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To study RNFL thickness in gestational diabetes mellitus based on OCT measurements. Methods: Case-control study with Inclusion criteria: 2groups of age 18-40yrs at 32-34weeks gestation Group 1: Healthy pregnant women Group 2: Pregnant women with GDM Exclusion Criteria: Preexisting hypertension/retinal diseases/renal disease/vascular disease/glaucoma/IOP>21mmHg/cataract/ refractive error correction more than or equal to +/-5D (spherical) or +/-3D (cylinder). Grouping-Study Design: more than 2 unrelated group study. Sample Size: n=182 Procedure: After detailed history taking &.written consent detailed ophthalmic examination is done Patients are classified into group1&2. Using CIRRUS HD OCT peripapillary RNFL is measured in superior, inferior, nasal and temporal fields. Results: Peripapillary RNFL showed significant thinning in GDM patients when compared to healthy pregnant female Conclusion: Peripapillary RNFL thinning in GDM patients measured in their third trimester suggest a neurodegenerative process preceding microvascular changes in gestational diabetes mellitus. The degree of retinal thinning at the level of macula correlated with the glycemic status of the patients. Thereby making it mandatory to carry out routine evaluation of retina with the help of OCT in all GDM patients to detect early neurodegenerative changes and to keep the blood glucose levels in normal range to prevent the occurrence of diabetic retinopathy.

BACKGROUND A descriptive, observational and non-interventional hospital-based study on diabetes-related chronic renal failure patients undergoing regular haemodialysis was conducted to evaluate the occurrences of ocular manifestations and to know whether ocular screening was useful. MATERIALS AND METHODS A cross-sectional study was conducted. Hundred patients who were diabetic and undergoing treatment for chronic renal failure were taken. Detailed history was collected and clinical examination was done. All ocular findings were noted. Vision was noted with Snellen's chart. Anterior segment was assessed with slit lamp. Intraocular Pressure (IOP) measured using applanation tonometer. Retinal pathologies were noted with 90 D lens under slit lamp and indirect ophthalmoscopy and ultrasound scan were used in mature cataract cases. RESULTS Diabetic Retinopathy (DR) was noted in 95% cases, and of this, 64% of diabetic retinopathy were detected for the first time and were advised to undergo treatment. Lid oedema (58%), dry eye (48%) and corneal conjunctival calcification (12%) were also detected. More severe grades of DR were detected with increasing severity of renal disease. Seventeen percent patients showed Age-Related Macular Degeneration (ARMD) changes. CONCLUSION Chronic Renal Failure (CRF) patients are at increased risk of visual loss since this condition causes worsening of diabetic retinopathy changes. Regular ocular examinations are required in these patients for timely interventions to reduce risk of visual loss and thereby to improve patient's quality of life.

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This study aimed to determine the effectiveness of treatment by laser or Intravitreal anti VEGF- Bevacizumab (IVB) or combined therapy (both laser and anti-VEGF) in diabetic macular edema (DME). A prospective observational study in which 90 eyes with diabetic macular edema (DME) were enrolled. According to patient compliance, they were divided in to 3 groups where there was 30 eyes in each group. Patients with DME who were treated with laser were observed (group A). Patients with DME who were treated with Intravitreal Bevacizuamb (IVB) were observed (group B).Patients with DME who were treated with both IVB and Laser were observed (group C). All patients underwent complete ophthalmic examination at baseline and at one and three months after treatment. The outcome measures were changes in Central macular thickness(CMT) and best corrected visual acuity(BCVA). A P value less than 0.05 considered statistically significant. One month after treatment, Group B showed more statistically significant reduction in CMT and improvement in BCVA than group A and group C(P<0.05). Three months after treatment, group C showed more statistically significant reduction in CMT and improvement in BCVA when compared to other two groups(P<0.05). Combined therapy with IVB and laser appeared to be superior to Laser alone or IVB alone in reducing macular thickness and improving visual acuity. Thus combined therapy can be considered as most effective treatment in DME.