scholarly journals Effect of Topical Nepafenac on Central Foveal Thickness following Panretinal Photocoagulation in Diabetic Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Nahla B. Abu Hussein ◽  
Ahmed A. Mohalhal ◽  
Dalia A. Ghalwash ◽  
Ahmed A. Abdel-Kader
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Panretinal Photocoagulation ◽  
Eye Drops ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Snellen Acuity

Purpose. To evaluate effectiveness of topical nepafenac in reducing macular edema following panretinal photocoagulation (PRP). Design. Prospective randomized double-blinded controlled study. Methods. Sixty eyes of 60 patients having proliferative or severe nonproliferative diabetic retinopathy had PRP. Patients were then divided into two groups: nepafenac group (30 eyes) receiving 1% topical nepafenac eye drops for 6 months and control group (30 eyes) receiving carboxymethylcellulose eye drops for 6 months. Best-corrected visual acuity (BCVA) and macular optical coherence tomography were followed up at 1, 2, 4, and 6 months after PRP. Results. BCVA was significantly better in nepafenac group than in control group at all follow-ups (P<0.01). At 6 months post-PRP, logMAR BCVA was 0.11 ± 0.04 (equivalent to 20/26 Snellen acuity) in the nepafenac group and 0.18 ± 0.08 (equivalent to 20/30 Snellen acuity) in the control group (P<0.01). Central foveal thickness (CFT) increased in both groups from the first month after PRP. Increase in CFT was higher in control group than in nepafenac group throughout follow-up, but the difference became statistically significant only after 4 months. No significant ocular adverse events were reported with topical nepafenac. Conclusion. Topical nepafenac can minimize macular edema and stabilize visual acuity following PRP for diabetic patients.

scholarly journals Clinical impact of the 0.2 µg/day fluocinolone acetonide intravitreal implant: outcomes from the ILUVIEN® clinical evidence study in Portugal

2020 ◽  
Vol 12 ◽  
pp. 251584142091776
Author(s):  
Angela Carneiro ◽  
Angelina Meireles ◽  
João Paulo Castro Sousa ◽  
Carla Teixeira
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Clinical Evidence ◽  
Fluocinolone Acetonide ◽  
Foveal Thickness ◽  
Time Points ◽  
Central Foveal Thickness ◽  
Study Population ◽  
Fluocinolone Acetonide Implant

Introduction: The ILUVIEN® (fluocinolone acetonide) Clinical Evidence in Portugal (ICE-PT) study is a retrospective, multicenter, observational study evaluating the effectiveness and safety of the FAc implant in patients with diabetic macular edema. Methods: Patients included in this study had received the 0.2 µg/day fluocinolone acetonide implant for the treatment of diabetic macular edema and had measurements of visual acuity and retinal thickness assessed by optical coherence tomography for at least 12 months pre- and post-fluocinolone acetonide implant administration, with ⩾2 follow-up visits. Outcomes measured included visual acuity, central foveal thickness, and intraocular pressure. Results: There was a significant increase in mean visual acuity compared with baseline at 3, 6, 9, and 12 months post-fluocinolone acetonide in both the overall study population and the pseudophakic subgroup ( p < 0.05 at all time points in both groups). A significant reduction in mean central foveal thickness compared with baseline was seen in the overall study population at 3, 6, 9, and 12 months post-fluocinolone acetonide ( p < 0.05 at all time points). At 12-month post-fluocinolone acetonide, a small but significant intraocular pressure increase of 1.0 mmHg was seen in the overall study population. Conclusion: The results of this analysis show that switching from the current standard of care to the fluocinolone acetonide implant leads to beneficial effects in terms of vision and retinal structure in patients with diabetic macular edema and that patients benefited from FAc implant administration, regardless of lens status.

scholarly journals Differentiating features of OCT angiography in diabetic macular edema

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Reza Mirshahi ◽  
Hamid Riazi-Esfahani ◽  
Elias Khalili Pour ◽  
Kaveh Fadakar ◽  
Parsa Yarmohamadi ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Optical Coherence Tomography Angiography ◽  
Vascular Density ◽  
Diabetic Patients ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Capillary Plexus ◽  
Superficial Capillary Plexus

AbstractThe purpose of current study was to evaluate different optical coherence tomography angiography (OCTA) metrics in eyes with diabetic retinopathy with and without diabetic macular edema (DME). In this retrospective study, macular OCTA images of eyes with non-proliferative or proliferative diabetic retinopathy were evaluated. Vascular density, vascular complexity and non-perfusion densities were compared between eyes with and without DME. One-hundred-thirty-eight eyes of 92 diabetic patients including 49 eyes with DME were included. In multivariate analysis, the presence of DME was positively associated with geometric perfusion deficit (GPD) in superficial capillary plexus (SCP), capillary non-perfusion (CNP) of SCP, and GPD in deep capillary plexus (DCP) (all P < 0.05). In eyes with DME, central foveal thickness was associated with VD ratio (SCP/DCP) (P = 0.001) and FAZ area (P = 0.001). In conclusion, in eyes with diabetic retinopathy, the presence of DME was associated with more extensive capillary non-perfusion compared to those with no macular edema.

scholarly journals Efficacy of Aflibercept for DME with Different OCT Types

2021 ◽  
Author(s):  
Yuan Tao ◽  
Mingrong Kou ◽  
Xia Yang ◽  
Yixiao Li ◽  
Shuting Li ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Statistical Significance ◽  
Serous Retinal Detachment ◽  
Post Treatment ◽  
Foveal Thickness ◽  
Time Points ◽  
Central Foveal Thickness

Abstract Background: This study aimed to assess efficacy differences of aflibercept by intravitreal injection for diabetic macular edema (DME) with different OCT types. Methods: according to OCT morphology, 128 patients (128 eyes) with DME were divided into the diffuse retinal thickening (DRT; 41 patients, 41 eyes), cystoid macular edema (CME; 47 patients, 47 eyes), and serous retinal detachment (SRD; 40 patients, 40eyes) groups. All patients were treated by intravitreal injection of 0.5 mg (0.05 mL) aflibercept according to the 3+prn regimen. BCVA (LogMAR) and central foveal thickness (CFT) among the three groups at baseline, and 1 month, 3 months, 6 months and 12 months after treatment, respectively, were assessed. Results: At 1 month, 3 months, 6 months and 12 months after treatment, improvements in BCVA and CFT in the three groups showed statistical significance (P<0.05). BCVA improvement was better at all time points in the DRT group compared with the SRD group (P<0.05). BCVA improvement was also better in the CME group compared with the SRD group at 6 months and 12 months post-treatment (P<0.05). At 1 month, 3 months and 6 months after treatment, CFT differences among the three groups had no statistical significance (P>0.05), while at 12 months post-treatment, CFT values among the three groups had significant differences (F=3.77, P=0.0269). at 12 months after treatment, CFT improvement was better in the DRT and CME groups compared with the SRD group (P<0.05). Conclusion: aflibercept by intravitreal injection could significantly improve visual acuity in DME patients with different OCT types and reduce CFT. At the initial treatment of 12 months, CFT and BCVA improvements in the DRT and CME types were the most pronounced.

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 ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Topical Therapy ◽  
Mean Value ◽  
Ophthalmological Examination ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

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.

scholarly journals Evaluation of Predictive Factors for Successful Intravitreal Dexamethasone in Pseudophakic Cystoid Macular Edema

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Vinodh Kakkassery ◽  
Tim Schultz ◽  
Marc Ilan Wunderlich ◽  
Marc Schargus ◽  
H. Burkhard Dick ◽  
...  
Keyword(s):  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Decision Rules ◽  
Controlled Study ◽  
Data Sets ◽  
Foveal Thickness ◽  
Central Foveal Thickness ◽  
Clinically Significant ◽  
One Year ◽  
Intravitreal Dexamethasone

Purpose. To determine the efficacy, safety, and predictive outcome factors for intravitreal dexamethasone implant (DEX) in pseudophakic cystoid macular edema (PCME). Methods. Retrospective, interventional, controlled study. Patients included had to have clinically significant PCME and have been treated with the DEX between 2012 and 2015. Charts and one-year data were selected consecutively, and efficacy and safety were abstracted. Visual acuity (VA) and central foveal thickness (CFT) were analysed. Results. Nineteen patient data sets were analysed. After treatment with DEX, mean VA increased significantly by 0.2 logMAR (p=0.034), while the mean CFT was reduced significantly by 162.79 μm (p<0.001). Five patients receiving a combination of DEX/bevacizumab have not experienced a higher mean VA gain or CFT reduction compared to fourteen patients receiving DEX alone. Decision rules, when to combine DEX with bevacizumab, have not been defined before the study. Only posttreatment VA gains in the nonhypertensive subgroup (n=11) were significantly better (p=0.026). Analysis of data from diabetes patients (n=4) versus nondiabetics yielded no significant differences in efficacy. There have been no adverse events within follow-up time. Conclusion. The use of DEX in PCME showed significant improvements in VA and CFT. The VA seems to show greater improvements in patients without hypertension.

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

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.

Prophylaxis of macular edema after cataract surgery in diabetic patients, topical Nepafenac versus intravitreal Ranibizumab

2021 ◽  
pp. 112067212110012
Author(s):  
Ahmed Howaidy ◽  
Zeiad H Eldaly ◽  
Mohamed Anis ◽  
Tageldin M Othman
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Study Groups ◽  
Macular Thickness ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Intravitreal Ranibizumab ◽  
Significant Difference ◽  
And Control

Purpose: To compare effect of topical Nepafenac versus intravitreal Ranibizumab on macular thickness after cataract surgery in diabetic patients with no preoperative macular edema. Patients and methods: A prospective randomized controlled study recruited diabetic patients with visually significant cataract and no diabetic macular edema (DME). Patient underwent uncomplicated phacoemulsification with IOL implantation and were randomly assigned to receive post-operative topical Nepafenac, intra-operative intravitreal Ranibizumab, or no prophylactic treatment. Changes in subfoveal and perifoveal macular thickness were assessed by SD-OCT. Results: The mean central macular thickness showed a significant increase in all study groups 1 week and 1 month postoperative when compared to baseline. At 3 months postoperative, there was a significant difference between Nepafenac and Control group ( p = 0.017), Ranibizumab and Control groups ( p = 0.009) with no significant difference between Nepafenac and Ranibizumab group ( p = 0.545) regarding CMT. Comparable results could be detected as regarding peri-foveal macular thickness changes. Concerning BCVA, there was a significant difference between topical Nepafenac/control ( p = 0.001) and intravitreal Ranibizumab/control ( p = 0.004) at 1-week visit. No significant difference in BCVA was observed between Nepafenac and Ranibizumab group throughout the whole study period. In postoperative visits, cystoid macular edema occurred in three patients (7.9%) in Nepafenac group, one patient (2.7%) in Ranibizumab group, and seven patients (17.07%) in control group. Conclusion: Both postoperative topical Nepafenac and intra-operative intra-vitreal Ranibizumab are effective adjunctive to phacoemulsification in diabetic patients for prophylaxis of macular edema.

scholarly journals A predictive screening tool to detect diabetic retinopathy or macular edema in primary health care: construction, validation and implementation on a mobile application

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1404 ◽  
Author(s):  
Cesar Azrak ◽  
Antonio Palazón-Bru ◽  
Manuel Vicente Baeza-Díaz ◽  
David Manuel Folgado-De la Rosa ◽  
Carmen Hernández-Martínez ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Care Physician ◽  
Mobile App ◽  
Diabetic Patients ◽  
Binary Logistic Regression Model ◽  
Foveal Thickness ◽  
Cross Sectional

The most described techniques used to detect diabetic retinopathy and diabetic macular edema have to be interpreted correctly, such that a person not specialized in ophthalmology, as is usually the case of a primary care physician, may experience difficulties with their interpretation; therefore we constructed, validated and implemented as a mobile app a new tool to detect diabetic retinopathy or diabetic macular edema (DRDME) using simple objective variables. We undertook a cross-sectional, observational study of a sample of 142 eyes from Spanish diabetic patients suspected of having DRDME in 2012–2013. Our outcome was DRDME and the secondary variables were: type of diabetes, gender, age, glycated hemoglobin (HbA1c), foveal thickness and visual acuity (best corrected). The sample was divided into two parts: 80% to construct the tool and 20% to validate it. A binary logistic regression model was used to predict DRDME. The resulting model was transformed into a scoring system. The area under the ROC curve (AUC) was calculated and risk groups established. The tool was validated by calculating the AUC and comparing expected events with observed events. The construction sample (n= 106) had 35 DRDME (95% CI [24.1–42.0]), and the validation sample (n= 36) had 12 DRDME (95% CI [17.9–48.7]). Factors associated with DRDME were: HbA1c (per 1%) (OR = 1.36, 95% CI [0.93–1.98],p= 0.113), foveal thickness (per 1 µm) (OR = 1.03, 95% CI [1.01–1.04],p< 0.001) and visual acuity (per unit) (OR = 0.14, 95% CI [0.00–0.16],p< 0.001). AUC for the validation: 0.90 (95% CI [0.75–1.00],p< 0.001). No significant differences were found between the expected and the observed outcomes (p= 0.422). In conclusion, we constructed and validated a simple rapid tool to determine whether a diabetic patient suspected of having DRDME really has it. This tool has been implemented on a mobile app. Further validation studies are required in the general diabetic population.

scholarly journals Effect of Dexamethasone Implant on Subfoveal Choroidal Thickness in Early Period in Vitrectomized Eyes with Diabetic Macular Edema

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
A. Altun ◽  
A. M. Hacimustafaoglu
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Choroidal Thickness ◽  
Early Period ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Dexamethasone Implant ◽  
Subfoveal Choroidal Thickness ◽  
Group 1

Aim. To investigate the change in subfoveal choroidal thickness (SFCT) in vitrectomized eyes with intravitreal dexamethasone (IVD) implant injection for the treatment of diabetic macular edema (DME). Method. In this prospective and controlled study, the vitrectomized eyes of diabetic patients were included. The study group (Group 1) was formed by diabetic vitrectomized eyes with DME. The control group (Group 2) was formed by diabetic vitrectomized eyes without DME. Only one intravitreal IVD implant was injected into the eyes in Group 1. In the first, second, and fourth months, choroidal layers were measured by optical coherence tomography and complete ophthalmologic examinations were performed for all cases. Results. Ninety-six eyes of 96 cases were included in the study. There were 48 eyes of 48 different patients in each group. After IVD injection, statistically significant improvement was observed in the best corrected visual acuity in Group 1. The mean SFCT in eyes with DME was statistically significantly thinner ( p  < 0.01) and thinness became more pronounced during the four-month follow-up period after IVD implant injection ( p  < 0.01). Conclusion. In the presence of DME in vitrectomized eyes, the thinness of the SFCT may become evident after dexamethasone implant injection.

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