The Impact of Aflibercept on Diabetic Macular Edema Patients Refractory to Ranibizumab in a Tertiary Care Eye Specialist Hospital, Saudi Arabia

Background: Pro re nata (PRN) regimen using anti-vascular endothelial growth factor (VEGF) agent is popular for the treatment of diabetic macular edema (DME). We investigated the influence of waiting time (WT) and interval between the date of recurrence of edema and re-injection on treatment efficacy. Methods: This retrospective study conducted at 7 sites in Japan enrolled patients who received intravitreal injection of ranibizumab (IVR) and aflibercept (IVA) in 1+PRN regimen. Enrolled patients were divided into 2 groups: prompt group (less than 1 week) and deferred group (3 weeks or more). Central retinal thickness (CRT) and best corrected visual acuity (BCVA) were measured every month for 1 year. Results: CRT in the deferred group was significantly higher than that in the prompt group at 2, 5, 6, 7, and 12 months (p < 0.05). BCVA in the prompt group was significantly better than that in the deferred group at 7, 10, and 12 months (p < 0.05). Conclusion: The prompt group was superior in anatomical and functional improvement of DME in anti-VEGF therapy than the deferred group. Our data suggests that shorter WT is recommended for better visual prognosis in the treatment for DME.

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The Impact of Baseline Retinal Volume on Visual Outcomes in the Treatment of Diabetic Macular Edema

Southern Clinics of Istanbul Eurasia ◽

10.14744/scie.2019.36854 ◽

2019 ◽

Author(s):

Mümin Hocaoğlu

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Visual Outcomes ◽

The Impact ◽

Retinal Volume

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Saudi Arabia Guidelines for diabetic macular edema

Saudi Medical Journal ◽

10.15537/smj.2021.2.25623 ◽

2021 ◽

Vol 42 (2) ◽

pp. 131-145

Author(s):

Abdullah S. AlQahtani ◽

Mohammad A. Hazzazi ◽

Saad A. Waheeb ◽

Valmore A. Semidey ◽

...

Keyword(s):

Saudi Arabia ◽

Macular Edema ◽

Diabetic Macular Edema

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Identifying Genetic Risk Factors for Diabetic Macular Edema and the Response to Treatment

Journal of Diabetes Research ◽

10.1155/2020/5016916 ◽

2020 ◽

Vol 2020 ◽

pp. 1-12

Author(s):

Rajya L. Gurung ◽

Liesel M. FitzGerald ◽

Bennet J. McComish ◽

Nitin Verma ◽

Kathryn P. Burdon

Keyword(s):

Risk Factors ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Genetic Risk ◽

Vision Loss ◽

Genetic Risk Factors ◽

Response To Treatment ◽

Diabetic Eye Disease ◽

Genetic And Environmental Factors ◽

The Impact

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM). DR is complex and the term encompasses several clinical subtypes of diabetic eye disease, including diabetic macular edema (DME), the most frequent cause of central vision loss in DR patients. Both genetic and environmental factors contribute to the pathophysiology of DR and its subtypes. While numerous studies have identified several susceptibility genes for DR, few have investigated the impact of genetics on DME susceptibility. This review will focus on the current literature surrounding genetic risk factors associated with DME. We will also highlight the small number of studies investigating the genetics of response to antivascular endothelial growth factor (anti-VEGF) injection, which is used to treat DME.

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The impact of central foveal thickness on the efficacy of subthreshold micropulse yellow laser photocoagulation in diabetic macular edema

Lasers in Medical Science ◽

10.1007/s10103-018-2672-9 ◽

2018 ◽

Vol 34 (5) ◽

pp. 907-912 ◽

Cited By ~ 4

Author(s):

Mehmet Citirik

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Laser Photocoagulation ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

Yellow Laser ◽

The Impact

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Comparison of Diabetic Macular Edema Treatment Patterns and Outcomes by European and US Retina-treating Ophthalmologists

US Ophthalmic Review ◽

10.17925/usor.2014.07.01.63 ◽

2014 ◽

Vol 07 (01) ◽

pp. 63 ◽

Cited By ~ 1

Author(s):

Eric G John ◽

James F Harris ◽

◽

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Treatment Patterns ◽

Self Report ◽

Patient Treatment ◽

Current Therapy ◽

Visual Outcomes ◽

Significant Difference ◽

The Us ◽

The Impact

AIM:To uncover and evaluate diabetic macular edema (DME) patient treatment patterns in the US and the largest EU countries.METHODS:Quantitative analyses of self-report data from retina-treating ophthalmologists via 30-minute Internet-based surveys. Data were collected across the US (one study) and EU (two studies— EU-1 and EU-2) between November 2011 and January 2013. Visual outcomes and rates of treatment success or failure were evaluated.RESULTS:Respondents were surveyed across the US (n=71) and EU (EU-1: n=180; EU-2: n=106). Nearly one-third of treated patients (US 38.6 %; EU-1 37.8 %; EU-2 30.7 %) reached a plateau in vision improvement. Geographical comparison showed no significant difference in responses between the US and the EU (EU-1, EU-2) (p>0.05).CONCLUSIONS:These data help to quantify the size of the chronic DME patient population in the US and EU, which is not achieving an acceptable functional outcome with current therapy. The paper provides solid empirical evidence regarding similarities in DME patient treatment and outcomes in the US and EU. The global and reproducible similarities in terms of physicians’ perceptions of the threshold of DME treatment burden and the visual outcomes when treatment benefit is limited are compelling. This is especially interesting within the present context where information regarding the effect of current treatments is limited. Diabetes is growing around the world at epidemic proportions, and these data provide insight into the impact DME may have on healthcare systems.

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Caspase-14 Expression Impairs Retinal Pigment Epithelium Barrier Function: Potential Role in Diabetic Macular Edema

BioMed Research International ◽

10.1155/2014/417986 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 9

Author(s):

Selina Beasley ◽

Mohamed El-Sherbiny ◽

Sylvia Megyerdi ◽

Sally El-Shafey ◽

Karishma Choksi ◽

...

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Barrier Function ◽

Potential Role ◽

Pigment Epithelium ◽

Retinal Pigment ◽

Retinal Pigment Epithelial Cells ◽

Impedance Sensing ◽

Normal Glucose ◽

The Impact

We recently showed that caspase-14 is a novel molecule in retina with potential role in accelerated vascular cell death during diabetic retinopathy (DR). Here, we evaluated whether caspase-14 is implicated in retinal pigment epithelial cells (RPE) dysfunction under hyperglycemia. The impact of high glucose (HG, 30 mM D-glucose) on caspase-14 expression in human RPE (ARPE-19) cells was tested, which showed significant increase in caspase-14 expression compared with normal glucose (5 mM D-glucose + 25 mM L-glucose). We also evaluated the impact of modulating caspase-14 expression on RPE cells barrier function, phagocytosis, and activation of other caspases using ARPE-19 cells transfected with caspase-14 plasmid or caspase-14 siRNA. We used FITC-dextran flux assay and electric cell substrate impedance sensing (ECIS) to test the changes in RPE cell barrier function. Similar to HG, caspase-14 expression in ARPE-19 cells increased FITC-dextran leakage through the confluent monolayer and decreased the transcellular electrical resistance (TER). These effects of HG were prevented by caspase-14 knockdown. Furthermore, caspase-14 knockdown prevented the HG-induced activation of caspase-1 and caspase-9, the only activated caspases by HG. Phagocytic activity was unaffected by caspase-14 expression. Our results suggest that caspase-14 contributes to RPE cell barrier disruption under hyperglycemic conditions and thus plays a role in the development of diabetic macular edema.

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Restoration of Foveal Bulge after Resolution of Diabetic Macular Edema with Coexisting Serous Retinal Detachment

Journal of Diabetes Research ◽

10.1155/2020/9705786 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Yijun Hu ◽

Qiaowei Wu ◽

Baoyi Liu ◽

Manqing Huang ◽

Qingsheng Peng ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Outer Nuclear Layer ◽

Serous Retinal Detachment ◽

Foveal Thickness ◽

Central Foveal Thickness ◽

Significant Difference ◽

The Impact

Purpose. To evaluate the impact of restoration of foveal bulge (FB) in optical coherence tomography (OCT) images on visual acuity after resolution of diabetic macular edema with coexisting serous retinal detachment (SRD-DME). Methods. A total of 52 eyes with resolved SRD-DME and an intact ellipsoid zone at the central fovea were included. All eyes underwent best-corrected visual acuity (BCVA) examination and OCT scanning at baseline and follow-up visits (1, 3, and 6 months). The eyes were divided into two groups according to the presence of FB at 6 months. BCVA, central foveal thickness (CFT), height of SRD (SRDH), outer nuclear layer (ONL) thickness, photoreceptor inner segment (PIS), and outer segment (POS) length were compared between the two groups. Results. A FB was found in 25 of 52 (48%) eyes at 6 months. The FB (+) group had lower SRDH at baseline, and better BCVA, longer POS length at 6 months (all P<0.05). There was no significant difference in the CFT, ONL thickness, and PIS length at 6 months between the two groups (all P>0.05). More eyes in the FB (+) group had complete SRD resolution at 1 month (P=0.009) and 3 months (P=0.012). Eyes with complete SRD resolution at 1 month (P=0.009) or 3 months (P=0.012) were more likely to have a FB at 6 months. Conclusions. The Presence of the FB is associated with better BCVA after resolution of SRD-DME. Eyes with lower baseline SRDH or faster SRD resolution are more likely to have a FB at 6 months.

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