalah 5-10 tahun (50,0%). Rata-rata BCVA (logMAR) sebelum injeksi intravitreal bevacizumab adalah 0,95, bulan pertama setelah injeksi adalah 0,68, dan bulan ketiga setelah injeksi adalah 0,55. CMT rata-rata sebelum injeksi bevacizumab intravitreal adalah 427,62, bulan pertama setelah injeksi 359,59, dan bulan ketiga setelah injeksi 318,12. Simpulan: Terdapat pengaruh bevacizumab anti-VEGF intravitreal terhadap BCVA dan CMT di DME di Rumah Sakit M Djamil Padang.

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