scholarly journals Estimation of the Level of Glycosylated Hemoglobin as a Predictor Factor to Bevacizumab Injection in Diabetic Macular Edema in a Sample of Iraqi Patients

2021 ◽  
Vol 9 (B) ◽  
pp. 1480-1483
Author(s):  
Hasanain Hasan Attar ◽  
Farooq Mohammed Abbas ◽  
Haider Layikh
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Glycosylated Hemoglobin ◽  
Study Groups ◽  
Corrected Visual Acuity ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Abstract Background: clinically significant macular edema ( CSME) consider as one of the most critical complications of poorly controlled diabetes and it’s the main reason for decreased vision in that kind of patients, we try in this article to find the relation between glycosylated hemoglobin level and the response to bevacizumab injections in people with macular edema   Materials and methods: Ninety-five patients (55 male:40 female) were recruited in this study, all of them had diabetes type2, age of the participants ranging from 42 to 70 years old, Complete ophthalmic examination was done for all the participants including (best-corrected visual acuity), (intraocular pressure) checking, fundus evaluation, and central macular thickness measurement, serum glycosylated hemoglobin (HbA1C) was also measured, Patients were given 0.05ml(1.25mg) of bevacizumab (Avastin)  intravitreally for three successive months, Follow up visit was at 4,8,12 week post-injection. On each follow up detailed examination was done including the( best-corrected visual acuity) examination, (Intraocular pressure), both fundus examination, and OCT of the macula. Results: This study included 111 patients who had type 2 diabetes mellitus who were classified according to HbA1c into two sub-groups, HbA1c ≤ 7 % (n = 45) and HbA1c > 7 % (n = 66) we found no significant difference in mean age and frequency distribution according to gender between study groups (p > 0.05), but, there was a highly significant difference in mean HbA1c % (p < 0.001). when we compare mean OCT and mean VA before and after the intervention in patients who had diabetes mellitus classified according to HbA1c into (HbA1c ≤ 7 % and HbA1c > 7 %) we found that before the intervention, there was no significant difference in mean OCT between study groups (p > 0.05), but after the intervention, there was a reduction in mean OCT and the reduction was more pronounced in the group of HbA1c of less than 7 % (p < 0.001). About visual acuity, we found no significant difference before the intervention and after the intervention, the changes were comparable between both study groups (p > 0.05). Conclusion: intra-vitreal injections of bevacizumab result in anatomical (macular thickness) and functional (vision ) improvement in those patients who had diabetic macular edema and strict glycemic control affecting the outcome of the treatment where strict regulation of glucose level have yield maximum benefit from the given therapy   

scholarly journals Effect of phacoemulsification with intraocular lens implantation in eyes with cataract and functioning filtering blebs

2013 ◽  
Vol 13 (2) ◽  
pp. 33-41
Author(s):  
Devendra Maheshwari ◽  
Rengappa Ramakrishanan ◽  
Mohideen Abdul Kader ◽  
Neelam Pawar ◽  
Ankit Gupta
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Intraocular Lens ◽  
Intraocular Lens Implantation ◽  
Corrected Visual Acuity ◽  
Lens Implantation ◽  
The Mean ◽  
One Year ◽  
Best Corrected Visual Acuity

Aim: To evaluate the effect of phacoemulsification with intraocular lens implantation in eyes with pre-existing trabeculectomy.Methods: This prospective single-center clinical study evaluated intraocular pressure in 60 eyes of 60 patients who underwent phacoemulsification and implantation of a foldable intraocular lens after a previous successful trabeculectomy. Patients who had a trabeculectomy more than one year prior to the study were included. Intraocular pressure, number of antiglaucoma medications, bleb appearance, and visual acuity were recorded preoperatively, and at each follow-up examination and 12 months after phacoemulsification.Results: The mean intraocular pressure before phacoemulsification was 12.42 mmHg (SD, 4.60 mmHg), which increased to 14.98 mmHg (SD, 4.18 mmHg), 14.47 mmHg (SD, 3.58 mmHg), 15.44 mmHg (SD, 3.60 mmHg), and 15.71 mmHg (SD, 3.47 mmHg) after one, three, six, and 12 months, respectively. At each follow-up visit, the mean IOP was significantly higher than the preoperative value (p < 0.001, p = 0.015, p ≤ 0.001, and p = 0.001 at month one, three, six, and 12, respectively). The mean preoperative best-corrected visual acuity was 0.98 logMAR (SD, 0.44 logMAR) and the mean postoperative best-corrected visual acuity at 12 months was 0.20 logMAR (SD, 0.21 logMAR) [p = 0.0001]. The mean preoperative number of antiglaucoma medications used was 0.57 (SD, 0.63), which increased to 0.65 (SD, 0.63 ), 0.70 (SD, 0.72 ) 0.68, (SD, 0.70), and 0.67 (SD, 0.77 ) at one, three, six, and 12 months, respectively, but there were no statistically significant differences. Bleb size decreased clinically after phacoemulsification. Nineteen of 60 eyes (32%) developed fibrosis of bleb with decreased bleb size.Conclusion: Phacoemulsification with intraocular lens implantation significantly increased intraocular pressure and increased the number of antiglaucoma medications in eyes with pre-existing functioning filtering blebs.

scholarly journals Safety and Efficacy of 25G vitrectomy surgery for malignant glaucoma in pseudophakia

2019 ◽  
Author(s):  
fei you
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Safety And Efficacy ◽  
Corrected Visual Acuity ◽  
Malignant Glaucoma ◽  
Intraocular Hemorrhage ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Abstract Background: malignant glaucoma after cataract surgery is still one of the serious complications, if not handled properly，it may lead to serious consequences. It is notoriously difficult to treat. 25G vitrectomy was performed to evaluate the safety and efficacy for the treatment of malignant glaucoma in pseudophakia. Methods: This is a retrospective, comparative case series study. A total of 20 eyes of 20 patients with malignant glaucoma after phacoemulsification were analyzed retrospectively in The First Affiliated Hospital Of Anhui Medical University from May 2015 to January 2018. All Medical Data including the best corrected visual acuity (BCVA), Change of intraocular pressure (IOP), the length of eye axis, and the depth of anterior chamber were recorded. SPSS 17.0 statistical software was used for analysis .Before surgery, the best corrected visual acuity (BCVA) was 1.8±0.6. The intraocular pressure was between 18-57mmHg, with an average of 35.2±10.4mmHg.The depth of anterior chamber was between 0.9-1.9mm, with an average of 1.3±0.2mm.The length of eye axis was 19.7-22.5mm,with an average of 20.6±0.5mm.All the patients were accomplished with 25G vitrectomy. Besides, anterior chamber inflammatory reaction and other complications were also observed postoperation. Results: The patients were followed up for 6-12 months with an average of 9 months. BCVA at the last follow up improved to 0.8±0.1, and there was significant difference compared to that before operation (P<0.01).IOP was from 12-19mmHg, an average of 16.1±2.5mmHg, there was significant difference compared to that before operation (t=7.6, p<0.01).Only one patient occurred low IOP (6mmHg) after surgery, IOP returned to normal level (14mmHg) after conservative treatment. No serious complications including corneal endothelium decompensation, intraocular lens (IOL) capture, intraocular hemorrhage, endophthalmitis and uncontrolled IOP were observed. Conclusions: 25G minimally invasive vitrectomy can treat malignant glaucoma after cataract surgery safely and effectively

Comparison of aflibercept and ranibizumab in diabetic macular edema associated with subretinal detachment

2019 ◽  
Vol 30 (2) ◽  
pp. 363-369 ◽  
Author(s):  
Abdullah Ozkaya ◽  
Gokhan Demir ◽  
Asli Kirmaci
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Secondary Outcome ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Best Corrected Visual Acuity

Purpose: To compare the efficacy of ranibizumab and aflibercept in the treatment of diabetic macular edema associated with subfoveal retinal detachment. Methods: This is a retrospective, comparative study. The treatment-naïve diabetic macular edema patients who had diabetic macular edema associated with subfoveal retinal detachment and underwent intravitreal aflibercept or intravitreal ranibizumab treatment were included. The patients were treated on a pro re nata treatment regimen after a loading dose of 3-monthly injections and the follow-up time was 12 months. The primary outcome measure of this study was the presence of subfoveal retinal detachment after treatment at different time points. The secondary outcome measures were the change in best corrected visual acuity and central retinal thickness. Results: A total of 46 eyes of 46 patients were included. The aflibercept group consisted of 20 and the ranibizumab group consisted of 26 eyes. During the follow-up period of 12 months, subfoveal retinal detachment was completely resolved in 75% versus 57.7% of the eyes at month 3 (p = 0.2), 90% versus 76.9% at month 6 (p = 0.2), 90% versus 65.4% at month 9 (p = 0.05), and 100% versus 80.8% at month 12 (p = 0.03) in the intravitreal aflibercept versus intravitreal ranibizumab groups. The change in best corrected visual acuity was not statistically different between the groups at months 3, 6, 9, and 12, respectively (p > 0.05 for all). Conclusion: Both intravitreal aflibercept and intravitreal ranibizumab were effective in regards to anatomical and functional outcomes of diabetic macular edema patients associated with subfoveal retinal detachment. Interestingly, intravitreal aflibercept seemed more effective than intravitreal ranibizumab in the resolution of subfoveal retinal detachment at month 12.

Phacoemulsification in Eyes with Neovascular AMD Treated with Anti-VEGF Injections

2011 ◽  
Vol 21 (6) ◽  
pp. 766-770 ◽  
Author(s):  
Maria Muzyka-Woźniak
Keyword(s):  
Visual Acuity ◽  
Median Time ◽  
Time Interval ◽  
Neovascular Amd ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Case Series Study ◽  
Significant Difference ◽  
Best Corrected Visual Acuity

Purpose. To evaluate visual results of phacoemulsification in eyes with neovascular age-related macular degeneration (AMD) treated with anti–vascular endothelial growth factor (VEGF) intravitreal injections. Methods. This retrospective noncomparative interventional case-series study assessed best-corrected visual acuity (BCVA) at 4 timepoints: 1) baseline, immediately before first anti-VEGF injection; 2) preoperative, immediately before phacoemulsification; 3) postoperative, 1 month after phacoemulsification; 4) endpoint, at the last visit. Anti-VEGF retreatment regimen was based only on optical coherence tomography. The median time between anti-VEGF injections was evaluated for the time period before and after phacoemulsification. Results. Sixteen eyes of 16 patients were included. The median (range) baseline, preoperative, post-operative, and endpoint BCVA was 0.7 (0.3–1.3), 0.72 (0.4–1.3), 0.5 (0.05–1.0), and 0.36 (0.0–1.0) logMAR, respectively. Best-corrected visual acuity significantly improved after phacoemulsification (mean 3 logMAR lines) and remained stable during follow-up (median 14 months, range 7–28). There was no statistically significant difference in the median time interval between injections before phacoemulsification and after phacoemulsification. Conclusions. Phacoemulsification significantly improved BCVA in patients with choroidal neovascular AMD. This effect persisted during follow-up with no increased need for anti-VEGF injections to keep macula dry.

scholarly journals Pneumatic induction of the posterior vitreous detachment - a minimally invasive method of treating vitreomacular traction syndrome

2017 ◽  
Vol 98 (5) ◽  
pp. 865-868
Author(s):  
D V Petrachkov ◽  
A V Zolotarev ◽  
P A Zamytskiy ◽  
E V Karlova ◽  
T A Podsevakina
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Posterior Vitreous Detachment ◽  
Vitreomacular Traction ◽  
Vitreous Detachment ◽  
Vitreomacular Traction Syndrome ◽  
Corrected Visual Acuity ◽  
Age Related ◽  
Best Corrected Visual Acuity

To study the efficacy of pneumatic induction of posterior vitreous detachment for the treatment of vitreomacular traction syndrome, the analysis of the results of surgical treatment of 10 patients (10 eyes) with vitreomacular traction syndrome was performed, among them 8 patients (8 eyes) had an accompanied immature age-related cataract and 2 patients (2 eyes) - pseudophakia. The average age of the patients was 64.1±4.6 years, among them 8 women and 2 men. The mean best corrected visual acuity on admission was 0.31±0.15, the average length of vitreomacular adhesion and retina thickness in the fovea by optical coherence tomography were 289.3±75.4 and 367.5±50.3 μm, respectively. Patients with pseudophakia underwent pneumatic induction of the posterior vitreous detachment, and patients with cataract underwent the same surgery in combination with phacoemulsification of the cataract and intraocular lens implantation. Within 1 month of follow-up, all patients had a complete posterior vitreous detachment and increased best corrected visual acuity. Intraocular pressure remained normal throughout the follow-up period in 9 out of 10 patients, 1 patient experienced hypertension on day 1 after the surgery, which required decompression during the gas expansion period. Further on, intraocular pressure was normalized and did not require therapy. Pneumatic induction of posterior vitreous detachment is an effective method of treatment of vitreomacular traction syndrome, which allows eliminating vitreomacular traction; the combination of pneumatic induction of the posterior vitreous detachment with phacoemulsification of cataract allows avoiding hypertension during and after operation and avoiding performing vitrectomy.

scholarly journals Comparison of the Effect of Trabeculectomy in Controlling Intraocular Pressure in Pseudo-Exfoliaiton and Primary Open Angle Glaucoma Patients

2019 ◽  
pp. 1-7
Author(s):  
S. Kavuncu ◽  
H. H. Erbil
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Study Groups ◽  
First Year ◽  
Open Angle ◽  
Significant Difference ◽  
The Mean

Objective: The aim of this study is to compare the efficacy of the trabeculectomy in controlling intraocular pressure in patients with primary open-angle and pseudo-exfoliation glaucoma. Materials and Methods: The medical data of a sum of 69 eyes of which 36 (52,2%) with primary open angle glaucoma (POAG) and 33 (47,8%) with pseudo-exfoliation (PEG), who have medically uncontrolled glaucoma and had undergone primary trabeculectomy in Göztepe Education and Research Hospital were evaluated in this retrospective study. Postoperatively, data at the first day, at the first month, and at the last examination evaluated in the study. Success of the surgery is defined as measurement of intraocular pressure under 21 mmHg with (incomplete success) or without (complete success) additional medications following the end of the first year follow-up examinations. Results: POAG group consists of 36 patients of which 16 male, 20 female and PEG group consists of 33 patients of which 21 male and 12 female. The mean age was 67.2±9.1 (42-80) years in POAG group and 70.7±6.6 (55-80) years in PEG group. There was no statistically significant difference between POAG and PEG groups in visual acuity, mean intraocular pressure, c/d ratio and the number of antiglaucomatous medications preoperatively and postoperatively (p>0.05). There was a statistically significant difference in groups between post and preoperative values in visual acuity, mean intraocular pressure, c/d ratio and the number of antiglaucomatous medications (p<0.05) Success of the trabeculectomy was 41,7% (complete success), 41,7% (incomplete success) and remaining 16,6% was unsuccessful, in POAG group and success rate in PEG group was 51.5%, 27,3% and 21,2% respectively. There was no statistically significant difference between groups (p=0.738). Conclusion: Trabeculectomy is an effective surgery in lowering intraocular pressure in both of the study groups equally.

scholarly journals Twelve-Month Results of a Single or Multiple Dexamethasone Intravitreal Implant for Macular Edema following Uncomplicated Phacoemulsification

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Solmaz Abdolrahimzadeh ◽  
Vito Fenicia ◽  
Maurizio Maurizi Enrici ◽  
Pasquale Plateroti ◽  
Dora Cianfrone ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Topical Therapy ◽  
Mean Value ◽  
Ophthalmological Examination ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

The clinical efficacy of one or two intravitreal injections of a continued deliverance dexamethasone 700 μg implant in ten patients with persistent macular edema following uncomplicated phacoemulsification was evaluated. Complete ophthalmological examination and spectral domain optical coherence tomography were carried out. Follow-up was at day 7 and months 1, 2, 4, 6, 8, and 12. At baseline mean best corrected visual acuity was 62 Early Treatment Diabetic Retinopathy Study Chart letters, which showed statistically significant improvement at each follow-up, except at month 6, to reach 79 letters at month 12 (P=0.018). Prior to treatment mean central foveal thickness was 622 μm, which showed statistically significant improvement at each follow-up to reach a mean value of 282 μm (P=0.012) at month 12. Five patients received a second dexamethasone implant at month 7. Two patients were excluded from the study at months 4 and 8. Intraocular pressure remained stable during the study period with the exception of mild increase in two patients requiring topical therapy. In conclusion there was statistically significant improvement of best corrected visual acuity and mean central foveal thickness with one or two intravitreal dexamethasone implants over 12 months.

Comparison of outcomes between Aurolab aqueous drainage implant placed in the superotemporal versus inferonasal quadrant

2020 ◽  
pp. bjophthalmol-2019-315558
Author(s):  
George Varghese Puthuran ◽  
Paul Frederic Palmberg ◽  
Hiruni Kaushalya Wijesinghe ◽  
Thandra Sai Shreya ◽  
S R Krishnadas ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Light Perception ◽  
Refractory Glaucoma ◽  
Significant Drop ◽  
Time Points ◽  
Corrected Visual Acuity ◽  
Surgical Option ◽  
Best Corrected Visual Acuity

AimTo determine the outcomes of Aurolab aqueous drainage implant (AADI) placed in the superotemporal versus the inferonasal quadrant in adult eyes with refractory glaucoma.MethodsThis was a retrospective study of eyes that had AADI placement and completed a minimum of 2-year follow-up. The choice of the quadrant was at the surgeon’s discretion and mainly depended on the amount of scarring and conjunctival mobility. The cumulative failure rate of the AADI was defined as intraocular pressure (IOP) >21 mm Hg or not reduced by 20% below baseline on two consecutive follow-up visits after 3 months, IOP ≤5 mm Hg on two consecutive follow-up visits after 3 months, reoperation for glaucoma or a complication, or loss of light perception vision.ResultsWe included 84 eyes with AADI in the inferonasal quadrant versus 69 eyes in the superotemporal quadrant. A significant drop in IOP was seen in both groups (18.4±10.4 mm Hg in the inferonasal group vs 17.7±11.1 mm Hg in the superotemporal group; p=0.63) at 3-month follow-up and this was maintained until last follow-up. Best-corrected visual acuity, IOP, number of IOP-lowering medications and complications were similar between the two groups at all time points. The cumulative success rate at 2-year follow-up without IOP-lowering medications was 57.1% (47.1%–68.1%) in the inferonasal group and 50.7% (39.8%–63.1%) in the superotemporal group (p=0.47).ConclusionsInferonasal AADI placement appears to be an equally safe and effective surgical option compared with superotemporal AADI placement and may be helpful in certain clinical situations.

Discontinuous to continuous therapy for persistent diabetic macular edema leads to reduction in treatment frequency

2020 ◽  
pp. 112067212090169 ◽  
Author(s):  
Olufemi E Adams ◽  
Sidney A Schechet ◽  
Seenu M Hariprasad
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Fluocinolone Acetonide ◽  
Central Retinal Thickness ◽  
Corrected Visual Acuity ◽  
Persistent Diabetic Macular Edema ◽  
Best Corrected Visual Acuity

Objective: To evaluate, in the setting of persistent diabetic macular edema, the impact that continuous fluocinolone acetonide delivery has on treatment burden, visual acuity, central retinal thickness, and intraocular pressure. Materials and methods: A single-center, retrospective, cohort study of patients with persistent diabetic macular edema, previously treated with anti–vascular endothelial growth factor injections, dexamethasone implants, or focal laser, who were subsequently treated with fluocinolone acetonide was conducted. All retinal visits were analyzed prior to fluocinolone acetonide, until the most recent follow-up visit. Primary outcomes were pre– and post–fluocinolone acetonide changes in the best-corrected visual acuity and number of treatments required for diabetic macular edema. Secondary outcomes included changes in the central retinal thickness and intraocular pressure. Results: A total of 19 eyes with persistent diabetic macular edema were included and followed for a mean (SD) of 399.3 (222.9) days. Post–fluocinolone acetonide, the mean best-corrected visual acuity improved by 0.4 ETDRS letters for all eyes ( p = 0.895) and the central retinal thickness decreased by 34.2 µm ( p = 0.077). After fluocinolone acetonide, the number of treatments decreased from an average of one treatment every 2.7 months to one every 6 months ( p = 0.009). Furthermore, post–fluocinolone acetonide, 10/19 eyes (52.6%) did not require additional treatment due to a dry macula, and those who did experienced a non-statistically significant reduction of treatments, from one every 2.6 months pre–fluocinolone acetonide, to one every 2.8 months post–fluocinolone acetonide ( p = 0.622). Conclusions: In the setting of persistent diabetic macular edema, fluocinolone acetonide significantly reduces the therapeutic burden, while maintaining best-corrected visual acuity and improving the central retinal thickness. In patient-centered discussions, judiciously employing fluocinolone acetonide should be performed to mitigate this therapeutic burden for patients.

scholarly journals Correlation between optical coherence tomographic patterns and visual acuity in eyes with diabetic macular edema

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
HA A A Mansour ◽  
A A Mohamed ◽  
H M Abdeldayem ◽  
A F Mahmoud
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Patients Âgés ◽  
Corrected Visual Acuity ◽  
High Prevalence ◽  
Best Corrected Visual Acuity

Abstract Background Diabetes mellitus is a disease of high prevalence as well as incidence and consequence worldwide. An approximate 387 million people have been found to be affected by diabetes mellitus worldwide in 2013. It is presumed that the number of people with diabetes will almost double the current numbers by 2035. Aim of the work To determine what is the most important predictor assessed by spectral domain optical coherence tomographic tomography (SD-OCT) correlates with best corrected visual acuity (BCVA) in eyes with untreated diabetic macular edema (DME). Patients and Methods Sixty eyes of forty three diabetic patients were included in this observational ,non intervention study. The patients’ ages ranged from 50 to 70 years. All cases had DM type2. This study was conducted at ophthalmic clinic of Al Mataria teaching Hospital from January 2018 till November 2018. Informed consent was obtained from all participants before enrolment. All applicable institutional regulations concerning the ethical use of human volunteers were followed during this research. Results In this study, we observed statistically significant correlation between best corrected visual acuity (BCVA) and central subfield thickness (C. S. T), moreover this study detect that the most important OCT pattern affecting vision is the presence of central macular edema. Conclusion In untreated diabetic macular edema cystoid macular edema was the most common OCT pattern and has worest vision during 1st ophthalmic examination

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