The relation between inner segment/outer segment junction and visual acuity before and after ranibizumab in diabetic macular edema

Purpose. To compare outer retinal layer (ORL) thickness and photoreceptor outer segment (PROS) length between normal eyes and eyes with diabetic macular edema (DME), and also, to study the correlation between central macular thicknesses (CMT), ORL, and PROS length with best corrected visual acuity (BCVA) in DME. Methods. 80 eyes were included in the study; they were divided into two groups, group Ι (40 normal eyes) and group ΙΙ (40 eyes) with DME. Complete ophthalmic examination and OCT were done for all eyes. Comparison between ORL and PROS was done between both groups; also, correlation between ORL thickness, PROS length, and CMT with BCVA in group ΙΙ was studied. Results. CMT was greater in group ΙΙ than group Ι (392.70 ± 62.91 and 265.73 ± 17.17, respectively) (SS, p<0.001). ORL thickness was statistically significantly greater in group Ι than group ΙΙ (104.80 ± 4.94, 93.68 ± 6.34, p<0.001). Regarding PROS length, it was statistically significantly greater in group Ι than group ΙΙ (31.38 ± 3.4 and 26.65 ± 3.39, respectively, p<0.001). There was moderate correlation between BCVA and ORL thickness (r = −0.440, p=0.004) and strong correlation between BCVA and PROS length in group ΙΙ (r = − 0.690, p<0.001), while there was weak correlation between BCVA and CMT (r = 0.198, p=0.220). Conclusion. Both ORL thickness and PROS length were greater in healthy normal eyes than eyes with DME. BCVA was correlated better with PROS length and ORL thickness than CMT.

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The Association Between Percent Disruption of the Photoreceptor Inner Segment–Outer Segment Junction and Visual Acuity in Diabetic Macular Edema

American Journal of Ophthalmology ◽

10.1016/j.ajo.2010.01.039 ◽

2010 ◽

Vol 150 (1) ◽

pp. 63-67.e1 ◽

Cited By ~ 147

Author(s):

Anjali S. Maheshwary ◽

Stephen F. Oster ◽

Ritchie M.S. Yuson ◽

Lingyun Cheng ◽

Francesca Mojana ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Outer Segment ◽

Percent Disruption

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How to Achieve Near-Normal Visual Acuity with Bevacizumab in Diabetic Macular Edema Patients

Journal of Clinical Medicine ◽

10.3390/jcm10163572 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3572

Author(s):

Bogumiła Sędziak-Marcinek ◽

Adam Wylęgała ◽

Elżbieta Chełmecka ◽

Edward Wylęgała ◽

Sławomir Teper

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Wide Field ◽

Swept Source ◽

Normal Visual Acuity ◽

Corrected Visual Acuity ◽

Central Subfield Thickness ◽

Before And After

Patients suffering from diabetic retinopathy (DR) and diabetic macular edema (DME) are inherently interested in achieving normal or near-normal visual acuity. The study aimed to investigate factors influencing the visual acuity achieved by DME patients after bevacizumab (IVB) treatment. 98 patients (98 eyes) diagnosed with DR and DME underwent IVB treatment (9 injections/12 months). Patients were diagnosed and monitored using swept-source optical coherence tomography (SS-OCT), ultra-wide-field fluorescein angiography (UWFFA) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart testing. We assessed macular central subfield thickness (CST), non-proliferative diabetic retinopathy (NPDR) indicators and best-corrected visual acuity (BCVA). After the treatment, patients were divided into BCVA£75 and BCVA>75 groups. The IVB therapy increased the number of ETDRS letters read by about 9 and 8 in the BCVA£75 and the BCVA>75 group, respectively. Before and after treatment, the BCVA>75 group had lower CST than the BCVA£75 group. The treatment reduced macular CST by 177 μm in the BCVA£75 group and only by 93 μm in the BCVA>75 group. Total non-perfusion area (NPA) decreased in both BCVA score groups after IVB therapy. Normal or near-normal vision can be achieved with IVB treatment, provided it starts when visual acuity is not significantly reduced yet. The ophthalmic screening of DR patients should also target those with relatively high visual acuity.

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Observational Study on Treatment of SRD-Type Diabetic Macular Edema With Aflibercept

10.21203/rs.3.rs-799123/v1 ◽

2021 ◽

Author(s):

Yanlei Hao ◽

Yuan Tao ◽

Yang Li ◽

Jundong Wang ◽

Shuting Li ◽

...

Keyword(s):

Visual Acuity ◽

Observational Study ◽

Macular Edema ◽

Intravitreal Injection ◽

Diabetic Macular Edema ◽

Aqueous Humor ◽

Before And After

Abstract To examine the changes before and after intravitreal injection of Aflibercept in patients with SRD- type DME compared with non-SRD-type DME patients. Fifty eyes with SRD-type DME and 50 eyes with non-SRD-type DME were treated with Aflibercept (2 mg, 3 + PRN). The concentration of IL-6 in aqueous humor was measured before treatment, at 3 and 6 months after treatment. The changes in VA, CFT, and HRDs were observed before treatment and at 1, 2, 3, 4, 5, and 6 months after treatment. The VA in the two groups was improved after treatment (P < 0.05). the CFT and the number of HRDs in the two groups after treatment were decreased compared to that before treatment (all P < 0.05). Moreover, the concentration of IL-6 in the aqueous humor at 3 and 6 months after treatment was reduced compared with that before treatment (P < 0.05). This data suggests that inflammation had an important role in DME occurrence, and the occurrence of SRD is closely related to inflammation. Intravitreal injection of Aflibercept can improve the visual acuity and macular edema in patients with DME.

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Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i3.1051 ◽

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.

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Predictors for 2-year functional and morphological outcomes of a treat and extend regimen with ranibizumab in patients with diabetic macular edema

Ophthalmic Research ◽

10.1159/000514721 ◽

2021 ◽

Author(s):

Helena Giannakaki-Zimmermann ◽

Alexandra Behrndt ◽

Laura Hoffmann ◽

Maria-Magdalena Guichard ◽

Cengiz Tuerksever ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Loading Dose ◽

Treatment Frequency ◽

Treat And Extend ◽

Free Treatment ◽

Younger Age ◽

One Year ◽

Treat And Extend Regimen

Abstract Purpose: To investigate longer-term functional and morphological outcomes and their predictors in diabetic macular edema (DME) following a treat and extend regimen (TER) without loading dose under ranibizumab. Methods: Patient data were reviewed and analyzed retrospectively over a period of 24 months after initiation of TER. Best-corrected visual acuity (BCVA), treatment frequency as well as quantitative and qualitative Spectral-domain Optical Coherence Tomography parameters were assessed. Results: 118 eyes of 87 patients were included. A mean of 9.742.13 injections in the first and 7.632.29 in the second year were applied. There were significant gains of BCVA and reductions in central retinal thickness from baseline to month 12 and 24 (all p<0.001). Percentage of eyes with an intact inner-/outer segment (IS/OS) junction increased from 15.3% at baseline to 42.1% at month 24 (p<0.001). An intact IS/OS junction at baseline increased the probability of having a dry retina after 12 months by 79.3% (p=0.017) and after 24 months by 88.1% (p=0.040). Less IS/OS disruption at baseline predicted longer maximum recurrence-free treatment intervals at 2 years (r=-0.345, p<0.001) and better BCVA at one year (r=-0.347, p<0.001). Baseline bigger intraretinal cysts were associated with more IS/OS disruption at 24 months (r=0.305, p=0.007). Younger age and lower BCVA at baseline were predictive for a higher BCVA gain at 24 months (p=0.046, p<0.001). Conclusion: Ranibizumab applied in a TER without loading dose in DME significantly improves visual acuity and retinal anatomical structure throughout two years. The evaluated predictors might help to guide routine clinical treatment in DME.

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

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

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.

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Micropulse laser in patients with refractory and treatment-naïve center–involved diabetic macular edema: short terms visual and anatomic outcomes

Therapeutic Advances in Ophthalmology ◽

10.1177/2515841420979112 ◽

2021 ◽

Vol 13 ◽

pp. 251584142097911

Author(s):

Diego Alejandro Valera-Cornejo ◽

Marlon García-Roa ◽

Jaime Quiroz-Mendoza ◽

Alejandro Arias-Gómez ◽

Paulina Ramírez-Neria ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

Thickness Change ◽

Macular Volume ◽

Naive Group ◽

Micropulse Laser ◽

Refractory Diabetic Macular Edema ◽

Treatment Naïve

Purpose: The purpose of the study is to describe visual and anatomic outcomes of 5774nm micropulse laser photocoagulation in eyes with either treatment-naïve or refractory diabetic macular edema (DME) at 3 months. Methods: This was a prospective case series that recruited 23 consecutive patients (33 eyes) with center-involved DME that was either treatment-naïve or had not responded to prior treatment. Micropulse therapy was performed with the Easy Ret 577 (Quantel Medical, Cournon d’Auvergne, France) diode laser in a high-density manner in eyes with treatment-naïve or refractory DME. The primary outcome was the change of best-corrected visual acuity (BCVA; logMAR) at 1 and 3 months. Secondary outcomes were changes in the central macular thickness (CMT), thickness area, macular volume, and macular capillary leakage at 1 and 3 months. Results: There were no significant changes in BCVA at 3 months, with mean ± standard deviation (SD) of −0.08 ± 0.01 ( p = 0.228) and + 0.01 ± 0.01 ( p = 0.969) for treatment-naïve and refractory groups, respectively. The change in CMT at 3 months was statistically but not clinically significant in the treatment-naïve group only (mean ± SD; –30 ± 130 µm; p = 0.011). The macular volume and area thickness change were not statistically significant ( p = 0.173 and p = 0.148 for macular volume and area thickness, respectively) in the treatment-naïve group. There was no difference concerning the leakage area in both groups. No adverse events were reported. Conclusion: We concluded that micropulse 577nm laser therapy maintained the visual acuity and macular thickness at 3 months in both treatment-naïve and refractory DME.

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