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https://www.readbyqxmd.com/read/28430331/factors-influencing-intravitreal-bevacizumab-and-triamcinolone-treatment-in-patients-with-diabetic-macular-edema
#1
Tai K Kim, Hye Y Shin, Su Y Kim, Young C Lee, Mee Y Lee
PURPOSE: To evaluate factors associated with response to intravitreal bevacizumab (IVB) and intravitreal triamcinolone acetonide (IVTA) in diabetic macular edema (DME). METHODS: Ninety-one eyes of 88 patients diagnosed with DME were enrolled in this retrospective chart review. Group 1 included eyes that showed good response to IVB. Group 2 included eyes that did not respond to IVB but responded to IVTA. Group 3 included eyes that responded to neither. Clinical factors, HbA1c, and optical coherence tomography (OCT) findings including patterns of macular edema were compared among the 3 groups...
April 11, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28427075/diabetic-macular-edema-emerging-strategies-and-treatment-algorithms
#2
Elad Moisseiev, Anat Loewenstein
Diabetic macular edema (DME) is the most common cause of vision loss in diabetic patients, and its management is often a long process requiring frequent monitoring and therapeutic interventions. During the past several decades, numerous treatments have been developed for the treatment of DME. Although many of them have been found to be effective and safe, there is relatively little comparative data, and no established guidelines for the optimal treatment approach exist. In this chapter, the evolution of DME therapies is reviewed, and the current common practice patterns are discussed...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427074/enzymatic-vitreolysis-for-vitreomacular-traction-in-diabetic-retinopathy
#3
Stanislao Rizzo, Daniela Bacherini
Vitreomacular traction (VMT) is one of many possible factors involved in the etiology of diabetic macular edema (DME). Pharmacologic vitreoretinal separation is a potential alternative to vitrectomy for VMT in diabetic retinopathy. Small case series have been published on the use of enzymatic vitreolysis in tractional DME, and demonstrate that the enzymatic release of the posterior vitreous cortex is more likely following the injection of plasmin enzyme. Further prospective and randomized clinical trials are necessary to evaluate the clinical relevance of ocriplasmin for vitreomacular traction in diabetic retinopathy, and additional studies are needed to determine more accurately which patients might benefit most from this treatment and how often and at what concentration ocriplasmin should be administered...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427072/anti-vascular-endothelial-growth-factor-injections-the-new-standard-of-care-in-proliferative-diabetic-retinopathy
#4
Xintong Li, Marco A Zarbin, Neelakshi Bhagat
For decades, panretinal photocoagulation (PRP) has been the standard of care for the treatment of proliferative diabetic retinopathy (PDR). The relatively recent advent of anti-vascular endothelial growth factor (VEGF) formulations for intravitreal injection has provided a fresh perspective on PDR treatment, especially in eyes with concurrent diabetic macular edema (DME). The anti-VEGF agent ranibizumab has demonstrated a potentially protective effect on eyes with DME in terms of progression to PDR in the RIDE/RISE trials, as has aflibercept in the VIVID/VISTA trials...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427070/practical-lessons-from-protocol-t-for-the-management-of-diabetic-macular-edema
#5
Lekha Mukkamala, Neelakshi Bhagat, Marco Zarbin
PURPOSE: To review the results of Diabetic Retinopathy Clinical Research Network Protocol T, as applied to clinical practice. METHODS: Review of major publications reporting the results of Protocol T, a randomized single-masked (in year-1 only), multicenter clinical trial comparing aflibercept, bevacizumab, and ranibizumab as treatment option for center-involving diabetic macular edema (DME). The main outcome measures were change in visual acuity (VA), central subfield thickness (CST) on optical coherence tomography, cost effectiveness, burden of care, and safety...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427069/practical-lessons-from-protocol-i-for-the-management-of-diabetic-macular-edema
#6
Lekha Mukkamala, Neelakshi Bhagat, Marco A Zarbin
Protocol I, a multicenter randomized clinical trial, compared the visual outcomes of patients treated with 0.5 mg intravitreal ranibizumab with either prompt or deferred (by 24 weeks laser), 4 mg intravitreal triamcinolone with prompt laser, or sham injection with prompt laser for the treatment of center-involving diabetic macular edema (DME). A total of 854 adult patients with type I or II diabetes and any level of non-proliferative diabetic retinopathy or proliferative retinopathy with adequate panretinal photocoagulation, with best-corrected visual acuity (BCVA) of 78 to 24 ETDRS letters (Snellen equivalent of 20/32 to 20/320) and visual loss attributed to macular edema, or retinal thickening with central subfield thickness of at least 250 µm by OCT were enrolled...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427068/intravitreal-steroids-in-diabetic-macular-edema
#7
Rosangela Lattanzio, Maria Vittoria Cicinelli, Francesco Bandello
Over the past decade, great strides have been made in the management of diabetic macular edema (DME). Therapeutic alternatives now include focal/grid laser photocoagulation, vitreo-retinal surgery, and intraocular injection of anti-angiogenic and steroid molecules. Intravitreal administration of steroids represents a fundamental alternative for recalcitrant and naive eyes with DME, especially in those cases when anti-vascular endothelial growth factor (VEGF) agents are contraindicated or a treatment regimen with fewer intravitreal injections is required...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427067/intravitreal-aflibercept-in-diabetic-macular-edema-long-term-outcomes
#8
Ugo Introini, Giuseppe Casalino
For decades, macular laser photocoagulation has been the standard of care in the treatment of diabetic macular edema (DME). With the relatively recent advent of anti-vascular endothelial growth factor (VEGF) agents, DME treatment has entered a new era. VEGF is a well-known pro-angiogenic and pro-permeability factor involved in the pathogenesis of DME. VEGF blockade has proven remarkably effective at reducing DME and improving visual acuity (VA) in eyes with center involved DME causing VA loss in several randomized controlled trials (RCTs)...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427066/intravitreal-ranibizumab-in-diabetic-macular-edema-long-term-outcomes
#9
Ilaria Zucchiatti, Francesco Bandello
Intravitreal ranibizumab (RBZ) has been shown in multiple randomized clinical trials to be a valuable treatment for diabetic macular edema (DME), promoting a significant improvement in best-corrected visual acuity (BCVA) and in anatomic outcomes. Compared to sham (RISE and RIDE studies), RBZ rapidly and sustainably improved BCVA and decreased macular edema at 2 years, reducing the risk of further vision loss, with low rates of local or systemic side effects. Compared to macular laser photocoagulation (READ-2 study), RBZ provided a greater improvement in BCVA and regression in foveal thickness, but required a higher number of injections compared to patients treated with both RBZ and laser...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427062/emerging-issues-for-optical-coherence-tomography
#10
Luisa Pierro, Alessandro Rabiolo
Almost 25 years after its introduction, optical coherence tomography (OCT) is still a crucial test in the evaluation of patients affected by diabetic retinopathy. In this chapter, the authors provide an extensive overview of the posterior segment pathological changes induced by diabetes, characterized using OCT. OCT plays a key role in diabetic macular edema (DME) as it assesses related retinal changes both in a qualitative (i.e., DME pattern, presence and aspects of cysts, fluid localization, integrity, and reflectivity of retinal layers) and quantitative (i...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28425529/influence-of-cations-in-lithium-and-magnesium-polysulphide-solutions-dependence-of-the-solvent-chemistry
#11
Georg Bieker, Julia Wellmann, Martin Kolek, Kirsi Jalkanen, Martin Winter, Peter Bieker
In order to gain a deeper understanding of Li and Mg polysulphides in Li/S and Mg/S batteries, respectively, this work investigates the impact of the two different cations as well as the influence of the electrolyte solvents' relative dielectric permittivity and Gutmann's donor number on the solubility and relative stability of different Li and Mg polysulphide species. Therefore, the disproportionation and dissociation equilibria of chemically prepared "Li2S8" and "MgS8" solutions in DMSO, DMF, ACN, THF, DME, TEGDME, and Pyr14TFSI are characterized by UV/Vis spectroscopy...
April 20, 2017: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/28423385/guidelines-for-the-management-of-diabetic-macular-edema-by-the-european-society-of-retina-specialists-euretina
#12
Ursula Schmidt-Erfurth, Jose Garcia-Arumi, Francesco Bandello, Karina Berg, Usha Chakravarthy, Bianca S Gerendas, Jost Jonas, Michael Larsen, Ramin Tadayoni, Anat Loewenstein
Diabetic retinal disease is envisioned to become the plague of the coming decades with a steep increase of worldwide diabetes incidence followed by a substantial rise in retinal disease. Improvements in diagnostic and therapeutic care have to cope with this dilemma in a clinically and socioeconomically efficient manner. Laser treatment has found a less destructive competitor in pharmacological treatments. As a consequence of recent rigorous clinical trials, laser photocoagulation is no longer recommended for the treatment of diabetic macular edema (DME), and anti-vascular endothelial growth factor therapy has emerged as first-line therapy...
April 20, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/28422835/predictive-factors-of-better-outcomes-by-monotherapy-of-an-antivascular-endothelial-growth-factor-drug-ranibizumab-for-diabetic-macular-edema-in-clinical-practice
#13
Shinri Sato, Hajime Shinoda, Norihiro Nagai, Misa Suzuki, Atsuro Uchida, Toshihide Kurihara, Mamoru Kamoshita, Yohei Tomita, Chigusa Iyama, Sakiko Minami, Kenya Yuki, Kazuo Tsubota, Yoko Ozawa
Intravitreal ranibizumab (IVR) has been approved for treating diabetic macular edema (DME), and is used in daily clinical practice. However, the treatment efficacies of IVR monotherapy in real-world clinical settings are not well known.The medical records of 56 eyes from 38 patients who received their first IVR for DME between April 2014 and March 2015, and were retreated with IVR monotherapy as needed with no rescue treatment, such as laser photocoagulation, were retrospectively reviewed. The clinical course, best-corrected visual acuity (BCVA), and fundus findings at baseline, before the initial IVR injection, and at 12 months, were evaluated...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422832/two-year-result-of-intravitreal-bevacizumab-for-diabetic-macular-edema-using-treat-and-extend-protocol
#14
Masahiko Sugimoto, Atsushi Ichio, Takayasu Nunome, Mineo Kondo
To determine the efficacy of the treat and extend (TAE) protocol with intravitreal bevacizumab (IVB) for managing diabetic macular edema (DME).Retrospective, single-center study.For this retrospective study, 42 eyes of 42 patients were initially treated with 3 consecutive monthly IVB injections (loading phase), after which they were selected for different additional therapies. For the TAE protocol, the baseline treatment interval was selected to be 8 weeks and was sequentially lengthened by 2 weeks if the central macular thickness (CMT) was <300 μm at 2 consecutive examinations...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419400/a-nine-year-follow-up-of-macular-complications-in-retinitis-pigmentosa-and-diabetes-mellitus
#15
Dario Pasquale Mucciolo, Andrea Sodi, Vittoria Murro, Gianni Virgili, Stanislao Rizzo
The authors report a 9-year follow-up of macular complications in a 66-year-old woman affected with retinitis pigmentosa (RP) and type 2 diabetes mellitus. Rarely, clinical signs of diabetic retinopathy are presented in a patient with retinal dystrophy. This patient developed a bilateral diabetic macular edema (DME), which made its management complex due to the multiple pathogenic processes involved. Despite the chronicity of the DME, visual acuity remained stable without therapy. To the authors' knowledge, this is the first report of DME in RP with such a long follow-up...
April 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28419397/influence-of-retinal-pathology-on-the-reliability-of-macular-thickness-measurement-a-comparison-between-optical-coherence-tomography-devices
#16
Bobak Bahrami, Shaun Y P Ewe, Thomas Hong, Meidong Zhu, Germane Ong, Kehui Luo, Andrew Chang
BACKGROUND AND OBJECTIVE: To evaluate the repeatability, reliability, and comparability of macular thickness measurements between three optical coherence tomography (OCT) machines in healthy eyes, eyes with diabetic macular edema (DME), and eyes with neovascular age-related macular degeneration (nAMD). PATIENTS AND METHODS: Twenty-three eyes with DME, 26 eyes with nAMD, and 24 healthy eyes as controls were evaluated. Scans were performed using the swept-source Triton (Topcon, Tokyo, Japan), the spectral-domain Cirrus (Carl Zeiss Meditec, Dublin, CA), and the Spectralis (Heidelberg Engineering, Heidelberg, Germany) machines...
April 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28419394/use-of-corticosteroids-in-the-treatment-of-patients-with-diabetic-macular-edema-who-have-a-suboptimal-response-to-anti-vegf-recommendations-of-an-expert-panel
#17
Carl D Regillo, David G Callanan, Diana V Do, Howard F Fine, Nancy M Holekamp, Baruch D Kuppermann, Michael A Singer, Rishi P Singh
BACKGROUND AND OBJECTIVE: Guidance on the use of corticosteroids in the treatment of diabetic macular edema (DME) is lacking. This study aimed to develop a clinically recommended treatment paradigm for DME with emphasis on the role of corticosteroids. PATIENTS AND METHODS: An expert panel of nine retinal specialists in the United States developed consensus recommendations for DME treatment through a modified Delphi process. RESULTS: The panelists typically use intravitreal injections of vascular endothelial growth factor (VEGF) antagonists as first-line treatment of DME and switch patients with an inadequate response to anti-VEGF therapy (failure of best-corrected visual acuity to improve to 20/40 or better because of edema after three to six monthly injections, or a less-than-50% reduction in excess macular thickness after three to four monthly injections) to intravitreal corticosteroid treatment...
April 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28407012/relation-between-macular-morphology-and-treatment-frequency-during-twelve-months-with-ranibizumab-for-diabetic-macular-edema
#18
Yuki Mori, Tomoaki Murakami, Kiyoshi Suzuma, Kenji Ishihara, Shin Yoshitake, Masahiro Fujimoto, Yoko Dodo, Tatsuya Yoshitake, Yuko Miwa, Akitaka Tsujikawa
PURPOSE: To investigate whether baseline optical coherence tomography (OCT) parameters can predict the treatment frequency of intravitreal ranibizumab (IVR) injections during the first year in patients with diabetic macular edema (DME) treated with pro re nata (PRN) IVR injections. METHODS: We retrospectively reviewed 68 eyes of 63 patients with center-involved DME who received IVR injections for 12 months or longer according to three monthly IVR injections followed by the PRN dosing...
2017: PloS One
https://www.readbyqxmd.com/read/28401213/an-organolanthanide-iii-single-molecule-magnet-with-an-axial-crystal-field-influence-of-the-raman-process-over-the-slow-relaxation
#19
Jérôme Long, Boris G Shestakov, Dan Liu, Liviu F Chibotaru, Yannick Guari, Anton V Cherkasov, Georgy K Fukin, Alexander A Trifonov, Joulia Larionova
Here, we report the synthesis and magnetic properties investigation of a series of new organometallic homoleptic complexes Li(DME)3[Ln(DAD)2] (Ln = Dy (1a, 1b), Tb(2), and Er(3)) based on paramagnetic Ln(iii) ions coordinated by an ene-diamido[2,6-iPr2C6H3N-CH[double bond, length as m-dash]CH-NC6H3iPr2-2,6](2-) (DAD) ligand. Dy-based compounds exhibit a genuine single-molecule magnet (SMM) behaviour, while the Tb(3+) analogue shows a field-induced slow relaxation of the magnetisation.
April 12, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/28397431/the-effects-and-safety-of-intravitreal-triamcinolone-injections-in-the-treatment-of-diabetic-macular-edema
#20
Hanna M Zając-Pytrus, Radosław Kaczmarek, Dorota Strońska-Lipowicz, Maria Pomorska, Marta Misiuk-Hojło
BACKGROUND: Diabetic macular edema (DME) is responsible for three-quarters of vision-loss cases in diabetic eye disease. In most cases, early treatment by laser photocoagulation can only stabilize vision. Glucocorticoids have been used as a local pharmacological treatment in DME when the inflammation seems to have a pathological background. OBJECTIVES: The aim of the study was to establish the effectiveness and safety of intravitreal triamcinolone injections in the treatment of DME...
January 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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