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 ◽  
...  

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.

2021 ◽  
Author(s):  
Yuan Tao ◽  
Mingrong Kou ◽  
Xia Yang ◽  
Yixiao Li ◽  
Shuting Li ◽  
...  

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.


2022 ◽  
Vol 8 ◽  
Author(s):  
Qiaowei Wu ◽  
Yijun Hu ◽  
Baoyi Liu ◽  
Zhanjie Lin ◽  
Yu Xiao ◽  
...  

Purpose: To evaluate factors associated with the presence of foveal bulge (FB) in resolved diabetic macular edema (DME) eyes.Methods: A total of 165 eyes with complete integrity of ellipsoid zone (EZ) at the fovea and resolved DME were divided into two groups according to the presence of FB at 6 months after intravitreal injection of ranibizumab treatment. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), outer nuclear layer (ONL) thickness, height of serous retinal detachment (SRD) and non-SRD, and inner segment (IS) and outer segment (OS) lengths of the two groups were measured and compared at baseline and each follow-up. The correlations between the presence of FB and pre- and post-treatment factors were determined by logistic regression analysis.Results: At baseline, BCVA was significantly better, and CFT and incidence and height of SRD were significantly lower in the FB (+) group (all P &lt; 0.05). At 6 months, FB was present in 65 (39.39%) eyes. Post-treatment BCVA was significantly better and OS length was significantly longer in the FB (+) group at 6 months (all P &lt; 0.05). Multivariate analysis identified younger age, better BCVA, and lower CFT before treatment as significant predictors of the existence of FB at 6 months (all P &lt; 0.05). At 6 months, better BCVA and longer OS length were significantly correlated with the existence of FB (all P &lt; 0.05).Conclusions: Factors associated with the presence of FB after the resolution of DME include younger age, better baseline BCVA and lower baseline CFT, and better post-treatment BCVA and longer post-treatment OS length.


2020 ◽  
Vol 12 ◽  
pp. 251584142091776
Author(s):  
Angela Carneiro ◽  
Angelina Meireles ◽  
João Paulo Castro Sousa ◽  
Carla Teixeira

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.


2020 ◽  
Vol 12 ◽  
pp. 251584142097193
Author(s):  
Alper Halil Bayat ◽  
Mustafa Nuri Elçioğlu

Purpose: To evaluate outcome of intravitreal dexamethasone implant (IDI) treatment on serous retinal detachment (SRD) in patients with ranibizumab-resistant diabetic macular edema (DME). Materials and methods: Forty-eight eyes of 48 patients with DME resistant to ranibizumab were enrolled in this retrospective and comparative study. Patients were divided into two groups according to presence of serous retinal detachment: (1) SRD or (2) non-SRD groups. All patients had at least three monthly ranibizumab injections, after which they were treated with IDI. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), use of antiglaucomatous drugs, and presence of cataract progression were noted at 1, 3, and 6 months post-IDI treatment. Results: There was not any statistically significant difference in terms of baseline characteristics of the patients. The mean CRT was declined in both groups at 1, 3, and 6 months ( p < 0.001). After IDI treatment, the mean BCVA was improved in both groups at 1, 3, and 6 months ( p < 0.001). When groups were compared, the change in CRT was higher in the SRD group ( p = 0.018), while there was no statistically significant difference between groups in terms of BCVA changes ( p = 0.448). Conclusion: The presence of SRD resulted in higher anatomical gain. SRD had no effects on visual changes after dexamethasone treatment in patients with ranibizumab-resistant DME.


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.


2016 ◽  
Vol 235 (3) ◽  
pp. 137-140 ◽  
Author(s):  
Mohamed M. Mahgoub ◽  
Tamer A. Macky

Purpose: The aim of this study was to compare the effect of panretinal photocoagulation for proliferative diabetic retinopathy (PDR) on diabetic macular edema (DME) using a Pascal® Photocoagulator (PP) or a conventional argon laser photocoagulator (CALP). Methods: Eighty eyes with PDR and center-involving DME were randomized to PP or CALP. Both groups had baseline assessment of best-corrected visual acuity (BCVA) and were examined with optical coherence tomography and fluorescein angiography. Results: The mean number of laser shots for the PP and CALP groups was 1,726.10 and 752.00 at session 1 and 1,589.00 and 830.00 (p < 0.001) at session 2, respectively. The mean central foveal thickness (CFT) at baseline was 306 ± 100 and 314 ± 98 for the PP and CALP groups, respectively. At 8 weeks, the mean CFT was 332 ± 116 and 347 ± 111 for the PP and CALP groups, respectively (p > 0.05). The mean BCVA was similar during the study period with no significant difference between the groups (p > 0.05). Conclusion: PP and CALP had similar effects on DME in PDR eyes and were equally safe with no significant increase in CFT.


2019 ◽  
Vol 10 (4) ◽  
pp. 3000-3005
Author(s):  
Khlood M. Aldossary ◽  
Anfal Alruzuq ◽  
Ghady Almohanna ◽  
Hessa Almusallam ◽  
Sara Alamri ◽  
...  

Diabetic macular edema (DME) is a significant cause of diabetic retinopathy and a major cause of vision loss. In this study, we aimed to evaluate and compare the efficacy of two injectable drugs; intravitreal Aflibercept and intravitreal Ranibizumab for the treatment of DME of the eyes. A retrospective chart review was conducted for patients diagnosed with DME from March 2014 to January 2019 who received either intravitreal Aflibercept or intravitreal Ranibizumab injection. A total of 57 eyes were included, of which 19 eyes were treated with intravitreal Ranibizumab injection, and 38 eyes were treated with intravitreal Aflibercept injection; all eyes were examined for 3 months. Two outcomes were assessed in this study, namely; visual acuity (VA) and central macular thickness (CMT). The mean age in the Ranibizumab group was 61.1±9.5 vs 64.3±10.2 in the Aflibercept group with no significant difference (p-value=0.25). The ratio of improvement in visual acuity (VA) in the Ranibizumab group was 68.4% vs 44.7% in the Aflibercept group; (p-value=0.038) which demonstrates the superiority of Ranibizumab over Aflibercept concerning visual acuity result. However, there is no statistically significant difference between the ratio of improvement in central macular thickness (CMT) results in both groups; (p-value=1.00). In fact, the ratio of improvement in CMT in both groups was the same 78.9% for both the groups. The pre and post results demonstrated improvement in post-procedural for CMT among both the groups but only Ranibizumab group showed VA improvement post-procedural. Through this study, we concluded that both injectable drugs improve visual acuity (VA) and decrease central macular thickness (CMT) in eyes with DME. However, Ranibizumab is superior in improving visual acuity compared to Aflibercept. Further comparative effectiveness trials between Aflibercept and Ranibizumab are still warranted.


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.


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