Diagnosis and Management of Diabetic Macular Edema Based On Optical Cohrence Tomography (Oct) Finding
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 4
Abstract
Purpose:To assess the effect of central macular thickness (CMT) measured by optical coherence tomography (OCT) on the response to treatment in diabetic macular edema. Methods: This was Prospective Interventional Study conducted in patients visiting the outdoor unit of Department of Ophthalmology, Maharani Laxmi Bai Medical College Jhansi, during the period of 13 months from March 2017 to March 2018. This study included patients with age above 21 years, with diabetes, which is defined as a fasting plasma glucose of more than or equal to 126 mg/dl or a 2-hour post glucose load plasma glucose of more than or equal to 200 mg/dl or a random plasma glucose of more than or equal to 200 mg/dl in the presence of symptoms of hyperglycemia, and duration > 5 years,and those who were physically fit to undergo a dilated fundus examination and OCT evaluation. Results: In this study the mean baseline Best corrected visual acuity right eye affected with DME is 0.822+0.249 and in left eye is 0.863+0.210.The follow up mean visual acuity BCVA as per log MAR right eye affected with DME at 1 month is 0.574+0.230 and, at 6 months is 0.379+0.166. The p value was <0.05, as calculated with the help of paired t-test, indicating that there was a significant difference in Best corrected visual acuity.The follow up mean visual acuity BCVA as per log MAR left eye affected with DME at 1 month is 0.544+0.185 and, at 6 months is 0.347+0.188. The p value was <0.05, as calculated with the help of paired ttest, indicating that there was a significant difference in Best corrected visual acuity.In our study baseline mean central macular thickness in right eye affected with DME are 664.6+31.63 (µm) and, At 1 month the follow up mean central macular thickness (CMT) thickness right eye affected with DME are 467.4+51.41(µm). After 3 months, CMT is 376.4±55.63 (µm), After 6 months of follow up the CMT is 299.3±47.20 (µm).We also measured the baseline mean central macular thickness in left eye affected with DME is 653.6+36.78 µm, At 1 month the follow up mean central macular thickness (CMT) thickness left eye affected with DME was 464.3+61.44 µm. After 3 months, CMT reduced to 370.4±73.25 µm, After 6 months of follow up the CMT reduced to 302.4±47.03 µm. The p value was <0.05, as calculated with the help of paired t-test, indicating that there was a significant difference in mean central macular thickness. conclusion: Macular edema after treatment was assessed by improvement in mean CMT and mean BCVA, which correlated with each other.In this study intravitreal ranibizumab or bevacizumab treatment provides superior visual outcomes compared to conventional laser treatment. Intravitreal ranibizumab with laser has been shown to be more effective compare to focal / grid laser alone for the treatment of DME. Intravitreal triamcinolone with focal/grid photocoagulation has been shown to be more effective than laser alone. we concluded that triamcinolone intravitreal injection has not been found to be superior to focal / grid photocoagulation or Anti-VEGF treatment.
Authors and Affiliations
Dr. Jitendra Kumar, Dr. Kanhaiya Prasad, Dr. arti kushwaha, Dr. jyoti sharma
Keywords
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- EP ID EP572733
- DOI 10.9790/0853-1804081422.
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