scholarly journals Bevacizumab and Treatment Regimes in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 155-159
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Intravitreal Bevacizumab ◽  
Retinal Neovascularization ◽  
Diabetic Patients ◽  
Treatment Regimes ◽  
Endothelial Growth Factor

Diabetic macular edema and proliferative diabetic retinopathy is the most important cause of vision loss in diabetic patients. Vascular endothelial growth factor has been shown to play a major role in retinal neovascularization and vascular hyperpermeability in eyes with diabetic patients. Recent studies have demonstrated the usefulness of an intravitreal injection of bevacizumab in the reduction of diabetic macular edema, vascular permeability, and fibrovascular proliferation in retinal neovascularization secondary to proliferative diabetic retinopathy. This review aimed to evaluate the intravitreal bevacizumab in diabetic retinopathy and diabetic macular edema.

scholarly journals Incidence of diabetic eye disease in accordance with duration, glycemic control, blood and ocular pressure

2017 ◽  
Vol 70 (11-12) ◽  
pp. 353-358
Author(s):  
Vladimir Canadanovic ◽  
Sandra Jovanovic ◽  
Sofija Davidovic ◽  
Ana Oros ◽  
Vladislav Dzinic ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Glycosylated Hemoglobin ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Group I

Introduction. Diabetic retinopathy remains the leading cause of visual disability and blindness among professionally active adults in economically developed societies, which is of particular concern because the prevalence and incidence of diabetes mellitus is expected to increase sharply during the next decade. There are several known factors responsible for the development of diabetic retinopathy, duration of disease and blood sugar level being the most important ones. Material and Methods. Prospective study of 280 diabetic patients (diabetes mellitus type 2) divided into 3 groups according to the duration of diabetes mellitus. All diabetic patients underwent complete ophthalmological examination in artificial mydriasis and optic coherence tomography. A full medical history included patient age, the time elapsed from diabetes diagnosis, current treatment of diabetes, presence of hypertension and glycemic control assessed by glycosylated hemoglobin measurement. Results. The mean age of patients was 63.5 years (SD?6.5, range 57-70 years). Mean duration of diabetes was 7.3 years in group I, 12.4 years in group II and 17.2 years in group III. The average value of glycosylated hemoglobin was 6.58% in the group I, 7.64% in the group II and 8.29% in the third group of patients. No statistically significant difference in intraocular pressure and the level of blood pressure were found among groups. Cataract was present in 104 patients (37.1%). Complications related to diabetes among all patients included in our study were: nonproliferative diabetic retinopathy in 48.5%, proliferative diabetic retinopathy in 25.7% and diabetic macular edema in 22.5% of patients. Conclusion. The duration of diabetes is one of the most significant factors for the development of diabetic maculopathy and the progression from nonproliferative to its proliferative stage. There is significantly higher incidence of proliferative diabetic retinopathy and diabetic macular edema in patients with increased serum level of glycosylated hemoglobin. Diabetes accompanied by hypertension is related to worsening of the clinical course of diabetic eye diseases and developing diabetic macular edema and proliferative diabetic retinopathy.

scholarly journals Multifocal Electroretinogram, Central Macula Thickness and Visual Acuity in Diabetic Macular Edema Following Intravitreal Injection of anti-VEGF

2021 ◽  
Vol 4 (2) ◽  
pp. 150
Author(s):  
Syntia Nusanti ◽  
Kirana Sampurna ◽  
Ari Djatikusumo ◽  
Anggun Rama Yudantha ◽  
Joedo Prihartono
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Post Injection ◽  
Anti Vegf ◽  
Sd Oct

Introduction :  Diabetic Retinopathy (DR) is one of the major cause of visual acuity deterioration in diabetic patients. The loss of central visual acuity in diabetic patients are mainly due to macula edema, which is found in 29% diabetic patients with the over 20 years duration of disease. The aim of this study is to evaluate and investigate the possible correlation among changes of visual acuity (VA), central macular thickness (CMT) using Spectral Domain Optical Coherence Tomography (SD-OCT). Electrophysiological responses using multifocal electroretinography (MfERG) in diabetic macular edema (DME) following intravitreal injection of bevacizumab. Methods: Single arm clinical trial. Thirty-three eyes of 33 DME patients (16 non-proliferative diabetic retinopathy and 17 non-high-risk proliferative diabetic retinopathy), receives intravitreal bevacizumab 1,25mg. All patients underwent complete ophthalmic examination including ETDRS VA testing, Sixty-one scaled hexagon MfERG and SD-OCT scan at baseline, 1-week and 1-month post-injection. Components of the first order kernel (N1, N2 and P1) in central 2o were measured. Result : MfERG showed reduced P1 amplitude (P<0.05) at 1-week after injection followed by increased P1 amplitude (P>0.05) at 1-month after treatment as compared to the baseline in all subjects. There was 19% improvement CMT and 0.2Logmar VA improvement in 1-month post-injection compared to the baseline (P<005). This study showed no serious ocular adverse effects. There was no significant correlation between changes in visual acuity with changes in CMT or other MfERG parameters. Conclusion: Intravitreal injection bevacizumab resulting in improved VA, reduction in CMT and mild improvement in the MfERG responses. Although VA changes did not correlate with reduced CMT nor with improved responses of MfERG, the combined use of SD-OCT and MfERG may be used to evaluate macular function in DME patient with worsened visual acuity post anti-VEGF injection.

scholarly journals Effect of glycemic control on diabetic retinopathy and diabetic macular edema: a prospective observational study

2021 ◽  
Author(s):  
Kajal Seema S. ◽  
Jayalekshmi T. ◽  
Manasa S. ◽  
Prasenna M.
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Observational Study ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Fasting Blood Glucose ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Hba1c Levels

Background: The objective of the study was to examine the effect of long-term glycemic control, as measured by glycated hemoglobin levels (HbA1C), on the onset and progression of diabetic retinopathy (DR) and diabetic macular edema (DME) over a period of 10 years.Methods: Patients who were diagnosed to have type 2 diabetes mellitus participated in this cross-sectional observational study. Duration of onset of diabetes and the glycemic control status were analyzed. Fasting and postprandial blood sugar levels and HbA1C levels were tested for every participant. Diabetic retinopathy was graded as per the ETDRS guidelines using stereoscopic fundus photographs. In addition to the clinical evaluation, optical coherence tomography was done to confirm the presence of DME.Results: A total of 212 diabetic patients were enrolled in this study. One sixty-four patients (78.1%) had DR, out of which 71 patients (43.3%) had mild non proliferative diabetic retinopathy (NPDR), 42 patients (25.6%) had moderate NPDR, 31 patients (18.9%) had severe NPDR, and 20 (12.2%) had proliferative diabetic retinopathy (PDR). Fifty-nine patients with DR (36%) had DME. Duration of diabetes (14.62±6.18 vs 9.72±3.68 years, p<0.001), higher fasting blood glucose (176.79±59.13 vs 138.46±49.44 mg/dl, p<0.001) and higher HbA1c levels (8.21±1.38 vs 7.48±1.25 %, p=0.002) were significantly associated with DR.Conclusions: The stage of diabetic retinopathy rather than metabolic status is a strong predictive factor for the development of diabetic macular edema.

Clinical Diagnosis and New Classification of Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 119-123
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Diabetic Patients ◽  
Common Causes ◽  
Diagnosis Classification

Diabetic retinopathy and diabetic macular edema are the most common causes of preventable blindness among the working class in many countries. The prevalence of diabetic macular edema, which is frequently associated with vision loss, is increasing. Classification of diabetic retinopathy is essential for precise and punctual treatment and follow-up, and ultimately for enhancing the quality of life of diabetic patients. Studies in recent years have shared protocols for diagnosis, classification, and follow-up.

scholarly journals Intravitreal Bevacizumab In Diabetic Macular Edema At RSUP Cipto Mangunkusumo in 2017

2019 ◽  
Vol 2 (2) ◽  
Author(s):  
Andi Arus Victor ◽  
Masniah Masniah ◽  
Ari Djatikusumo ◽  
Elvioza Elvioza ◽  
Gitalisa Andayani Adriono ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
The Third ◽  
Department Of Ophthalmology

Introduction: Diabetic Macular Edema (DME) is a manifestation of diabetic retinopathy and is the most common cause of vision loss in diabetics. The incidence of DME has a tendency to increase, concomitant with the prevalence of diabetes globally by more than 50% from 2000 to 2030. This study aims to evaluate the proportion of central macular thickness (CMT) improvement and visual acuity in DME patients treated with intravitreal bevacizumab (IVB) injection. Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Ophthalmology at RSUP Cipto Mangunkusumo (RSCM) Jakarta. Data were obtained from the medical records of all diabetic retinopathy patients with macular edema who were treated with IVB at RSCM Kirana Vitreoretina Polyclinic on January – December 2017. Results: Of the 44 subjects, improvement in best corrected visual acuity (BCVA) occurred in 24 (54.54%) subjects at the first-month evaluation and 19 (43.18%) subjects at the third-month evaluation. CMT decreased in 37 (84.41%) subjects at the first-month evaluation and 35 (81.81%) subjects at the third-month evaluation. Conclusion: Visual acuity improvement and central macular thickness reduction 3 months after IVB injection. These results strengthen IVB injection to be an alternative to adjuvant therapy in DME.   Keywords: Diabetic Macular Edema, Intravitreal Bevacizumab Injection

scholarly journals Visual Morbidity in Diabetic Retinopathy Associated with Diabetic Nephropathy - Our Experience in a Multispecialty Tertiary Hospital in Chennai, India

2021 ◽  
Vol 10 (34) ◽  
pp. 2888-2893
Author(s):  
Praveena Venkatakrishnan ◽  
Radha Annamalai ◽  
Muthayya Muthukumar
Keyword(s):  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Vision Loss ◽  
Statistical Significance ◽  
Tertiary Hospital ◽  
Diabetic Patients ◽  
Ocular Morbidity ◽  
Clinically Significant

BACKGROUND The increased prevalence of diabetes mellitus (DM) worldwide has resulted in worsening diabetic retinopathy (DR) and nephropathy. The pathophysiological changes that occur at a cellular and anatomical level are similar in DR and DN. The risk factors for DR and DN are common hence investigating both is paramount to reduce morbidity. We wanted to study the association of diabetic retinopathy and diabetic nephropathy, their ophthalmic features, patterns of vision loss and extent of ocular morbidity. METHODS This is a retrospective observational study performed on 100 diabetic patients over 2 years. Patients with a confirmed diagnosis of DN based on clinical evaluation and laboratory tests were included. Ophthalmic evaluation and investigations were done and DR was classified based on early treatment diabetic retinopathy study (ETDRS). RESULTS Mild non-proliferative diabetic retinopathy (NPDR) occurred in 60 %, moderate to severe NPDR in 9 %, proliferative diabetic retinopathy (PDR) in 4 % and no diabetic retinopathy in 27 %. Macula was involved in 48 % with clinically significant macular edema (CSME) in 33 % and ischemic maculopathy in 5 %. Retinopathy occurred in 3 % after 5 years and in 40 % after 20 years of DM. The incidence of DN +DR was 65 % and statistical significance was noted with longer duration of diabetes, higher serum creatinine, proteinuria, lower haemoglobin, decreased GFR, higher age and higher lipid levels (P = 0.04). Improvement in vision was seen in 63 % after blood sugar control with laser photocoagulation, 27 % with laser alone and 7 % of patients with intravitreal anti-VEGF CONCLUSIONS DR and DN have an overlapping significant association and all patients have to be screened for both to prevent ocular morbidity. KEY WORDS Diabetic Retinopathy, Diabetic Nephropathy, Vision, Glomerular Filtration Rate, Macular Edema.

scholarly journals Modern aproaches to diabetic macular edema diagnosticks

2020 ◽  
Vol 23 (3) ◽  
pp. 260-266
Author(s):  
A. V. Doga ◽  
P. L. Volodin ◽  
E. V. Ivanova ◽  
D. A. Buryakov ◽  
O. I. Nikitin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Early Diagnosis ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Diagnostic Methods ◽  
Diabetic Patients ◽  
Timely Treatment

Diabetic macular edema (DME) continues to be an important problem of modern ophthalmology and endocrinology. Therisk of edema is higher in patients with type 2 diabetes. Thus, this is the main cause of irreversible vision loss in these patients. DME is one of the prognostically unfavorable and difficult to treat manifestations of diabetic retinopathy. As themain cause of vision loss in diabetic patients, diabetic macular edema is often not diagnosed immediately, which causes difficulties in the treatment of pathology. Thus, early diagnosis and timely treatment of this disease is the key to successfully counteract the uncontrolled decline in the patients visual functions. In this article, the team of authors highlighted the possibilities of informative instrumental research methods available in the Arsenal of modern ophthalmological services. Based on the analysis of modern literature, the main principles of these diagnostic methods were indicated, their key capabilities and limitations compared to each other were highlighted. Knowledge of these characteristics is, in our opinion, an integral and most important tool in the Arsenal of a practicing ophthalmologist who supervises patients with this pathology.

scholarly journals Fundus fluorescein angiographic assessment of patients with proliferative Diabetic Retinopathy and Macular Edema before and after intravitreal injection of Bevacizumab

2019 ◽  
Vol 7 (11) ◽  
pp. 4111
Author(s):  
Ankur . ◽  
Yogesh Kumar ◽  
Deepesh Arora ◽  
Rupali Tyagi ◽  
Sanjeev Kumar Mittal
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Fundus Fluorescein Angiography ◽  
Intravitreal Bevacizumab Injection ◽  
Department Of Ophthalmology ◽  
Leakage Area ◽  
Before And After

Background: To assess the role of intravitreal bevacizumab (1.25 mg) in patients with proliferative diabetic retinopathy with macular edema in terms of change in leakage area and best-corrected visual acuity.Methods: This prospective randomized interventional study was conducted in the Department of Ophthalmology from September 2013 to August 2015 and included thirty eyes of twenty patients.After a detailed history and ocular examination, diagnosed cases of proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) underwent sequential fundus fluorescein angiography. Bevacizumab was administered intravitreally. Patients were assessed two hours after injection for anterior chamber reaction and intraocular pressure and were advised follow-ups at 24 hours and then at 1, 4, 8 and 12 weeks. For the outcome, the change of retinal new vessels by assessment of leakage area using Quantitative Planimetric Analysis (QPA) of photographs as well as the change in best-corrected visual acuity (BCVA) from baseline to the 12 weeks follow-up, were done. Results were analyzed statistically by applying t-test.Results: Intravitreal bevacizumab injection lead to a significant decrease in leakage in DME and PDR, and improvement in mean BCVA. The effect was maximum at 4 weeks which weaned off as the study progressed through it remains statistically significant at the end of 12 weeks.Conclusions: Intravitreal bevacizumab plays a major role in treating and reducing visual deterioration in patients with proliferative diabetic retinopathy and diabetic 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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