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Diabetic macular edema

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https://www.readbyqxmd.com/read/29346499/repeatability-and-agreement-of-visual-acuity-using-the-etdrs-number-chart-landolt-c-chart-or-etdrs-alphabet-chart-in-eyes-with-or-without-sight-threatening-diseases
#1
Voraporn Chaikitmongkol, Onnisa Nanegrungsunk, Direk Patikulsila, Paisan Ruamviboonsuk, Neil M Bressler
Importance: The Early Treatment Diabetic Retinopathy Study (ETDRS) alphabet chart is not feasible for measuring best-corrected visual acuity (BCVA) for individuals who are unfamiliar with the Roman alphabet. The ETDRS Landolt C chart is an alternative, but it may not reflect true BCVA among those with confusion between left and right. The ETDRS number chart might overcome these limitations, but little is known regarding its reliability. Objective: To evaluate repeatability and agreement of BCVA using the ETDRS number chart or Landolt C chart compared with ETDRS alphabet charts in healthy and diseased eyes...
January 18, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29339919/effect-of-oral-tranexamic-acid-on-macular-edema-associated-with-retinal-vein-occlusion-or-diabetes
#2
Masayuki Takeyama, Fumio Takeuchi, Masahiko Gosho, Keijiro Sugita, Masahiro Zako, Masayoshi Iwaki, Motohiro Kamei
Purpose: Tranexamic acid (TXA) is a widely used antifibrinolytic agent that can also cause a decrease in vascular permeability. We hypothesized that TXA could improve macular edema (ME) that is caused by an increase in retinal vascular permeability. The aim of this study is to evaluate the efficacy of oral TXA for ME associated with retinal vein occlusion (RVO) or diabetic ME (DME). Patients and methods: Oral TXA (1,500 mg daily for 2 weeks) was administered to patients with persistent ME secondary to RVO (7 eyes) and DME (7 eyes)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29339917/association-of-treatment-adherence-with-real-life-va-outcomes-in-amd-dme-and-brvo-patients
#3
Christoph Ehlken, Mandy Helms, Daniel Böhringer, Hansjürgen T Agostini, Andreas Stahl
Purpose: Real-life clinical outcomes of patients treated with anti-VEGF drugs for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or macular edema secondary to branch retinal vein occlusion (BRVO) are often inferior to results from randomized clinical trials. This observational cohort study investigates treatment adherence and real-life clinical outcomes within the first year of treatment. Patients and methods: A total of 708 treatment-naïve patients (466 nAMD, 134 DME, and 108 BRVO) were included...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29339646/automated-screening-for-diabetic-retinopathy-a-systematic-review
#4
Mads Fonager Nørgaard, Jakob Grauslund
PURPOSE: Worldwide ophthalmologists are challenged by the rapid rise in the prevalence of diabetes. Diabetic retinopathy (DR) is the most common complication in diabetes, and possible consequences range from mild visual impairment to blindness. Repetitive screening for DR is cost-effective, but it is also a costly and strenuous affair. Several studies have examined the application of automated image analysis to solve this problem. Large populations are needed to assess the efficacy of such programs, and a standardized and rigorous methodology is important to give an indication of system performance in actual clinical settings...
January 16, 2018: Ophthalmic Research
https://www.readbyqxmd.com/read/29339063/evolution-of-intravitreal-therapy-for-retinal-diseases-from-cmv-to-cnv-the-lxxiv-edward-jackson-memorial-lecture
#5
Daniel F Martin
PURPOSE: To present the evolution of intravitreal therapy for retinal diseases and its impact on clinical practice. DESIGN: Retrospective literature review and personal perspective. METHODS: Retrospective literature review and personal perspective. RESULTS: Pharmacotherapeutic advances in retinal disease have been remarkable over the last 25 years. Almost all of the new drugs developed have required intravitreal administration to be highly effective, leading to an exponential increase in the annual number of intravitreal injections given...
January 12, 2018: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29336896/targeted-retinal-photocoagulation-for-diabetic-macular-edema-with-peripheral-retinal-nonperfusion-three-year-randomized-dave-trial
#6
David M Brown, William C Ou, Tien P Wong, Rosa Y Kim, Daniel E Croft, Charles C Wykoff
PURPOSE: To evaluate the effect of targeted retinal photocoagulation (TRP) on visual and anatomic outcomes and treatment burden in eyes with diabetic macular edema (DME). DESIGN: Phase I/II prospective, randomized, controlled clinical trial. PARTICIPANTS: Forty eyes of 29 patients with center-involved macular edema secondary to diabetes mellitus. METHODS: Eyes with center-involved DME and Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) between 20/32 and 20/320 (Snellen equivalent) were randomized 1:1 to monotherapy with 0...
January 11, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29327033/disorganization-of-inner-retina-and-outer-retinal-morphology-in-diabetic-macular-edema
#7
Radha Das, Gareth Spence, Ruth E Hogg, Michael Stevenson, Usha Chakravarthy
Importance: In diabetic macular edema (DME), identification of baseline markers on spectral-domain optical coherence tomography (SD-OCT) and their association with severity of diabetic retinopathy (DR) might aid in disease management and the design of future trials. Objective: To examine associations between DR severity, retinal morphology on SD-OCT, and visual acuity in participants with DME. Design, Setting, and Participants: This cross-sectional observational case series was conducted at a single tertiary care referral center...
January 11, 2018: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29326539/microvascular-outcomes-of-pediatric-onset-type-1-diabetes-mellitus-a-single-center-observational-case-reviews-in-sana-a-yemen
#8
Abdallah Ahmed Gunaid
Microvascular complications of pediatric-onset type 1 diabetes are common in low-income countries. In this study, we aimed at reviewing microvascular outcomes in 6 cases with type 1 diabetes over 14 to 31 years of follow-up. Severe proliferative diabetic retinopathy (PDR) and/or diabetic macular edema (maculopathy) (DME) and overt diabetic nephropathy (macroalbuminuria) were seen among 4 of 6 patients, whereas severe diabetic peripheral neuropathy with Charcot neuroarthropathy was seen in 1 patient only, who had the longest duration of follow-up...
2018: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/29318442/an-exudate-detection-method-for-diagnosis-risk-of-diabetic-macular-edema-in-retinal-images-using-feature-based-and-supervised-classification
#9
D Marin, M E Gegundez-Arias, B Ponte, F Alvarez, J Garrido, C Ortega, M J Vasallo, J M Bravo
The present paper aims at presenting the methodology and first results of a detection system of risk of diabetic macular edema (DME) in fundus images. The system is based on the detection of retinal exudates (Ex), whose presence in the image is clinically used for an early diagnosis of the disease. To do so, the system applies digital image processing algorithms to the retinal image in order to obtain a set of candidate regions to be Ex, which are validated by means of feature extraction and supervised classification techniques...
January 10, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29316563/visual-outcomes-based-on-early-response-to-anti-vascular-endothelial-growth-factor-treatment-for-diabetic-macular-edema
#10
Yoshito Koyanagi, Shigeo Yoshida, Yoshiyuki Kobayashi, Yuki Kubo, Takahito Nakama, Keijiro Ishikawa, Shintaro Nakao, Toshio Hisatomi, Yasuhiro Ikeda, Yuji Oshima, Tatsuro Ishibashi, Koh-Hei Sonoda
OBJECTIVE: To examine the relationship between early response to anti-vascular endothelial growth factor (VEGF) treatment and visual prognosis. METHODS: We retrospectively separated 20 patients with persistent diabetic macular edema (DME) into two responder status groups based on the reduction of central macular thickness (CMT) from baseline to month 3: a delayed responder group (DRG) (≤25% CMT reduction, n = 11) and an immediate responder group (IRG) (>25% CMT reduction, n = 14)...
January 9, 2018: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/29311618/choroidal-vascularity-index-in-type-2-diabetes-analyzed-by-swept-source-optical-coherence-tomography
#11
Mirinae Kim, Min Ji Ha, Seung Yong Choi, Young-Hoon Park
The relationships between changes in choroidal vasculature and the severity of diabetic retinopathy (DR) remain unclear. We assessed choroidal changes in diabetic patients by measuring choroidal vascularity index (CVI) in conjunction with DR stage. In this study, patients with diabetes and healthy controls were retrospectively analyzed. Subjects were divided into seven groups as follows: Healthy controls, no DR, mild/moderate non-proliferative DR (NPDR), severe NPDR, proliferative DR (PDR), panretinal photocoagulation-treated DR, and clinically significant macular edema...
January 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29300755/incremental-cost-effectiveness-of-screening-and-laser-treatment-for-diabetic-retinopathy-and-macular-edema-in-malawi
#12
Damir Vetrini, Christine A Kiire, Philip I Burgess, Simon P Harding, Petros C Kayange, Khumbo Kalua, Gerald Msukwa, Nicholas A V Beare, Jason Madan
OBJECTIVE: To investigate the economic impact of introducing targeted screening and laser photocoagulation treatment for sight-threatening diabetic retinopathy and macular edema in a setting with no previous screening or laser treatment for diabetic retinopathy in sub-Saharan Africa. MATERIALS AND METHODS: A cohort Markov model was built to compare combined targeted screening and laser treatment for patients with sight-threatening diabetic retinopathy and macular edema against no intervention...
2018: PloS One
https://www.readbyqxmd.com/read/29297055/pharmacology-of-corticosteroids-for-diabetic-macular-edema
#13
Scott M Whitcup, John A Cidlowski, Karl G Csaky, Jayakrishna Ambati
Purpose: Corticosteroids remain the mainstay of treatment for inflammatory diseases almost 80 years after their first clinical use. Topical ophthalmic formulations of corticosteroids have been available to treat disease of the anterior segment of the eye, but the approval of corticosteroids to treat vitreoretinal diseases, including vein occlusion, diabetic macular edema, and uveitis, has occurred only recently. Although most diseases respond to corticosteroid therapy, some patients are resistant to this therapy and side effects, including cataract and elevated intraocular pressure, can limit their use...
January 1, 2018: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29283694/in-vivo-study-of-the-long-term-structural-changes-induced-by-macular-argon-laser
#14
Joel Hanhart, Yishay Weill, Yaakov Rozenman
PURPOSE: To assess the long-term structural changes induced by macular argon laser using en face optical coherence tomography (OCT). MATERIALS AND METHODS: We reviewed the charts and OCT pictures of patients who had undergone macular laser for diabetic macular edema at least four years ago. Clinical parameters were recorded for each eye, including laser settings. We obtained En face pictures, that were flattened at the RPE (retinal pigment epithelium) plane. We then measured the retinal surface covered by laser marks and the maximal diameter of the largest identified lesion at this plane...
December 28, 2017: Current Eye Research
https://www.readbyqxmd.com/read/29283132/efficiency-of-fenofibrate-in-facilitating-the-reduction-of-central-macular-thickness-in-diabetic-macular-edema
#15
Srilakshmi Srinivasan, Prathibha Hande, Jyoti Shetty, Sindhu Murali
PURPOSE: The purpose of this study is to study the benefit of addition of oral fenofibrate to the current regimen of diabetic macular edema (DME) management and quantify its effect on macular thickness and visual function in DME. METHODS: Fifty-three eyes of 50 patients were randomized into treatment (Group A) (oral fenofibrate 160 mg/day) and control groups (Group B). Both groups underwent treatment of DME as per the standard treatment protocol of our hospital including intravitreal injections (anti-vascular endothelial growth factor/steroid) and grid laser...
January 2018: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29280940/changes-in-plasma-vascular-endothelial-growth-factor-level-after-intravitreal-injection-of-bevacizumab-aflibercept-or-ranibizumab-for-diabetic-macular-edema
#16
Takao Hirano, Yuichi Toriyama, Yasuhiro Iesato, Akira Imai, Toshinori Murata
PURPOSE: The aim of this study was to investigate the changes in plasma vascular endothelial growth factor (VEGF) level depending on the severity of diabetic retinopathy (DR) or diabetic macular edema (DME) and after intravitreal injection of bevacizumab, aflibercept, or ranibizumab for treatment of DME. METHODS: Plasma VEGF level was evaluated in 72 patients with DR and changes were measured in 42 patients with DME receiving intravitreal injections of bevacizumab, aflibercept, or ranibizumab at the initial injection...
December 21, 2017: Retina
https://www.readbyqxmd.com/read/29280367/intravitreal-bevacizumab-in-diabetic-retinopathy-recommendations-from-the-pan-american-collaborative-retina-study-group-pacores-the-2016-knobloch-lecture
#17
J Fernando Arevalo, T Y Alvin Liu
The advent of intravitreal anti-vascular endothelial growth factor (anti-VEGF) medications has revolutionized the treatment of diabetic eye diseases. Herein, we report the outcomes of clinical studies carried out by the Pan-American Collaborative Retina Study Group (PACORES), with a specific focus on the efficacy of intravitreal bevacizumab in the management of diabetic macular edema and proliferative diabetic retinopathy. We will also discuss the use of intravitreal bevacizumab as a preoperative, adjuvant therapy before vitrectomy for proliferative diabetic retinopathy...
December 27, 2017: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/29275147/lack-of-longitudinal-association-between-thiazolidinediones-and-incidence-and-progression-of-diabetic-eye-disease-the-accord-eye-study
#18
Emily W Gower, James F Lovato, Walter T Ambrosius, Emily Y Chew, Ronald P Danis, Matthew D Davis, David C Goff, Craig M Greven
PURPOSE: To report the longitudinal association between use of thiazolidinediones (TZDs), visual acuity (VA) change and diabetic eye disease incidence and progression. DESIGN: Cohort study ancillary to a randomized clinical trial METHODS: We analyzed baseline and four-year follow up data of 2,856 ACCORD trial participants with no history of proliferative diabetic retinopathy. Based on stereoscopic fundus photographs, we evaluated diabetic macular edema (DME) progression and DR progression...
December 21, 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/29260195/diabetic-retinopathy-and-macular-edema-quality-of-life-item-banks-development-and-initial-evaluation-using-computerized-adaptive-testing
#19
Eva K Fenwick, Jyoti Khadka, Konrad Pesudovs, Gwyn Rees, Tien Y Wong, Ecosse L Lamoureux
Purpose: The purpose of this study was to assess the psychometric properties of diabetic retinopathy (DR) and diabetic macular edema (DME) quality-of-life (QoL) item banks and determine the utility of the final calibrated item banks by simulating a computerized adaptive testing (CAT) application. Methods: In this clinical, cross-sectional study, 514 participants with DR/DME (mean age ± SD, 60.4 ± 12.6 years; 64% male) answered 314 items grouped under nine QoL item pools: Visual Symptoms (SY); Ocular Comfort Symptoms (OS); Activity Limitation (AL); Mobility (MB); Emotional (EM); Health Concerns (HC); Social (SC); Convenience (CV); and Economic (EC)...
December 1, 2017: Investigative Ophthalmology & Visual Science
https://www.readbyqxmd.com/read/29259899/infliximab-relieves-blood-retinal-barrier-breakdown-through-the-p38-mapk-pathway-in-a-diabetic-rat-model
#20
Mao-Song Xie, Yong-Zheng Zheng, Li-Bin Huang, Guo-Xing Xu
AIM: To clarify the mechanism of infliximab treatment in diabetic macular edema (DME) and to provide a new alternative therapy for DME. METHODS: Rats were randomly divided into the control group, the model group and the infliximab treatment group. A diabetic rat model was created. The concentration of TNF-α in the vitreous body was detected by ELISA. The expressions of B-Raf, p38, claudin-1 and occludin in the retina were detected by Western blot. The integrity of the blood retinal barrier (BRB) was measured using Evan's blue as a tracer...
2017: International Journal of Ophthalmology
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