RESUMO
Objective: To determine the frequency of vitreo macular traction [VMT] in patients of diabetic macular edema [DME] as detected on spectral domain optical coherence tomography [SD-OCT]
Study Design: Cross-sectional study
Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO] Rawalpindi, from May 2013 to Jan 2014. Patients and Methods: Diabetic patients of less than 18 years of age with DME and central macular thickness of more than 250 micrometers [micro m] were included. The patients with idiopathic VMT, history of vitreoretinal surgery, and history of other retinal vascular diseases were excluded from the study. Dilated fundus was done in each patient using 90 D lens on a slit lamp biomicroscope and patients with diabetic retinopathy changes and DME were subjected to OCT examination using Topcon 3-D OCT 1000 [Topcon Corporation]. Record of each patient including demographic data, ocular findings and OCT data were endorsed on a pre-devised proforma
Results: Seventy one eyes of 68 patients were included, 36 [50.7%] were males and 35 [49.29%] were females. Mean age was 53.17 +/- 8.79 years. Mean central macular thickness [CMT] was 361.8 +/- 109 micro m. VMT was detected in 17 [23.9%] eyes. Amongst these, 2[12.5%] eyes had vitreofoveal traction, epiretinal membrane was found in 4 [25%] eyes and 11[62.5%] eyes had extra foveal VMT
Conclusion: Detection of VMT in about a quarter of cases reflects that OCT is a viable tool for early detection of vitreomacular interface abnormalities
RESUMO
Objective: To compare the effect of intravitreal triamcinolone [IVT] alone with combined intravitreal triamcinolone [IVT] and intravitreal bevacizumab [IVB] on central macular thickness [CMT] in patients of diabetic macular edema [DME]
Study Design: Randomized control trial
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Jun 2013 to Dec 2013
Material and Methods: Eighty patients were included in the study through non probability consecutive sampling and were randomized to IVT alone or IVT + IVB group using random number table. Pre and post injection [12 weeks] CMT were recorded and intra and inter group comparison was performed
Results: Both groups showed statistically significant reduction in mean CMT at 12 weeks [p<0.05]. In Group A, mean CMT reduction at 12 weeks was 64.33 microns [SD=15.17] while in Group B it was 75.18 [SD=20.82]. On comparison, IVT + IVB group was more effective in reducing CMT with statistically significant difference [p=0.009]
Conclusion: Intravitreal triamcinolone used in combination with IVB is more effective in reducing central macular thickness in diabetic macular edema [DME] than intravitreal triamcinolone alone