The effect of posterior sub-Tenon&amp;rsquo;s capsule triamcinolone acetonide injection to that of pars plana vitrectomy for diabetic macular edema

BioMed Research International

Tatsumi

et al. 2017

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We compared the efficacy of intravitreal aflibercept (IVA) to intravitreal ranibizumab (IVR) injections in eyes with diabetic macular edema (DME). The medical records of 49 eyes of 36 patients who were diagnosed with DME and had received IVR and 46 eyes of 40 patients who had received IVA treatment were reviewed. The central macular thickness (CMT) and best-corrected visual acuity (BCVA) were measured at the baseline and at 1, 3, and 6 months after the IVR or IVA. The mean number of injections of IVR was 2.6 ± 1.1 and of IVA was 2.7 ± 1.4. At 6 months, the CMT was significantly thinner than the baseline after IVR and after IVA. The mean BCVA was significantly better than the baseline after IVR only at 1 and 3 months and after IVA at 1 and 6 months. The BCVA of eyes with serous retinal detachment (SRD) was significantly better at 1 month after the IVR and at 1 month and 6 months after the IVA. The BCVAs improved more significantly in the SRD+ group than in the SRD− group. The effects of IVA persist longer than that of IVR. The effectiveness of both IVR and IVA was not dependent on the presence of SRD (IRB#2107).

Section: Resultsmentioning

confidence: 99%

Comparisons of Efficacy of Intravitreal Aflibercept and Ranibizumab in Eyes with Diabetic Macular Edema

Shimizu

BioMed Research International

Tatsumi

et al. 2017

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“…The specific indications for MAPC and SMDLP were not determined but the patients with microaneurysms at the posterior pole underwent STTA combined with MAPC immediately or within one month after the STTA injection. The effect of the STTA injection for DME is rapid, and our results indicate that the CMT was significantly reduced 1 month after the STTA injection [ 14 ]. In our hospital, SMDLP was determined to be a better treatment than grid laser photocoagulation for DME [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our recent study indicated that the short-term effect of STTA for DME is comparable to that of pars plana vitrectomy [ 14 ]. However, the benefits of steroid therapies were no longer evident at 6 months [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Refractory Diabetic Macular Oedema after Sub-Tenon’s Capsule Triamcinolone Acetonide Injection

Journal of Ophthalmology

Kitamura

Nonomura

et al. 2015

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The purpose of this study is to identify the risk factors for a recurrence or persistence of diabetic macular oedema (DME) after a sub-Tenon's capsule triamcinolone acetonide (STTA) injection. The medical records of 124 patients (124 eyes) treated by STTA were reviewed. The age, sex, HbA1c level, best-corrected visual acuity, central macular thickness, insulin use, pioglitazone use, systemic hypertension, serous retinal detachment, proteinuria, panretinal photocoagulation, microaneurysm photocoagulation (MAPC), subthreshold micropulse diode laser photocoagulation (SMDLP), cataract surgery, and history of vitrectomy were examined by logistic regression analysis. Procedures of MAPC and SMDLP were significantly associated with DME treated with STTA (P = 0.0315, P = 0.04, resp.). However, a history of vitrectomy was found to have significantly fewer recurrences or persistent DME after STTA (P = 0.0464). In conclusion, patients who required combined MAPC or SMDLP with a STTA injection had significantly higher refractoriness to STTA, but postvitrectomy may prevent the recurrence or persistence of DME after STTA injection.

“…In fact, switching from anti-VEGF to triamcinolone acetonide injections led to significant therapeutic effects in eyes with refractory DME treated with repeated anti-VEGF injections [ 78 ]. Sub-Tenon triamcinolone acetonide injections are also known to be effective in the treatment of DME [ 79 , 80 , 81 , 82 ]. Because steroids are strong anti-inflammatory agents, inflammation is involved in the development of DME.…”

Section: Physiology and Pathology Of Nvu In Diabetic Retinopathymentioning

confidence: 99%

Neurovascular Impairment and Therapeutic Strategies in Diabetic Retinopathy

2021

IJERPH

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Diabetic retinopathy has recently been defined as a highly specific neurovascular complication of diabetes. The chronic progression of the impairment of the interdependence of neurovascular units (NVUs) is associated with the pathogenesis of diabetic retinopathy. The NVUs consist of neurons, glial cells, and vascular cells, and the interdependent relationships between these cells are disturbed under diabetic conditions. Clinicians should understand and update the current knowledge of the neurovascular impairments in diabetic retinopathy. Above all, neuronal cell death is an irreversible change, and it is directly related to vision loss in patients with diabetic retinopathy. Thus, neuroprotective and vasoprotective therapies for diabetic retinopathy must be established. Understanding the physiological and pathological interdependence of the NVUs is helpful in establishing neuroprotective and vasoprotective therapies for diabetic retinopathy. This review focuses on the pathogenesis of the neurovascular impairments and introduces possible neurovascular protective therapies for diabetic retinopathy.