Session Title: Quick Fire Free Paper Session 02
Session Date/Time: Thursday 26/09/2013 | 14:30-16:00
Paper Time: 15:15
Venue: Hall G1 (Level 2)
First Author: R.Fayzrakhmanov RUSSIA
Co Author(s): M. Bikbov A. Yarmukhametova T. Gilmanshin
Assess the impact of antivasoproliferative therapy on the state of macular area in diabetic macular edema
Ufa Eye Research Institute, Ufa, Russia
37 patients (38 eyes) with a spongiform diabetic macular edema were observed, the edema was diagnosed with the help of the optical coherence tomography (OCT) RetinaScan - 3000 (NIDEK). The average age of the patients was 61.6 ± 8.7 years. The average diabetes mellitus experience was 9±4 years. Before and after the treatment patients underwent ophthalmological examination, which included visiometry, perimetry, ophthalmoscopy with use of high-diopter lenses (78D). The study of macular area was carried out with the help of OCT RetinaScan - 3000 (NIDEK). When identifying the diabetic macular edema all patients underwent anti- VEGF therapy with 0.05 ml of Ranibizumab in the conditions of operating room under the local anesthesia. Results evaluation was carried out after 2 intravitreous injections at 1 month intervals.
As a result of the treatment the best corrected visual acuity increased on the average by 0.15±0.02 (p<0.05). The comparative evaluation of OCT parameters before and after the treatment showed the flattening of the surface of the macular area. The reduction of the total retinal thickness within 400 µm from the central part of macular area was an average of 44 µm (with 306±77 µm up to 262 ±30 µm, p<0.05), and at a distance of 1000 µm from foveola - 48 µm (with 406±48 µm up to 358±43 µm, p<0.05). The indicators of change in thickness of retina showed a steady decrease in macular edema after anti - VEGF therapy. A comparative analysis of the profile of the outer nuclear layer before and after the treatment showed a steady decrease of macular edema with a maximum decrease of the thickness of 400±100 µm from foveola (from 72±19 µm up to 29±6 µm) with a gradual increase to the periphery - 100±8 µm. Within 400 mm from the central part of foveola thickness of retina decreased on average by 7 µm (with 93 ±40 µm up to 86±9 µm, p<0.05).
Antivasoproliferative therapy contributes to the improvement of visual acuity and reduction of diabetic macular edema in patients with a spongiform diabetic macular edema, remaining pathogenetically substantiated treatment. The effect of Ranibizumab on all layers of the retina was revealed. The leveling of total thickness of the retina is determined by more pronounced effect on the outer layers of the pigment epithelium. Anti-VEGF therapy determines the change in the profile of the macular area.