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@#AIM: To investigate the ocular surface changes of diffuse diabetic macular edema(DDME)treated by intravitreal injection of Conbercept. <p>METHODS: Twenty patients(20 eyes, right eyes)diagnosed as DDME and requiring vitreous injection of conbercept in the Department of Ophthalmology, the First Affiliated Hospital of Nanchang University from January 2019 to June 2019, were selected as experiment group. Experiment goup was treated with three vitreous injections of Conbercept. The left eyes of the patients without macular edema were treated as control group without any treatment. Before operation and on the first day after operation, we used corrected visual acuity, superficial punctate epithelial erosion(SPEE), lacrimal river height, intraocular pressure, symptom and sign scores, Schirmer I test(S I t)and corneal fluorescein staining(CSF)to estimate eyes.<p>RESULTS: Before treatment, there was no difference in intraocular pressure, the height of lacrimal river, OSDI score, S I t, CSF score between the two groups(<i>P</i>>0.05), and there was no superficial punctate epithelial erosion in both groups, but the corrected visual acuity of the control group was significantly better than that of the experimental group(0.50±0.20 <i>vs</i> 1.65±0.35, <i>P</i><0.05). After treatment, the corrected visual acuity, lacrimal river height and S I t in the experimental group were significantly lower than those in the control group, OSDI and CSF scores were significantly higher than those in the control group(all <i>P</i><0.05), and the intraocular pressure increased more significantly than that in the control group, but there was no difference between the two groups(<i>P</i>>0.05). Compared with before treatment, the corrected visual acuity of the experimental group was significantly improved, the lacrimal river height and S I t were significantly decreased, OSDI and CSF scores were significantly increased(<i>P</i><0.05), but the intraocular pressure had no significant change(<i>P</i>>0.05); the observation indexes of the control group had no significant changes(<i>P</i>>0.05).<p>CONCLUSION: Intravitreal injection of conbercept in the treatment of diffuse diabetic macular edema can damage the ocular surface.
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· AIM:To compare the clinical curative effect of triamcinolone acetonide and Ranibizumab on diffuse diabetic macular edema (DME).· METHODS:We collected 84 cases of patients with diffuse DME treated in our hospital from February 2016 to May 2017.According to 1:1 matching method,they were divided into Ⅰ,Ⅱ groups.They were all treated with laser photocoagulation.Preoperative auxiliary application of triamcinolone acetonide was given to Group Ⅰ,while Group Ⅱ received preoperative application of ranibizumab.After treatment,the efficacy of the two groups were analyzed and compared.· RESULTS:The total clinical efficiency of Group Ⅱ at 3mo after treatment was 93％,higher than that of Group Ⅰ (77％;x2 =4.981,P =0.025).Compared with before treatment,BCVA and CMT of the two groups at each time after treatment were significantly improved (P＜ 0.05).BCVA of Group Ⅱ at 1 and 3mo after treatment was better than that of Group Ⅰ (P＜0.05);CMT of Group Ⅱ at 1,3 and 6mo after treatment improved more than that of Group Ⅰ,with significant difference (P ＜ 0.05);occurrence rate of adverse reactions Group Ⅰ and Group Ⅱ were 17％ and 13％ with no significant statistical difference (X2 =0.243,P=0.621).There were no serious adverse reactions such as retinal detachment,endophthalmitis or cataract in the two groups.· CONCLUSION:Compared with triamcinolone acetonide,the effect of ranibizumab on diffuse diabetic macular edema is better,and has high clinical value.
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Purpose: To study the efficacy of dexamethasone (DEX) intravitreal implant followed by macular laser after 1-month for diffuse diabetic macular edema (DDME). Methods: Interventional case series of 49 eyes of 33 patients with DDME attending the retina clinic from November 2013 to December 2014. All patients underwent detailed ophthalmic evaluation followed by fluorescein angiography and optical coherence tomography. The sequential macular laser was done after 1-month after DEX implant. All patients had a minimum follow-up of 6 months. Results: Mean age was 58.33 years ± 9.4 years, mean best corrected visual acuity (VA) was 0.5418 logMAR units at presentation improved to 0.4748 at 1-month and maintained 0.4385 at 3 months and 0.4376 at 6 months follow-up (P = 0.01). Mean Central macular thickness was 529.2 μ at presentation reduced to 285.4 μ at 1-month and maintained 296.1 μ at 3 months and 321.1 μ at 6 months follow-up (P = 0.0001). Total macular volume was 11.78 mm3 at presentation reduced to 7.78 mm3 at 1-month and maintained 7.97 mm3 at 3 months and 8.1 mm3 at 6 months follow-up (P = 0.0001). Conclusion: DEX intravitreal implant followed by macular laser showed favorable results by decreasing macular edema and improving VA in DDME, where the role of laser alone is limited.
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PURPOSE: To compare the short-term effects of intravitreal versus posterior subtenon injection of triamcinolone acetonide for diabetic macular edema. METHODS: This is a prospective and interventional study. Sixty eyes of 60 patients who had diffuse diabetic macular edema were assigned to receive a single intravitreal injection (4 mg) or a single posterior subtenon injection (40 mg) of triamcinolone acetonide. The central retinal thickness was measured using optical coherent tomography before injection and at 1 and 3 months after injection. Visual acuity and intraocular pressure (IOP) were also measured. RESULTS: Both intravitreal and posterior subtenon injections of triamcinolone acetonide resulted in significant improvements in visual acuity at 1 month and 3 months after injection. Both groups resulted in a significant decrease in central macular thickness (CMT) at 1 month and 3 months post-injection. IOP in the intravitreal injection group was significantly higher than in the posterior subtenon injection group at 3 months after injection. CONCLUSIONS: The posterior subtenon injection of triamcinolone acetonide had a comparable effect to the intravitreal triamcinolone injection and showed a lower risk of elevated IOP. Posterior subtenon injection of triamcinolone acetonide may be a good alternative for the treatment of diffuse diabetic macular edema.
Subject(s)
Middle Aged , Male , Humans , Female , Aged , Vitreous Body , Visual Acuity , Triamcinolone Acetonide/administration & dosage , Treatment Outcome , Tomography, Optical Coherence , Prospective Studies , Orbit , Macular Edema/drug therapy , Injections , Glucocorticoids/administration & dosage , Fundus Oculi , Follow-Up Studies , Fluorescein Angiography , Diabetic Retinopathy/complicationsABSTRACT
We reviewed 92 eyes(65 patients) of diffuse diabetic macular edema which were treated with grid laser photocoagulation and followed up for more than 4 months from March 1992 to March 1997. There were improvements of visual acuity in 24 eyes(26.1%)and non changes in 50 eyes(54.3%), and 18 eyes(19.6%) showed worsened visual acuity. Initial visual acuity, presence of clinically significant macular edema and severity of retinopathy had not significant effects on visual outcome(P>0.05). Patients with grid photocoahulation without panretinal photocoagulation showed significantly good results than panretinal photocoagulation before or after grid photocoagulation(p<0.05).