الفهرس 
? Diabetic RetinopathyOnly 14 pages are availabe for public view
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Abstract
SUMMARY
Diabetic retinopathy is one of the common complications of diabetes mellitus.
DR is a progressive condition with microvascular alterations that lead to retinal ischemia, retinal permeability, retinal neovascularization and macular edema.
Diabetic retinopathy is classified into no apparent retinopathy, nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR), characterised by the growth of new blood vessels (retinal neovascularization). NPDR is further divided into mild, moderate, and severe stages that may or may not involve the development of a macula diabetic macular edema (DME).
Diabetic maculopathy is a leading cause of decreased vision from diabetic retinopathy. It is usually encountered in older non-insulin-dependent diabetics with mainly nonproliferative diabetic retinopathy. Diabetic maculopathy can be divided into three main types, exudative (focal), edematous (diffuse or cystoid) and ischemic. DMI is an irreversible category of diabetic maculopathy.
Ischaemic maculopathy occurs due to capillary loss within the macula, is diagnosed by fluorescein angiography.
Evaluation of the structural changes in the choroid might be very insightful to determine the pathogenesis of progression of the macular changes in diabetic eyes.
It was reported that choroidal circulation is affected by diabetic diffuse macular edema.
Optical coherence tomography (OCT) is a non-invasive, noncontact transpupillary imaging modality that has revolutionized ophthalmic clinical practice. It utilizes light to image tissue using low coherence interferometry. OCT offers several advantages over slit lamp biomicroscopy and FA. OCT produces cross sectional images of the macula allowing objective evaluation of macular thickness,choroidal thickness and evaluation of the vitreomacular interface. However, it must be noted that there is poor correlation between macular thickness and visual acuity.
Ranibizumab is a recombinant, humanized monoclonal antibody antigen-binding fragment, has been reported to neutralize all known active forms of VEGF-A and block vessel permeability and angiogenesis and hence prevent vision loss and improve visual acuity in patients with DME.
This study compared the effect of intravitreal injection of ranibizumab on the subfoveal choroidal thickness and central macular thickness in patients with non ischemic versus ischemic diabetic maculopathy by enhanced depth imaging technique.
This study included 40 eyes of 35 diabetic retinopathy patients (50-75 years old), type 2 diabetes mellitus, 17 females and 23 males were randomized into two groups with 20 eyes in each group as following: non ischemic maculopathy (group I), ischemic maculopathy (group II).
Follow up was done by assessment of best corrected visual acuity, central macular thickness, subfoveal choroidal thickness 1month after 1st injection and 1 month after second injection.
The baseline value of the mean subfoveal choroidal thickness (mean ±SD) was 224.45 ± 68.69.0µ in group I (non ischemic), 236.50 ± 69.19 µ in group II(ischemic) showed statistically extremely significant change in group I to194.10 ±65.04 µ, and significant change in group II to 221.95 ± 65.61µ after 2 injections.
The baseline value of the mean central macular thickness (mean ±SD) was 460.35 ± 79.32µ in group 1 (non ischemic), 413.00±127.01 µ in group II(ischemic) showed statistically extremely significant change in group I to328.30±55.22 µ, and non significant change in group 2 to 402.00 ± 127.42µ after 2 injections.
The baseline value of the best corrected visual acuity was 0.54 ±0.16 logMAR units in group1(non ischemic), 1.22±0.39 logMAR units in the ischemic group. Showed statistically extremely significant change in group 1 to0.36± 0.10 logMAR units and non significant change in group 2 to1.27±0.35 logMAR units.