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Diabetic macular edema

Michael E Jansen, Chelsey J Krambeer, Daniel S Kermany, Jana N Waters, Wayne Tie, Sepehr Bahadorani, Julia Singer, Jordan M Comstock, Kendall W Wannamaker, Michael A Singer
BACKGROUND AND OBJECTIVE: The purpose of this study is to compare cancellation and no-show rates in patients with diabetic macular edema (DME) and exudative macular degeneration (wet AMD). PATIENTS AND METHODS: An anonymous survey was sent to 1,726 retina specialists inquiring as to the number of appointments their patients with DME and wet AMD attended, cancelled, or did not show up for in 2014 and 2015. RESULTS: Data were obtained on 109,599 appointments...
March 1, 2018: Ophthalmic Surgery, Lasers & Imaging Retina
Samaneh Sepahi, Seyed Ahmad Mohajeri, Seyedeh Maryam Hosseini, Elham Khodaverdi, Nasser Shoeibi, Maral Namdari, Sayyed Abolghasem Sajadi Tabassi
OBJECTIVE: Diabetic macular edema (DME) is one of the most important sight-threatening complications in patients with diabetes. Due to neuroprotective properties, crocin, as the main constituent in saffron, is thought to be useful in the treatment and prevention of diabetic maculopathy. The aim of this trial was to evaluate the effects of crocin as a supplement on reducing inflammation in patients with diabetic maculopathy. DESIGN: Double blind, placebo controlled, phase 2 randomized clinical trial...
March 14, 2018: American Journal of Ophthalmology
Kiran Shah, Alka Gandhi, Sundaram Natarajan
Background: Diabetic retinopathy (DR) is leading cause of visual impairment in working-age adults. Macular edema can occur with or without other signs of retinopathy. Methods: This was a single-center, retrospective study conducted over 2 years in patients (>40 years of age) having type 2 diabetes mellitus (T2DM). Outcome measures were to analyze awareness and prevalence of DR and association of DR with identified risk factors. Results: Overall 6000 T2DM patients over 2 years were retrospectively evaluated...
January 2018: Indian Journal of Endocrinology and Metabolism
Divya Singh, Anita Ganger, Noopur Gupta, Murugesan Vanathi, Rajesh Khadgawat, Radhika Tandon
Here, we present, to the best of our knowledge, the first case of Werner syndrome with corneal blindness due to bilateral primary bullous keratopathy. Werner syndrome is a rare autosomal recessive disorder characterized by features of premature aging, insulin-dependent diabetes mellitus, osteoporosis, atherosclerosis, hypergonadotrophic hypogonadism, hypertriglyceridemia, scleroderma-like skin changes, and sarcomas. Among ocular manifestations, cataracts, cystoid macular edema, and retinal detachment have been reported...
March 9, 2018: Experimental and Clinical Transplantation
Tracy W Krick, Neil M Bressler
PURPOSE OF REVIEW: To present some recent clinically relevant results from Diabetic Retinopathy Clinical Research (DRCR) Network trials that may guide management of diabetic macular edema (DME) or proliferative diabetic retinopathy (PDR). RECENT FINDINGS: Among eyes with DME and visual acuity 20/50 or worse, aflibercept, on average, had greater improvement in visual acuity over 2 years compared with bevacizumab or ranibizumab. Aflibercept is associated with higher rates of improvements in diabetic retinopathy severity among eyes with PDR and vision-impairing DME at baseline compared with bevacizumab or ranibizumab...
March 9, 2018: Current Opinion in Ophthalmology
Y Motohashi, Y Kemmochi, T Maekawa, H Tadaki, T Sasase, Y Tanaka, A Kakehashi, T Yamada, T Ohta
No abstract text is available yet for this article.
March 12, 2018: Physiological Research
Justis P Ehlers, Kevin Wang, Rishi P Singh, Amy S Babiuch, Andrew P Schachat, Alex Yuan, Jamie L Reese, Laura Stiegel, Sunil K Srivastava
Purpose: To assess the efficacy of ranibizumab for persistent diabetic macular edema (DME) previously treated with bevacizumab and compare monthly vs treat-and-extend (TAE) dosing. Design: 12-month, open-label, prospective randomized comparative dosing study. Participants: 27 participants with persistent foveal-involving DME recently treated with bevacizumab. Methods: All subjects were to receive three initial monthly 0...
March 2018: Ophthalmology Retina
Lee M Jampol, Adam R Glassman, Danni Liu, Lloyd Paul Aiello, Neil M Bressler, Elia J Duh, Susan Quaggin, John A Wells, Charles C Wykoff
PURPOSE: To assess systemic vascular endothelial growth factor (VEGF)-A levels after treatment with intravitreous aflibercept, bevacizumab, or ranibizumab. DESIGN: Comparative-effectiveness trial with participants randomly assigned to 2 mg aflibercept, 1.25 mg bevacizumab, or 0.3 mg ranibizumab after a re-treatment algorithm. PARTICIPANTS: Participants with available plasma samples (N = 436). METHODS: Plasma samples were collected before injections at baseline and 4-week, 52-week, and 104-week visits...
March 7, 2018: Ophthalmology
Fatih Yenihayat, Berna Özkan, Murat Kasap, V Levent Karabaş, Nil Güzel, Gürler Akpınar, Dilara Pirhan
PURPOSE: To determine the cytokine levels in vitreous samples of diabetic macular edema (DME) patients in comparison with nondiabetic patients, and to evaluate the effect of subretinal fluid on the cytokine levels of vitreous samples. METHODS: In this prospective case-control study, 11 eyes of 11 patients with DME and subretinal fluid, 11 eyes of 11 patients with DME without subretinal fluid, and 14 eyes of 14 patients who had undergone vitreoretinal surgery for the epiretinal membrane or a macular hole (control group) were evaluated...
March 9, 2018: International Ophthalmology
Roxane J Hillier, Elvis Ojaimi, David T Wong, Michael Y K Mak, Alan R Berger, Radha P Kohly, Peter J Kertes, Farzin Forooghian, Shelley R Boyd, Kenneth Eng, Filiberto Altomare, Louis R Giavedoni, Rosane Nisenbaum, Rajeev H Muni
Importance: Variability in response to anti-vascular endothelial growth factor (VEGF) treatment in diabetic macular edema (DME) remains a significant clinical challenge. Biomarkers could help anticipate responses to anti-VEGF therapy. Objectives: To investigate aqueous humor cytokine level changes in response to intravitreal ranibizumab therapy for the management of DME, and to determine the association between baseline aqueous levels and anatomic response. Design, Setting, and Participants: In this prospective multicenter cohort study, 49 participants with diabetes mellitus complicated by center-involving DME, with a central subfield thickness of 310 μm or greater on spectral-domain optical coherence tomography (SD-OCT), were recruited from December 22, 2011, to June 13, 2013 and statistical analysis were performed from March 1, 2017, to June 1, 2017...
March 8, 2018: JAMA Ophthalmology
Daniel P Teufel, Gavin Bennett, Helen Harrison, Katerine van Rietschoten, Silvia Pavan, Catherine Stace, François Le Floch, Tine Van Bergen, Elke Vermassen, Philippe Barbeaux, Tjing-Tjing Hu, Jean H M Feyen, Marc Vanhove
Plasma kallikrein, a member of the kallikrein-kinin system, catalyzes the release of the bioactive peptide bradykinin, which induces inflammation, vasodilation, vessel permeability and pain. Preclinical evidence implicates the activity of plasma kallikrein in diabetic retinopathy, which is a leading cause of visual loss in patients suffering from diabetes mellitus. Employing a technology based on phage-display combined with chemical cyclization, we have identified highly selective bicyclic peptide inhibitors with nano- and pico-molar potencies towards plasma kallikrein...
March 8, 2018: Journal of Medicinal Chemistry
Kathleen A Regan, Charles R Blake, Zachary L Lukowski, Siva S R Iyer
Reported here is a case of intralenticular sustained-release dexamethasone implant (Ozurdex®, Allergan, Irvine, CA, USA) present for 1 year with effective treatment of refractory diabetic macular edema without rapid cataract formation. The crystalline lens remained stable for 12 months on exam despite the presence of the steroid-secreting foreign body. The diabetic macular edema resolved on exam and on optical coherence tomography. After 1 year, cataract extraction was uneventfully performed by phacoemulsification for a mild decline in visual acuity...
September 2017: Case Reports in Ophthalmology
Conceição Lobo, Isabel Pires, Dalila Alves, Rajeev Pappuru, Luísa Ribeiro, José Cunha-Vaz
PURPOSE: The aim of this study was to examine the relationship between subclinical diabetic macular edema (SCME) and the development of central-involved macular edema (CIME) in patients with diabetes mellitus type-2 and mild nonproliferative diabetic retinopathy (NPDR), from 2 populations of different ethnicities. METHODS: Two hundred and five patients with diabetes mellitus type-2 and mild NPDR with no prior laser or intravitreal treatment were followed for 2 years or until the development of CIME...
March 6, 2018: Ophthalmic Research
Ahmad M Mansour, Robert E Foster, Roberto Gallego-Pinazo, Marilita M Moschos, Robert A Sisk, Jay Chhablani, Duangnate Rojanaporn, Tharikarn Sujirakul, J Fernando Arevalo, Luiz H Lima, Lihteh Wu, Abdulrazzak Charbaji, Ali O Saatci, Hana A Mansour, Clara Martinez-Rubio, Yogin Patel, Sankeert Gangakhedkar
PURPOSE: There is no established therapy for exudative-hemorrhagic complications in primary retinal arteriolar macroaneurysm (RAM). METHODS: Retrospective multicenter interventional study of anti-vascular endothelial growth factor in symptomatic RAMs. Central macular thickness in μm and best-corrected visual acuity in logMar were correlated with the RAM size and distance to the macula. Statistical analyses were performed using paired comparisons and Pearson correlation...
March 2, 2018: Retina
Yusuke Kameda, Akira Hirose, Tomohiro Iida, Yasuko Uchigata, Shigehiko Kitano
Purpose: To report a case of a giant retinal pigment epithelial (RPE) tear associated with fluid overload in a patient with diabetic macular edema (DME) and kidney disease. Observations: A 60-year-old man with type 2 diabetes mellitus and end-stage diabetic kidney disease who had gained weight because of fluid overload complained of a visual disturbance in the left eye that had started a few days earlier. The left fundus showed a RPE defect in two temporal quadrants under an extensive serous retinal detachment (SRD) with exacerbation of the original DME...
April 2017: American Journal of Ophthalmology Case Reports
Matias Iglicki, Dinah Zur, Catharina Busch, Mali Okada, Anat Loewenstein
PURPOSE: Intravitreal anti-vascular endothelial growth factor agents have been shown to reduce diabetic retinopathy (DR) progression; data on the effects of intravitreal corticosteroids on modifying disease severity are limited. This study evaluates the long-term effect of intravitreal dexamethasone implant (DEX) on the severity and progression of non-proliferative DR (NPDR). METHODS: This was a retrospective cohort study. Sixty eyes from 60 consecutive patients with NPDR and diabetic macular edema (DME) treated with dexamethasone implant (DEX group) and 49 eyes from consecutive 49 patients without DME requiring observation only...
March 1, 2018: Acta Diabetologica
Sonja G Karst, Gabor G Deak, Bianca S Gerendas, Sebastian M Waldstein, Jan Lammer, Christian Simader, Tadhg Guerin, Ursula M Schmidt-Erfurth
Importance: Anti-vascular endothelial growth factor treatment is the first-line therapy in the treatment of center-involving diabetic macular edema. Data on capillary perfusion changes under repeated treatment in a possibly compromised vascular network are limited. Objective: To evaluate the association of repeated ranibizumab injections on macular perfusion in patients with diabetic macular edema. Design, Setting, and Participants: This study analyzed prospectively collected data from the 12-month RESTORE core study and the 24-month open label RESTORE extension study, which assessed the efficacy and safety of ranibizumab in patients with visual impairment due to diabetic macular edema...
March 1, 2018: JAMA Ophthalmology
Masahiro Okamoto, Mariko Yamashita, Nahoko Ogata
PURPOSE: To determine the effects of an intravitreal injection of ranibizumab (IVR) on the choroidal structure and blood flow in eyes with diabetic macular edema (DME). METHODS: Twenty-eight consecutive patients with DME who received an IVR and 20 non-diabetic, age-matched controls were followed for 1 month. The eyes with DME were divided into those with prior panretinal photocoagulation (PRP, n = 16) and those without prior PRP (no-PRP, n = 12). The enhanced depth imaging optical coherence tomography (EDI-OCT) scans and Niblack's image binarization were performed to determine the choroidal structure...
March 1, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Daniela Claessens, Alexander K Schuster
BACKGROUND: Amsler Test is the standard used to detect metamorphopsia. To develop a tool to quantitatively measure and monitor metamorphopsia, the computer-based test "AMD - A Metamorphopsia Detector® " was developed. This study was performed to examine the correlation of metamorphopsia index (MI) and central retinal thickness (CRT) in exsudative age-related macular degeneration (AMD) and diabetic macular edema (DME). MATERIAL AND METHODS: Sixty-six eyes of 66 patients, DME: 19 (11 males, 8 females; age 42 - 76); AMD: 47 (13 male, 34 female; age 56 - 93) were included in this convenient sample study and classified as having or not having macular edema (central 500 µm, Cirrus HD-OCT)...
February 28, 2018: Klinische Monatsblätter Für Augenheilkunde
Rui Shi, Lei Zhao, Feng Wang, Fen Liu, Zhuo Chen, Rong Li, Yang Liu, Rong Lin
AIM: To clarify this controversy and to provide evidence for application of lipid lowering agents in treatment of diabetic retinopathy (DR). METHODS: We searched the databases of PubMed, Embase and Cochrane Library Central Register of Controlled Trials (CENTRAL) and abstracts from main annual meetings up to January 1, 2017. Google scholar and were also searched for unpublished relevant studies. We included randomized controlled trials (RCTs) that studied lipid-lowering agents in type 1 or type 2 diabetes in this Meta-analysis...
2018: International Journal of Ophthalmology
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