VISUAL OUTCOME IN DIABETIC MACULAR EDEMA AFTER GRID LASER TREATMENT

2016 ◽  
Vol 23 (04) ◽  
pp. 478-483
Author(s):  
Muhmmad Jameel Shahid ◽  
Faheem Ahmad ◽  
Muhammad Asif ◽  
Muhmmad Nabeel Sultan
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Case Series ◽  
Visual Outcome ◽  
Blood Retinal Barrier ◽  
Department Of Ophthalmology

Regarding the causes of blindness, Diabetic retinopathy is a one the majorcause of blindness in all types persons from both industrialized and developing countries.Due to inadequate eating habits, prevalence of diabetic retinopathy is increasing. Both focaland diffuse leakage from retinal capillaries can cause Diabetic macular edema. Varioustreatment modalities for macular photocoagulation are focal laser, Grid laser and modified gridused in patients having diabetic macular edema Study Design: Prospective, interventional,noncompetitive case series. Setting: Department of Ophthalmology, Allied Hospital andDepartment of Ophthalmology, Divisional Headquarter Hospital Faisalabad. Period: One yearfrom April 2012 to April 2013. Materials and Methods: A total of 200 eyes of 200 patientswith clinical significant macular edema that met the inclusion criteria were enrolled. Results: Inthis study, 200 patients with diabetic macular edema were studied. Of these 121 (60.5%) weremales and 79 (39.5%) females with mean age of 38.52 years (SD 7.512, Range 25-50 years).All patients had diffuse, clinically significant macular edema at baseline for which they hadreceived grid laser photocoagulation. Discussion: In recent past number of diabetic patientsall over the world has increased that has caused increase incident of diabetic retinopathy .Soin patients having diabetic retinopathy, macular edema can cause deterioration in visual acuityduring any stage of diabetic retinopathy. The pathogenesis of Diabetic macular edema (DME)is the disruption of inner blood – retinal barrier that is known to be associated with metabolicalteration affecting the retinal pigment epithelium or retinal vascular endothelium. Focal and/orgrid laser photocoagulation is being considered as the treatment of DME. Conclusion: Macularphotocoagulation was found to be an effective method of treatment for CSME among diabeticpatients, which has resulted in a positive visual outcome in 87% of the patients (stable andimproved vision).

scholarly journals The use of diod laser in microphotocoagulation and high density photocoagulation regimens in the treatment of diabetic macular edema

2016 ◽  
Vol 9 (2) ◽  
pp. 27-29
Author(s):  
Aleksandr S Izmaylov ◽  
Tat’yana V Kotsur
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Retinal Pigment ◽  
High Density ◽  
Retinal Sensitivity ◽  
Laser Applications ◽  
Clinically Significant ◽  
Modern Standard

The modern standard of treatment of clinically significant diabetic macular edema is macular laser photocoagulation was suggested in the reports of the Early Treatment of Diabetic Retinopathy Study (ETDRS, 1985-1990). Subthreshold microphotocoagulation (MicroPulase) leads to developing barely visible or invisible retinal burns and also has been shown to be effective in treating macular edema with no side effects comparing with ETDRS methodic (retinal pigment and choroidal atrophy, decreasing of retinal sensitivity). Effectiveness of microphotocoagulation may arise in high density laser applications, however in modern literature exists rare publications concerning this question.

scholarly journals Treatment of diabetic macular edema and proliferative diabetic retinopathy with anti-vascular endothelial growth factor agents under the reimbursement policy of the Taiwan National Health Insurance Bureau: Aflibercept or ranibizumab?

2021 ◽  
Author(s):  
Ming-Chieh Hsieh ◽  
Chieh-Yin Cheng ◽  
Kun-Hsien Li ◽  
Chih-Chun Chuang ◽  
Jian-Sheng Wu ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Incidence Rates ◽  
Panretinal Photocoagulation ◽  
Reimbursement Policy ◽  
Micropulse Laser ◽  
The Mean

Abstract The purpose of this retrospective interventional case series is to compare the functional and anatomical outcomes in eyes with diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) treated intravitreally with aflibercept or ranibizumab under the Taiwan National Insurance Bureau reimbursement policy. 84 eyes were collected and all eyes were imaged with spectral-domain optical coherence tomography (SD-OCT), color fundus photographs (CFPs), and fluorescein angiography (FA). At 24 months after therapy initiation, the logMAR BCVA improved from 0.58 ± 0.33 to 0.47 ± 0.38 (p < 0.01), the CRT decreased from 423.92 ± 135.84 to 316.36 ± 90.02 (p < 0.01), and the number of microaneurysms decreased from 142.14 ± 57.23 to 75.32 ± 43.86 (p < 0.01). The mean injection count was 11.59 ± 6.54. There was no intergroup difference in logMAR BCVA (p = 0.96), CRT (p = 0.69), or injection count (p = 0.81). However, the mean number of microaneurysms was marginally reduced (p = 0.06) in eyes treated with aflibercept at the end of the follow-up, and the incidence rates of supplementary panretinal photocoagulation (PRP) (p = 0.04) and subthreshold micropulse laser (SMPL) therapy sessions (p = 0.01) were also reduced. Multivariate analysis revealed that only initial logMAR BCVA influenced the final VA improvements (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.21 ~ 0.93, p < 0.01); in contrast, age (OR -0.38, 95% CI -6.97~-1.85, p < 0.01) and initial CRT (OR 0.56, 95% CI 0.34 ~ 0.84, p < 0.01) both influenced the final CRT reduction at 24 months. To sum up, both aflibercept and ranibizumab are effective in managing DME with PDR in terms of VA, CRT and MA count. Eyes receiving aflibercept required less supplementary PRP and SMPL treatment than those receiving ranibizumab. The initial VA influenced the final VA improvements at 24 months, while age and initial CRT were prognostic predictors of 24-month CRT reduction.

scholarly journals CHOROIDAL THICKNESS IN PATIENTS WITH DIABETIC MACULAR EDEMA

2021 ◽  
Vol 71 (2) ◽  
pp. 433-37
Author(s):  
Amash Aqil ◽  
Muhammad Moin ◽  
Khadijah Abid ◽  
Ahsan Mehmood
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Choroidal Thickness ◽  
Macular Thickness ◽  
Control Group ◽  
Central Macular Thickness ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
The Mean

Objective: To evaluate central macular thickness and choroidal thickness in patients with macular edema due to diabetic retinopathy versus controls. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital, Lahore, from Jan to Jul 2018. Methodology: A retrospective data of 100 eyes from 50 patients having with diabetic macular edema associated with diabetic retinopathy was extracted from hospital registry. Additionally, 100 eyes of 50 individuals without any preexisting ocular conditions, comprising a control group was included in the study. Choroidal thickness measurements were made from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at subfoveal level using optical coherence tomography. Central macular thickness was also measured for all the enrolled patients. Results: One hundred patients fulfilling the inclusion criteria were enrolled in our study. The mean age was 56.27 ± 14.41 years. The mean Central macular thickness of all the patients were reported as 270.49 ± 72.38 μm, while the choroidal thickness was 284.89 ± 96.51 μm. There was statistically significant difference in central macular thickness between both healthy and diabetic retinopathy with diabetic macular edema groups (p=0.001), whereas insignificant difference existed between the two groups forchoroidal thickness (p=0.735). Conclusion: In patients with diabetic macular edema no significant change in choroidal thickness was observed compared with healthy controls, while the thickness of the retina was high in patients with macular edema due to diabetes.

scholarly journals Relationship between Outer Retinal Layers Thickness and Visual Acuity in Diabetic Macular Edema

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Raymond L. M. Wong ◽  
Jacky W. Y. Lee ◽  
Gordon S. K. Yau ◽  
Ian Y. H. Wong
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Correlation Coefficient ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Retinal Layers ◽  
Snellen Chart ◽  
Foveal Center

Purpose. To investigate the correlation of outer retinal layers (ORL) thickness and visual acuity (VA) in patients with diabetic macular edema (DME).Methods. Consecutive DME patients seen at the Retina Clinic of The University of Hong Kong were recruited for OCT assessment. The ORL thickness was defined as the distance between external limiting membrane (ELM) and retinal pigment epithelium (RPE) at the foveal center. The correlation between total retinal thickness, ORL thickness, and vision was calculated.Results. 78 patients with DME were recruited. The mean age was 58.1 years (±11.5 years) and their mean visual acuity measured with Snellen chart was 0.51 (±0.18). The correlation coefficient between total retinal thickness and visual acuity was 0.34 (P< 0.001) whereas the correlation coefficient was 0.65 between ORL thickness and visual acuity (P< 0.001).Conclusion. ORL thickness correlates better with vision than the total retinal thickness. It is a novel OCT parameter in the assessment of DME. Moreover, it could be a potential long term visual prognostic factor for patients with DME.

scholarly journals Role of Peoxisome Proliferator Activator Receptor on Blood Retinal Barrier Breakdown

PPAR Research ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-4 ◽  
Author(s):  
Yasuo Yanagi
Keyword(s):  
Diabetic Retinopathy ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Critical Role ◽  
Blood Retinal Barrier ◽  
Early Diabetes ◽  
Pathological Conditions ◽  
Barrier Breakdown ◽  
Brb Breakdown

The retinal vessels have two barriers: the retinal pigment epithelium and the retinal vascular endothelium. Each barrier exhibits increased permeability under various pathological conditions. This condition is referred to as blood retinal barrier (BRB) breakdown. Clinically, the most frequently encountered condition causing BRB breakdown is diabetic retinopathy. In recent studies, inflammation has been linked to BRB breakdown and vascular leakage in diabetic retinopathy. Biological support for the role of inflammation in early diabetes is the adhesion of leukocytes to the retinal vasculature (leukostasis) observed in diabetic retinopathy. is a member of a ligand-activated nuclear receptor superfamily and plays a critical role in a variety of biological processes, including adipogenesis, glucose metabolism, angiogenesis, and inflammation. There is now strong experimental evidence to support the theory that inhibits diabetes-induced retinal leukostasis and leakage, playing an important role in the pathogenesis of diabetic retinopathy. Therapeutic targeting of may be beneficial to diabetic retinopathy.

Photocoagulation for Diabetic Macular Edema

2020 ◽  
pp. 169-176
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Diabetic Patients ◽  
Nonproliferative Diabetic Retinopathy ◽  
Argon Laser Photocoagulation ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

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.

scholarly journals Aqueous humour concentrations of PEDF and Erythropoietin are not influenced by subthreshold micropulse laser treatment of diabetic macular edema

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Edoardo Midena ◽  
Silvia Bini ◽  
Luisa Frizziero ◽  
Elisabetta Pilotto ◽  
Graziana Esposito ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Aqueous Humour ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Future Research ◽  
Micropulse Laser ◽  
Subthreshold Micropulse Laser ◽  
Treatment Naïve ◽  
Glass Chip

Abstract Purpose: To determine if aqueous humour (AH) concentrations of Retinal Pigment Epithelium (RPE)’s biomarkers are modified after subthreshold micropulse laser (SMPL) treatment of diabetic macular edema (DME). Methods: Naïve DME and healthy subjects were enrolled. All DME patients received SMPL treatments (577-nm yellow light, 5% duty cycle of 0.2 s, power 250 mW), according to study protocol. AH of DME eyes was sampled at baseline and periodically after first SMPL treatment. Control eyes were sampled before cataract surgery. Pigment Epithelium Derived Factor (PEDF) and Erythropoietin (EPO) were quantified with glass-chip protein array. Results: Eighteen DME patients (central retinal thickness ≤ 400 μm on Spectral Domain Optical Coherence Tomography (SD-OCT)) and ten controls were enrolled. The main exclusion criteria were high refractive error, proliferative diabetic retinopathy, glaucoma and neurodegenerative disorders. PEDF concentration was decreased in DME patients at baseline versus controls (P=0.012), while EPO was increased (P=0.029). Both molecules’ concentrations remained stable during follow-up after treatments, compared with DME-baseline. Conclusions: The AH concentrations of RPE biomarkers were significantly different in DME treatment-naïve eyes versus controls. The expression of PEDF and EPO remained unchanged after treatments with SMPL in DME eyes. These data are relevant for future research and applications of SMPL.

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