Central Macular Thickness In Patients Research Articles

Central retinal artery occlusion without cherry-red spots

BackgroundCherry-red spots are a very important sign for the clinical diagnosis of central retinal artery occlusion (CRAO). We retrospectively summarized the clinical manifestations of CRAO and analysed the causes and characteristics of CRAO without cherry-red spots. In this study, we explored a diagnostic method for CRAO without cherry red spots.MethodsSeventy patients (70 eyes) with CRAO were examined retrospectively. Corrected distance visual acuity, fundus photos, FA and OCT images were collected at the first outpatient visit. The causes of CRAO without cherry-red spots were analysed through fundus photos. The incidence of increased hyperreflectivity of the inner retina, central macular thickness (CMT) and arteriovenous transit time in patients with and without cherry-red spots were compared.ResultsFundus examination showed posterior retinal whitening in 57 cases (81.43%) and cherry-red spots in 39 cases (55.71%). Thirty-one patients presented at the first outpatient visit without cherry-red spots. The reasons for the absence of cherry-red spots included leopard fundus (32.26%), retinal vein occlusion (25.81%), no obvious inner retinal coagulative necrosis (19.35%), ciliary retinal artery sparing (12.90%), high macular oedema (9.68%) and cherry-red spot enlargement (3.23%). OCT revealed increased hyperreflectivity of the inner retina in 67 CRAO patients (95.71%). All 3 patients without increased hyperreflectivity of the inner retina did not present with cherry-red spots at the first visit. The median CMT in patients without cherry-red spots was 166.00 μm, while the median MCT in patients with cherry-red spots was 180.00 μm; there was no significant difference between these two groups (P = 0.467). FA showed delayed arteriovenous transit time > 23 s in 20 patients (28.57%), > 15 s in 43 patients (61.43%) and no delay in 27 patients (30.77%). The median arteriovenous transit time in patients without cherry-red spots was 19.00 s, while it was 18.00 s in patients with cherry-red spots; there was no significant difference between these two groups (P = 0.727).ConclusionsThere are multiple factors that could cause the absence of cherry-red spots in CRAO. The use of OCT to observe increased hyperreflectivity of the inner retina is the most effective imaging method for the early diagnosis of CRAO without cherry-red spots.

COMPARING THE EFFICACY OF 4 MG VS 2 MG INTRAVITREAL TRIAMCINOLONE ACETONIDE IN THE TREATMENT OF DIFFUSE DIABETIC MACULAR EDEMA

The prospective study was conducted in the Department of Ophthalmology from January 2022 to January 2023 to compare the effectiveness of two doses of TA on DME using central macular thickness (CMT) as the primary criterion. A total of 30 patients were included in the study. Participants were randomly divided into a 4mg TA group (n=16) and a 2 mg TA group(n=16).  The injection was given in the eye with higher CMT. Patients were followed up until 6 months after injection. Results showed that regarding mean CMT and change in macular thickness, there was no statistically significant difference between both groups during the whole study period. After 1 month of injection, the ETDRS score in the 4 mg group increased significantly from 37.7±14.1 to 51.3±14.3 (P=0.0012) and from 41.9± 13.3 to 49.4± 13.7 in the 2mg group (P=0.002). Based on the results it can be concluded that the intravitreal 2 mg or 4 mg TA injection had a similar effect on both VA and CMT in patients with DME.

Consequences of Real-World Surveillance of Fellow Eyes in Neovascular Age-Related Macular Degeneration.

This study investigated whether the interval of monitoring at-risk, fellow eyes of patients with unilateral neovascular age-related macular degeneration (nAMD) has any bearing on the severity of the disease at the time of diagnosis. The study comprised a retrospective, cross-sectional comparative case series of treatment-naïve eyes in patients who were diagnosed sequentially with nAMD. We compared the visual acuity (VA) and central macular thickness (CMT) of patients who were actively receiving intravitreal injections (IVIs) of anti-vascular endothelial growth factor (anti-VEGF) agents at the time of second eye diagnosis with the VA and CMT of patients who had ceased treatment in their first eye because of reaching end-stages of disease. Intervals of visits and frequency of monitoring the macula of fellow eyes by means of optical coherence tomography (OCT) were abstracted from the medical record. We found that the at-risk fellow eyes of patients who had stopped treatment for nAMD in their first eye prior to fellow eye conversion were monitored significantly less frequently than the fellow eyes of patients who continued to receive treatment at the time of second eye diagnosis. Despite less frequent monitoring, VA and CMT were similar at the time of fellow eye diagnosis for both groups.

Reproducibility of each retinal layer thickness measurement in epiretinal membrane patients with ectopic inner foveal layers

BackgroundTo identify the reliability of each retinal layer thickness measurement in epiretinal membrane (ERM) patients with ectopic inner foveal layers (EIFLs).MethodsSubjects were divided into two groups: ERM patients with EIFLs (Group 1) and without EIFLs (Group 2). The retinal layer thickness was measured twice, and intraclass correlation coefficient (ICC) and coefficient of variation (CV) values were calculated.ResultsIn Group 1, the CVs of the nerve fiber layer (NFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), and outer nuclear layer (ONL) were 22.39%, 13.12%, 13.37%, 13.21%, 15.09%, and 11.94%, while the ICCs were 0.431, 0.550, 0.440, 0.286, 0.279, and 0.503, respectively. In Group 2, the CVs were 18.20%, 10.59%, 10.65%, 13.27%, 14.75%, and 10.37%, while the ICCs were 0.788, 0.834, 0.830, 0.715, 0.226, and 0.439, respectively. The average central macular thickness (CMT) was significantly correlated with the CVs of NFL (coefficient = 0.317; P < 0.001), GCL (coefficient = 0.328; P < 0.001), and IPL (coefficient = 0.186; P = 0.042) in Group 1.ConclusionsThe reproducibility of the inner retinal layer thickness measurements in ERM patients with EIFLs was low compared to those without EIFLs. The reproducibility of the outer retinal layer thickness measurements, including OPL and ONL, was poor regardless of the presence of EIFLs in ERM patients. Additionally, the thicker the CMT in patients with EIFLs, the lower the reproducibility of the inner retinal layer thickness measurements.

Long-term clinical effects of intravitreal injections of conbercept for the treatment of choroidal neovascularization in patients with pathological myopia.

To observe the long-term clinical efficacy of intravitreal injections of conbercept, a novel vascular growth factor inhibitor, for the treatment of pathological myopia choroidal neovascularization (PM-CNV). A total of 67 eyes (from 67 patients; mean age, 54.90±12.7y) with PM-CNV were retrospectively researched. Based on the different schemes used for the administration of the drug, the patients were divided into two groups: group A (n=35; average age, 53.31±13.6y; average diopter, 9.25±1.72 D), which received only one injection of pro re nata (PRN; 1+PRN regimen), and group B (n=32; average age, 56.49±11.8y; average diopter, 9.63±2.24 D), which received one injection per month for 3mo (3+PRN regimen). Best-corrected visual acuity (BCVA) analysis, intraocular pressure (IOP) examination, slit-lamp microscopy, fundus examination and optical coherence tomography were performed at each follow-up. The recurrence and treatment times of CNV were recorded. The patients were followed up for at least 12mo. The BCVA was increased in 29 eyes (82.9%) in group A and 30 eyes (93.75%) in group B; no increase or decrease was observed in 6 (17.1%) and 2 (6.25%) eyes in groups A and B, respectively. The BCVA (logMAR) values before treatment (0.67±0.48 and 0.71±0.56) were significantly higher than those 12mo after treatment (0.31±0.26 and 0.33±0.17) in groups A and B, respectively (P<0.05). The mean central macular thickness (CMT) values had significantly decreased from 346.49±65.99 and 360.10±82.31 µm at baseline to 257.29±40.47 and 251.97±48.26 µm in groups A and B, respectively, after 12mo of treatment. A total of 21 eyes in group A needed reinjection (60%; average number of injections, 2.51±0.98); the corresponding values in group B were 6 eyes (18.75%; average number of injections, 3.74±1.22). There were no adverse ocular and systemic complications during the treatment and follow-up. Intravitreal injection of conbercept with 1+PRN or 3+PRN improve the visual acuity, reduce macular edema and reduce the level of CMT in patients with PM-CNV. The 3+PRN regimen demonstrates a lower recurrence rate of CNV than the 1+PRN regimen, but requires more treatment. However, both treatment regimens demonstrate long-term safety and efficacy for the treatment of PM-CNV.

The efficacy of intravitreal dexamethasone implant for branch retinal vein occlusion related macular edema

Background: To study the efficacy of intravitreal injection of dexamethasone implant on central macular thickness in patients with BRVO.Methods: A prospective, longitudinal and interventional study was conducted on 30 patients of BRVO presenting to our OPD over a period of one year. Thorough history and detailed ocular examination was done. All cases included in this study received intravitreal injection of dexamethasone implant and were followed up at the first, third and sixth month post-injection to record any change in BCVA, CMT and IOP.Results: In this study, the mean age of patients was 60.67±7.02 years with a M:F ratio of 1:2. Maximum patients (46.6%) were of 61-70 years age group. A significant change from baseline was observed in BCVA and CMT at 1, 3 and 6 months post injection. BCVA significantly improved at 6th month (0.46±0.20 log MAR) compared to the mean BCVA at 3rd month (0.39±0.15 log MAR) (p&lt;0.001). At the 6th month follow up, the mean CMT (338.33±77.91 µm) (p&lt;0.001) was significantly lower compared to the baseline value (536.23±114.56 µm) (p&lt;0.001) but got significantly increased compared to the mean CMT at third month (p&lt;0.001). IOP values were significantly higher at 1 month (p&lt;0.001) and 3 months (p&lt;0.001) compared to the baseline value.  Conclusions: Dexamethasone implant 0.7 mg is beneficial in the improvement of BCVA and treatment of macular edema due to BRVO. However, any beneficial effect on visual acuity and macular edema on OCT seen initially, starts weaning off after 3 months.

Efficacy of Intravitreal Injection of Filtered Modified Low-Dose Triamcinolone Acetonide and Ranibizumab on Pseudophakic Cystoid Macular Edema.

PurposeTo compare the visual and morphological effects between intravitreal injection of filtered modified 2 mg triamcinolone acetonide (TA) and 0. 5 mg ranibizumab in patients with pseudophakic cystoid macular edema (PCME).MethodsA retrospective, interventional study was conducted from January 2015 to February 2020 involving patients with PCME after uneventful cataract surgery. A total of 25 patients (25 eyes) with PCME received an intravitreal injection of 0.22 μm filtered modified 2 mg TA, while 15 patients (15 eyes) received 0.5 mg ranibizumab injection. Central macular thickness (CMT), best-corrected visual acuity (BCVA), intraocular pressure (IOP), times of repeated injections, and other side effects were observed at 2 weeks, 1 month, 3 months, and 6 months after injection; then, the data were compared with preinjection information in each group and between the two groups.ResultsBoth the TA and ranibizumab intravitreal injection can achieve improved BCVA and reduced CMT in patients with PCME (P < 0.05), with a trend toward greater improvement in the TA group, but the difference was only significant at 3 months (P < 0.05). IOP was in the normal range without any significant difference (P > 0.05). Thirty-three percent of patients in the ranibizumab group required repeated intravitreal injection compared to 4% in the TA group. Further stratified analysis showed that the better therapeutic effect of the TA group at 3 months after injection only existed in patients with diabetes mellitus (DM), while not in patients without DM. There was no repeat injection in the TA group and 12.5% in the ranibizumab group for patients without DM, while 16.7% in the TA group and 57.1% in the ranibizumab group required repeated injection for patients with DM, which had a significant difference (P < 0.05).ConclusionIntravitreal injection of filtered modified 2 mg TA is safe, effective, and an inexpensive alternative to antivascular endothelial growth factor (anti-VEGF) agents for patients with PCME, especially for patients concurrently with DM. A large number of clinical randomized controlled studies along with long-term follow-up observations are needed.

Prospective evaluation of the effectiveness of combined treatment of macular edema secondary to retinal vein occlusion with intravitreal bevacizumab and dexamethasone implants.

To evaluate the effectiveness of in---travitreal bevacizumab injections following a single dexamethasone implant in the treatment of macular edema secondary to branch and central retinal vein occlusion. This was a prospective interventional non-comparative study, 44 eyes of patients with naïve macular edema related to branch and central retinal vein occlusion were treated with a dexamethasone implant. Patients were followed-up at four-week intervals from the second to the sixth month. If persistent or recurrent macular edema occurred during this period, the patient was treated with intravitreal bevacizumab injections on an as-needed basis. The outcome measures were best-corrected visual acuity and central macular thickness changes. The mean best-corrected visual acuity changed from 0.97 ± 0.33 LogMAR at baseline to 0.54 ± 0.40 at the six-month post-implant examination (p<0.00001). Improvement ≥3 Snellen lines were seen in 20 eyes (45.54%). The mean central macular thickness at baseline was 670.25 ± 209.9 microns. This had decreased to 317.43 ± 112.68 microns at the six-month follow-up (p<0.00001). The mean number of intravitreal bevacizumab injections received in the six months post-implant was 2.32. The mean time from dexamethasone implant to first anti-VEGF injection was 3.45 months. Intravitreal bevacizumab injections following a single dexamethasone implant were found to improve best-corrected visual acuity and central macular thickness in patients with macular edema due to branch and central retinal vein occlusion at six months, with few intravitreal injections required.

Afibercept treatment for macular edema with and without serous retinal detachment due to branch retinal vein occlusion.

To evaluate the effectiveness of intravitreal aflibercept treatment for macular edema with and without serous retinal detachment due to branch retinal vein occlusion. Thirty-seven eyes with branch retinal vein occlusion treated with intravitreal aflibercept injection for macular edema were evaluated retrospectively. The patients were divided into two groups according to whether they showed serous retinal detachment on spectral domain optical coherence tomography. Pro re nata regimen was applied after 1 dose of intravitreal aflibercept injection. After the initial injection, control treatments were administered at months 1, 2, 3, 6, and 12. The best-corrected visual acuity and central macular thickness were measured. Fifteen patients had serous retinal detachment, and 22 with macular edema only (non-serous retinal detachment). The central macular thickness was significantly greater in the group with than in the group without serous retinal detachment (811.73 ± 220.68 µm and 667.90 ± 220.68 µm, respectively, p=0.04). The difference between the groups disappeared from the third month. The central macular thickness was similar between the two groups at the last control treatment (407.27 ± 99.08 µm and 376.66 ± 74.71 µm, p=0.66). The best-corrected visual acuity increased significantly in both groups. No significant difference was found between the two groups in terms of the best-corrected visual acuities at baseline and the final control. The intravitreal aflibercept treatment was highly effective in improving best-corrected visual acuity and central macular thickness in patients with branch retinal vein occlusion-induced macular edema independent of serous retinal detachment.

Clinical efficacy of conbercept plus micropulse laser (577 nm) treatment in macular edema secondary to non-ischemic central retinal vein occlusion.

Objectives:To observe the clinical efficacy and complications of conbercept combined with a 577-nm micropulse laser in patients with macular edema (ME) secondary to non-ischemic central retinal vein occlusion (CRVO).Methods:A total of 153 patients who were diagnosed with non-ischemic CRVO-induced ME and treated by Shijiazhuang People’s Hospital during January 2019 and January 2021 were included in this study. The patients were divided into a control group and an experimental group by choice of treatment. The control group was treated by conbercept alone, while the experimental group underwent laser treatment on this basis. The best corrected visual acuity (BCVA) was determined by the internationally standardized logarithm of the minimum angle of resolution (logMAR) chart and the central macular thickness (CMT) was measured by optical coherence tomography (OCT) before and at one and three months after treatment. Complications such as conjunctival hemorrhage and elevated intraocular pressure (if any) were recorded during the 3-month follow-up period.Results:Conbercept could improve the BCVA and CMT of patients with non-ischemic CRVO (P <0.05, respectively), and the combined use of conbercept with micropulse laser treatment yielded greater improvements in these measures compared with the pre-treatment condition (P <0.05, respectively); moreover, the differences between the control group and the experimental group were statistically significant (all P <0.05). The two groups had similar complication rates and did not record any serious adverse reactions.Conclusions:Conbercept combined with 577-nm micropulse laser treatment can benefit patients with non-ischemic CRVO-induced ME by improving their visual acuity and relieve ME symptoms. As a regimen of impressive clinical efficacy, it is of great value for wide application in clinical practice.

Impact of Different Clinical Baseline Characteristics on Intravitreal Dexamethasone Implant Ozurdex® Outcomes.

PurposeTo determine the impact of different baseline clinical characteristics on the improvement in best corrected visual acuity (BCVA) in patients with diabetic macular edema (DME) who underwent the intravitreal dexamethasone implant (DEX) Ozurdex®.MethodsThis was a single center retrospective study conducted on patients with DME, either naïve or previously treated, who were treated with one or more DEX and had a follow-up of at least 6 months. The main outcome measure was the proportion of DEX achieving an improvement ≥15 letters in BCVA.ResultsThe study analyzed 192 DEX implants administered to 97 eyes (65 patients). Among the 192 DEX analyzed, 57 (29.7%) implants achieved a BCVA improvement ≥15 letters (ETDRS) from baseline, with a mean time for achieving such improvement of 89.2 (39.7) days. Eyes who received an additional DEX and those with a duration of DME < 6 months had a greater probability of achieving a BCVA improvement ≥15 letters (odds-ratio: 2.55, p = 0.0028 and odds-ratio: 1.93, p = 0.0434). The mean (standard deviation) change in BCVA from baseline was 7.5 (14.5) letters, p < 0.0001. The mean change in central macular thickness (CMT) from baseline was −128.0 (151.0) µm, p < 0.0001. The mean number of DEX implanted was 1.9 (0.8). Four (2.1%) DEX experienced an intraocular pressure increased ≥10 mm Hg; all the cases were successfully managed with topical antiglaucoma medication.ConclusionThe results of this study confirmed previous evidence suggesting that DEX is effective for improving BCVA and CMT in patients with DME.

Central macular thickness in patients with sickle cell disease and no signs of retinopathy: a cross-sectional study of Jordanian patients.

ObjectivesTo measure central macular thickness in Jordanian patients with sickle cell disease who did not have retinopathy and compare the findings with age- and sex-matched controls using spectral domain optical coherence tomography (SDOCT).MethodsIn this cross-sectional study, participants underwent visual acuity testing, slit-lamp bio-microscopy, dilated ophthalmoscopy, and SDOCT imaging to measure central macular thickness. Macular quadrant measurements and thickness difference indexes (TDIs) were compared between groups.ResultsTwenty eyes with sickle cell disease and 20 control eyes were enrolled. The median visual acuity in both groups was 20/20. The mean macular thickness was significantly lower in eyes with sickle cell disease than in matched controls (mean difference, 22.15 ± 6.44 µm). Peripheral quadrants were all significantly thinner in eyes with sickle cell disease, especially in superior and temporal quadrants. TDIs were lower in eyes with sickle cell disease than in control eyes.ConclusionsEyes with sickle cell disease that had no clinical evidence of retinopathy exhibited significantly lower central macular thickness in all quadrants, compared with eyes in age- and sex-matched controls. SDOCT is a non-invasive imaging modality that can detect preclinical changes in eyes with sickle cell disease and can be used to screen and monitor the disease process.

Pharmacological Effects of Saffron and its Constituents in Ocular Disorders from in vitro Studies to Clinical Trials: A Systematic Review.

Introduction: Some medicinal plants have shown promising therapeutic potential for the management of the diseases. We aimed to systematically review the literature wherein the therapeutic effects of saffron have been studied on eye disorders.Methods A systematic literature search was performed in PubMed, Scopus, Web of Science, Google scholar and other databases using eye disorders and saffron as key terms. No strict inclusion criteria were defined, and almost all clinical studies, as well as in vivo and in vitro studies were included. The reported data in each study were extracted and then qualitatively described.Results Finally, 78 articles were found but only 29 relevant articles were included. Nine articles were clinical trials and 20 articles were studies conducted on cellular and molecular aspects of saffron on eye disorders. According to the included studies, crocin prevented the pro-inflammatory response in retinal cells and decreased glucose levels in diabetic mice. Also, crocetin prevented retinal degeneration and saffron protected photoreceptors from light-induced damage in retinal cells. Saffron also improved visual function in age-related macular edema and decreased intraocular pressure in patients with glaucoma. In addition, it was shown that crocin can improve best corrected visual acuity and decrease central macular thickness in patients with diabetic maculopathy.Conclusion The results of this review indicated that saffron and its main ingredients such as crocin could be a potential candidate for the treatment of ocular disease especially eye inflammation; however, further clinical studies are needed to confirm such efficiency.

Switch to aflibercept in the treatment of neovascular age-related macular degeneration: 30-month results.

This study was conducted to evaluate visual function and changes in the central macular thickness of patients with unresponsive neovascular age-related macular degeneration who were switched from ranibizumab (Lucentis®) to aflibercept (Eylea®) treatment at 30 months. This retrospective study examined patients with neovascular age-related macular degeneration who were switched to aflibercept after ≥6 previous intravitreal ranibizumab injections at 4- to 8-week intervals. All patients were switched to intravitreal aflibercept (2.0 mg) and analyzed after 3 consecutive injections followed by a prore nata dosing regimen and after 30 months of treatment. Best corrected visual acuity, biomicroscopic examination, intraocular pressure, fundus examination, and central macular thickness were recorded at the start of treatment, before the transition to intravitreal aflibercept treatment, and at 6, 12, 18, 24, and 30 months of intravitreal aflibercept treatment. A total of 33 eyes met the inclusion criteria. The median age of the patients was 73.57 ± 7.98 years, and 21 (61.8%) patients were males and 12 (35.3%) were females. Before the transition, the patients received a mean of 16.8 ± 8.8 ranibizumab injections (range 6-38).After the transition to intravitreal aflibercept treatment, the mean number of aflibercept injections was 9.09 ± 3.94. No significant differences were observed in best corrected visual acuity after the aflibercept switch in any of the months. The central macular thickness was significantly decreased at 6, 12, 18, and 30 months (p=0.01, p=0.03, p=0.05, p=0.05, p<0.001, respectively). Patients with neovascular age-related macular degeneration who were switched to intravitreal aflibercept treatment due to unresponsiveness to intravitreal ranibizumab exhibited a significant anatomic improvement in the retina, and although this state persisted, there was no significant functional gain.

Effect of Intravitreal Bevacizumab Injection before Panretinal Photocoagulation on the Prevention of Macular Edema Aggravation in Proliferative Diabetic Retinopathy.

Objective: To investigate the effects of intravitreal bevacizumab (IVB) injection before PRP on the prevention of macular edema (ME) in patients with PDR. Methods: This retrospective observational study included patients diagnosed with PDR treated by PRP with (combination group) or without (PRP alone group) preoperative IVB injection (1.25 mg/0.05 mL). The primary outcome measure was the change in the central macular thickness (CMT), while the secondary outcome measure was the change in visual acuity. Measurements were made before and at one, two, and three months after treatment. Results: In the PRP alone group, the mean baseline CMT of 277.8 μm increased to 290.4 μm at one month (p = 0.201) and 308.8 μm at two months (p = 0.002), followed by a decrease to 271.2 μm at three months (p = 0.437). In the combination group, the values at baseline and one, two, and three months after PRP were 322.9 μm, 295.4 μm (p = 0.002), 330.1 μm (p = 0.906), and 274.5 μm (p = 0.030), respectively. Visual acuity changes were comparable between the two groups at all time points. Conclusion: IVB injection before PRP leads to decreased CMT in comparison to CMT in patients with PRP alone.

Assessment of conbercept therapy for high myopia macular neovascularization by optical coherence tomography angiography

This study aimed to evaluate the efficacy and safety of the intravitreal injection of conbercept in the treatment of macular neovascularization (MNV) secondary to high myopia and to observe the application of optical coherence tomography angiography (OCTA) in the treatment follow-up. We reviewed the medical records of 20 patients (21 eyes) with MNV secondary to high myopia who were enrolled in the Department of Ophthalmology of the First Hospital of China Medical University between May 2018 and January 2020. Each patient received one or more intravitreal injections of conbercept (0.5 mg/0.05 mL). The treatment was conducted according to a 1 + PRN (pro re nata) regimen. The changes of best corrected visual acuity (BCVA), central macular thickness (CMT), and selected MNV and flow areas measured by OCTA were observed over a 6-month follow-up period. The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 1.03 ± 0.61 before treatment and improved to 0.83 ± 0.59 (P = 0.007), 0.78 ± 0.62 (P = 0.001), 0.81 ± 0.73 (P = 0.027), and 0.79 ± 0.72 (P = 0.023) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. The mean CMT was 358.16 ± 206.11 μm before treatment and decreased to 295.38 ± 178.70 μm (P = 0.003), 288.34 ± 165.60 μm (P = 0.004), 284.36 ± 163.07 μm (P = 0.005), and 283.00 ± 160.32 μm (P = 0.004) at 1 month, 2 months, 3 months, and 6 months after treatment, respectively. Nineteen eyes (90.5%) had stable or improved vision at 6 months of follow-up. One month after conbercept injection, in OCTA images, the small-diameter blood vessels of the MNV decreased, the intertwined small blood vessels decreased or even disappeared, and the main or larger-diameter blood vessels were still present. The mean selected MNV and blood flow areas were 0.62 ± 0.81 and 0.22 ± 0.27 mm2, respectively, before treatment and decreased to 0.23 ± 0.33 and 0.07 ± 0.08 mm2 (P = 0.04 for both), respectively, 1 month after treatment. No drug-related systemic or ocular adverse effects were observed. Our results suggest that conbercept can effectively and safely improve BCVA and reduce CMT in patients with myopic MVN (mMNV). OCTA can be used to observe MNV area, blood flow area, and MNV morphological changes after treatment with conbercept, thus providing a reference for treatment follow-up.

Evaluating the effect of intravitreal triamcinolone-moxifloxacin during cataract surgery on central macular edema in patients with preexisting diabetic retinopathy.

To evaluate the effect of intravitreal triamcinolone acetonide-moxifloxacin at the time of cataract surgery on central macular edema in patients with preexisting diabetic retinopathy. Loma Linda University Eye Institute, California, USA. Retrospective observational clinical study. Retrospective chart review included 75 eyes of 64 patients who had cataract surgery between February 2015 and October 2018 performed by 2 surgeons. Intravitreal injection of triamcinolone-moxifloxacin (15 mg/1 mg/mL, 0.2 mL injection with 3.0 mg triamcinolone acetonide and 0.2 mg moxifloxacin) was given at the time of surgery. Visual acuity and central macular thickness (CMT) with optical coherence tomography were recorded at preoperative and postoperative visits. Mean visual acuity (logarithm of the minimum angle of resolution) at 4 to 6 weeks, 6 to 12 weeks, and 12 weeks or more postoperatively was 0.32, 0.35, and 0.43, respectively. Baseline mean CMT of 75 eyes was 294 μm (SD = 72). Mean CMT 4 to 6 weeks postoperatively for 46 eyes decreased from 299 μm (78) to 297 μm (79), with a mean decrease of 2 μm (50) (P = .97). Mean CMT 6 to 12 weeks postoperatively for 34 eyes increased from 317 μm (88) to 344 μm (111), with a mean increase of 26 μm (98) (P = .021). Mean CMT 12 weeks or more for 60 eyes increased from 295 μm (72) to 328 μm (108), with a mean increase of 33 μm (85) (P = .0023). Triamcinolone acetonide-moxifloxacin maintained stability of postoperative CMT in patients undergoing cataract surgery with preexisting diabetic retinopathy in the short term, with the greatest effect at 4 to 6 weeks postoperatively.

Efficacy of dexamethasone implant in the treatment of macular edema due to different etiologies

Purpose: The aim of this study was to evaluate the effectiveness of intravitreal DEX implant injection in the treatment of macular edema due to four different etiologies.Materials and Methods: This is a retrospective and case control study. A total of 177 patients who underwent intravitreal DEX implant between 2014 and 2018 for four different etiologies, which are diabetic retinopathy (DR), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO) and posterior uveitis (PU), were included in the study. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) were evaluated in pre-injection, 1st, 3rd, and 6th months post-injection.Results: Eighty-one patients (45.8%) had DR, 44 (24.9%) had BRVO, 35 (19.8%) had CRVO, and 17 (9.6%) had PU. There was a statistically significant difference in BCVA in the DR, BRVO and PU groups after the injection, but no significant difference was observed in the CRVO group. It is observed that there was a statistically significant decrease in CMT in all groups after the injection. The change in CMT in the 1st month was 153.4 ± 137 µm in the DR group, 161.1 ± 151 µm in the BRVO, 270.5 ± 189 µm in the CRVO and 142.2 ± 174 µm in the PU group.Conclusion: The intravitreal DEX implant reduces the CMT in patients with macular edema secondary to various etiologies and improves BCVA in patients with macular edema secondary to various etiologies except for patients with CRVO.

Comparison of conbercept and ranibizumab for the treatment efficacy of diabetic macular edema: a Meta-analysis and systematic review.

To evaluate the efficacy of intravitreal injection of conbercept (IVC) and ranibizumab (IVR) in patients with diabetic macular edema. Reviewers have searched 12 databases, including PubMed, Medline, EMBASE, Web of Science, Springer, ScienceDirect, OVID, Cochrane Library, ClinicalTrials.gov, cqVIP, WanFangdata and China National Knowledge Infrastructure (CNKI), up to December 28, 2018. RevMan 5.3 (Cochrane Library Software, Oxford, UK) was employed for statistical analysis. Fixed and random effects models were applied to assess heterogeneity. Odds ratio (OR) was applied for dichotomous variables; weighted mean difference (WMD) was applied for continuous variables. The confidence interval (CI) was set at 95%. Central macular thickness (CMT) and best-corrected visual acuity (BCVA) were employed to analyze the improvement of DME patients. Inclusion criteria for picking out studies were retrospective studies and randomized controlled trials (RCTs) that compared IVC and IVR for the treatment of diabetic macular edema. Four retrospective studies and five RCTs were included with a total of 609 patients. No statistically significant difference was observed in mean CMT and mean BCVA in the baseline parameters [BCVA (WMD: -0.48; 95%CI: -1.06 to 0.10; P=0.1), CMT (WMD: -0.83; 95%CI: -15.15 to 13.49; P=0.91). No significant difference was found in the improvement of BCVA and adverse event (AE) in IVC group, compared with IVR group after treatment of loading dosage [the 1st month BCVA (WMD: 0.01; 95%CI: -0.26 to 0.27; P=0.96), the 3rd month BCVA (WMD: -0.04; 95%CI: -0.14 to 0.06; P=0.46); the 6th month BCVA (WMD: -0.24; 95%CI: -1.62 to 1.14; P=0.73)], AE (OR: 0.84; 95%CI: 0.38 to 1.84; P=0.66)]. A slight difference was found in the effectiveness rate (OR: 1.70; 95%CI: 0.97 to 2.96; P=0.06), There were statistically significant differences between IVC and IVR treatment in terms of CMT [1st month CMT (WMD: -19.88; 95%CI: -27.94 to -11.82; P<0.001), 3rd month CMT (WMD: -23.31; 95%CI: -43.30 to -3.33; P=0.02), 6th month CMT (WMD: -74.74; 95%CI: -106.22 to -43.26; P<0.001)]. Pooled evidence suggests that both IVC and IVR are effective in the therapy of diabetic macular edema and affirms that IVC presents superiority over IVR therapy in regard of CMT in patients with diabetic macular edema, but no statistically significant difference with regard to visual improvement. Relevant RCTs with longer-term follow-up are necessary to back up our conclusion.

Outcome following single intravitreal injection of ranibizumab in branch retinal vein occlusion patients: a single centre experience

Objective:To find out outcome following single intravitreal injection of ranibizumab in branch retinal vein occlusion (BRVO) patients in a government hospital in the capital of Odisha. Methods: This study was a prospective interventional study of 18 months duration, done from August 2017 to February 2019 which included 21 cases of BRVO. Thorough history was taken and detail ophthalmological evaluation was done. Best corrected visual acuity (BCVA) was examined with Snellen’s chart and central macular thickness (CMT) was measured using optical coherence tomography (OCT). Routine blood tests were done. Intravitreal injection of ranibizumab 0.5 mg in 0.05 ml was given. BCVA and CMT was measured at 1 day, 1 week, 1 month and 3 months follow up visit. Results: Mean age was 55.29 ± 16.86 yrs. Male: female ratio was 3.2:1. 33. About 3% patients presented within 1 month of onset of symptoms. Diastolic blood pressure of ≥ 90 was found in 81% patients. 90.5% showed improvement at 1 week post-operatively.At post-operative day 1 CMT was significantly decreased (p= 0.0011). Reduction in mean CMT at post-operative day 7 was >270 µ. Conclusion: Single intravitreal injection of ranibizumab 0.5 mg in 0.05 mlcauses significant increase in vision and significant reduction of central macular thickness in patients with branch retinal vein occlusion.