scholarly journals Diabetic Macular Edema Treatment with Bevacizumab Does Not Depend on the Retinal Nonperfusion Presence

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Bogumiła Sędziak-Marcinek ◽  
Sławomir Teper ◽  
Elżbieta Chełmecka ◽  
Adam Wylęgała ◽  
Mateusz Marcinek ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Study Groups ◽  
Wide Field ◽  
Bevacizumab Treatment ◽  
Area Distribution ◽  
Leakage Area ◽  
The Relationship ◽  
Positive Effect

This study evaluated the relationship between the retinal nonperfusion area (NPA) presence and the effectiveness of bevacizumab treatment (IVB) in patients with diabetic macular edema (DME). It also tested the prognostic usefulness of ultra-wide-field fluorescein angiography (UWFFA) and OptosAdvance software for diabetic retinopathy monitoring. Eighty-nine patients with DME with a macular central   subfield   thickness   CST ≥ 250   μ m , with ( N = 49 eyes) and without ( N = 49 eyes) retinal NPA, underwent nine bevacizumab injections over 12 months. NPA distribution, leakage area distribution, microaneurysm (MA) count, macular CST, diabetic retinopathy severity, and best-corrected visual acuity (BCVA) were assessed. The results show that bevacizumab reduced the macular CST from 420 to 280 μm ( p < 0.001 ) and improved BCVA ( p < 0.001 ) by about 10 ETDRS letters in both groups of patients. Additionally, the therapy reduced total retinal NPA from 29 (14-36) mm2 to 12 (4-18) mm2 (Me (Q1-Q3); p < 0.001 ) in patients with diagnosed nonperfusion. The effect of the therapy measured with vascular leakage, MA count, BCVArelative, and CSTrelative strongly depended on the zone of the retina and the NPA distribution. We conclude that the bevacizumab treatment had a positive effect on DME and BCVA in both study groups and on the size of retinal NPA in patients with retinal nonperfusion.

Pathogenetic factors of the formation of morphological forms of diabetic macular effeas (review)

2020 ◽  
Vol 21 (3) ◽  
pp. 131-135
Author(s):  
I. V. Ionkina ◽  
◽  
O. M. Zherebtcova ◽  
A. G. Grinev ◽  
◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Technical Equipment ◽  
Macular Area ◽  
Central Vision ◽  
Relationship Of ◽  
The Relationship

Diabetic macular edema (DME) is a pathological accumulation of fluid in the subretinal or intraretinal spaces of the macular area in patients with diabetic retinopathy and leads to a significant decrease in Central vision. Various types of technical equipment for retinal imaging have led to significant advances in the study of diabetic macular edema. In particular, optical coherence tomography (OCT) can provide linear and structural analysis of macular layers in great detail. The important role of inflammation in the development of changes in the macular region, based on OCT classification, associated with characteristic changes in the retina, has been studied. In this review, we will describe the pathogenesis of diabetic macular edema and discuss its types based on the results of OCT and identify the relationship of various types of (DME) with inflammation. Inflammation plays an important role in the pathogenesis of diabetic macular edema, but its role differs depending on the type of changes detected on OCT.

scholarly journals How to Achieve Near-Normal Visual Acuity with Bevacizumab in Diabetic Macular Edema Patients

2021 ◽  
Vol 10 (16) ◽  
pp. 3572
Author(s):  
Bogumiła Sędziak-Marcinek ◽  
Adam Wylęgała ◽  
Elżbieta Chełmecka ◽  
Edward Wylęgała ◽  
Sławomir Teper
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Wide Field ◽  
Swept Source ◽  
Normal Visual Acuity ◽  
Corrected Visual Acuity ◽  
Central Subfield Thickness ◽  
Before And After

Patients suffering from diabetic retinopathy (DR) and diabetic macular edema (DME) are inherently interested in achieving normal or near-normal visual acuity. The study aimed to investigate factors influencing the visual acuity achieved by DME patients after bevacizumab (IVB) treatment. 98 patients (98 eyes) diagnosed with DR and DME underwent IVB treatment (9 injections/12 months). Patients were diagnosed and monitored using swept-source optical coherence tomography (SS-OCT), ultra-wide-field fluorescein angiography (UWFFA) and Early Treatment Diabetic Retinopathy Study (ETDRS) chart testing. We assessed macular central subfield thickness (CST), non-proliferative diabetic retinopathy (NPDR) indicators and best-corrected visual acuity (BCVA). After the treatment, patients were divided into BCVA£75 and BCVA>75 groups. The IVB therapy increased the number of ETDRS letters read by about 9 and 8 in the BCVA£75 and the BCVA>75 group, respectively. Before and after treatment, the BCVA>75 group had lower CST than the BCVA£75 group. The treatment reduced macular CST by 177 μm in the BCVA£75 group and only by 93 μm in the BCVA>75 group. Total non-perfusion area (NPA) decreased in both BCVA score groups after IVB therapy. Normal or near-normal vision can be achieved with IVB treatment, provided it starts when visual acuity is not significantly reduced yet. The ophthalmic screening of DR patients should also target those with relatively high visual acuity.

scholarly journals Fundus fluorescein angiographic assessment of patients with proliferative Diabetic Retinopathy and Macular Edema before and after intravitreal injection of Bevacizumab

2019 ◽  
Vol 7 (11) ◽  
pp. 4111
Author(s):  
Ankur . ◽  
Yogesh Kumar ◽  
Deepesh Arora ◽  
Rupali Tyagi ◽  
Sanjeev Kumar Mittal
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Fundus Fluorescein Angiography ◽  
Intravitreal Bevacizumab Injection ◽  
Department Of Ophthalmology ◽  
Leakage Area ◽  
Before And After

Background: To assess the role of intravitreal bevacizumab (1.25 mg) in patients with proliferative diabetic retinopathy with macular edema in terms of change in leakage area and best-corrected visual acuity.Methods: This prospective randomized interventional study was conducted in the Department of Ophthalmology from September 2013 to August 2015 and included thirty eyes of twenty patients.After a detailed history and ocular examination, diagnosed cases of proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) underwent sequential fundus fluorescein angiography. Bevacizumab was administered intravitreally. Patients were assessed two hours after injection for anterior chamber reaction and intraocular pressure and were advised follow-ups at 24 hours and then at 1, 4, 8 and 12 weeks. For the outcome, the change of retinal new vessels by assessment of leakage area using Quantitative Planimetric Analysis (QPA) of photographs as well as the change in best-corrected visual acuity (BCVA) from baseline to the 12 weeks follow-up, were done. Results were analyzed statistically by applying t-test.Results: Intravitreal bevacizumab injection lead to a significant decrease in leakage in DME and PDR, and improvement in mean BCVA. The effect was maximum at 4 weeks which weaned off as the study progressed through it remains statistically significant at the end of 12 weeks.Conclusions: Intravitreal bevacizumab plays a major role in treating and reducing visual deterioration in patients with proliferative diabetic retinopathy and diabetic macular edema.

scholarly journals Evaluation of the Response to Ranibizumab Therapy following Bevacizumab Treatment Failure in Eyes with Diabetic Macular Edema

2015 ◽  
Vol 6 (1) ◽  
pp. 44-50 ◽  
Author(s):  
Joel Hanhart ◽  
Itay Chowers
Keyword(s):  
Treatment Failure ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Median Number ◽  
Vascular Endothelial ◽  
Spectral Domain Oct ◽  
Bevacizumab Treatment ◽  
Central Subfield Thickness ◽  
The Mean ◽  
Endothelial Growth Factor

Background/Aims: Bevacizumab and ranibizumab are routinely used to treat diabetic macular edema (DME). We aim to evaluate the usefulness of switching to ranibizumab therapy following bevacizumab treatment failure in eyes with DME. Methods: We performed a retrospective analysis of a consecutive group of patients with DME who received ranibizumab injections following the failure of bevacizumab injections. The injections were delivered following a pro re nata protocol every 4-6 weeks. The data collected included demographics, systemic and ophthalmic findings, as well as the central subfield thickness according to spectral-domain OCT. Results: Eight eyes (5 patients) were included in the study. The median number of bevacizumab injections prior to the switch to ranibizumab was 4, and the median number of ranibizumab injections during the study was 2. The mean follow-up period was 541 ± 258 days. The mean central retinal thickness (CRT) (±SEM) was 539 ± 75 μm before the initiation of bevacizumab treatment, and 524 ± 43 μm after the last bevacizumab injection (p = 0.7). It reduced to 325 ± 26 μm following the ranibizumab injections (p = 0.0063). The best-corrected visual acuity (BCVA) improved in 4 eyes and remained stable in 4 eyes following the ranibizumab injections. Conclusion: A ranibizumab therapy was effective in reducing the CRT in eyes that failed bevacizumab therapy. A BCVA improvement can also occur in these eyes. Switching between anti-vascular endothelial growth factor compounds may be beneficial in eyes with DME.

The Relationship Between Macular Sensitivity and Retinal Thickness in Eyes With Diabetic Macular Edema

2011 ◽  
Vol 152 (3) ◽  
pp. 400-405.e2 ◽  
Author(s):  
Elham Hatef ◽  
Elizabeth Colantuoni ◽  
Jianmin Wang ◽  
Mohamed Ibrahim ◽  
Matthew Shulman ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Macular Sensitivity ◽  
The Relationship
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