scholarly journals Intravitreal Avastin as a Treatment of Diffuse Diabetic Macular Edema

2020 ◽  
Vol 5 (3) ◽  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Expression System ◽  
Chinese Hamster ◽  
Macular Thickness ◽  
Diabetic Patients ◽  
Central Macular Thickness ◽  
Diffuse Diabetic Macular Edema ◽  
The Mean

Background: Macular edema, defined as retinal thickening within 2 disc diameters of the center of the macula, results from retinal microvascular changes that compromise the blood-retinal barrier, causing leakage of plasma constituents into the surrounding retina and, consequently, retinal edema. Focal edema is associated with hard exudate rings caused by leakage from micro aneurysms. Diffuse edema is caused by leakage from micro aneurysms, retinal capillaries, and arterioles. Avastin (Bevacizumab) is a recombinant humanized monoclonal IgG1 antibody that binds to and inhibits the biologic activity of human vascular endothelial growth factor (VEGF). It contains human framework regions and the complementaritydetermining regions of a murine antibody that binds to VEGF. Avastin produced in a Chinese Hamster Ovary mammalian cell expression system in a nutrient medium containing the antibiotic gentamicin and has a molecular weight of approximately 149 kilo Daltons. Purpose: To assess the anatomic effect and visual acuity response after intravitreal (Avastin) in patients with diffuse diabetic macular edema. Patients and Methods: This study included 15 eyes of15 Patients with stable diabetes mellitus with diffuse diabetic macular edema. All eyes had received some form of argon laser photocoagulation (pan retinal photocoagulation (PRP), Focal or Grid of duration not less than 6 months. Mean age of 59 years treated with two intravitreal injections of Avastin 1.25 mg in 0.05 ml six weeks apart. Patients were examined by experienced ophthalmologist visual acuity, evaluation of diabetic retinopathy, central macular thickness by optical coherence tomography each was evaluated at the begging of study (baseline) and follow-up visits. Results: 15 eyes of 15 diabetic patients with persistent diffuse macular edema with no improvement in visual acuity. All the patients received two injections of A vastin six weeks apart. No complications were observed in any patient. The mean baseline visual acuity was (log Mar=1.338±0.455) and the mean visual acuity at three months following the second intravitreal injection was (log Mar=1.094±0.254), the mean central macular thickness at baseline was 492 µm decreased to 369 µm at the end of three months. Conclusions: A vastin resulted in a significant decrease in macular thickness and improvement in visual acuity at three months after the second injection.

scholarly journals Outcomes of Intravitreal Bevacizumab in Patients with Diabetic Macular Edema at a Tertiary Hospital in Northern Tanzania

2020 ◽  
pp. 27-34
Author(s):  
Shariza Kanji ◽  
Kazim Dhalla ◽  
William Makupa
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Central Vision ◽  
Macular Volume ◽  
The Mean ◽  
Anatomical Outcomes

Background: Diabetic macular edema is a type of diabetic maculopathy affecting the central vision, ranging from mild blur to blindness. Laser photocoagulation has been the mainstay of treatment for the past three decades but it has a limited role in improving the central vision. Recent introduction of anti-vascular endothelial growth factors appears to be promising in restoring vision. However, due to its short half life multiple injections are required to control edema and maintain vision. Objectives: To determine the visual and anatomical outcomes of intravitreal bevacizumab in patients with diabetic macular edema. Methods: A hospital based retrospective cross-sectional study was done at Kilimanjaro Christian Medical Center eye department from 2011- 2015. During this time, patients with  diabetic macular edema who were given intravitreal bevacizumab and satisfied the inclusion criteria were included in the study. Visual acuity, central macular thickness and macular volume were recorded at baseline, six, twelve, eighteen, twenty four and thirty weeks respectively. Optical coherence tomography was used to record central macular thickness and macular volume. Univariate and multivariate binary regression analysis were done and the p-value, odds ratio and 95% confidence interval were calculated. Results: The prevalence of Diabetic macular edema was 15.4%. Mean baseline visual acuity improved from  0.9 ± 0.57 log MAR (6/48) to 0.6±0.49 log MAR (6/24) (95% CI 0.207 - 0.389) at 30 weeks. The mean baseline central macular thickness decreased from 426.97 ± 148.358 μm to 280.98 ± 95.89  μm at 30 weeks (95% 151.531 - 187.044, P < .001). The mean baseline macular volume decreased significantly from 10.59 ± 2.55 mm3 to 8.38 ± 1.498 mm3 (95% CI 1.860 - 2.886) at 30 weeks. In multivariate analysis, patients with no hypertension were more likely to have a better visual outcome of 6/18 or better (95% CI 1.064 - 4.420, P < .033). Conclusion: This study shows a high burden of diabetic macular edema in our setting. Intravitreal bevacizumab injection results in better visual and anatomical outcomes.

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.

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

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
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.

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.

Correlation of visual acuity and central macular thickness in diabetic macular edema

2015 ◽  
Vol 93 ◽  
pp. n/a-n/a ◽  
Author(s):  
A. El Matri Hassairi ◽  
A. Chebil ◽  
M. Ben Abdallah ◽  
R. Maamouri ◽  
N. Chaker ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Macular Thickness ◽  
Central Macular Thickness

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 Effect of Adding Losartan to Bevacizumab for Treating Diabetic Macular Edema

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fariba Ghassemi ◽  
Abdulrahim Amini ◽  
Masoud Yasemi ◽  
Amin Nabavi ◽  
Mohammadkarim Johari
Keyword(s):  
Blood Pressure ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Glycosylated Hemoglobin ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Nonproliferative Diabetic Retinopathy ◽  
Significant Difference

Introduction. Diabetic retinopathy is the most common cause of visual loss and blindness in the age group of 20 to 64 years. This study aimed to evaluate the efficacy of oral Losartan adjuvant therapy in combination with intravitreal injection of Bevacizumab in the treatment of diabetic macular edema. Methods. In this randomized clinical trial, 61 eyes of 47 patients with normal blood pressure and diabetic macular edema and nonproliferative diabetic retinopathy were studied. Patients were randomly divided into Losartan (n = 33) and control (n = 28) groups. All patients received 3–6 intravitreal injections of Bevacizumab over 6 months. General examination including blood pressure and glycosylated hemoglobin measurements were performed in all patients. Complete ophthalmologic examination and macular OCT were performed at the first, third, and sixth months of treatment in all patients. Results. The mean age of the patients studied was 57.1 ± 7.4 years and 37.7% of the patients were male. There was no significant difference between the two groups in terms of initial visual acuity, central macular thickness, and frequency of injections. There was no significant difference in visual acuity and central macular thickness between the two groups at the first, third, and sixth months of treatment. Age, frequency of injection, and initial macular thickness less than 450 microns were effective in patients’ final visual acuity. Conclusion. Short-term adjuvant treatment with Losartan in patients with diabetic macular edema and nonproliferative diabetic retinopathy has no greater effect than the standard treatment.

scholarly journals Real-Life Management of Patients with Retinal Vein Occlusion Using I-Macula Web Platform

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Massimo Nicolò ◽  
Monica Bonetto ◽  
Raffaella Rosa ◽  
Donatella Musetti ◽  
Maria Musolino ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Real Life ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Vein Occlusion ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Web Platform

Aim.Real-lifeevaluation in the management of patients affected by macular edema secondary to retinal vein occlusion.Material and Methods. A retrospective, observational study using theI-Macula Webplatform.Results. Thirty-five patients (37 eyes; 15 females and 20 male) affected by RVO were analysed. At 12 months, there was a statistically significant improvement of best-corrected visual acuity (p=0.0235) and central macular thickness (p<0.0001). The mean change in visual acuity was 8.9 letters. Twenty-seven eyes underwent DEX implant (n=62; mean: 2.29) only. Of these, 8, 4, 14, and 1 eyes underwent 1, 2, 3, and 4 DEX implants, respectively. The remaining 10 eyes were also injected with ranibizumab (n=49; mean: 4.9). At 12 months, 12 eyes (32.5%) presented a dry macula, whereas the remaining 25 eyes (67.5%) still had macular edema. Mean interval between the first and second treatment (T1) and between the second and third treatment (T2) were 5.15 and (T2) 3.7 months, respectively. Where only DEX implants were received, T1 and T2 was 5.1 and 4.9 months, respectively.Conclusions. This study confirms that DEX implants and/or anti-VEGF drugs improve visual acuity and central macular thickness in patients affected by RVO.

scholarly journals Efıcacy of Mıcropulse Laser In The Treatment of Dıabetıc Macular Edema

2021 ◽  
Author(s):  
Faruk Bıçak ◽  
Özcan Rasim Kayıkçıoğu ◽  
Muhammed Altınışık ◽  
Suzan Doğruya ◽  
Emin Kurt
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Thickness Change ◽  
Macular Volume ◽  
Micropulse Laser ◽  
Significant Difference

Abstract Purpose: In this study, we aimed to evaluate and compare the visual acuity, macular volume, central macular thickness, change in number of intravitreal ranibizumab injections with micropulse laser applications after loading dose of antiVEGF to DME patients.Study Design: Retrospective study Methods: This study was carried out on 97 patients (45 ranibizumab and 52 micropuls grid laser + ranibizumab) with diabetic macular edema patients who were followed in the Retina Unit. At the control visit after three loading ranibizumab injections administered once a month, micropuls grid laser was applied to one group and ranibizumab injection was continued PRN to both groups for an average of 9.27 ± 2.42 months and central macular thickness, macular volume and visual acuity were recorded. Results: There was no significant difference between the groups in terms of gender, smoking and systemic diseases, initial central macular thickness, macular volume and visual acuity measurements (p> 0.05). Central macular thickness, macular volume and visual acuity values measured at the last follow-up of the patients were not significantly different between the groups (p> 0.05). The mean post-treatment injection requirement was 4.19 ± 1.01 for the ranibizumab with micropuls laser group and 5.53 ± 1.14 for the ranibizumab group. In the group treated with micropuls laser, statistically less number of intravitreal ranibizumab injections were needed (p <0.001). Conclusion: Micropulse laser treatment after initial loading doses reduces the need for antiVEGF injections. Studies with the participation of more patients may help in the selection of treatment methods by comparing micropulse laser combined with different injection protocols.

scholarly journals Sequential applied Benzalkonium Chloride and Insulin Eye Drops Reduces Ocular Central Macular Thickness and Improves vision of Diabetics and Non-Diabetics

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Herman C.I. Themen ◽  
Jerry R. Toelsie ◽  
Jerrel C. Pawiroredjo ◽  
Dinesh Jiawan ◽  
Robbert Bipat
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Benzalkonium Chloride ◽  
Macular Thickness ◽  
Eye Drops ◽  
Pathophysiological Mechanism ◽  
Central Macular Thickness ◽  
Efficient Treatment ◽  
Inflammatory Processes ◽  
The Mean

Introduction  Macular Edema is a rather disabling condition that can be the consequence of several disorders of the eye. Most of the time it occurs in patients suffering from diabetic eye retinopathy. The exact pathophysiological mechanism of this condition is not clear, but it is probably the result of inflammatory processes or structural and mechanical disturbances of the vitreomacular tissue. Due to this obscure pathophysiological mechanism, a targeted efficient treatment is still lacking. However, accumulating evidence is suggesting that local application of insulin might reduce the structural and functional defects of this disorder. The aim of this study is to assess the effects of sequential applied benzalkonium chloride and Insulin eye drops on the visual acuity and central macular thickness of eyes suffering from macular edema. Methods Patients refractive to or refusing treatment with anti-VEGF agents were selected. Their visual acuity and central macular thickness were measured immediately before and until six months after treatment. The treatment consisted of twice a day application of specially prepared benzalkonium chloride and Insulin eye drops. Results are expressed as mean ± SD. The procedures followed were all in line with the guides for ethics of the hospital and were not in conflict with the declaration of Helsinki. Result After six months, the mean visual acuity increased significantly from 0.28±0.17 to 0.53±0.27 (p = 0.001) and the central macular thickness decreased from 393±122 µm to 250±72 µm (p = 0.0001). Conclusion Sequential applied benzalkonium chloride and insulin eye drops improve visual acuity and reduce central macular thickness in eyes suffering from macular edema. Further studies to elucidate the exact mechanism of action are necessary. Apart from this, the use of these drops may prove to be a cheaper and more efficient method to treat the rather disabling condition.

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