scholarly journals Diabetic Macular Edema-Like Ocular Lesions in Male Spontaneously Diabetic Torii Fatty Rats

2018 ◽  
pp. 423-432 ◽  
Author(s):  
Y. MOTOHASHI ◽  
Y. KEMMOCHI ◽  
T. MAEKAWA ◽  
H. TADAKI ◽  
T. SASASE ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Outer Nuclear Layer ◽  
Internal Limiting Membrane ◽  
Vitreous Humor ◽  
Diabetic Patients ◽  
New Therapeutic Approaches ◽  
Number Of Patients ◽  
Ocular Lesions

Diabetic macular edema (DME) is a major factor contributing to visual disabilities in diabetic patients, and the number of patients is increasing. Animal models play a key role in the development of novel therapies. In this study, pathophysiological analyses of ocular lesions in Spontaneously Diabetic Torii (SDT) fatty rats were performed. First, vascular endothelial growth factor (VEGF) concentrations in vitreous humor, retinal vascular permeability and retinal thickness were measured in SDT fatty rats (Experiment 1). Furthermore, the pharmacological effects of two anti-diabetic drugs, phlorizin and pioglitazone, on retinal lesions were evaluated (Experiment 2). As results, the SDT fatty rats exhibited VEGF increase in vitreous humor at 8 and 16 weeks of age, and both retinal vascular hyperpermeability and retinal thickening at 16 weeks of age. In particular, the layers between the retinal internal limiting membrane and the outer nuclear layer were thickened. Phlorizin treatment from 4 to 16 weeks of age improved hyperglycemia and normalized retinal thickness; however, the effect of pioglitazone on retinal thickness was not strong despite the normalization of hyperglycemia. These data demonstrate that the male SDT fatty rat is a useful model for developing new therapeutic approaches in DME.

scholarly journals Multifocal Electroretinogram Changes after Vitrectomy in Patients with Diabetic Macular Edema

2021 ◽  
Author(s):  
Fathy Elsalhy ◽  
Hisham Fawzy Khalil ◽  
Mohamed Mohamed-Aly Ibrahim
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Multifocal Electroretinogram ◽  
Internal Limiting Membrane ◽  
Diabetic Patients ◽  
Macular Area ◽  
Ilm Peeling ◽  
Group A ◽  
Pars Plana ◽  
Group B

Abstract Purpose: was to assess the results of vitrectomy with and without internal limiting membrane (ILM) peeling on retinal function and anatomy in patients with diabetic macular edema (DME). Methods: Pars plana vitrectomy (PPV) was done in 40 eyes of 40 patients with DME (15 male, 25 female). Patients were enrolled randomly into two different groups. Group A- comprised (20) eyes who underwent vitrectomy without ILM peeling. Group B- comprised (20) eyes who underwent vitrectomy with ILM peeling. For each patient, visual acuity (VA) examination (in decimal charts), assessment of central macular thickness (CMT) with optical coherence tomography (OCT) and multifocal eletroretinogram (MF-ERG) were done before and 3 months post vitrectomy. Results: Postoperative mean VA increased significantly (from 0.17 to 0.27 in group A and from 0.21 to 0.38 in group B). Mean CMT decreased significantly after surgery (from 493 μm to 315 μm in group A and from 502 μm to 299 μm in group B). Mean P1 wave amplitude (nV/ deg2) in the macular area increased after surgery (from 32.15 to 41.10 in group A and from 35.5 to 40.8 in group B). Mean P1 wave latency (millisecond) in the macular area decreased after surgery (from 50.30 to 36.40 in group A and from 49.5 to 39.2 in group B).Conclusion: Vitrectomy with and without ILM peeling improve VA and macular edema in diabetic patients moreover an increase of amplitude and reduction of the latency of the macular mf-ERGs indicated an improvement of the macular visual function.

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

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.

scholarly journals En face image-based classification of diabetic macular edema using swept source optical coherence tomography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Atsushi Fujiwara ◽  
Yuki Kanzaki ◽  
Shuhei Kimura ◽  
Mio Hosokawa ◽  
Yusuke Shiode ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Nuclear Layer ◽  
Subretinal Fluid ◽  
Plexiform Layer ◽  
Optical Coherence ◽  
Fiber Layer ◽  
Swept Source ◽  
En Face

AbstractThis retrospective study was performed to classify diabetic macular edema (DME) based on the localization and area of the fluid and to investigate the relationship of the classification with visual acuity (VA). The fluid was visualized using en face optical coherence tomography (OCT) images constructed using swept-source OCT. A total of 128 eyes with DME were included. The retina was segmented into: Segment 1, mainly comprising the inner nuclear layer and outer plexiform layer, including Henle’s fiber layer; and Segment 2, mainly comprising the outer nuclear layer. DME was classified as: foveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 24), parafoveal cystoid space at Segment 1 and no fluid at Segment 2 (n = 25), parafoveal cystoid space at Segment 1 and diffuse fluid at Segment 2 (n = 16), diffuse fluid at both segments (n = 37), and diffuse fluid at both segments with subretinal fluid (n = 26). Eyes with diffuse fluid at Segment 2 showed significantly poorer VA, higher ellipsoid zone disruption rates, and greater central subfield thickness than did those without fluid at Segment 2 (P < 0.001 for all). These results indicate the importance of the localization and area of the fluid for VA in DME.

Evaluation of retinal inflammatory biomarkers after intravitreal steroid implant and Ranibizumab injection in diabetic macular edema

2021 ◽  
pp. 112067212110294
Author(s):  
Ilkay Kilic Muftuoglu ◽  
Ecem Onder Tokuc ◽  
Fatma Sümer ◽  
V Levent Karabas
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Outer Nuclear Layer ◽  
Plexiform Layer ◽  
Retinal Layer ◽  
Treatment Naïve ◽  
The Mean ◽  
The Individual ◽  
Inflammatory Component

Purpose: To compare the efficacy of intravitreal (IV) ranibizumab (IVR) injection with IV dexamethasone implant (IVDEX) in treatment naive diabetic macular edema (DME) patients with inflammatory component. Materials and methods: Treatment naive DME eyes with subfoveal neurosensorial detachment (SND) and hyperreflective spots (HRS) were treated either three loading doses of IVR (18 eyes) or one dose of IVDEX (19 eyes). Central macular thickness (CMT), height of SND, the number of HRSs scattered on the individual retinal layers and photoreceptor integrity were assessed using spectral domain- optical coherence tomography scans over 3-months follow-up. Results: The mean change in best-corrected visual acuity (BCVA) was −0.11 ± 0.08 logMAR in IVDEX group and −0.04 ± 0.06 logMAR in IVR group at 1-month ( p = 0.011). IVDEX group showed statistically significant more increase in BCVA compared to those receiving IVR injections at 2-months ( p = 0.004) and 3-months ( p = 0.017) visits. Compared to baseline, the number of total HRSs and the number of HRSs at each individual inner retinal layer significantly decreased in both groups at all follow-up visits. However, IVDEX group showed more decrease in the total number of HRSs at 2- and 3-months ( p < 0.001 at 2-months, and p = 0.006 at 3-months) and in the mean number of HRSs located at inner nuclear layer–outer plexiform layer level ( p = 0.016 at 1-month, p < 0.001 at 2-months, and p < 0.001 at 3-months). After treatment, the number of HRSs on the outer nuclear layer showed some non-significant increase in both groups. Conclusion: HRSs tended to migrate from inner retina to the outer retina in DME eyes by treatment. Dexamethasone seemed to be more effective option in such cases with inflammatory component.

Efficacy of Subthreshold Photocoagulation for Persistent Diabetic Macular Edema After Internal Limiting Membrane Peeling: A Retrospective Comparative Study

2021 ◽  
Author(s):  
Hirotsugu Takashina ◽  
Akira Watanabe ◽  
Koji Komatsu ◽  
Tadashi Nakano
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Internal Limiting Membrane ◽  
Macular Thickness ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling ◽  
Group A ◽  
Group B ◽  
Subthreshold Photocoagulation ◽  
Persistent Diabetic Macular Edema

Abstract Background Subthreshold photocoagulation is one of the therapeutic options for treating diabetic macular edema, and have characteristic advantages, which are the lack of chorioretinal damage and the repeatability of the treatment. However, the effect of subthreshold photocoagulation is thought to be minimal among these options. In this study, we retrospectively examined the efficacy of repeated subthreshold photocoagulation for persistent diabetic macular edema after vitrectomy with peeling of the internal limiting membrane. Methods We enrolled ten consecutive eyes of eight patients who underwent monthly Endpoint Management™ (EpM) six times for diabetic macular edema that persisted for more than 3 months after vitrectomy with internal limiting membrane peeling for epiretinal membrane, and classified according to the interval between vitrectomy and initial EpM (Group A: within 6 months, Group B: beyond 6 months). Two type of retinal thickness (central macular thickness and macular thickness within 3mm diameter of the fovea) were measured monthly using optical coherence tomography. Results Mean intervals between vitrectomy and initial EpM were 4.0 ± 1.2 months (range 3–6 months) in Group A (six eyes of five patients) and 17.3 ± 7.5 months (range 10–27 months) in Group B (four eyes of four patients). No other treatments were performed between vitrectomy and initial EpM in Group A, while triamcinolone acetonide injection in the sub-Tenon’s capsule was performed in two eyes in Group B (one eye was injected thrice, the other eye received a single injection). Improvement rates of mean central macular thickness after 6 months were 18.2% in all eyes, 10.8% in Group A, and 28.7% in Group B, and improvement rates of mean macular thickness within 3mm diameter of the fovea after 6 months were 8.5% in all eyes, 4.1% in Group A, and 15.3% in Group B. Conclusions Monthly EpM treatment was efficacious against persistent diabetic macular edema after internal limiting membrane peeling. In particular, the efficacy was greater in eyes in which the initial EpM was performed more than 6 months after vitrectomy. Furthermore, residual efficacy of triamcinolone acetonide, which was injected at the end of vitrectomy, might have contributed to the results.

24-Hour variation of optical coherence tomography–measured retinal thickness in diabetic macular edema

2012 ◽  
Vol 22 (5) ◽  
pp. 785-791 ◽  
Author(s):  
Sokratis T. Kotsidis ◽  
Simeon S. Lake ◽  
Alexandros D. Alexandridis ◽  
Nikolaos G. Ziakas ◽  
Panagiotis K. Ekonomidis
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Optical Coherence

VITRECTOMY WITH INTERNAL LIMITING MEMBRANE PEELING FOR TRACTIONAL AND NONTRACTIONAL DIABETIC MACULAR EDEMA

Retina ◽  
2015 ◽  
Vol 35 (5) ◽  
pp. 921-928 ◽  
Author(s):  
Sophie Bonnin ◽  
Otman Sandali ◽  
Sébastien Bonnel ◽  
Claire Monin ◽  
Mohamed El Sanharawi
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Internal Limiting Membrane ◽  
Internal Limiting Membrane Peeling ◽  
Membrane Peeling

scholarly journals Anti-angiogenic therapy for diabetic macular edema

2018 ◽  
Vol 11 (4) ◽  
pp. 51-66
Author(s):  
Fedor E. Shadrichev ◽  
Nyurguyana N. Grigor'eva ◽  
Elizaveta S. Rozhdestvenskaya
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Severe Disease ◽  
Diabetic Patients ◽  
Vegf Inhibitors ◽  
Angiogenic Therapy ◽  
Examination Quality ◽  
Endothelial Growth Factor

Diabetic retinopathy remains one of the greatest challenges for healthcare system worldwide despite the fact that the incidence of visual acuity impairment in diabetic population has decreased due to examination quality improvement and dynamic observation of patients. Visual acuity impairment in diabetic patients is often related to diabetic macular edema. Until recently, laser photocoagulation of the retina was regarded as gold standard for diabetic macular edema treatment. Laser photocoagulation of the retina provides visual acuity stabilization rather than improvement. Since early 2000s, pharmacological approach to this severe disease has been established. As vascular endothelial growth factor (VEGF) is one of the crucial factors involved in the pathogenesis of diabetic retinal disorders, VEGF inhibitors are now recognized as a treatment of choice for diabetic macular edema. This article considers results of different clinical trials investigating anti-VEGF therapy efficacy in DME treatment.

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