Current Treatment Approaches in Diabetic Macular Edema

Meyer, Carsten H.

doi:10.1159/000098257

Cited by 57 publications

(47 citation statements)

References 162 publications

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“…Bu hastalarda, interlökin-6 ve VEGF gibi sitokinlerin artması ve kan-retina bariyerinde bozulma olmaktadır. Mikroanevrizmalar ve anormal kılcal damarlar yoluyla retina içi ve subretinal boşluğa sızıntı ve eksudasyon gerçekleşmekte ve bu biyokimyasal ve hücresel değişiklikler ile makula ödemi gerçekleşmektedir [12].…”

Section: Discussionunclassified

Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi

Yumuşak¹,

Örnek²

2016

Turk J Clin Lab

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ÖZAmaç: Diyabetik makula ödemi olan hastalarda katarakt cerrahisi sonrası makula ödemindeki değişikliklerin ve hemoglobin A1C ile ilişkisinin incelenmesi. Gereç ve Yöntemler:Bu retrospektif klinik çalışma diyabetik makula ödemi olan ve komplikasyonsuz fakoemülsifikasyon ameliyatı uygulanan 30 hastanın 30 gözünü kapsamaktadır. Olgulara operasyon öncesi ve sonrası birinci hafta birinci ay ve üçüncü aylarda oftalmolojik muayene yapıldı ve optik koherens tomografi yardımıyla santral foveal kalınlık ölçümü yapıldı. Bulgular: Başlangıç değerlerine göre en iyi düzeltilmiş görme keskinliği bakımından birinci ay ve üçüncü ay değerleri artma gösterdi ve bu farklılık istatistiksel olarak anlamlıydı (P < 0,05). Foveal kalınlık bakımından da birinci ay ve üçüncü ay değerleri başlangıca göre istatistiksel olarak anlamlı derecede yüksek bulundu. Ancak bir aydan sonra artma eğilimi azaldı. Hemoglobin A1C ile ilk ay foveal kalınlık arasında anlamlı pozitif bir korelasyon bulundu (P = 0,030, r = 0,38). Sonuçlar: Diyabetik makula ödemi ve kataraktı olan hastalar fakoemülsifikasyonla katarakt cerrahisinden fayda görmektedir. Katarakt cerrahisi sonrası makula ödemi açısından özellikle ilk altı ay optik koherens tomografi ile düzenli takip yapılmalıdır.

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Section: Discussionunclassified

Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi

Yumuşak¹,

Örnek²

2016

Turk J Clin Lab

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“…The risk of diabetic retinopathy (DR) and cataract increases with duration of disease (16, 23). The benefi t of laser photocoagulation (LK) on course of DR and diabetic maculopathy was presented in various studies (6,19,1,18,12). The number of patients treated by LK is growing.…”

Section: Discussionmentioning

confidence: 99%

The impact of phacoemulsification cataract surgery on eyes previously treated by laser photocoagulation for diabetic retinopathy

Ilavska¹

2013

BLL

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Aim of study: to evaluate the evolution of diabetic retinopathy (DR) after cataract surgery on eyes previously treated by photocoagulation for DR. The compensation of glycaemia (glycosylated haemoglobin, HbA1c) and prevalence of attendant diseases (hypertension, ischemic heart disease and alteration of lipid metabolisms) were evaluated. Methods: Forty eyes (40 patients) were evaluated, of which ten (25 %) eyes with DR were treated without laser photocoagulation (LK), and 30 (75 %) eyes were previously treated by LK. Two criteria for evaluating the stabilisation were used, particularly the best corrected visual acuity (BCVA) and the necessity of additional laser photocoagulation. Results: As many as 100 % of eyes without LK and 86.7 % of eyes with LK had BCVA improved on the fi rst day after surgery (p ≤0.05). The BCVA of 0.5 or better was achieved in 31 eyes (77.5 %). The mean level of HbA1c in group without LK was 7.09 ±1.21 %; in group after LK it was 7.36 ±1.64 %. The mean level of HbA1c in the group with stable BCVA was 7.14 ± 0.46 % and the duration of DM was 18.6 ± 2.93 years. HbA1c, in group of eyes with worsened BCVA, was 7.86 ± 2.23 %, and the duration of DM was 21.0 ± 8.54 years. HbA1c in the group of stable eyes (without LK after surgery) was 6.71± 0.1 %, and the duration of DM was 17.84 ± 8.97 years. HbA1c, in group, where additional LK was applied, was 7.56 ± 0.69 %, and the duration of DM was 19.54 ± 3.26 years. The difference in levels of HbA1c was statistically signifi cant (p≤0.1). The prevalence of attendant disease was highest in the group of eyes with worsened BCVA and necessity of additional LK. Conclusion:The results of study confi rm an improvement in BCVA after cataract surgery by phacoemulsifi cation in the most of patients. Better stabilisation of glycaemia levels and lower frequency of internal diseases were in group with stable BCVA and without necessity of additional LK after cataract surgery (Tab. 3, Fig. 1 The study investigates the development of diabetic retinopathy (DR) after phacoemulsifi cation cataract surgery on eyes previously treated with photocoagulation for DR. The compensation of glycaemia (based on the level of glycosylated haemoglobin), and prevalence of attendant diseases (hypertension, coronary ischaemic disease and alteration of lipid metabolisms) were evaluated.Diabetes mellitus (DM) is one of the mostly extended diseases in the world and the number of people suffering from DM is growing permanently. This evolution has repercussions on population's morbidity and mortality. The risk of diabetic retinopathy (DR) and cataract increases with duration of disease (16, 23). The benefi t of laser photocoagulation (LK) on course of DR and diabetic maculopathy was presented in various studies (6,19,1,18,12). The number of patients treated by LK is growing. Patients with DM develop cataract earlier and more frequently. Cataract surgery is made also on eyes previously treated by LK. The infl uence of cataract surgery on DR was documented in several studies (5,8,10,1...

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“…Novel IVT injections in vascular AMD are vitally dependent on repeated injections and close follow-up examinations: Up to now we have treated macular edema in AMD or diabetes mellitus [8] by argon photocoagulation or photodynamic therapy and scheduled reexaminations conventionally 3 months after treatment. However, with novel anti-VEGF agents we may face a different situation in the future.…”

Section: Discussionmentioning

confidence: 99%

Computer-Based Visual Evaluation as a Screening Tool after Intravitreal Injections of Vascular Endothelial Growth Factor Inhibitors

Meyer

Lapolice²

2008

Ophthalmologica

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Purpose: To evaluate the visual acuity (VA) of patients following intravitreal (IVT) injections. Methods: 15 patients received 3 anti-vascular-endothelial-growth-factor (VEGF) injections on a monthly basis. Prior to each injection as well as 2 months after, the patients received a standardized examination including Snellen VA and optical coherence tomography (OCT). During this time the patients were trained to evaluate their central VA by 3 computer-based tests: (a) VA was examined by the patient on a computer-based vision chart and (b) subjectively categorized as ‘same’, ‘worse’ or ‘better’; (c) the edge of metamorphopsia was outlined on a digital Amsler grid. Results: VA improved during the 3 injections by ≥2 lines (13/15). The assessment demonstrated subjective improvement (13/15), i.e. a gain of 2 or more lines or decreased central metamorphopsia (12/15). Reevaluation 2 months later demonstrated a decline of ≥1 Snellen line or increased retinal thickness on OCT (8/15), and a decline of ≥1 line or an enlarged metamorphopsia in the computer-based tests (6/15). Conclusion: Our pilot study demonstrated a good correlation between the professional examination and the computer-based assessment. Selected patients can define their visual impairment. A web-based VA evaluation may help to screen patients after IVT injections on a regular basis at home.

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Current Treatment Approaches in Diabetic Macular Edema

Cited by 57 publications

References 162 publications

Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi

Diabetik makula ödemi olan hastalarda katarakt cerrahisinin postoperatif makula ödemine etkisi

The impact of phacoemulsification cataract surgery on eyes previously treated by laser photocoagulation for diabetic retinopathy

Computer-Based Visual Evaluation as a Screening Tool after Intravitreal Injections of Vascular Endothelial Growth Factor Inhibitors

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