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 ◽  
...  

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.

2019 ◽  
Author(s):  
Hiroyuki Nakashizuka ◽  
Yorihisa Kitagawa ◽  
Yu Wakatsuki ◽  
Koji Tanaka ◽  
Koichi Furuya ◽  
...  

Abstract Purpose: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA≦logMAR0.046 (Good group) to 35 patients with logMAR BCVA 0.52–0.10 (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery was effective for MH, BCVA, aniseikonia, and QOL.


2019 ◽  
Vol 30 (2) ◽  
pp. 363-369 ◽  
Author(s):  
Abdullah Ozkaya ◽  
Gokhan Demir ◽  
Asli Kirmaci

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.


2020 ◽  
pp. 112067212092800
Author(s):  
Tommaso Verdina ◽  
Cecilia Ferrari ◽  
Edoardo Valerio ◽  
Alberto Brombin ◽  
Andrea Lazzerini ◽  
...  

Purpose: To report the safety and efficacy of subthreshold micropulse yellow laser of 577 nm for a complex case of refractory pseudophakic cystoid macular edema. Methods: A retrospective chart review of an interventional case report of three subthreshold micropulse yellow laser interventions for refractory pseudophakic cystoid macular edema. Patient: A 77-year-old healthy female underwent pseudoexfoliative cataract surgery complicated by posterior capsule rupture and sulcus intraocular lens implantation. After 3 months, she required a scleral fixation of the same lens, due to a lack of capsular support and decentration of the intraocular lens. One month later, she experienced a severe pseudophakic cystoid macular edema (foveal thickness of 399 µm and best-corrected visual acuity of 20/80 Snellen). The condition was refractory to conventional treatments prior to subthreshold micropulse yellow laser interventions, including non-steroidal anti-inflammatory eye drops, topical steroids, oral indomethacin and three sub-Tenon’s triamcinolone injections, attempted over a 14-month period. Results: Subthreshold micropulse yellow laser treatment was performed and immediate resolution was achieved and maintained for 2 months. Two cases of edema relapse were observed at 3 months from initial laser treatment and again at 4 months from the second laser treatment. Final patient’s follow-up at 6 months from the third laser treatment evidenced the absence of edema, improved visual acuity (foveal thickness of 265 µm/best-corrected visual acuity of 20/30 Snellen) and the absence of complications. Conclusions: Subthreshold micropulse yellow laser seems to be a safe and effective treatment for short-term resolution of refractory pseudophakic cystoid macular edema after complicated cataract surgery and represents a useful alternative to expensive and invasive therapies. A trend towards a longer duration of edema resolution with every subthreshold micropulse yellow laser repetition was observed.


2019 ◽  
Author(s):  
Hiroyuki Nakashizuka ◽  
Yorihisa Kitagawa ◽  
Yu Wakatsuki ◽  
Koji Tanaka ◽  
Koichi Furuya ◽  
...  

Abstract Backgroud: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA ≦ 0.046 logMAR (Good group) to 35 patients with 0.10 - 0.52 logMAR (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery for patients with BCVA ≦ 0.046 logMAR was effective for improvement of HM, BCVA, and QOL and prevented worsening of aniseikonia.


2018 ◽  
Vol 29 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Mohammed Mamdouh Elwan ◽  
Ayman Elsayed Abd Elghafar ◽  
Sherein Mahmoud Hagras ◽  
Waleed Ali Abou Samra ◽  
Sameh Mohamed Saleh

Purpose: To compare between vitrectomy with internal limiting membrane peeling over the whole macula and preservation of the epi-foveal internal limiting membrane in myopic foveoschisis. Patients and methods: A prospective controlled non- randomized comparative study included patients with myopic foveoschisis recruited between 2013 and 2017. Patients were allocated into two groups: group A included patients who underwent vitrectomy with complete macular internal limiting membrane peeling and group B included those who underwent preservation of the epi-foveal membrane. Pre- and postoperative best corrected visual acuity and macular optical coherence tomography were obtained and compared. Results: There was no statistically significant difference between the two groups regarding the preoperative baseline data. The difference between the two groups was insignificant as regard postoperative best corrected visual acuity (p = 0.18) and central foveal thickness (p =0.504). There was statistically significant improvement in final best corrected visual acuity within each group (p < 0.0001). Central foveal thickness significantly decreased postoperatively within each group (p < 0.001). No macular holes or other visual-threatening complications were recorded in either group. Conclusion: Vitrectomy with complete internal limiting membrane peeling resulted in comparable outcomes to those achieved with preservation of the epi-foveal membrane in treating cases with myopic foveoschisis. There was no statistically significant difference in final visual acuity between the two groups. No macular holes were recorded in either group.


2021 ◽  
Vol 20 (3) ◽  
pp. 105-109
Author(s):  
Da Yeong Kim ◽  
Sung Kun Chung ◽  
Ki Seok Kim ◽  
Jie Hyun Youm

Purpose: To investigate the functional and structural recovery period of idiopathic epiretinal membranes after phacovitrectomy with posterior capsulectomy.Methods: From March 2012 to January 2015, 57 patients diagnosed with idiopathic epiretinal membranes with cataracts who underwent combined vitrectomy and cataract surgery with pars plana posterior capsulectomy were enrolled. The best-corrected visual acuity and central foveal thickness were analyzed retrospectively.Results: The average best-corrected visual acuity before surgery was 0.30 ± 0.23 logarithm of minimal angle of resolution (logMAR), and the mean central foveal thickness was 442 ± 93 μm. As of the 12-month follow-up, the average postoperative best-corrected visual acuity had improved to 0.08 ± 0.11 logMAR, and the central foveal thickness after surgery had decreased to 386 ± 58 μm at 12 months.Conclusions: After removing the potential influence of cataracts and posterior capsular opacity, the recovery of idiopathic epiretinal membranes continued up to 12 months after surgery.


PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257695
Author(s):  
Francesco Saverio Sorrentino ◽  
Claudio Bonifazzi ◽  
Francesco Parmeggiani

Purpose To suggest the safety and efficacy of preservative-free triamcinolone acetonide intravitreal injectable suspension (Taioftal) for the treatment of diabetic macular edema. Methods A prospective clinical study involved 49 patients (49 eyes), that were treated with Taioftal and followed-up for six months. Complete ophthalmic examination, including spectral domain optical coherence tomography, was performed at baseline, and at month 1, 3, 6 after the intravitreal injection. Accurate collection and analysis of best-corrected visual acuity (BCVA), central foveal thickness (CFT), intraocular pressure (IOP), and adverse events (AEs) were carried out in order to evaluate visual function and macular morphology before and after treatment Results Median BCVA value chosen as comparing statistics was significantly improved at every follow-up time points (gain of 6 letters at month 1, 12 at month 3 –improvement up to 24% at month 3 with stabilization until month 6) compared to baseline, as certified by Kruskal-Wallis rank sum test (P<0.05). Median CFT significantly waned at each follow-up times (decrease of about 65 μm at month 1, 155 at month 3 –reduction up to 28% at month 3 keeping good outcome until month 6) compared to baseline (P<0.05). IOP elevation, with no severe increases, was the most common among spotted AEs (median of 23 mmHg at month 1, 20 at month 3). Conclusion Intravitreal injection of preservative-free triamcinolone (Taioftal) is an effective, safe and inexpensive drug used to improve visual acuity and reduce central foveal thickness in eyes affected by diabetic macular edema during an average time of 6 months. Temporary, never severe, elevation of IOP is totally manageable with topical medications. No serious vision-threatening complications are related to the use of intravitreal triamcinolone injections.


2019 ◽  
Author(s):  
Hiroyuki Nakashizuka ◽  
Yorihisa Kitagawa ◽  
Yu Wakatsuki ◽  
Koji Tanaka ◽  
Koichi Furuya ◽  
...  

Abstract Purpose: To evaluate the efficacy of epiretinal membrane removal in patients with good best-corrected visual acuity (BCVA) for improving visual function and quality of life (QOL). Methods: This prospective case study compared 37 subjects with preoperative BCVA≦logMAR0.046 (Good group) to 35 patients with logMAR BCVA 0.52–0.10 (Moderate group) at 3 and 6 months. Linear mixed-effect models were used for statistical analysis. The primary outcome was the horizontal metamorphopsia score (MH) at 6 months postoperatively (post-6 M), while secondary outcomes were postoperative BCVA, vertical metamorphopsia score (MV), aniseikonia, stereopsis and central foveal thickness. In the Good group, QOL was assessed using the National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) at 6 and 12 months. Results: MH was significantly improved at post-3 M and post-6 M in the both groups but there were no significant differences between the two groups. MV showed no improvement at the final observation in either group. LogMAR BCVA was significantly improved at post-6 M in the Good group, which had significantly better vision than the Moderate group. Preoperative vertical and horizontal aniseikonia scores remained unchanged in the Good group at post-6 M but worsened in the Moderate group. The NEI VFQ-25 score improved in the Good group, reflecting improved general health, general vision, and mental health. Conclusions: Early epiretinal surgery was effective for MH, BCVA, aniseikonia, and QOL.


2021 ◽  
Vol 9 (B) ◽  
pp. 1480-1483
Author(s):  
Hasanain Hasan Attar ◽  
Farooq Mohammed Abbas ◽  
Haider Layikh

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   


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