[Combined transpupillary thermotherapy with subtenon triamcinolone injection in treatment of choroidal neovascularization secondary to exudative age related macular degeneration]

In spite of several treatment methods which are being used to treat exudative age-related macular degeneration [ARMD] like laser therapy, Intravitreal steroids injections or anti-vascular endothelial growth factors [VEGF], no method has been yet presented as the best treatment way. This study aimed to assess the effectiveness of combined transpupillary thermotherapy [TTT] with subtenon triamcinolone acetonide [TA] injection in treatment of choroidal neovascularization [CNV] in patients with ARMD. In this clinical trial, 63 eyes of 57 patients with CNV secondary to exudative age-related macular degeneration [ARMD] were studied. All CNVs [including 20 predominantly classic and 43 predominantly occult lesions] were treated with diode laser [810nm]. In 20 eyes with predominantly classic CNVs, 20 mg and 40 mg subtenon triamcinolone was injected in 12 and 8 eyes respectively. The patients were followed for a mean of 9.1 months [ranging from 5.5 to 16 months]. The average number of treatment sessions was 1.25. In 43 eyes with occult CNV, 20 mg and 40 mg subtenon triamcinolone was injected in 31 eyes and in 12 eyes respectively. Mean follow up time was 12 months [4.5 to 23 months]. Mean treatment times was 1.17. A variable spot size of 0.8, 1.2, 2 and 3 mm was used depending on the size of CNV; and treatment was given in one area for 1 minute. Thermotherapy was adminstered through a contact lens at a power range between 120-560 mw. At the end of treatment, each patient randomly received 20 mg or 40 mg subtenon triamcinolone acetonide injection in superotemporal quadrant. Outcome was assessed with clinical and angiographic examination collected data were analyzed by one-sample and paired - sample T test, using SPSS software. At the end of the study in first group, visual acuity remained stable [0 to +/- one line] in 14 out of 20 [70%] of eyes, improved [> one line] in 2 of 20 [10%] eyes and showed a decline [> one line worsening] in 4/20 [20%] eyes. In second group thirty one eyes [72.1%] had stable vision [ +/- 1 line], 4 eyes [9.32%] had better vision more than 1 line and 8 eyes [18.6%] had more than 1 line decrease in vision. All CNVs were closed in last follow up. No statistically significant difference was found between two groups in clinical and functional with 20 mg and 40 mg injection of subtenon TA. Combined TTT and subtenon injection of TA in eyes with exudative ARMD can be an effective method to stabilize visual acuity of these patients

[Evaluation of correlation between severity of dry eye syndrome and retinopathy in patients with diabetes mellitus]

Diabetes is one of the most common systemic diseases. Dry eye syndrome is one of the eye involvements in diabetic patient. Evaluation of correlation between dry eye syndrome and diabetic retinopathy in patients with insipidus diabetes was the aim of this study. In this study two hundred eyes from 100 diabetic patients [non-insulin dependent] were selected and evaluated for dry eye syndrome. The patients then were divided into four groups: group 1: patients without diabetic retinopathy group 2: patients with non-proliferative diabetic retinopathy; group 3: patients with proliferative diabetic retinopathy; group 4: patients with proliferative diabetic retinopathy undergone PRPAll. The patients were examined for Schirmer test, BUT, painting cornea with flourecein and then allocated in different group based on the severity of dry eye. Collected data were analyzed by X2 and Kendle-taue tests using SPSS software. Prevalence of dry eye syndrome in patients in group 1 was 48% and in patients in group 2, 3 and 4 was 52%, 60% and 80% respectively. Dry eye syndrome is a complication of diabetes mellitus and its severity correlates with severity of diabetic retinopathy