Evaluation of outer retinal layers changes before and after intervention in diabetic macular edema

Aim of the work: this study aimed to evaluate changes in photoreceptors, inner segment/outer segment [IS/OS] junction and external limiting membrane [ELM] following grid argon laser versus intravitreal injection of antivgef [ Ranibizumab ] in diabetic type2 patients affected by clinically significant macular edema

Methods: forty eyes of diabetic type 2 patients who were affected by clinically significant macular edema were randomly categorized into two groups[ Group treated by argon grid laser and group treated by intravitreal injection of antivgef for the first time] both groups were investigated for best corrected visual acuity [BCVA] and the integrity of the photoreceptors, IS/OS and ELM as being [Continuous[+], interrupted[ +/- ] or Absent [-] ] by spectral-domain optical coherence tomography [SD-OCT][ CIRRUS HD-OCT] before treatment , 1month, 2months and 3months after treatment . Other variables, included central macular thickness [CMT] and central macular volume [CMV] were evaluated

Results: significant difference was found between [photoreceptor, is/os] [+], photorecptor, is/os [+,-] and photoreceptor, is/os [-] groups in BCVA at baseline; it was 0.61,0.73,and 1 and after 6 months it was 0.48,0.73 and 1 . Results were similar for ELM groups. Signiant difference was found between ELM [+], ELM [+,-] and ELM [-] groups in BCVA at baseline it was 0.59,0.72,and 1 and after 6 months it was 0.46,0.68 and 1 in lucentis group and signiant difference was found between photoreceptor, is/os [+] and photorecptor ,is/os [+,-] groups in BCVA at baseline was[0.32and 0.3 and after 6 months it was 0.27and 0.3 . Results were similar for ELM groups. Signiant difference was found between ELM [+] and ELM [+,-] groups in BCVA at baseline it was 0.29 and 0.5 and after 6 months it was 0.25 and 0.4 in argon laser group

Conclusion: the more damage of outer retinal layers at the time of DME the lower visual acuity following DME resolution and the presence of intact of these layers is an important factor in determining final visual acuity

future of glaucoma treatment ripasudil

Glaucoma is a leading cause for worldwide blindness and is characterized by progressive optic nerve damage. The etiology of glaucoma is unknown, but elevated intraocular pressure [IOP] and advanced age have been identified as risk factors. IOP reduction is the only known treatment for glaucoma. Recently, drugs that inhibit Rho associated protein kinase [ROCK] have been studied in animals and people for their ability to lower IOP and potentially treat POAG. ROCK inhibitors lower IOP through a trabecular mechanism and may represent a new therapeutic approach for the treatment of glaucoma. Ripasudil is the first Rho-kinase inhibitor ophthalmic solution developed for the treatment of glaucoma and ocular hypertension in Japan 2014. ROCK inhibition not only reduces intraocular pressure [IOP] but also increases ocular blood flow

Quality of life and self-esteem in Hemophilic children and adolescents

Background: The present study aimed to assess of quality of life and self esteem and to discover the relation of both to the clinical and therapeutic parameters in children with hemophilia. To achieve this target, 100 hemophilic children were included in the study. They had a mean age of 10.091 4.44. They were subjected to careful history taking and thorough clinical examination. In addition, they were subjected QOL and self esteem assessment. It was shown that 48% of the studied children are obese, the most commonly encountered manifestation was target joint 75.0% followed by gum bleeding 72%, circumcision bleeding 69.0%, epistaxis 54.0%, hemartherosis 50.0% muscle hematoma 49.0%, dental bleeding 45%, and limited joint movement 33.0%. Regarding the QOL, the present study found that it is clear that the studied children had generally poor quality of life domain. This is manifested by the mean total QOL score which is only 50.9, comparison between individual and total QOL scores in the studied age groups had revealed that children of the middle age had significantly better QOL scores when compared with the other two groups. The relatively poor QOL scores in the present study is explained by the higher frequency of joint problems which had detrimental effects on the studied children physical health and other QOL domains. Also patients with joint problems including hemartherosis, target joint and limited joint movement had significantly worse QOL score when compared with patients without, assessing patients self-esteem reveled significantly lower Coppersmith self-esteem inventory in patients when compared with controls, obese children had significantly lower self esteem scores when compared with children with normal weight. Finally, we showed a statistically significant inverse correlation between self esteem and QOL