Diabetes mellitus (DM) is a chronic disease that affects 387 million people worldwide. Diabetic retinopathy (DR), a common complication of DM, is the main cause of blindness in the active population. Diabetic macular edema (DME) may occur at any stage of DR, and is characterized by vascular hyperpermeability accompanied by hard exudates within the macula. Medical and surgical therapies have dramatically reduced the progression of DR, and timely intervention can reduce the risk of severe vision loss by more than 90 %. In 2012, intravitreal ranibizumab became the first antivascular endothelial growth factor (anti-VEGF) agent approved for DME and, since then, many reports of the use of ranibizumab for DME have been promising. Randomized, prospective, multicenter clinical trials-most notably, RESOLVE, READ-2, RISE/RIDE, RESTORE, DRCR.net protocol I, and RETAIN-reported improvements in best-corrected visual acuity and decreased central retinal thickness as measured with optical coherence tomography in patients with DME. Similar treatment benefits have also been noted in clinical trials evaluating intravitreal aflibercept and bevacizumab (DAVINCI, VISTA/VIVID, and BOLT) and more recently DRCR.net protocol T. Intravitreal steroids (dexamethasone intravitreal implant and fluocinolone acetonide), particularly in refractory cases, also play a significant role in the management of DME (MEAD/CHAMPLAIN and FAMOUS/FAME studies). In summary, over the last 5 years, blocking VEGF and inflammation has been shown to improve visual outcomes in patients with macular edema due to DM, revolutionizing the treatment of center-involved DME and establishing a new standard of care.
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http://dx.doi.org/10.1007/s40265-015-0447-1 | DOI Listing |
GMS Ophthalmol Cases
December 2024
Department of Ophthalmology, Disha Eye Hospital, Siliguri, India.
Background: Pseudophakic cystoid macular edema (CME) following primary anterior-chamber intraocular lens (ACIOL) implantations is commonly seen. Intravitreal triamcinolone acetonide (IVTA) injections have shown significant improvement in visual acuity and retinal thickness in refractory pseudophakic CME. Pseudohypopyon following IVTA injection is a known entity.
View Article and Find Full Text PDFBMJ Open
December 2024
Westmead Institute for Medical Research, Westmead, New South Wales, Australia
Introduction: Diabetic macular oedema (DMO), a serious ocular complication of diabetic retinopathy (DR), is a leading cause of vision impairment worldwide. If left untreated or inadequately treated, DMO can lead to irreversible vision loss and blindness. Intravitreal injections using antivascular endothelial growth factor (anti-VEGF) and laser are the current standard of treatment for DMO.
View Article and Find Full Text PDFInt J Retina Vitreous
January 2025
Army Hospital Research & Referral, Delhi Cantt, New Delhi, Delhi, 110010, India.
Background: Management of Diabetic Macular edema (DME) requires repeated injections. Therefore newer Anti-VEGFs like Brolucizumab with longer durability have been introduced. We compared two different dosages of Brolucizumab, 6.
View Article and Find Full Text PDFActa Dermatovenerol Croat
November 2024
Prof. Marija Jelušić, MD, PhD, Department of Paediatrics, University of Zagreb, School of Medicine, Division of Clinical Immunology, Rheumatology and Allergology, Centre of Reference for Paediatric and Adolescent Rheumatology of Ministry of Health of the Republic Croatia, University Hospital Centre Zagreb, Kispaticeva 12, 10 000 Zagreb, Croatia;
Juvenile dermatomyositis with emphasized vasculopathy is rare, but the most severe form of the disease, with a poor prognosis with relapsing and chronic course or, in some cases, lethal outcome. We present a case of a 19-year-old Caucasian female, who developed severe acute juvenile dermatomyositis with emphasized multisystem vasculopathy, including retinal vasculopathy and maculopathy (cotton-wool spots, retinal hemorrhages, macular edema) at the age of 8. Due to no response to standard treatment protocols and rapid worsening of clinical symptoms and laboratory findings, a TNF inhibitor (infliximab) was introduced after the third week of treatment resulting in complete normalisation of muscle enzyme levels and complete resolution of eye changes within the next 2 weeks with a gradual general recovery.
View Article and Find Full Text PDFPurpose: The purpose of this study is to evaluate the impact of foveal bulge presence on visual acuity (VA) in patients with diabetic macular edema (DME) and retinal vein occlusion (RVO).
Methods: Spectral-domain optical coherence tomography (SD-OCT) scans were conducted on 22 DME patients and 20 RVO patients. Ordinary least squares (OLS) regression was employed to analyze the association between VA and the presence of the foveal bulge, as well as factors such as sex, age, central foveal thickness, various line scans of the fovea, and the external limiting membrane (ELM).
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