Background: Macular edema due to diabetic retinopathy is among the most common causes of blindness in diabetics from working age group around the world . Diabetic macular edema which involves the center of the macula is among the major cause of visual decline in patients with diabetes mellitus. Intra-Vitreal Triamcinolone Acetonide with intravitreal Bevacizumab and intravitreal Bevacizumab only have been in practice as treatment options for cases not responsive to anti-vascular endothelial growth factor agents. Objective: To compare safety and efficacy profile of suprachoroidal injection of triamcinolone acetonide with intravitreal Bevacizumav Vs intravitreal injection of Bevacizumab alone in management of resistant diabetic macular edema. Patients & Methods: In this study, Fourty eyes of fourty patients who had resistant diabetic macular edema were randomly divided into two groups of 20 patients each (n=20) , our group A was injected with suprachoroidal triamcinolone acetonide 2 mg along with intravitreal Bevacizumab 1.25mg and the group B wasinjected with intravitreal Bevacizumab 1.25 mg only. Change in central macular thickness was observed after one month on Optical coherence tomography. Data was collected and analyzed by using SPSS software. Results: The mean age of subjects in this study was 58.46±3.62 years ( 30-65 years) . Out of 40 patients 26 were male patients and 14 were female .The mean decline (change) in central macular thickness in comparison to baseline thickness on OCT in group A was 113±10microns and mean change in the central thickness of macula on OCT in group B was 83+-10 microns with a p value of 0.01. Conclusion: Suprachoroidal triamcinolone acetonide with intravitreal bevacizumab is superior to intravitreal Bevacizumab alone in reducing central macular thickness among patients with resistant diabetic macular edema. Keywords: Macular edema, Suprachoroidal triamcinolone , intravitreal Bevacizumab, Optical coherence tomography
Background: Proliferative diabetic retinopathy is the proliferation of retinal neo vessels due to uncontrolled diabetes mellitus and long duration of this disease that leads to advance diabetic eye disease . proliferative diabetic retinopathy is treated by pan retinal photocoagulation which reduces retinal oxygen demand by retinal photocoagulation. Retinal photocoagulation leads to the laser tissue interaction called thermal damage leading to coagulative necrosis of the retinal pigment epithelial cells as these cells contain melanin a dark pigment that has the ability to absorb light energy in argon laser spectrum. Objective: To determine the mean change in central macular thickness after pan retinal photocoagulation on optical coherence tomography of the macula in patients with proliferative diabetic retinopathy . Material & Methods: Our study was a Quasi experimental study conducted at Department of Ophthalmology, Services Hospital Lahore for duration of six months from April 2021 to September 2021. In this study 40 eyes from 40 patients with proliferative diabetic retinopathy were selected who underwent pan retinal photocoagulation in one sessions with 1500 burn marks. Patients in the age group of 15 to 70 years, male and female, with proliferative diabetic retinopathy in at least one eye with no history of ocular surgery or ocular trauma in last one year were included in this study . Optical coherence tomography of macula was performed before and four weeks after the session of pan retinal photocoagulation. CMT (central macular thickness) was measured for mean change in central macular thickness. Results: In this study , the mean age of patients was 48.68±1.52 years, and gender ratio of female to male patients was 1:0.77,The mean CMT before start of treatment that was considered as baseline was 230.55±5.0 and the mean CMT value after four weeks of pan retinal photocoagulation was 238.50±6.43. (p-value=0.001) Conclusion: No significant change in CMT was found from baseline CMT to four weeks after pan retinal photocoagulation. Keywords: Optical coherence tomography, pan retinal photocoagulation, Central Macular Thickness, proliferative diabetic retinopathy
Objective: To determine the relationship of myopia with height in young group of age 12-25 year. Methodology: Descriptive type/ cross sectional study was carried out in Bahawalpur Victoria hospital From15th September 2012 to 15th February 2013. 167 patients were included in this study by using non-probability convenience sampling technique. Data was collected from self-designed Performa with informed patient consent. Visual acuity was assessed by snellen acuity chart. Objective refraction was carried out by retinoscopy. Subjective refraction was also done by using trial box. After refraction, the height of the patient was measured in feet. Results: In the range of height 4.8-5.4 feet there were 30 myopic and 35 were non myopic while in the range of height 5.4-6 feet 70 were myopic and 32 were non myopic. There is association between myopia and height (P<0.05 ). Conclusion: There is significant association between myopia and height as myopia is more common in heighted individuals. Keywords: Myopia, Axial length, Height.
Objective: To compare safety as well as efficacy of topical anesthesia against peribulbar anesthesia for patients undergoing three ports pars plana removal of silicone oil . Background: Silicone oil is used as a temponarding agent for vitreoretinal procedures and have to be removed according to the duration of temponard required as it is associated with complications like development and acceleration of cataract devlopment , secondary open angle glaucoma and corneal decompensation. It can be removed via three port 23 gauge ROSO procedure both under topical and peribulbar anesthesia. Patients & Methods: 40 eyes from 40 patients who underwent three port ROSO with a 23 gauge port system were randomised into two groups of 20 patients each for this study. In group A eyes was operated under topical anesthesia using soaked cotton wisk with 0.5 % proparacaine hydrochloride , placed for five minutes in superior and inferior fornix before the start of surgery and the group B was operated under peri bulbar block with 4 ml of bupivacaine given five minutes before the start of surgical procedure. Pain scoring charts were used by patients to rate their pain after the procedure. Results: The patients in this study had a mean age of 58.46 ±3.62 years, with a range of 30-65 years. 40 individuals were treated, with 26 being male and 14 being female. The mean pain score for patients in topical anesthesia group was 3.8+- 0.5 and the mean pain score in peribulbar block group was 2.2+-0.2 with a p value of 0.01. Conclusion: Peribulbar block is superior to topical anesthesia in patient comport for patients undergoing three port ROSO procedures. Keywords: ROSO, Silicone oil, peribulbar, Topical anesthesia, Bupicaine, Proparacaine hydrochloride.
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