scholarly journals Pegaptanib Sodium versus Pegaptanib Sodium Combined with Macular Laser Photocoagulation or Laser Alone for Diabetic Macular Edema

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
G. Querques ◽  
A. V. Bux ◽  
A. R. Fusco ◽  
C. Iaculli ◽  
N. Delle Noci
Keyword(s):  
Treatment Group ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Combined Treatment ◽  
Group 13 ◽  
Pegaptanib Sodium ◽  
Corrected Visual Acuity ◽  
Group 12

Purpose. To report the outcomes after primary intravitreal pegaptanib sodium in patients with diabetic macular edema (DME).Methods. We conduced a retrospective analysis of eyes with DME treated with primary intravitreal pegaptanib sodium (Macugen) (intravitreal pegaptanib group). The results were compared with the ones of eyes treated with intravitreal pegaptanib sodium associated with macular laser photocoagulation (combined treatment group), and the ones of eyes treated with primary macular laser photocoagulation (macular laser photocoagulation group).Results. For the intravitreal pegaptanib group (13 eyes), we found significant changes in mean best-corrected visual acuity (BCVA) and reductions in mean central macular thickness (CMT) at the last follow-up visit ( and ). For the macular laser photocoagulation group (15 eyes), we found no statistically significant changes in mean BCVA and CMT at the last follow-up visit (). For the combined treatment group (12 eyes), we found no significant changes in mean BCVA at the last follow-up visit () despite significant reductions in mean CMT ().Conclusion. Intravitreal pegaptanib treatment alone may be superior to macular laser photocoagulation alone and to combined intravitreal pegaptanib treatment associated with macular laser photocoagulation in patients with DME.

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.

scholarly journals Effect of Calcium Dobesilate (CaD) on Diabetic Macular Edema Treated by Intravitreal Ranibizumab

2021 ◽  
Author(s):  
Dongxuan Wang ◽  
Hui Wang ◽  
Shuang Wu ◽  
Xueqiu Yang ◽  
Jiansen Xu
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Calcium Dobesilate ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Pro Re Nata ◽  
Dose Injection ◽  
Control Study

Abstract Background: Calcium dobesilate (CaD) had been used in the treatment of diabetic retinopathy (DR) due to its potential in protecting against retinal vascular damage. However, it did not reduce the risk of development of diabetic macular edema (DME). The aim of this study was to investigate the effect of CaD plus intravitreal ranibizumab in the treatment of DME.Methods: This retrospective, observational, consecutive case control study enrolled patients newly diagnosed with DME who received intravitreal ranibizumab (IVR) administration with 3-monthly loading dose injection followed by pro re nata (3+PRN) regimen with or without CaD orally daily for at least 12-month follow-up. Medical records and optical coherence tomography (OCT) results were reviewed and compared at baseline and at 3, 6, and 12 months after injection.Results: A total of 102 eyes from 102 patients were enrolled in this study. Fifty-four patients received IVR combined with CaD orally (IVR+CaD group), while forty-eight patients received IVR solely (IVR group). No statistically significant differences were found in the general condition of patients between the two groups at baseline (P > 0.05). At every follow-up, 3, 6 and 12 months after injection, the best corrected visual acuity (BCVA) improved and the central macular thickness (CMT) decreased in both groups when compared with those at baseline (P < 0.05), while there were no significant differences in BCVA improvement and CMT reduction between the two groups (P > 0.05). The mean number of ranibizumab injections in R+C group was significantly lower than that in R group (5.4 ± 1.1 injections versus 6.7 ± 1.6 injections, P<0.05) within 1-year treatment. No adverse events were found in neither groups.Conclusions: Adding oral CaD to intravitreal ranibizumab was demonstrated to have similar effectiveness and safety for improving visual function and restoring the anatomy of the retina in macular with fewer injections in DME patients.

scholarly journals Effectiveness of Intravitreal Ranibizumab in Nonvitrectomized and Vitrectomized Eyes with Diabetic Macular Edema: A Two-Year Retrospective Analysis

2019 ◽  
Author(s):  
Ozgun Melike Gedar Totuk ◽  
Ayse Yagmur Kanra ◽  
Mohammed Nadim Bromand ◽  
Guler Kilic ◽  
Sevil Ari Yaylali ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Medical Records ◽  
Response To Treatment ◽  
Intravitreal Ranibizumab ◽  
Female Ratio ◽  
Corrected Visual Acuity ◽  
Baseline Values ◽  
Male To Female

Abstract Background: To compare the effectiveness of intravitreal ranibizumab (IVR) injections for the treatment of diabetic macular edema (DME) in eyes with and without previous vitrectomy. Methods: The medical records of 30 eyes (13 vitrectomized, 17 nonvitrectomized) of 28 patients (mean age, 59.09.6 years; male to female ratio 1:1) who were diagnosed with DME and had received IVR treatment were reviewed retrospectively. The best-corrected visual acuity (BCVA), central macular thickness (CMT), and total macular volume (TMV) were measured at baseline and at months 6, 12, 18, and 24 of the follow-up. The number of IVR injections, the duration between diagnosis of DME and IVR injection, and hemoglobin A1c (HbA1c) level at baseline were also recorded. Results: Baseline demographics, HbA1c, BCVA, CMT, and TMV values were similar between the vitrectomized and nonvitrectomized groups (p>0.05). The duration between diagnosis of DME and IVR injections was longer in the nonvitrectomized group than in the vitrectomized group (165 years vs. 134 years, respectively; p=0.045). IVR injection was performed 6.3 times in vitrectomized eyes and 6.1 times in nonvitrectomized eyes during the 24-month period (p>0.05). BCVA improved significantly during the 24-month period in both groups. The improvement in BCVA was significant at month 6 in nonvitrectomized eyes, while there was no significant improvement in vitrectomized eyes before month 18. Compared to the baseline values, the decrease in both CMT and TMV was significant in months 6, 12, 18, and 24 in the nonvitrectomized group (p<0.05). In the vitrectomized group both CMT and TMV improved significantly only in months 18 and 24 (p<0.05). Conclusion: IVR treatment for DME is equally effective in both vitrectomized and nonvitrectomized eyes. However, the response to treatment is seen later in vitrectomized eyes compared to nonvitrectomized eyes.

scholarly journals Direct Photocoagulation Guided by Merged Retinal Images for the Treatment of Focal Diabetic Macular Edema

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Yoshihiro Takamura ◽  
Takehiro Matsumura ◽  
Shogo Arimura ◽  
Makoto Gozawa ◽  
Masakazu Morioka ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Retinal Thickness ◽  
Functional Results ◽  
Retinal Images ◽  
Image Guided ◽  
Corrected Visual Acuity ◽  
Laser Treatments ◽  
Best Corrected Visual Acuity

Purpose. To introduce a novel laser photocoagulation (PC) protocol named merged image-guided PC (MIG-PC), which included merging the images of the fundus, optical coherence tomography (OCT) map, and fluorescein angiography (FA). We compared the anatomical and functional results between MIG-PC and FA-guided PC (FG-PC) for the treatment of focal diabetic macular edema (DME). Method. We examined the treatment outcomes in 27 consecutive eyes treated with MIG-PC compared with 28 matched eyes treated with FG-PC. We identified the microaneurysms (MAs) located in the focal edema areas and ablated them using focal PC. Best-corrected visual acuity (BCVA) and retinal thickness (RT) measured using OCT were compared between the groups at baseline and 2, 4, 8, 12, and 24 weeks after treatment. Results. The foveal and perifoveal RT were reduced after treatment in both the groups, and the perifoveal RT in the MIG-PC group was significantly lower than that in the FG-PC group at 4 weeks and thereafter. BCVA in the MIG-PC group was significantly higher than that in the FG-PC group at 12 and 24 weeks. The numbers of laser spots (p=0.0001), additional laser treatments (p=0.0121), and intravitreal injection of ranibizumab (p=0.0012) in the MIG-PC group were significantly lower than those in the FG-PC group (Mann–Whitney test). Conclusion. MIG-PC contributed to the improvement in BCVA and reduction in RT, number of laser shots required, and retreatment rates. Based on our data, MIG-PC can be recommended for the treatment of focal DME. This trial is registered with ID UMIN000030390.

Minimally Invasive Microincision Vitrectomy Surgery with an Intraoperative Dexamethasone Implant for Refractory Diabetic Macular Edema

2016 ◽  
Vol 235 (3) ◽  
pp. 150-156 ◽  
Author(s):  
Dong Hoon Lee ◽  
Yoon Jeon Kim ◽  
Young Hee Yoon
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Safe Alternative ◽  
Corrected Visual Acuity ◽  
Refractory Diabetic Macular Edema ◽  
History Of ◽  
Microincision Vitrectomy Surgery ◽  
Vitrectomy Surgery

Purpose: To evaluate the 1-year results of 25-gauge microincision vitrectomy surgery (MIVS25) combined with intraoperative dexamethasone (DEX) implant for persistent diabetic macular edema (DME). Methods: This study enrolled patients who had a history of DME for ≥12 months and underwent MIVS25 and DEX implant injection. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed postoperatively. Results: Eighteen eyes were included in the analysis. Preoperatively, logMAR BCVA was 0.90 and CRT was 594 µm on average. CRT decreased until the 3-month follow-up visit and tended to increase at 6 months, but stabilized at 12 months with additional treatments in five eyes at 5 months postoperatively. Statistically significant improvement in BCVA was noted 1 month after treatment and at each subsequent follow-up visit (p < 0.001). Conclusion: MIVS25 combined with DEX implant injection might be utilized as an effective and safe alternative treatment for intractable DME.

scholarly journals Renal Biomarkers for Treatment Effect of Ranibizumab for Diabetic Macular Edema

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Ivan Pochou Lai ◽  
Wei-Lun Huang ◽  
Chung-May Yang ◽  
Chang-Hao Yang ◽  
Tzyy-Chang Ho ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Ranibizumab ◽  
Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Renal Biomarkers ◽  
One Year ◽  
Ranibizumab Treatment

Aims. To investigate the correlations between renal biomarkers and the treatment outcomes of ranibizumab for diabetic macular edema (DME). Methods. This hospital-based study retrospectively enrolled 88 eyes from 67 patients who had received one-year intravitreal ranibizumab treatment for DME. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) at baseline and during the follow-up period were recorded. BCVA and OCT characteristics at baseline and their changes after ranibizumab treatment were compared between different proteinuria and estimated glomerular filtration rate (eGFR) groups. Results. Of the 88 eyes studied, those with moderately increased proteinuria had a thicker central subfield foveal thickness (CFT) and a higher proportion of intraretinal cysts than those with no proteinuria (P=0.012 and 0.045, respectively) at baseline. After one year of ranibizumab treatment, the reduction in CFT was greater in patients with severely increased proteinuria than those with normal to mildly increased proteinuria (P=0.030). On the other hand, patients with an eGFR <30 tended to have poorer visual improvements than those with normal eGFR (P=0.044). Conclusions. After ranibizumab treatment for DME, patients with severe proteinuria tended to gain better anatomical improvement, while those with poor eGFR tended to have poorer visual improvement.

Early treatment with dexamethasone intravitreal implants in diabetic macular edema: Naïve versus refractory patients

2021 ◽  
pp. 112067212110248
Author(s):  
Anna V Bux ◽  
Francesca Fortunato ◽  
Antonio Barone ◽  
Vincenzo Russo ◽  
Nicola Delle Noci ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
First Line ◽  
Corrected Visual Acuity ◽  
Real World Setting ◽  
Treatment Naïve ◽  
Group 2 ◽  
Group 1

Purpose: To assess the efficacy and safety of dexamethasone 0.7 mg implants (DEX-I) in patients with diabetic macular edema (DME) either naïve to therapy or refractory to anti-VEGF treatment, in a single-center, real-world setting. Methods: Patients diagnosed with DME and treated with DEX-I were retrospectively enrolled in the study and split in two groups: naïve (Group 1, n = 64) and refractory (Group 2, n = 64) to treatment. Patients were evaluated at baseline, at 1 month, and every 3 months after each DEX-I implant. Main outcome measures were change in best-corrected visual acuity (BCVA) and central macular thickness (CMT) from baseline to follow-up visits. Results: Significant improvements in BCVA were observed in treatment-naïve patients at 6 months following the first and second DEX-I injection ( p = 0.0023 and p = 0.0063, respectively), with significant reductions in mean CMT at 6 months after all DEX implants. In treatment-refractory patients, mean CMT was significantly reduced from baseline to 6 months ( p < 0.05) after all DEX-I injections, although no changes were observed in BCVA. Conclusions: DEX-I improved visual acuity and macular edema mostly in treatment-naïve patients, suggesting DEX-I may be a viable first-line treatment option in DME.

scholarly journals Vitreomacular interface after anti-VEGF injections in diabetic macular edema

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Carlos E. Veloso ◽  
Daniel N. Brocchi ◽  
Rishi P. Singh ◽  
Márcio B. Nehemy
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Short Term ◽  
Vitreomacular Adhesion ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Vitreomacular Interface ◽  
The Mean

Abstract Background The purpose of this study was to evaluate the incidence of vitreomacular adhesion (VMA) release after anti-VEGF therapy for the treatment of diabetic macular edema (DME) and to evaluate further changes in outcome. Methods This was a retrospective study that enrolled 66 eyes of 66 patients with DME who presented with VMA diagnosed by spectral-domain optical coherence tomography (OCT) at baseline. VMA was classified as focal (attachment: ≤ 1500 μm) or broad (attachment: > 1500 μm). All patients received at least three monthly intravitreal injections of an anti-VEGF agent. Follow-up visits were performed 1 month after each injection to evaluate the incidence of VMA release. Results The mean patient age was 61.4 years (range: 29 to 78 years), and 72.7 % were male. The mean best-corrected visual acuity was 0.62 logMAR, and the mean central retinal thickness (CRT) was 473 μm at baseline. The mean length of follow-up was 18.5 months, and the mean number of injections was 5.8. The intravitreal drugs used were aflibercept (40.9 %), ranibizumab (37.9 %) and bevacizumab (21.2 %). Forty-seven eyes had broad VMA, and 19 had focal VMA. Twenty-two eyes (33.3 %) developed VMA release following a mean of 5.7 injections (range: 3–13). Sixteen eyes (72.7 %) with focal VMA and 6 eyes (27.3 %) with broad VMA at baseline developed VMA release. Twenty-one eyes that developed VMA release showed an improvement in CRT following VMA release (mean: -106 μm; range: 22 to 289 μm). Conclusions VMA release occurs in approximately 1/3 of patients with DME following anti-VEGF therapy. Most of them show a short-term decrease in CRT.

scholarly journals Effectiveness of Intravitreal Ranibizumab in Nonvitrectomized and Vitrectomized Eyes with Diabetic Macular Edema: A Two-Year Retrospective Analysis

2019 ◽  
Author(s):  
Ozgun Melike Gedar Totuk ◽  
Ayse Yagmur Kanra ◽  
Mohammed Nadim Bromand ◽  
Guler Kilic ◽  
Sevil Ari Yaylali ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Response To Treatment ◽  
Intravitreal Ranibizumab ◽  
Female Ratio ◽  
Corrected Visual Acuity ◽  
Baseline Values ◽  
The Mean ◽  
Male To Female

Abstract Background: To compare the effectiveness of intravitreal ranibizumab (IVR) injections for the treatment of diabetic macular edema (DME) in eyes with and without previous vitrectomy. Methods: The medical records of 30 eyes (13 vitrectomized, 17 nonvitrectomized) of 28 patients (mean age, 59.0±9.6 years; male to female ratio 1:1) who were diagnosed with DME and had received IVR treatment were reviewed retrospectively. The indications of vitrectomy in 13 vitrectomized eyes were intravitreal hemorrhage (n=8), vitreomacular traction (n=1), and epiretinal membrane (n=4). The best-corrected visual acuity (BCVA), central macular thickness (CMT), and total macular volume (TMV) were measured at baseline and at months 6, 12, 18, and 24 of the follow-up. The number of IVR injections, the duration between diagnosis of DME and IVR injection, and hemoglobin A1c ( HbA1c ) level at baseline were also recorded. Retreatment criteria included persistence of submacular fluid, intraretinal cysts, or CMT of more than 300 μm. Results: Baseline demographics, HbA1c, BCVA, CMT, and TMV values were similar between the vitrectomized and nonvitrectomized groups (p>0.05). The duration between diagnosis of DME and IVR injections was longer in the nonvitrectomized group than in the vitrectomized group (16±5 months vs. 13±4 months, respectively; p=0.045). IVR injection was performed 6.3 times in vitrectomized eyes and 6.1 times in nonvitrectomized eyes during the 24-month period (p>0.05). The mean BCVA improved significantly during the 24-month period in both groups (for vitrectomized group from 0.51±0.26 logMAR to 0.40±0.22 logMAR; for nonvitrectomized group from 0.72±0.28 logMAR to 0.50±0.22 logMAR). The improvement in BCVA was significant at month 6 in nonvitrectomized eyes, while there was no significant improvement in vitrectomized eyes before month 18. Compared to the baseline values, the decrease in both CMT and TMV was significant in months 6, 12, 18, and 24 in the nonvitrectomized group (p<0.05). In the vitrectomized group both CMT and TMV improved significantly only in months 18 and 24 (p<0.05). Conclusion: IVR treatment for DME is equally effective in both vitrectomized and nonvitrectomized eyes. However, the response to treatment is seen later in vitrectomized eyes compared to nonvitrectomized eyes.

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