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Objective To investigate the effects of intravitreal injection of conbercept on diffuse macular edema (DME) of diabetes mellitus.Methods Together 51 diabetic patients (51 eyes) with diffuse macular edema were collected between July 2016 to July 2017,and randomly divided into three groups (n =17):group A,in which patients received solely intravitreal injection of 0.5 mg conbercept,group B,those who was intravitreally injected with 0.5 mg of conbercept and modified macular grating photocoagulation,and group C,patients undergoing modified grid photocoagulation (GPG).Then,before treatment and 1 week,1 month,3 months and 6 months after treatment,all patients were examined by optical coherence tomography for determining central macular thickness (CMT),followed by fundus fluorescein angiography (FFA),the best corrected visual acuity (BCVA),slit lamp,intraocular pressure for compare the efficacy and safety of the three procedures.Results All the three treatments improved BCVA,CMT,retinal neovascularization (RNV) leakage in diffuse DME patients,but group A and B were better than group C (both P ＜ 0.05),while there was no significant difference in BCVA improvement between A and B group (P ＞ 0.05),whereas the improvement in CMT of group B patients was better than that of group A [(197.47 ±45.26) μm vs.(205.59 ± 47.33) μm] (P ＜ 0.001),and this was true of RNV leakage [(9.91 ±3.18)mm vs.(13.24 ±4.87) rnm] (P＜0.001),without related complications.Conclusion Combination of modified macular grid photocoagulation and intravitreal injection of conbercept can quickly relieve diabetic macular edema and alleviate neovascularization,thus improving the patients' vision acuity,of which the efficacy is superior to the pure modified macular grid photocoagulation and conbercept injection.
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Objetivos: Mostrar la experiencia y resultados del tratamiento con el implante intravítreo de Dexametasona (Ozurdex) para el edema macular (EM) secundario a patologías vítreo retinianas en una Clínica Oft almológica en Barranquilla - Colombia. Métodos: Reporte de casos retrospectivo, 22 historias clínicas desde el mes de enero del 2012 a mayo del 2016. Se incluyeron datos de pacientes pseudofáquicos con historia clínica de EM secundario a Retinopatía diabética, DMRE húmeda multitratada con Anti VEGF, Oclusión venosa retiniana central (OVCR), uveítis, postoperatorio de cirugía vitreorretiniana por desprendimiento de retina y pelaje de membrana epirretiniana. Las variables registradas fueron edad, sexo, agudeza visual mejor corregida (AVMC), presión intraocular (PIO), subtipo de EM, etiología del EM, respuesta del EM a los 4 meses de tratamiento valorada por OCT. Se utilizó la prueba de T de Wilcoxon para muestras pareadas. Resultados: Edad promedio de 68 años, 61.9% mujeres y 42.86% hombres. En la distribución del EM por OCT de todos los casos en estudio, 54.5% de los casos presentó un EM predominantemente quístico y 45.5% presentó un EM predominantemente difuso. La AVMC de base fue de 0.45 +/- 0.41 logMAR (R: 0 2 LogMAR) y la AVMC posterior a los 4 meses del tratamiento fue de 0.40 +/- 0.44 logMAR (R: 0 2 LogMAR, P: 0.476). La PIO presentó picos de elevación durante los meses 1 y 2 posterior al tratamiento en 59.9%, siendo manejada satisfactoriamente con antihipertensivos oculares. Los grosores maculares promedios previos y a los 4 meses del implante fueron de 372.13 µm (R:184 661 µm) y de 300.18 µm (R: 176 495 µm) en su grosor foveal central respectivamente. El grupo de EM quístico tuvo una reducción promedio de 121.41 µm (IC 95% 31.07 211.75, P: 0.013), el grupo de EM difuso tuvo reducción promedia de 13.66 µm (IC 95% -8.94 36.27, P: 0.201). Conclusiones: Se muestra la experiencia y efectividad del tratamiento con ozurdex intravítreo en el EM asociado a diversas patologías. Se encontró una respuesta con disminución de grosores maculares a 4 meses del tratamiento, con una mayor respuesta por parte del subtipo de EM predominantemente quístico y el EM secundario a OVCR como mejor respondedor de acuerdo a su etiología. Los picos de PIO fueron manejados adecuadamente con antihipertensivos tópicos, no se reportaron otros efectos adversos en la evolución de los pacientes.
Purpose: To show the experience and results of the treatment with intravitreal dexamethasone implant (Ozurdex) for macular edema secondary to vitreous retinal pathologies at an ophthalmologic clinic in Barranquilla, Colombia. Methods: Retrospective case reports study. We reviewed 22 clinical records from January 2012 to May 2016 that met the inclusion criteria. Pseudophakic patients data with clinical history of macular edema (ME) secondary to diabetic retinopathy, wet AMD multitreated with Anti VEGF, Central Retinal Vein Occlusion (CRVO), Uveitis, postoperative vitreoretinal surgery due to retinal detachment and epiretinal membrane peeling were included. The variables recorded were age, sex, best corrected visual acuity (BCVA), intraocular pressure (IOP), subtype of ME, etiology of ME, ME response at 4 months of treatment assessed by OCT. Th e Wilcoxon T test was used for paired samples. Results: Th e average age was 68 years. According to sex there were 61.9% female and 42.86% male. In the distribution of ME by OCT of all the cases under study, 54.5% of the cases had a predominantly cystic ME and 45.5% had a predominantly diff use ME. Th e baseline BCVA was 0.45 +/- 0.41 logMAR (R: 0-2 LogMAR), the BCVA aft er 4 months of treatment was 0.40 +/- 0.44 logMAR (R:0-2 LogMAR, P: 0.476). IOP showed elevation peaks during months 1 and 2 posttreatment in 59.9%, being satisfactorily managed with ocular antihypertensives. The mean macular thickness prior to and at 4 months of Ozurdex was 372.13 µm (R: 184 - 661 µm) and 300.18 µm (R: 176 - 495 µm) at its central foveal thickness, respectively. Th e cystic ME group had a mean reduction of 121.41 µm (95% CI 31.07 - 211.75, P: 0.013); the diff use ME group had a mean reduction of 13.66 µm (95% CI -8.94 - 36.27, P: 0.201). Conclusions: We show our experience and the eff ectiveness of treatment with intravitreal ozurdex in ME associated with various pathologies. We found a response with a decrease in macular thickness at 4 months of treatment, with a higher response by the subtype of a predominantly cystic ME and ME secondary to CRVO as the best responder according to its etiology. IOP peaks were handled adequately with topical antihypertensives, no other adverse eff ects were reported in the evolution of patients.