ABSTRACT
Objective: To evaluate the effectiveness of combined Intravitreal triamcinolone acetonide [IVTA] and Intravitreal Bevacizumab [IVB] for treatment of refractory diabetic macular edema
Study Design: Quasi-experimental study
Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi, from January to December 2017
Methodology: Pseudophakic diabetic patients with macular edema refractory to prior treatment were included. Patients having best corrected visual acuity [BCVA] better than 20/40 [6/12] or worse than 20/200[6/60] or the central subfield thickness [CSFT] less than 300 um on spectral domain optical coherence tomography [OCT] were excluded. Effectiveness of treatment was compared in terms of change in BCVA and CSFT on OCT. Intravitreal injection of 2 mg IVTA and 1.25 mg of IVB was given. IVB was repeated on monthly basis in next two months. Follow-up was done after one week of first injection and then monthly for next three months
Results: Fifty eyes of 42 patients were studied. Mean age of the patients was 62.4 years +/- 7.13. Male to female ratio was 2:1. Mean pre op LogMAR visual acuity was 0.708 +/- 0.12 and CSFT was 439.10 +/- 54.64 um. Mean postoperative LogMAR visual acuity was 0.586 +/- 0.13 um and mean post op CSFT was 382.80 +/- 56.12. There is statistically significant difference in improvement of LogMAR BCVA and decrease in CSFT after treatment. [p<0.001, paired t-test]
Conclusion: Eyes with refractory macular edema showed improvement of visual acuity and reduction of CSFT at three months when treated with combined IVTA and IVB
ABSTRACT
Objective: To evaluate the effectiveness of intravitreal Bevacizumab in decreasing central macular thickness in branch retinal vein occlusion [BRVO] related macular edema
Study Design: Quasi experimental study
Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi, Pakistan, from March to August 2017
Methodology: Intravitreal Bevacizumab [1.25 mg/0.05 ml] was given in inferotemporal quadrant under aseptic conditions on monthly basis for consective three months. Post-injection, all the patients were followed up on monthly basis for consecutive three months. CMT [in ìm] was measured by using OCT at baseline and after intravitreal Bevacizumab injections at one month, two months, and finally at three months
Results: Forty eyes of forty patients were included in the study. There were 25 [62.5%] male patients and 15 [37.5%] female patients. Baseline mean CMT +/-SD was 358 +/-36 Mum before IVB injection. Mean CMT was 252 +/-12 Mum at 3 months [after three IVB injections]. At three months, mean percentage decrease in CMT was 29.60%
Conclusion: Intravitreal Bevacizumab is effective and results in decrease in central macular thickness to normal or nearnormal levels in branch retinal vein occlusion [BRVO] related macular edema
ABSTRACT
Objective: To evaluate the effectiveness of intravitreal Bevacizumab in decreasing central macular thickness in branch retinal vein occlusion [BRVO] related macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi, Pakistan, from March to August 2017
Methodology: Intravitreal Bevacizumab [1.25 mg/0.05 ml] was given in inferotemporal quadrant under aseptic conditions on monthly basis for consective three months. Post-injection, all the patients were followed up on monthly basis for consecutive three months. CMT [in microm] was measured by using OCT at baseline and after intravitreal Bevacizumab injections at one month, two months, and finally at three months
Results: Forty eyes of forty patients were included in the study. There were 25 [62.5%] male patients and 15 [37.5%] female patients. Baseline mean CMT +/-SD was 358 +/-36 microm before IVB injection. Mean CMT was 252 +/-12 microm at 3 months [after three IVB injections]. At three months, mean percentage decrease in CMT was 29.60%
Conclusion: Intravitreal Bevacizumab is effective and results in decrease in central macular thickness to normal or nearnormal levels in branch retinal vein occlusion [BRVO] related macular edema
ABSTRACT
Objective: The objective of this study is to evaluate the outcome of the surgical management including the surgical techniques [ligation and stripping, phlebectomy] and recurrence of varicose veins. Study design: Observational study. Setting: Study was conducted at the unit of general surgical of Liaquat University Hospital. Study period: One year from February 2011 to February 2012
Materials and methods: This study was contains 40 patients of varicose veins who were undergone surgery. The routine investigations were done. The patients underwent suitable treatment based on their clinical and investigational profile. The post operative course was noted. Further the patients were followed up and final outcome evaluated
Results: From all of 40 cases females were more found in this study as compare to men and mostly patients were found in the age group of 41 to 60 and the second most common age group was 21-40. From the postoperative complications wound infection was noted in the majority of the cases 17.5%. 2 patient had recurrence of varicose veins i.e. 5.0%
Conclusions: Varicose vein surgery is safe, acceptable and cost effective as a day case or ambulatory surgical procedure. Preoperative selection of the patients is mandatory to achieve optimal results. Surgical techniques, [ligation and stripping, phlebectomy] has given good results at our Hospital
ABSTRACT
Objective: To determine the frequency of preclinical nephropathy in patients with diabetic retinopathy and its correlation to the severity of retinopathy
Study Design: Prospective case study
Place and Duration of Study: Department of Ophthalmology, Military Hospital [MH], Rawalpindi for six months
Methods: Ninety [90] diabetic patients [thirty in each grade of retinopathy i.e. background, preproliferative and proliferative] with no known renal dysfunction were included in the study. They were investigated for albumin/creatinine ratio a sport urine sample. The outcome of renal function was described as either positive or negative. The cutoff value for albumin creatinine ratio was 200 mg/g. The various grades of retinopathy were compared to the values of urine albumin creatinine ratio, to find the correlation
Results: Five [17%] patients with background diabetic retinopathy had preclinical nephropathy. Seventeen [60%] patients with preproliferative diabetic retinopathy and 27 [90%] of patients with proliferative diabetic retinopathy had preclinical nephropathy. The frequency of nephropathy correlated to the severity of retinopathy [correlation co efficient, r value: 0.630] and p value of <0.001
Conclusion: it is important for ophthalmologists to carefully consider the renal status of any patient with retinopathy as this can influence the progression of retinopathy and its response to treatment