Diabetic Macular Edema
Conditions
Brief summary
Diabetic retinopathy (DR) is considered the main etiology of blindness among working-age adults, and Diabetic macular edema (DME) is the main reason for vision loss related to DR . Retinal oedema is responsible for retinal micro-structural alterations, retinal atrophy of photoreceptors and ganglion cell disorders . In addition, it might be considered consensual that the best improvements in VA could be accomplished when retinal oedema is managed. In the context of a chronic and progressive disease, DME has to be faced as a state to control as effectively and rapidly as possible . Vascular endothelial growth factor (VEGF) is a protein that promotes the growth of new blood vessels. It also makes the blood vessels more leaky. Anti- VEGF medicines stop the growth of these new blood vessels. This prevents damage to the retinal light receptors and loss of central vision. The DME treatment has been shifted from the laser photocoagulation to anti-VEGF therapy . The advantages of anti-VEGF therapy in decreasing DME and improving patient's vision have been reported in many studies . Ranibizumab, in addition to aflibercept, have been reported as the first line therapies among the other anti-VEGF . There are several data demonstrating the efficiency of ranibizumab in treatment of patients with DME . On the other hand, there are studies that revealed poor response of some patients to anti-VEGF therapies even after 3 or more injections Non-modifiable risk factors for diabetic retinopathy are gender and DM duration. Modifiable risk factors contributing to the development of diabetic retinopathy are elevated blood sugar levels, blood pressure, and dyslipidemia which is the imbalance of lipids such as cholesterol, low-density lipoprotein cholesterol, (LDL-C), triglycerides, and high-density lipoprotein (HDL). This condition can result from diet, tobacco exposure, or genetic . Hard exudates are thought to be induced by the leakage of lipids from dysfunctional retinal capillaries . Therefore, theses were formulated that higher levels of total cholesterol, LDL-C and triglycerides could be considered biomarkers of the development of hard exudates in DM patients . Aim of the work \- Correlate between dyslipidemia and the response of patients with diabetic macular oedema to intravitreal anti-VEGF injection
Interventions
Three consecutive monthly intravitreal injections of Ranibizumab at a dosage of 0.5mg/0.05ml were administered in a sterile manner using a 30-G needle toward the center of the vitreous at 4mm in phakic or 3.5mm in pseudo phakic eyes from the limbus.
Three consecutive monthly intravitreal injections of Aflibercept at a dosage of 2mg/0.05ml were administered in a sterile manner using a 30-G needle toward the center of the vitreous at 4mm in phakic or 3.5mm in pseudo phakic eyes from the limbus.
Sponsors
Sohag University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
35 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* patients with type II DM and center involving DME with central foveal thickness more than 280 um.
Exclusion criteria
1. Evidence of macular ischemia 2. Evidence of macular traction 3. Previous intravitreal injections 4. Previous macular laser therapy 5. Previous pars plana vitrectomy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change in the best corrected visual acuity in meters | 2 months | measure of the ability of the eye to distinguish shapes and the details of objects at a given distance with the help of corrective lenses |
| change in the retina and macula measurements by Optical coherence tomography (OCT) | 2 months | assess the state of the retina and macula by measuring : * Average Thickness in (μm) |
Countries
Egypt
Contacts
Primary ContactOla G Ameen, resident
Backup Contact. Khulood M Mahmood, professor
Outcome results
None listed