scholarly journals Update on the Management of Uveitic Macular Edema

2021 ◽  
Vol 10 (18) ◽  
pp. 4133
Author(s):  
Slawomir Jan Teper
Keyword(s):  
Macular Edema ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Biological Drugs ◽  
Vegf Inhibitors ◽  
Local Immunity ◽  
Positive Effects ◽  
Drug Intolerance ◽  
Therapeutic Drugs ◽  
Uveitic Macular Edema

Uveitic macular edema (ME) is a frequent complication in 8.3% of uveitis patients and is a leading cause of serious visual impairment in about 40% of cases. Despite the numerous available drugs for its treatment, at least a third of patients fail to achieve satisfactory improvement in visual acuity. First-line drugs are steroids administered by various routes, but drug intolerance or ineffectiveness occur frequently, requiring the addition of other groups of therapeutic drugs. Immunomodulatory and biological drugs can have positive effects on inflammation and often on the accompanying ME, but most uveitic randomized clinical trials to date have not aimed to reduce ME; hence, there is no clear scientific evidence of their effectiveness in this regard. Before starting therapy to reduce general or local immunity, infectious causes of inflammation should be ruled out. This paper discusses local and systemic drugs, including steroids, biological drugs, immunomodulators, VEGF inhibitors, and anti-infection medication.

scholarly journals Anti-VEGF agents in the treatment of diabetic macular edema

2013 ◽  
Vol 16 (4) ◽  
pp. 78-84
Author(s):  
Vladimir Iosifovich Konenkov ◽  
Vadim Valerievich Klimontov ◽  
Valeriy Vyacheslavovich Chernykh ◽  
Nadezhda Viktorovna Tjan
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Randomized Clinical Trials ◽  
Diabetic Patients ◽  
Vegf Inhibitors ◽  
Vascular Endothelium Growth Factor ◽  
Future Studies ◽  
Anti Vegf ◽  
New Treatment

Diabetic macular edema (DME) is a common complication associated with the loss of visual acuity in diabetic patients. Intravitreal injections of vascular endothelium growth factor (VEGF) inhibitors (anti-VEGF therapy) have been proposed recently as a new treatment option for patients with DME. In this review we summarized results of randomized clinical trials of VEGF inhibitors in DME patients. The results indicate that all studied inhibitors (ranibizumab, bevacizumab, pegaptanib and aflibersept) reduce the retinal thickness and improve of visual acuity in DME when are used as a monotherapy or in combination with the laser treatment. Optimal course duration and effectiveness predictors of anti-VEGF therapy in DME should be elucidate in the future studies.

scholarly journals Can Transcranial Direct Current Stimulation Enhance Functionality in Older Adults? A Systematic Review

2021 ◽  
Vol 10 (13) ◽  
pp. 2981
Author(s):  
Andrés Pino-Esteban ◽  
Álvaro Megía-García ◽  
David Martín-Caro Álvarez ◽  
Hector Beltran-Alacreu ◽  
Juan Avendaño-Coy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Randomized Clinical Trials ◽  
Scientific Evidence ◽  
Healthy Older Adults ◽  
Sham Stimulation ◽  
Direct Current Stimulation ◽  
Potential Benefits

Transcranial direct current stimulation (tDCS) is a non-invasive, easy to administer, well-tolerated, and safe technique capable of affecting brain excitability, both at the cortical and cerebellum levels. However, its effectiveness has not been sufficiently assessed in all population segments or clinical applications. This systematic review aimed at compiling and summarizing the currently available scientific evidence about the effect of tDCS on functionality in older adults over 60 years of age. A search of databases was conducted to find randomized clinical trials that applied tDCS versus sham stimulation in the above-mentioned population. No limits were established in terms of date of publication. A total of 237 trials were found, of which 24 met the inclusion criteria. Finally, nine studies were analyzed, including 260 healthy subjects with average age between 61.0 and 85.8 years. Seven of the nine included studies reported superior improvements in functionality variables following the application of tDCS compared to sham stimulation. Anodal tDCS applied over the motor cortex may be an effective technique for improving balance and posture control in healthy older adults. However, further high-quality randomized controlled trials are required to determine the most effective protocols and to clarify potential benefits for older adults.

scholarly journals Patterns of Macular Edema in Uveitis as Diagnosed by Optical Coherence Tomography in Tertiary Eye Center

2018 ◽  
Vol 10 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Sharad Gupta ◽  
Dev Narayan Shah ◽  
Sagun Narayan Joshi ◽  
Manoj Aryal ◽  
Lila Raj Puri
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Edema ◽  
Serous Retinal Detachment ◽  
Posterior Uveitis ◽  
Invasive Technique ◽  
Optical Coherence ◽  
Fundus Fluorescein Angiography ◽  
Cross Sectional ◽  
Female Ratio ◽  
Uveitic Macular Edema

Aim: The aim of the study is to classify the patterns of uveitic macular edema using Optical Coherence Tomography as a diagnostic tool.Methodology: It is the Descriptive, cross-sectional study. All patients fulfilling the diagnostic criteria with Optical coherence tomography diagnosed macular edema were enrolled from 1 January 2012 to 30 June 2013. Patterns of uveitic macular edema were classified.Results: A total of 65 eyes of 47 patients were included. Twenty eight (59.57%) were male. The male to female ratio was 1.5:1. The mean age was 38 years (SD 14.68). Twenty nine patients (61.71%) had unilateral involvement and 18 (38.29%) had bilateral involvement. Forty five eyes of 33 cases (69.23%, 70.21%) had intermediate uveitis, followed by 10 eyes of 7 cases (15.38, 14.9%) of posterior uveitis, 6 eyes of 5 cases (9.23%, 10.63 %) of anterior uveitis and 4 eyes of 2 cases (6.16%,4.2%) of pan-uveitis. Patterns of macular edema were classified: diff use macular edema (DME), cystoid macular edema (CME) and serous retinal detachment (SRD) of which 35 (53.84%) eyes had CME. The etiological diagnosis was found in 7(14.90 %) out of 47 patients.Conclusion: A significant percentage of cases were idiopathic. Macular edema may go unnoticed unless OCT is performed. Macular detachment is an important feature of macular edema that affects visual acuity and is not readily detected by Fundus Fluorescein Angiography (FFA). Optical coherence tomography (OCT) is safe and non-invasive technique and has the potential for measuring changes in retinal thickness and axial extent of edema.

Recent progress in the treatment of uveitic macular edema

2019 ◽  
Vol 14 (4-5) ◽  
pp. 227-236 ◽  
Author(s):  
Alfredo Adán ◽  
Aina Moll-Udina ◽  
Carmen Alba-Linero ◽  
Juan Pablo Figueroa-Vercellino ◽  
Victor Llorenç
Keyword(s):  
Macular Edema ◽  
Recent Progress ◽  
Uveitic Macular Edema

Treatment of Uveitic Macular Edema

2020 ◽  
pp. 205-216
Author(s):  
Ilaria Testi ◽  
Andres Rousselot ◽  
Rupesh Agrawal ◽  
Carlos Pavesio
Keyword(s):  
Macular Edema ◽  
Uveitic Macular Edema

Pathophysiology of Uveitic Macular Edema

2020 ◽  
pp. 171-181
Author(s):  
Ilaria Testi ◽  
Andres Rousselot ◽  
Rupesh Agrawal ◽  
Carlos Pavesio
Keyword(s):  
Macular Edema ◽  
Uveitic Macular Edema

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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