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Salongcay RP, Aquino LAC, Salva CMG, Peto T, Silva PS. Comparison of Diabetic Retinopathy Lesions Identified Using Ultrawide Field Imaging and Optical Coherence Tomography Angiography. Ophthalmic Res 2023; 66:1053-1062. [PMID: 37379803 PMCID: PMC10614530 DOI: 10.1159/000531723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
INTRODUCTION Optical coherence tomography (OCT) angiography (OCTA) has the potential to influence the diagnosis and management of diabetic eye disease. This study aims to determine the correlation between diabetic retinopathy (DR) findings on ultrawide field (UWF) color photography (UWF-CP), UWF fluorescein angiography (UWF-FA), and OCTA. METHODS This is a cross-sectional, prospective study. One hundred and fourteen eyes from 57 patients with diabetes underwent mydriatic UWF-CP, UWF-FA, and OCTA. DR severity was assessed. Ischemic areas were identified on UWF-FA using ImageJ and the nonperfusion index (NPI) was calculated. Diabetic macular edema (DME) was assessed using OCT. Superficial capillary plexus vessel density (VD), vessel perfusion (VP), and foveal avascular zone (FAZ) area were automatically measured on OCTA. Pearson correlation coefficient between the imaging modalities was determined. RESULTS Forty-five eyes were excluded due to non-DR findings or prior laser photocoagulation; 69 eyes were analyzed. DR severity was associated with larger NPI (r = 0.55944, p < 0.0001) even after distinguishing between cones (Cone Nonperfusion Index [CPI]: r = 0.55617, p < 0.0001) and rods (Rod Nonperfusion Index [RPI]: r = 0.55285, p < 0.0001). In eyes with nonproliferative DR (NPDR), NPI is correlated with DME (r = 0.51156, p = 0.0017) and central subfield thickness (CST) (r = 0.67496, p < 0.0001). UWF-FA macular nonperfusion correlated with NPI (r = 0.42899, p = 0.0101), CPI (r = 0.50028, p = 0.0022), and RPI (r = 0.49027, p = 0.0028). Central VD and VP correlated with the DME presence (r = 0.52456, p < 0.0001; r = 0.51952, p < 0.0001) and CST (r = 0.50133, p < 0.0001; r = 0.48731, p < 0.0001). Central VD and VP were correlated with macular nonperfusion (r = 0.44503, p = 0.0065; r = 0.44239, p = 0.0069) in eyes with NPDR. Larger FAZ was correlated with decreased central VD (r = -0.60089, p = 0.0001) and decreased central VP (r = -0.59224, p = 0.0001). CONCLUSION UWF-CP, UWF-FA, and OCTA findings provide relevant clinical information on diabetic eyes. Nonperfusion on UWF-FA is correlated with DR severity and DME. OCTA metrics of the superficial capillary plexus correlate with the incidence of DME and macular ischemia.
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Affiliation(s)
- Recivall P. Salongcay
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
- Eye and Vision Institute, The Medical City, Pasig, Metro Manila, Philippines
- Philippine Eye Research Institute, University of the Philippines, Manila, Philippines
| | - Lizzie Anne C. Aquino
- Philippine Eye Research Institute, University of the Philippines, Manila, Philippines
| | | | - Tunde Peto
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Paolo S. Silva
- Eye and Vision Institute, The Medical City, Pasig, Metro Manila, Philippines
- Philippine Eye Research Institute, University of the Philippines, Manila, Philippines
- Beetham Eye Institute, Joslin Diabetes Center, Boston, MA, USA
- Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Petroni S, Catena G, Iarossi G, Federici M, Zinzanella G, Parrilla R, Valente P, Buzzonetti L. Treatment of Advanced Coats' Disease With Combination Therapy of Laser Photocoagulation, Intravitreal Ranibizumab, and Sub-Tenon Methylprednisolone Acetate. J Pediatr Ophthalmol Strabismus 2022; 59:187-191. [PMID: 34928773 DOI: 10.3928/01913913-20211110-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the efficacy of combination therapy with laser photocoagulation, intravitreal ranibizumab, and sub-Tenon methylprednisolone acetate in patients presenting with advanced Coats' disease. METHODS This was a retrospective analysis of 16 patients who underwent laser photocoagulation combined with intravitreal ranibizumab and sub-Tenon methylprednisolone acetate between 2008 and 2017. The primary outcome was anatomic success and the secondary outcomes were globe preservation and final visual acuity. RESULTS The average age at surgery was 5.12 ± 2.7 years (range: 3 to 10 years). The mean follow-up time was 45.43 ± 29.01 months (range: 12 to 108 months). Of the 16 patients (16 eyes) reviewed, 6 patients had stage 3A and 10 patients had stage 3B Coats' disease. The mean number of applications was 10 (range: 4 to 18). Globe preservation was achieved in all patients. Final visual acuity outcomes were satisfactory: 20/20 to 20/50 in 2 patients, 20/60 to 20/100 in 1 patient, and 20/200 or worse in 13 patients. CONCLUSIONS Intravitreal ranibizumab used in combination with laser photocoagulation and sub-Tenon methylprednisolone acetate could be an effective treatment option for patients with advanced Coats' disease. The combined therapy achieved anatomical success, globe preservation, and reasonable visual acuity outcomes. [J Pediatr Ophthalmol Strabismus. 2022;59(3):187-191.].
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Kodjikian L, Baillif S, Couturier A, Creuzot-Garcher C, Delyfer MN, Matonti F, Weber M. Recommendations for the management of diabetic macular oedema with intravitreal dexamethasone implant: A national Delphi consensus study. Eur J Ophthalmol 2021; 32:2845-2856. [PMID: 34779302 DOI: 10.1177/11206721211052852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The intravitreal dexamethasone implant (DEX-I) is an alternative to anti-VEGF for the first-line treatment of diabetic macular oedema (DME). However, several questions remain regarding its routine use and its place in certain situations not always specified in current recommendations. A national consensus approach was, therefore, initiated by French retinal experts. METHODS An iterative Delphi consensus approach was used. A steering committee (SC) of seven experts analysed data from the literature to formulate statements divided into five key areas of treatment. These statements were submitted to the independent and anonymous electronic vote of 87 French retina experts among whom 39 expressed their opinion and therefore constituted the voting panel. RESULTS After two rounds of voting, 22 and 7 of 38 statements received a strong consensus and a good consensus, respectively. The consensus level was higher for statements regarding first-line indications and safety of DEX-I compared to those regarding efficacy assessment, reprocessing time or pathophysiological biomarkers. The panellists recommended the preferential use of DEX-I for patients with limited availability for multiple injections, those who needed to undergo cataract surgery or who had a recent cardiovascular history, and as a therapeutic alternative to anti-VEGF in patients with a history of vitrectomy, retinal serous detachment, hyper-reflective points or dry exudates in optical coherence tomography (OCT). However, some statements proposed by SC experts were not validated. CONCLUSION This study provides some key recommendations to clinicians treating diabetic macular oedema, which may be useful when using intravitreal dexamethasone implants in daily practice.
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Affiliation(s)
- Laurent Kodjikian
- 386696Hospital La Croix-Rousse Ophthalmology, Lyon, Rhône-Alpes, France
| | - Stephanie Baillif
- Department of Ophthalmology, 37045Centre Hospitalier Universitaire de Nice, Nice, France
| | - Aude Couturier
- Department of Ophthalmology, 378772Hospital Lariboisière, Paris, Île-de-France, France
| | | | | | - Frédéric Matonti
- Centre Monticelli Paradis, Marseille, France.,Aix Marseille University, Marseille, France
| | - Michel Weber
- 26922University Hospital Centre Nantes, Nantes, Pays de la Loire, France
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Gillam M, Richardson T. Bilateral fingolimod-associated macular oedema development after cataract surgery. BMJ Case Rep 2021; 14:14/6/e240562. [PMID: 34088686 DOI: 10.1136/bcr-2020-240562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Postoperative cystoid macular oedema (CMO) is a recognised complication of cataract surgery, occurring in around 1.5% of cases. It is generally managed with topical steroids or non-steroidal anti-inflammatory medications. We present a case of a patient who developed bilateral sequential CMO following bilateral sequential cataract surgery which was non-responsive to topical therapy and worsened following sub-Tenons administration of steroid. The patient took fingolimod for multiple sclerosis both prior to and during the period of cataract surgery which is known to result in the development of macular oedema in some patients. On fingolimod cessation, the oedema resolved over a period of 5 months with good visual recovery. We present this case to inform cataract surgeons of the risk of fingolimod-associated macular oedema in patients undergoing cataract surgery and to inform neurologists of the potential need to adjust treatment for patients undergoing cataract surgery.
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Affiliation(s)
- Matthew Gillam
- Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Theresa Richardson
- Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UK
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Abstract
PURPOSE OF REVIEW Diabetes mellitus is a global epidemic which is growing in prevalence, and diabetic macular edema (DME) is a leading cause of visual impairment among patients affected by this disease. Our objective is to review current and upcoming therapeutic approaches to DME. RECENT FINDINGS Once considered the gold standard in treatment of DME, focal/grid laser is now reserved mostly for non-center-involving DME, while anti-vascular endothelial growth factor (anti-VEGF) therapy has become the first-line treatment. However, suboptimal responders to anti-VEGF and the burden of frequent injections have stimulated the development of novel approaches. Corticosteroids can be effective in treating DME, but adverse effects such as intraocular pressure elevation and cataract formation must be considered. Emerging therapeutics and drug delivery systems in the pipeline offer exciting potential solutions to this vision-threatening disease. Multiple types of therapeutics targeting various pathways implicated in the pathogenesis of DME may help lessen the global burden of vision loss from diabetes.
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Affiliation(s)
- Eric J Kim
- Cullen Eye Institute, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX, 77030, USA
| | - Weijie V Lin
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Sean M Rodriguez
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Ariel Chen
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD, USA
| | - Asad Loya
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Christina Y Weng
- Cullen Eye Institute, Baylor College of Medicine, 1977 Butler Blvd., Houston, TX, 77030, USA.
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Srinivasarao DA, Lohiya G, Katti DS. Fundamentals, challenges, and nanomedicine‐based solutions for ocular diseases. WILEY INTERDISCIPLINARY REVIEWS-NANOMEDICINE AND NANOBIOTECHNOLOGY 2018; 11:e1548. [DOI: 10.1002/wnan.1548] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/21/2018] [Accepted: 10/28/2018] [Indexed: 01/07/2023]
Affiliation(s)
- Dadi A. Srinivasarao
- Department of Biological Sciences and Bioengineering Indian Institute of Technology Kanpur Kanpur India
| | - Garima Lohiya
- Department of Biological Sciences and Bioengineering Indian Institute of Technology Kanpur Kanpur India
| | - Dhirendra S. Katti
- Department of Biological Sciences and Bioengineering Indian Institute of Technology Kanpur Kanpur India
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Lin J, Chang JS, Yannuzzi NA, Smiddy WE. Cost Evaluation of Early Vitrectomy versus Panretinal Photocoagulation and Intravitreal Ranibizumab for Proliferative Diabetic Retinopathy. Ophthalmology 2018; 125:1393-1400. [PMID: 29606379 DOI: 10.1016/j.ophtha.2018.02.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/22/2018] [Accepted: 02/27/2018] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To evaluate costs and cost-utility of early vitrectomy (pars plana vitrectomy [PPV]) compared with panretinal photocoagulation (PRP) and intravitreal ranibizumab (IVR) for proliferative diabetic retinopathy (PDR) without diabetic macular edema. DESIGN A decision analysis model of cost-utility. PARTICIPANTS There were no participants. METHODS A decision analysis was based on results from the Diabetic Retinopathy Clinical Research Network Protocol S comparing treatment of PRP with IVR (0.3 mg) in PDR without incident macular edema to model the total 2-year costs and outcomes for each treatment scenario. These values were compared with the 2-year hypothetical costs of early PPV for PDR. Centers for Medicare and Medicaid Services data were used to calculate associated modeled costs in a hospital/facility-based and nonfacility setting. Cost-utility was calculated on the basis of the preserved visual utility and estimated life years remaining. In addition, costs for lifetime treatment were modeled for all scenarios and used to calculate lifetime quality-adjusted life years (QALY) costs for each scenario. Sensitivity analyses were performed to evaluate the impact of the model's assumptions. MAIN OUTCOME MEASURES Cost of treatment, utility, and cost per QALY. RESULTS The modeled cost per QALY of treatment for PDR for 2 years of utility in the facility (nonfacility) setting was $163 988 ($102 559) in the PRP group, $436 992 ($326 424) in the IVR group, and $181 144 ($107 965) in the PPV group. Sensitivity analysis showed that both IVR and PPV groups would have equivalent costs per QALY over the first 2 years if 78% (facility) and 80% (nonfacility) of patients in the PPV group required additional treatment with IVR (at the dose of 10.1 injections as in Protocol S). Beyond 2 years, the cost per QALY in the facility (nonfacility) setting was calculated as $61 695 ($21 752) in the PRP group, $338 348 ($239 741) in the IVR group, and $63 942 ($22 261) in the PPV group. CONCLUSIONS Early PPV as a strategy for treatment of PDR without macular edema demonstrates cost-utility similar to management with PRP and more favorable cost-utility compared with IVR in the short term. This advantage over IVR continues when lifetime costs are factored.
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Affiliation(s)
- James Lin
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - Jonathan S Chang
- Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Nicolas A Yannuzzi
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida
| | - William E Smiddy
- Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
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Agarwal M, Elizabeth A, George R, Biswas J. Conjunctival Necrosis Masquerading as Necrotizing Scleritis. Ocul Immunol Inflamm 2017; 26:1223-1224. [PMID: 28910555 DOI: 10.1080/09273948.2017.1340959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mamta Agarwal
- a Uveitis Services, Medical Research Foundation, Sankara Nethralaya, Chennai , India
| | - Amala Elizabeth
- a Uveitis Services, Medical Research Foundation, Sankara Nethralaya, Chennai , India
| | - Ronnie George
- a Uveitis Services, Medical Research Foundation, Sankara Nethralaya, Chennai , India
| | - Jyotirmay Biswas
- a Uveitis Services, Medical Research Foundation, Sankara Nethralaya, Chennai , India
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Iacono P, Parodi MB, Scaramuzzi M, Bandello F. Morphological and functional changes in recalcitrant diabetic macular oedema after intravitreal dexamethasone implant. Br J Ophthalmol 2016; 101:791-795. [DOI: 10.1136/bjophthalmol-2016-308726] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/22/2016] [Accepted: 08/28/2016] [Indexed: 01/04/2023]
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10
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Ozkurt YB, Akkaya S, Aksoy S, Evciman T, Haboğlu M. Posterior Subtenon's Capsule Triamcinolone Acetonide Injection for the Treatment of Diabetic Macular Edema. J Ocul Pharmacol Ther 2015; 31:455-60. [PMID: 26154736 DOI: 10.1089/jop.2014.0130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate and compare the efficacy of posterior subtenon's triamcinolone injections versus grid laser photocoagulation (GLP) combined with posterior subtenon's triamcinolone injection in eyes with diabetic macular edema (DME). METHODS In this prospective clinical study, 42 eyes with DME that showed a decrease in visual acuity (VA) were included. The first group consisted of 22 eyes that received a posterior subtenon's injection of 40 mg of triamcinolone acetonide under topical anesthesia. The second group of 20 eyes received macular GLP applied 1 month after subtenon's triamcinolone acetonide (STTA) injection. All patients were evaluated at baseline and 1 day; 1, 2, 4, 6, and 8 weeks; and 3 and 6 months after injection. In some patients, injections were repeated after 3 months. The main outcome measures were VA, central macular thickness (CMT), intraocular pressure, cataract progression, and frequency of complications. RESULTS The mean baseline CMT for Group I was 456.85 ± 56.90 μm. The mean baseline CMT for Group II was 455.66 ± 57 μm. In the first group, mean CMTs for second week, 8th week, 12th week, and 6th month were 258.15, 276.50, 280.05, and 433.30 μm, respectively. In the second group, mean CMTs for second week, 8th week, 12th week, and 6th month were 261.42, 272.76, 284.71, and 291.76 μm, respectively. Before treatment, in the first group, the mean best-corrected visual acuity (BCVA) measured using a Snellen chart was 0.19, while the first week, third, and sixth month BCVA means were 0.59, 0.57, and 0.41, respectively. Before treatment, BCVA in the second group was 0.17, while the first week, third, and sixth month means were 0.61, 0.64, and 0.60, respectively. Treatment complications included cataracts in 4 eyes and glaucoma in 1 eye. CONCLUSION There is a temporary therapeutic effect of posterior subtenon's triamcinolone injection without laser photocoagulation. GLP improves VA and reduces the risk of recurrent macular edema after posterior STTA injection.
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Affiliation(s)
- Yelda Buyru Ozkurt
- 1 Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital , Istanbul, Turkey
| | - Sezen Akkaya
- 1 Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital , Istanbul, Turkey
| | - Sibel Aksoy
- 1 Department of Ophthalmology, Fatih Sultan Mehmet Training and Research Hospital , Istanbul, Turkey
| | - Tufan Evciman
- 2 Department of Ophthalmology Clinics, Ersoy Hospital , Istanbul, Turkey
| | - Melih Haboğlu
- 3 Department of Ophthalmology Clinics, Asya Eye Hospital , Istanbul, Turkey
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Corticosteroids for the Treatment of Diabetic Macular Edema. CURRENT OPHTHALMOLOGY REPORTS 2014. [DOI: 10.1007/s40135-014-0051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Patel RD, Messner LV, Teitelbaum B, Michel KA, Hariprasad SM. Characterization of ischemic index using ultra-widefield fluorescein angiography in patients with focal and diffuse recalcitrant diabetic macular edema. Am J Ophthalmol 2013; 155:1038-1044.e2. [PMID: 23453693 DOI: 10.1016/j.ajo.2013.01.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/03/2013] [Accepted: 01/03/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore the association of angiographic nonperfusion in focal and diffuse recalcitrant diabetic macular edema (DME) in diabetic retinopathy (DR). DESIGN A retrospective, observational case series of patients with the diagnosis of recalcitrant DME for at least 2 years placed into 1 of 4 cohorts based on the degree of DR. METHODS A total of 148 eyes of 76 patients met the inclusion criteria at 1 academic institution. Ultra-widefield fluorescein angiography (FA) images and spectral-domain optical coherence tomography (SD OCT) images were obtained on all patients. Ultra-widefield FA images were graded for quantity of nonperfusion, which was used to calculate ischemic index. Main outcome measures were mean ischemic index, mean change in central macular thickness (CMT), and mean number of macular photocoagulation treatments over the 2-year study period. RESULTS The mean ischemic index was 47% (SD 25%; range 0%-99%). The mean ischemic index of eyes within Cohorts 1, 2, 3, and 4 was 0%, 34% (range 16%-51%), 53% (range 32%-89%), and 65% (range 47%-99%), respectively. The mean percentage decrease in CMT in Cohorts 1, 2, 3, and 4 were 25.2%, 19.1%, 11.6%, and 7.2%, respectively. The mean number of macular photocoagulation treatments in Cohorts 1, 2, 3, and 4 was 2.3, 4.8, 5.3, and 5.7, respectively. CONCLUSIONS Eyes with larger areas of retinal nonperfusion and greater severity of DR were found to have the most recalcitrant DME, as evidenced by a greater number of macular photocoagulation treatments and less reduction in SD OCT CMT compared with eyes without retinal nonperfusion. Areas of untreated retinal nonperfusion may generate biochemical mediators that promote ischemia and recalcitrant DME.
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Affiliation(s)
- Ravi D Patel
- Department of Surgery, Section of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois, USA
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Javadzadeh A, Ghorbanihaghjo A, Adl FH, Andalib D, Khojasteh-Jafari H, Ghabili K. Calcium dobesilate reduces endothelin-1 and high-sensitivity C-reactive protein serum levels in patients with diabetic retinopathy. Mol Vis 2013; 19:62-8. [PMID: 23335852 PMCID: PMC3548576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 01/08/2013] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To determine the benefits of calcium dobesilate (CaD) administration on endothelial function and inflammatory status in patients with diabetic retinopathy through measurement of serum levels of endothelin-1 and high-sensitivity C-reactive protein (hsCRP). METHODS In a double-blind, randomized clinical trial, 90 patients with either severe nonproliferative or proliferative diabetic retinopathy and with blood glucose level of 120-200 mg/dl were randomly allocated to treatment with either CaD tablets (500 mg daily) or placebo for 3 months. Visual acuity, intraocular pressure, and macular status were performed before the study. The serum levels of endothelin-1 and hsCRP were evaluated in both groups before and at the third month of the trial. RESULTS The median serum level of hsCRP significantly differed between the groups 3 months following the CaD or placebo administration (2.2 mg/l in the CaD group versus 3.7 mg/l in the placebo group, p=0.01). The mean endothelin-1 serum level was 0.69±0.32 pg/ml in the CaD group and 0.86±0.30 pg/ml in the placebo group (p=0.01). Furthermore, in the CaD group, the serum levels of both endothelin-1 and hsCRP were significantly decreased 3 months after administration of CaD (p<0.001). CONCLUSIONS Administration of the CaD in the patients with diabetic retinopathy may reduce the serum levels of endothelin-1 and hsCRP. This might imply amelioration of the endothelial function and inflammatory status following CaD therapy in these patients.
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Affiliation(s)
- Alireza Javadzadeh
- Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Ghorbanihaghjo
- Drug Applied Res earch Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Hami Adl
- Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Dima Andalib
- Nikookari Eye Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Kamyar Ghabili
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran,Young Researchers Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran
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Sukhija J, Dogra MR, Ram J, Ichhpujani P, Gupta A. Acute orbital abscess complicating deep posterior subtenon triamcinolone injection. Indian J Ophthalmol 2008; 56:246-7. [PMID: 18417832 PMCID: PMC2636107 DOI: 10.4103/0301-4738.40370] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 54-year-old diabetic female presented with orbital abscess
and corneal infiltrate 3 days after deep posterior subtenon
triamcinolone acetonide injection in her right eye. This was
administered immediately after focal laser photocoagulation for
diabetic macular edema. The orbital abscess and corneal infiltrate
responded to systemic and topical antibiotics.
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Affiliation(s)
- Jaspreet Sukhija
- Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Laser literature watch. Photomed Laser Surg 2006; 24:661-76. [PMID: 17069502 DOI: 10.1089/pho.2006.24.661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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