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Purpose: This study was conducted to determine the morphological and functional retinal changes in patients with neovascular age?related macular degeneration (nAMD) treated with intravitreal bevacizumab 1.25 mg. Methods: This was a prospective, nonrandomized, interventional study. Eighteen eyes of 18 subjects with nAMD were treated with intravitreal bevacizumab (1.25 mg) injection. Subjects underwent complete ophthalmic evaluation which included visual acuity, slitlamp examination, tonometry, binocular ophthalmoscopy, optical coherence tomography (OCT), and MP1 microperimetry before the intravitreal injection and the follow?up at 1 and 3 months. Test of significance such as Chi?squared test, paired ttest and oneway analysis of variance (ANOVA) linear trend were used to compare the pre? and post?anti?VEGF outcomes. Intraclass correlation was done to assess the intra observer variability. Results: Mean retinal sensitivity had increased from 3.77 ± 3.13 dB at baseline to 4.93 ± 2.42 dB at 3 months (P = 0.05). Visual acuity improved from 0.62 ± 0.36 at baseline to 0.52 ± 0.36 at 1 month and 0.48 ± 0.34 at 3?month followup, but overall change was not significant (P = 0.40). There was a significant reduction in central foveal thickness (CFT) from 274.61 ± 117.95 at baseline to 179.83 ± 84.18 at 1 month and 179.00 ± 126.55 at 3?month follow?up (P = 0.013). Conclusion: Intravitreal bevacizumab (1.25 mg) injection in nAMD improves retinal function, quantified by retinal sensitivity, scotoma characteristics, fixation stability by MP 1 microperimetry and morphological parameters quantified by CFT in SDOCT. These changes show the effectiveness of treatment with intravitreal bevacizumab in nAMD
RESUMO
Aim: To study the Framingham cardiovascular risk assessment scores in subjects with diabetes and their association with diabetic retinopathy in subjects with diabetes. Materials and Methods: In this population-based prospective study, subjects with diabetes were recruited (n=1248; age ≥40 years). The Framingham cardiovascular risk scores were calculated for 1248 subjects with type 2 diabetes. The scores were classified as high risk (>10%), and low risk (<10%). Results: Out of the 1248 subjects, 830 (66.5%) patients had a low risk of developing cardiovascular disease (CVD) in 10 years and 418 (33.5%) had a high risk of developing CVD in 10 years. The risk of developing CVD was more in males than females (56.8% vs. 7%) The prevalence of both diabetic retinopathy and sight-threatening retinopathy was more in the high-risk group (21% and 4.5%, respectively). The risk factors for developing diabetic retinopathy were similar in both the groups (low vs. high) – duration of diabetes (OR 1.14 vs. 1.08), higher HbA1c (OR 1.24 vs. 1.22), presence of macro- and microalbuminuria (OR 10.17 vs. 6.12 for macro-albuminuria) and use of insulin (OR 2.06 vs. 4.38). The additional risk factors in the high-risk group were presence of anemia (OR 2.65) and higher serum high density lipoprotein (HDL) cholesterol (OR 1.05). Conclusion: Framingham risk scoring, a global risk assessment tool to predict the 10-year risk of developing CVD, can also predict the occurrence and type of diabetic retinopathy. Those patients with high CVD scores should be followed up more frequently and treated adequately. This also warrants good interaction between the treating physician/cardiologist and the ophthalmologist.