The relation between inner segment/outer segment junction and visual acuity before and after ranibizumab in diabetic macular edema

Hareedy, Noha H; Gaafar, Ayman A; El-Dayem, Hisham K. Abd; Elshinawy, Reham F.

doi:10.4103/ejos.ejos_26_18

Cited by 6 publications

(3 citation statements)

References 1 publication

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“…Hareedy et al [29] found that improvement in photoreceptor integrity took place after second and third dose of ranibizumab with improvement in VA and colour vision. They found a statistically significant relation between colour vision and EZ after the first injection, but the correlation after the second and third injections was much more significant.…”

Section: Discussionmentioning

confidence: 99%

Sequential restoration of external limiting membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema

Saxena

Kaur

et al. 2020

Eye

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Background/Objectives To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Subjects/Methods Forty-four consecutive patients aged 40-65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), external limiting membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Results Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p < 0.001). Similarly, CST reduced from 354.23 ± 15.0 µm pre-intervention to 233.18 ± 7.88 µm post intervention (p < 0.001). Among qualitative variables, DRIL decreased from 93.2% pre-intervention to 13.6% post intervention. Likewise, global ELM disruption reduced from 81.8 to 9.1% and global EZ disruption reduced from 79.5 to 11.4%. ELM restoration preceded EZ restoration. Conclusion Anti-VEGF therapy restores the barrier effect of ELM. It causes ELM to restore first followed by EZ restoration in DMO.

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Section: Discussionmentioning

confidence: 99%

Sequential restoration of external limiting membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema

Saxena

Kaur

et al. 2020

Eye

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“…There was nearly an approval among studies about that. Nesper et al [26] , Hareedy et al [27] and Abd Elhamid [28] . Who claimed that there is a strong relation between the integrity of photoreceptor layer& BCVA.This was approved with our results.…”

Section: Discussionmentioning

confidence: 98%

Correlation between Macular Non-Perfusion and Patterns of Corresponding Retinal Layers in Diabetic Patients

Shawky

Shalaby

Mohammed

2021

International Journal of Medical Arts

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Background: Diabetic retinopathy is a common deficiency of diabetes mellitus. Diabetic macular ischemia [DMI] is a permanent form of diabetic maculopathy, and its presence reduces the potential benefits of diabetic retinopathy management. Optical coherence tomography [OCT] is used to precisely and reliably measure the macular thickness and outline the retinal layers. Optical coherence tomography angiography [OCTA] can be utilized as a reliable tool to classify the superficial capillary plexus [SCP], the deep capillary plexus [DCP] and the capillary non-perfusion [NP]. Aim of the work:The current research aimed to investigate the correlation between macular non-perfusion that diagnosed by OCTA and patterns of macular layers that diagnosed by OCT scans through the same parts, in a trial to help in the evaluation of both structural and vascular integrity. Patients and Methods:The study included 250 eyes of 125 diabetic patients. All study participants were scanned by OCTA. OCT angiograms were re-sampled with OCT scans from the same region, permitting synchronous evaluation of structure and blood flow.Results: 250 of 125 diabetic patients were categorized into two groups according to capillary NP, ischemic [G1] and non-ischemic [G2].In current study the incidence of DMI was 40%. The incidence of DCPNP was 100% in eyes with DMI while the incidence of SCPNP was 71%. The incidence of foveal avascular zone [FAZ] irregularity, disorganization of the retinal inner layers [DRIL], inner/outer segment IS/OS and external limiting membrane ELM disruptions were 100%, 83%, 95%, 71% respectively among eyes with DMI. DCPNP was more found in all eyes with FAZ irregularity, DRIL, IS/OS and ELM disruption than SCP NP which makes it as the central cause of structural changes in the retina during ischemia. There was a strong positive correlation between the appearance of FAZ irregularity, DRIL, IS/OS and ELM disruption with each of the duration and severity of DR. Conclusion:FAZ irregularity, DRIL, IS/OS and ELM disruption are considered reliable OCT/OCTA findings that reflect an underling DMI and their existence can influence the visual prognosis.

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“…Studies nearly all came to the same conclusion. Multiple researchers have found a correlation between the health of the photoreceptor layer and BCVA: Scarinci et al [10] , Nesper et al [23] , Hareedy et al [24] , and Abd Elhamid [25] . The current state of IS/OS disruption thus appears to be a potentially useful predictor of VA Chung et al [26] .…”

Section: Retinal Capillary Occlusion and Atrophy Accompany Precapilla...mentioning

confidence: 99%

Relation between quantitative measurement of the foveal avascular zone, outer retinal layers disruptions, and visual acuity in diabetic macular ischemia

Elmawla,

GA,

Ghoraba

et al. 2023

Int. J. Med. Ophthalmol.

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Background: With the potential to offer more in-depth images of the macula than foveal avascular (FA) imaging, optical coherence tomography angiography (OCTA) is emerging as a novel imaging tool for the detection of diabetic macular ischemia (DMI). The study's goal was to determine the relationship between visual acuity (VA) in DMI, foveal avascular zone (FAZ) and retinal vessel density (VD) as measured by OCTA, and the integrity of the outer retinal layers as measured by optical coherence tomography angiography (OCT). Methods: This a cross sectional research enrolled 25 eyes of 25 diabetic cases diagnosed with DMI using FFA, and 25 normal eyes as a control group. All cases underwent ocular exam including VA testing, anterior segment exam, intra ocular pressure, fundus exam, and fundus fluorescein angiography (FFA). Results: Reduction of vision was noticed in ischemic cases, the mean BCVA for the cases was 0.88±0.27 (LogMAR), while for the control was 0.03±0.04. A statistically prominent positive relation was detected between best corrected visual acuity (BCVA) (LogMAR) and (FAZ) area (rs=0.530, P=0.006), a statistically prominent negative relation was detected between BCVA (LoMAR) and both vessel area density (VAD) parameters (SCP and DCP) (VADSCP: rs= -0.415, P=0.039) (VADDCP: rs = -0.525, P =0.007). Conclusions: OCTA allows for the quick, automated, and non-invasive quantification of vascular density and FAZ in DMI.

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The relation between inner segment/outer segment junction and visual acuity before and after ranibizumab in diabetic macular edema

Cited by 6 publications

References 1 publication

Sequential restoration of external limiting membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema

Sequential restoration of external limiting membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema

Correlation between Macular Non-Perfusion and Patterns of Corresponding Retinal Layers in Diabetic Patients

Relation between quantitative measurement of the foveal avascular zone, outer retinal layers disruptions, and visual acuity in diabetic macular ischemia

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