scholarly journals Management of Diabetic Retinopathy

2021 ◽  
pp. 95-103
Author(s):  
Marieta Dumitrache ◽  
Rodica Lascu
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Effective Treatment ◽  
Prophylactic Treatment ◽  
Vision Loss ◽  
Vitreous Hemorrhage ◽  
Tractional Retinal Detachment ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant ◽  
Photocoagulation Laser

Management in D.R. through prophylactic treatment (maintaining a glycemic level as close as possible to normal, control hypertension <150/85 mmHg, hyperlipidemia) and curative treatment of D.R. does not cure the disease, but may slow the evolution of D.M. and D.R. AntiVEGF agents are indicated as adjuvant therapy in pan-photocoagulation laser and / or vitrectomy in patients with DR to block angiogenesis by inhibiting VEGF. All antiVEGF agents are an effective treatment for the clinically significant macular edema. Photocoagulation laser is a treatment of choice in preproliferative and proliferative DR and an effective treatment of diabetic macular edema. The indications for laser treatment in diabetic retinopathy are related to the incidence, evolution of neovessels, duration of diabetes, HbA1c level, presence of macular edema, stage of DR. The laser for macular lesions reduces the risk of vision loss in the eyes with incipient and moderate non-proliferative DR and macular edema concomitant; the laser should be applied to all patients with clinically significant macular edema. Vitrectomy in proliferative DR is indicated in vitreous hemorrhage, tractional retinal detachment in order to remove the vitreous hermorrhage and excision of tractional preretinal membranes.

scholarly journals Diabetic retinopathy with or without clinically significant macular edema: The influencing factors

2016 ◽  
Vol 7 (2) ◽  
pp. 142-147
Author(s):  
Barsha Suwal ◽  
Jeevan Kumar Shrestha ◽  
Sagun Narayan Joshi ◽  
Ananda Kumar Sharma
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Macular Edema ◽  
Total Cholesterol ◽  
Cholesterol Level ◽  
Total Cholesterol Level ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Introduction: Diabetic retinopathy is the commonest micro vascular complication in patients with diabetes and remains a leading cause of blindness in people of working age group. Objective: to determine the prevalence of clinically significant macular edema (CSME) and the influence of systemic risk factors Materials and methods: It is a hospital based comparative study conducted in 220 eyes of 110 diabetic patients. DR was graded according to International Clinical Diabetic Retinopathy Severity Scale and CSME was defined according to Early Treatment Diabetic Retinopathy Study (ETDRS) system. The patients were grouped as 1) CSME group (DR and CSME in one or both eyes) and 2) Non- CSME group(CSME in none of the eyes but with any grade of DR).Level of glycosylated hemoglobin (HbA1C), serum total cholesterol, triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and urine for albumin were studied in both groups. Results: CSME was present in 36% of 110 patients. Poor glycemic control and high total cholesterol level showed positive association with CSME (p<0.05). LDL and TG levels were higher and HDL lower in CSME group. However, no statistical significance was found. Conclusion: The CSME is significantly associated with poorer glycemic control and elevated total cholesterol level.

scholarly journals Functional and Structure Outcome Intravitreal Bevacizumab in Diabetic Retinopatic with Clinically Significant Macular Edema at Bali Mandara Eye Hospital

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Dewi Adnya Swari ◽  
Ni Luh Diah Pantjawati
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Alternative Therapy ◽  
Intravitreal Bevacizumab ◽  
Fluid Accumulation ◽  
The Third ◽  
Corrected Visual Acuity ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Introduction: The increase in diabetics has an impact incidence of diabetic retinopathy and Diabetic Macular Edema (DME). DME due to changes in the blood retina barrier (BRB), causes fluid accumulation in the macula. This study aims to evaluate the functional outcome visual acuity and structure with optical coherence tomography (OCT) intravitreal bevacizumab (IVB) injection in DME with Clinically Significant Macular Edema (CSME). Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Opthalmology, Bali Mandara Eye Hospital, Denpasar. Data were obtained from the medical records of all diabetic retinopathy patients with clinically significant macular edema who treated with IVB at Bali Mandara Eye Hospital in Denpasar January - December 2018. Result: Of the 52 subjects, improvement in best corrected visual acuity (BCVA) occurred in 26 (50.0%) subjects at the first month evaluation, 21 (40.4%) subjects at the third month, and 10 (19.2%) subjects at the sixth month evaluation. OCT decreased in 44 (84.6%) subjects at the first month evaluation, 16 (30.8%) subjects at the third month, and 14 (26.9%) subjects at the sixth month evaluation. Conclusion: There are visual acuity improvement and central retinal thickness reduction at 6 months after IVB injection. These results strengthen IVB injection to be an alternative therapy in DME with CSME.   

Photocoagulation for Diabetic Macular Edema

2020 ◽  
pp. 169-176
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Diabetic Patients ◽  
Nonproliferative Diabetic Retinopathy ◽  
Argon Laser Photocoagulation ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 1) describes the findings in the subgroup of eyes in the ETDRS that were identified as having mild to moderate nonproliferative diabetic retinopathy and macular edema. The analysis showed that immediate focal argon laser photocoagulation of “clinically significant” diabetic macular edema substantially reduced the risk of visual loss, increased the chance of visual improvement, decreased the frequency of persistent macular edema, and caused only minor visual field losses. The authors recommended immediate focal argon laser photocoagulation for all eyes with clinically significant macular edema and mild or moderate nonproliferative diabetic retinopathy, regardless of the level of visual acuity.

scholarly journals Prophylaxis of Macular Edema with Intravitreal Ranibizumab in Patients with Diabetic Retinopathy after Cataract Surgery: A Pilot Study

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Patricia Udaondo ◽  
Maria Garcia-Pous ◽  
Salvador Garcia-Delpech ◽  
David Salom ◽  
Manuel Diaz-Llopis
Keyword(s):  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Macular Edema ◽  
San Francisco ◽  
Case Series ◽  
Control Group ◽  
Intravitreal Ranibizumab ◽  
Previous Diagnosis ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

The purpose of this study was to evaluate the effectiveness of intravitreal ranibizumab (Lucentis, Genentech, South San Francisco, Calif, USA) combined with cataract surgery for the prevention of clinically significant macular edema (CSME) in patients with diabetic retinopathy (DR). This prospective interventional case series included fifty-four eyes of 54 patients with a previous diagnosis of nonproliferative diabetic retinopathy (NPDR) without macular edema preoperatively. Subjects were assigned in a 1 : 1 ratio to receive an intraoperative intravitreal ranibizumab injection (n=27) or not (control group,n=27) associated with standardised phacoemulsification surgery. The main outcome measure was the incidence of CSME one and three months after surgery. One month after surgery the incidence of CSME in the control group was 25.92% and 3.70% in the treatment group and at three months was 22.22% and 3.70%, respectively. Short-term results suggest that intravitreal ranibizumab immediately after phacoemulsification prevents CS ME in patients with NPDR.

scholarly journals Macular thickness in diabetic retinopathy without clinically significant macular edema

2018 ◽  
Vol 16 (2) ◽  
pp. 64-78
Author(s):  
Krishna Rao ◽  
Ravi Chandra ◽  
Lavanya Rao ◽  
Shailaja S ◽  
Manali Hazarika
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Cross Sectional Study ◽  
Macular Thickness ◽  
Cross Sectional ◽  
Significant Difference ◽  
Central Subfield Thickness ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Aim: To measure macular thickness by optical coherence tomography (OCT) in various grades of diabetic retinopathy with no clinically significant macular edema (CSME) and its comparison with non-diabetics. Design: Prospective cross–sectional study. Methods: Macular thickness was measured by OCT in 72 healthy volunteers (107 control eyes), 45 patients with mild and moderate non-proliferative diabetic retinopathy (NPDR) (78 eyes) and 37 patients with severe NPDR and proliferative diabetic retinopathy (PDR) (66 eyes). Patients with diabetic macular edema (DME) as assessed by stereoscopic evaluation or photographs were excluded. One-way ANOVA test to compare the mean thickness and Tukey's test for multiple comparison between groups were used. Results: Central subfield thickness (CST) was 238.57 ± 25.077 µm, 251.22 ± 24.649 µm, and 270.45 ± 28.956 µm in the three groups respectively. As the severity of retinopathy increased, the macular thickness significantly increased (p = < 0.001) in all the nine zones on OCT. There was a significant increase in CST noted in all the grades of retinopathy when compared with non-diabetics (p = 0.004, p = < 0.0001). No significant difference in macular thickness was noted between genders, irrespective of their groups (p = 0.72), or between the three groups in all the nine zones (p = 0.609). Conclusion: There is a significant increase in CST in all grades of retinopathy, as well as with increasing severity of retinopathy when compared to non-diabetics. This warrants the need to obtain OCT measurements even in patients with moderate NPDR without CSME to rule out subclinical DME.

Sign in / Sign up

Export Citation Format

Share Document