Egyptian Retina Journal最新文献

{"title":"Current trends in the treatment of diabetic macular edema","authors":"S. Theodoropoulou, A. Sallam","doi":"10.4103/2347-5617.150214","DOIUrl":"https://doi.org/10.4103/2347-5617.150214","url":null,"abstract":"Since the introduction of focal/grid macular laser over 25 years ago and until recently, laser photocoagulation has been the standard of care in the treatment of diabetic macular edema (DME). Whilst laser photocoagulation was shown to halve the risk of moderate visual loss over 3 years, from 24% to 12%, only < 5% of patients achieves better visual acuity. Within the last 5 years, the use of intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor (VEGF) agents have come into clinical practice for the management of DME and several recent randomized clinical trials have shown superior effectiveness of anti-VEGF treatments compared to conventional macular laser. The introduction of depot steroid injections as flucinolone acetoinde has also lead to a current increase in interest in the use of intravitreal corticosteroids for DME treatment. In this review, we discuss the ocular treatment options currently available for the treatment of DME, mainly focusing on macular laser as well as intravitreal anti-VEGF and corticosteroid treatments.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115909978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular imaging in diabetic retinopathy","authors":"Q. Mohamed","doi":"10.4103/2347-5617.152481","DOIUrl":"https://doi.org/10.4103/2347-5617.152481","url":null,"abstract":"Imaging of the fundus has revolutionized our understanding of the pathogenesis of diabetic retinopathy (DR), allowed standardized grading and follow-up with the ability to evaluate treatments in randomized clinical studies. Ocular imaging provides the tools for screening of diabetic individuals to detect and treat changes before vision loss. Modern instruments allow rapid in vivo imaging of the diabetic fundus using multiple modalities with higher resolution. Images can be transmitted, manipulated, analyzed, and graded with increasing ease. These imaging techniques are now entwined in the paradigms for newer treatments for DR. This paper aimed to provide a brief overview of current imaging modalities including conventional and digital fundus imaging, scanning laser ophthalmoscopy, fluorescein angiography, wide-field retinal imaging, and optical coherence tomography. Future developments in these imaging techniques are discussed.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"269 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116066871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for sight-threatening diabetic retinopathy: An update","authors":"P. Scanlon, M. Dirani, P. van Wijngaarden","doi":"10.4103/2347-5617.152479","DOIUrl":"https://doi.org/10.4103/2347-5617.152479","url":null,"abstract":"Aims: To review the literature on Screening for Diabetic Retinopathy. Materials and Methods: A comprehensive review of the English language literature, published from March 1980 to June 2014 using key words in Zetoc. Results: Several methods were found to achieve adequate sensitivities and specificities for diabetic retinopathy screening. Studies were compared with respect to (a) Classifications used to grade diabetic retinopathy (b) The evidence for population-based screening for diabetic retinopathy (c) Alternatives to digital photography for screening (d) Reference standards used to study the effectiveness of screening methods (e) The evidence for mydriatic versus non-mydriatic digital photography, or a combination of the two (f) The number of photographic fields captured (g) Measurement of distance visual acuity (h)  Cost-effectiveness of screening for diabetic retinopathy (i) Future developments in screening for diabetic retinopathy Conclusion: Based on an assessment of available studies, the most effective DR screening strategy is the use of mydriatic or staged mydriasis with digital retinal photography. Variables between different screening strategies include whether Visual Acuity is measured and the number of fields captured.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130846426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proliferative diabetic retinopathy and the use of anti-vascular endothelial growth factors agents","authors":"E. Fletcher, Fadi Alkherdhaji","doi":"10.4103/2347-5617.152486","DOIUrl":"https://doi.org/10.4103/2347-5617.152486","url":null,"abstract":"Current gold standard treatment for proliferative diabetic retinopathy (PDR) is panretinal photocoagulation (PRP) aimed at reducing the drive for new vessel proliferation. The focus is now changing to include the use of anti-vascular endothelial growth factor (VEGF) agents in conjunction with the gold standard in order to improve efficacy and reduce known side-effects associated with PRP, thus providing better outcomes for this group of advanced retinopathy. This paper aims to summarize our current knowledge behind the development of PDR, with review of treatment with anti-VEGF agents. Systematic search of both PubMed and the Cochrane Central Register of Controlled Trials was performed to identify relevant articles. Only articles in the English-language were selected for review. The use of anti-VEGF agents in conjunction with PRP has been shown to be beneficial in the regression of new vessels, reduction of macular edema as well as reduced duration of vitreous hemorrhage. In addition, its use during surgical intervention for PDR can reduce the duration of surgery and early postoperative complications. Despite the lack of large randomized controlled trials in this area there is significant evidence from case series showing the beneficial as well as the adverse effects of this treatment modality. The need for a large randomized controlled trial is an important development for diabetic retinopathy management.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128267469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between fundus autofluorescence images and color fundus photos in patients with late dry age-related macular degeneration","authors":"A. A. Hadi, Kyrollos Girgis Andrawos","doi":"10.4103/2347-5617.143445","DOIUrl":"https://doi.org/10.4103/2347-5617.143445","url":null,"abstract":"Purpose: The purpose was to compare between color fundus photography (CFP) images and fundus autofluorescence (FAF) images of cases with geographical atrophy (GA) about size. To evaluate the relation between different phenotypes of FAF changes and best corrected visual acuity (BCVA) in cases with late dry age-related macular degeneration (AMD) (GA). Materials and Methods: This study was conducted on 18 eyes of 18 patients aged 55 years. Patients unwilling to participate in the study, suffering from hereditary fundus diseases, had previous laser photocoagulation treatment for any cause, were excluded. BCVA using Snellen chart was measured. Retinal imaging including CFP with 50° field camera: Topcon TRC-50 IX - and FAF using spectralis Heidelberg retinal angiograph (HRA) + optical coherence tomography (HRA, Heidelberg Engineering, Germany) were done. All images were optimized and then manually measured using image analysis software (Adobe Photoshop version CS6; Inc., San Jose, California, USA). Images of fundus autofluorescence in cases of late dry AMD were classified to phenotypes at the junctional zone according to the classification of abnormal FAF patterns. Results: According to sex distribution, 33.3% (6 eyes) were males and 66.7% (12 eyes) were females . The mean age of the study participants was 72.89 ± 9.09 years. About surface area of GA, the mean surface area of GA by FAF was 71094.56 ± 21490.53 pixels and by color fundus camera were 46236.56 ± 13153.46 pixels. About FAF phenotypes in late dry AMD cases, Twelve eyes (66.7%) had diffuse pattern, 11.1% (2 eyes) had a none pattern (no specific pattern), and 22.2% (4 eyes) had focal pattern. Color fundus camera underestimated the surface area of GA in cases of late dry AMD. BCVA was best in cases with no specific pattern of autofluorescence at the junctional zone of the GA, followed by cases with focal pattern of hyperautofluorescence while cases with diffuse increases of autofluorescence at the junctional zone showed the worst VA. Conclusions: CFP underestimated the size of the GA, as compared with FAF measured sizes. BCVA was best in cases with no specific pattern of autofluorescence at the junctional zone of the GA, followed by cases with focal pattern of hyperautofluorescence while cases with diffuse increases of autofluorescence at the junctional zone showed the worst VA.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116175071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normative macular cirrus spectral domain optical coherence tomography data in Indian pediatric population","authors":"Vishal Katiyar, Kumari Mugdha, Sonal Bangwal, S. Gupta","doi":"10.4103/2347-5617.143818","DOIUrl":"https://doi.org/10.4103/2347-5617.143818","url":null,"abstract":"Aim: Cirrus spectral-domain optical coherence tomography (SD-OCT) being noninvasive is gaining more popularity in identifying, monitoring, and classifying children with vitreo-retinal disorder. Normal values of cirrus SD-OCT from children are currently available from developed countries, but not from India. Objective: The primary objective of this study is to provide a normative pediatric database for macular thickness in healthy Indian children using the cirrus SD-OCT. Materials and Methods: The prospective observational study on 157 consecutive healthy children seen between January 2013 and January 2014. Included in the study were 157 subjects with no ocular abnormality, normal (20/20) visual acuity and normal fundoscopy. Cirrus HD-OCT (Carl Zeiss, Dublin, California, USA) device was used. Outcome: Study patients have a mean age of 12.59 ± 3.5 years, with 112 male (12.88 ± 3.5 years) and 45 female (11.8612.88 ± 3.5 years) children. In the linear regression analysis, changes in central subfield thickness and field of the outer macula were independently affected by increase in the age (β = −1.17-1.7, P = 0.004-0.022) and male are found to have significantly higher value when compared with the female (the t-test; t = 1.9-4.8, P = 0.00-0.24). Conclusion: This study established normal reference values for macular parameters measured by Cirrus SD-OCT in healthy Indian children 6-17 years of age, which is statistically different from the databases from other countries. It establishes the importance of the fact that age and gender warrants special consideration during cirrus SD-OCT interpretations in children.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"904 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133833956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the effect of intravitreal ranibizumab on choroidal thickness in eyes treated for diabetic macular edema","authors":"A. A. Hadi","doi":"10.4103/2347-5617.143447","DOIUrl":"https://doi.org/10.4103/2347-5617.143447","url":null,"abstract":"Purpose: To evaluate the effect of intravitreal Ranibizumab on central choroidal thickness (CCT) in eyes treated for diabetic macular edema (DME). Materials and Methods: This prospective non-randomized interventional cohort study included 20 eyes of 20 diabetic patients, recruited between March 2013 and March 2014. Eyes with DME (thickness from 290 to 600 μm) underwent intravitreal injection of Ranibizumab (three consecutive injections, 1 month apart). Prior to injection, all patients had a complete ophthalmic examination, including manifest refraction, slit-lamp bio-microscopy, intraocular pressure measurement, and a detailed fundus examination. Prior to injection and 1 month from the third injection, the central macular thickness and CCT were assessed again by SD-OCT. After each injection, patients were followed to diagnose and treat any complications from injections. Results: Twenty eyes of 20 diabetic retinopathy (DR) patients, 9 females and 11 males with a mean age of 49.7 ± 4.1 years, were included. The pre-injection mean CCT was 234.35 ± 38.36 μm. In the NPDR group, it was 238.2 ± 41.36 μm; and in the PDR group, it was 228.5 ± 35.26 μm. This was not significantly different (P = 0.851). After injections, the mean CCT in all patients, in the NPRD group and in the PDR group showed a decrease to 215.5 ± 39.08, 224.9 ± 40.72 and 201.31 ± 34.02 μm, respectively (P = 0.362). There was a statistically significant difference between the pre-injection and the post-injection CCT (P < 0.001). The improvement in the CCT after treatment was not significantly correlated with the pre-injection CCT or the pre-injection CMT (P = 0.346, P = 0.096 respectively). No significant correlation was found between post-injection CCT and CMT in all patients (P = 0.436) or in the different groups separately (P = 0.191, P = 0.817, respectively). No injection-related complication was observed in either group. Conclusion: Intravitreal injection of Ranibizumab was effective in significantly decreasing the CCT as well as the CMT after three consecutive injections, 1 month apart regardless of the level of DR. Whether the number of injections can influence the amount of this reduction or not should be evaluated in future studies. No correlation was found between the reduction in CMT and that of the CCT after intravitreal injection with 0.5 mg of Ranibizumab.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115332470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intravitreal bevacizumab injection for management of macular edema in branch retinal vein occlusion","authors":"W. Ewais, M. ElShazly, A. A. Nossair","doi":"10.4103/2347-5617.143817","DOIUrl":"https://doi.org/10.4103/2347-5617.143817","url":null,"abstract":"Purpose: The aim was to evaluate visual and anatomical outcome of intravitreal bevacizumab (IVB) in eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO). Methods: Retrospective, consecutive case series. Study was done on 26 eyes of 26 patients. Outcome measures include: Best corrected visual acuity (BCVA), central macular thickness (CMT) by spectral domain optical coherence tomography, and complications. Results: BCVA improved by a mean of 3.2 lines from an initial mean BCVA: 0.1 (counting fingers: 1 m-0.3) to a mean BCVA 0.4 (0.05-0.8) over the follow-up period of 6.9 months (4-12 months). CMT was reduced from an initial mean of 613 (401-959 μ) to the mean of 400 μ (274-623 μ) at the end of the follow-up period. No complications were recorded. This was achieved through a mean number of injections: Four with a range (3-6 injections). Conclusion: IVB is an effective treatment for ME secondary to BRVO. There was a significant improvement of VA and significant reduction in macular thickness in many cases, but not in all cases.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120961325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albuminuria as a biomarker for risk of retinopathy in type II diabetic patients in Suez Canal area","authors":"W. Abdelghaffar, Waleed A. Ghobashy, M. Abdo, Amani A. El-Baz, M. Ibrahim","doi":"10.4103/2347-5617.135243","DOIUrl":"https://doi.org/10.4103/2347-5617.135243","url":null,"abstract":"Aim: The aim of this study is to estimate the prevalence of albuminuria in type II diabetes mellitus and report its influence, as a risk factor, for the presence and severity of diabetic retinopathy (DR). Subjects and Methods: During the period of January 2012 to May 2013, 420 type II diabetic patients were examined. Albuminuria adjusted for creatinine concentration was measured. Body mass index and hemoglobin A1c were also measured. Patients were evaluated by direct and indirect ophthalmoscopy and were classified as non-retinopathy, non-proliferative, proliferative or diabetic maculopathy. Results: The prevalence of albuminuria among type II diabetic patients in this study was 40.2%. The prevalence of microalbuminuria and macroalbuminuria were 30.7% and 9.5% respectively. The study also showed an association between the degree of albuminuria and severity of retinopathy. Nearly 97.5% of the macroalbuminuric patients had sight threatening forms of retinopathy (proliferative diabetic retinopathy + diabetic maculopathy DM) compared with 87%of the microalbuminuric and only 15% of the normoalbuninuric patients. Conclusion: Micro- or macroalbuminuria are highly prevalent in subjects with type II diabetes. Subjects with micro- and macroalbuminuria are more likely to have DR compared with those without albuminuria.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"31 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123188437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical coherence tomography evaluation of retinal and optic nerve head neovascularization in proliferative diabetic retinopathy","authors":"Mahmoud Alaa Aboeuhussein","doi":"10.4103/2347-5617.135244","DOIUrl":"https://doi.org/10.4103/2347-5617.135244","url":null,"abstract":"Purpose: The purpose of this study is to describe the in vivo spatial and morphological vitreoretinal relationships associated with diabetic retinal neovascularization (NV) using optical coherence tomography (OCT). Patient and Methods: This was a prospective observational study that involved 50 eyes of 46 patients with proliferative diabetic retinopathy (PDR) documented by fluorescein angiography either treatment naοve or laser treated were included. Qualitative assessment of macula, retina and optic disc head OCT imaging of patients with PDR. The morphology and plane of retinal neovascularization at the disc (NVD) and elsewhere in the retina (NVE) was examined, and the posterior vitreous relationships were evaluated. Results: The mean age of patients was 52.1 years. Ten patients had type 1 diabetes and 36 had type 2 diabetes. It was possible to evaluate changes of retina, vessels and vitreous in the 50 eyes. This study describes OCT characteristics of: NVD in 35 eyes (70%), NVEs in 20 eyes (40%), NV causing traction without retinal detachment in 15 eyes (30%), and NV causing traction with retinal detachment in 10 eyes (20%). Conclusion: It is possible to image NV of proliferative retinopathy using spectral domain OCT and to visualize the retinal, vascular and vitreous changes associated with NV.","PeriodicalId":201997,"journal":{"name":"Egyptian Retina Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125834076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}