Suprachoroidal injection of triamcinolone acetonide for management of resistant diabetic macular oedema.

OBJECTIVE: To estimate the effects and safety of suprachoroidal triamcinolone acetonide injections in treating patients with resistant diabetic macular oedema. METHODS: The quasi-experimental study was conducted at the Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi, from November 2019 to March 2020, and adult patients of either gender with uncontrolled diabetes mellitus. Central macular thickness, intraocular pressure and best corrected visual acuity were recorded at baseline, and the patients were followed up at one and three months after the suprachoroidal triamcinolone acetonide injection and post-intervention parameters were compared. Data was analysed using SPSS 20. RESULTS: There were 60 patients with a mean age of 49.25±5.6 years. Of the 70 eyes, 38(54.30%) belonged to male subjects and 32(45.70%) to female subjects. There were significant differences in terms of central macular thickness and the best corrected visual acuity at both follow-ups compared to the baseline readings (p<0.05). CONCLUSIONS: Suprachoroidal triamcinolone acetonide injection significantly reduced diabetic macular oedema.

Diagnostic accuracy of non-mydriatic fundus camera for screening of diabetic retinopathy: A hospital based observational study in Pakistan.

OBJECTIVE: To determine the diagnostic accuracy of non-mydriatic fundus camera for the detection of diabetic retinopathy. METHODS: The cross-sectional study was conducted at Al Ibrahim Eye Hospital, Karachi, from January to May 2015, and comprised patients with type 2 diabetes who were screened for diabetic retinopathy. Single 45° fundus image focussed at macula was obtained and labelled using non-mydriatic fundus camera by a trained optometrist. Photos were labelled as positive (diabetic retinopathy present), negative (no diabetic retinopathy) or unreadable. The pupil was then dilated and fundi were examined by ophthalmologist with slit-lamp and fundus lens. Results of fundus examination were labelled as positive, negative or invisible/indecisive. Results of ophthalmologist were taken as the standard reference to evaluate sensitivity and speci?city for detecting diabetic retinopathy with non-mydriatic fundus camera. SPSS 20 was used for data analysis. RESULTS: Total eyes screened numbered 2970 related to 1485 patients. Diabetic retinopathy was found in 646(21.8%) eyes, 485(20.9%) photographs were unreadable and 1839(57.3%) were normal. Ophthalmologist on slit lamp bio-microscopy labelled 736(25%) eyes as positive for diabetes retinopathy, 335(15%) as indecisive and 1899(60%) as normal. The sensitivity of non-mydriatic fundus camera was 400/556 (72%) while specificity was 1548/1794 (86.3%). Positive predictive value and negative predictive value were 400/646 (62%) and 1548/1704 (90%) respectively. The level of agreement was moderate (k=0.0551) for optometrist compared to ophthalmologist. False positive diagnosis by optometrist numbered 78/1839 (4.24%) and false negative was 123/646(19%). CONCLUSIONS: Non-mydriatic fundus camera was found to be a reliable screening tool for detecting and referral diabetic retinopathy cases to ophthalmologist for further evaluation and management.