Recent advances in the treatment of diabetic Macular edema
Heba Abu Alhemam Alkenany;
Abstract
DME is the major cause of vision loss in diabetic retinopathy patients.
Occur when blood vessels of diabetic patient leaks into retina in HFL & OPL which make weakest point of retina from thinnest fovea to thickest parafovea.
Patient then complain of gradual painless visual loss explained in his fundus by CSME which further sub grouped by FFA & OCT in order to seek the appropriate way of treatment.
Focusing into main pathogenic ways in order to fight the disease which consisting of BRBs breakdown, liberation of vasoactive factors, vitro retinal interface malformations and blood changes.
The classic standard way to fight the disease starting by medical control , health education and strict follow up in order to prevent its complications to come to light.
Going to the second weapon if DME born , shout its leaking sources by laser if edema is mild and responding ,if vision not affected and if no macular traction.
Going to the third weapon Intra Vitreal injections when edema is affecting vision or severe from the start because it will not respond to laser or persistent not responding edema after laser.
Intra vitreal triamicolone injection was the first one coming to light followed by anti vaso active factors Ranibizumab (Lucentis) and Bevacisumab (Avastin) which more effective on long term multiple injections ,more anti vaso active Intra Vitreal Injections under investigation as VEGF Trap Eye, Sirolimus , Bevasiranib and Extended Release Corticosteroids Delivery Systems which reduce the need for multiple injections as Flucinolone Acetonide-eluting intra vitreal implant, Triamicolone –eluting intra vitreal implant and Dexamethasone-eluting implant Osurdex .
Vitro macular traction as well as persistent edema after laser and injections shift the treatment way in the direction of vitrectomy.
Occur when blood vessels of diabetic patient leaks into retina in HFL & OPL which make weakest point of retina from thinnest fovea to thickest parafovea.
Patient then complain of gradual painless visual loss explained in his fundus by CSME which further sub grouped by FFA & OCT in order to seek the appropriate way of treatment.
Focusing into main pathogenic ways in order to fight the disease which consisting of BRBs breakdown, liberation of vasoactive factors, vitro retinal interface malformations and blood changes.
The classic standard way to fight the disease starting by medical control , health education and strict follow up in order to prevent its complications to come to light.
Going to the second weapon if DME born , shout its leaking sources by laser if edema is mild and responding ,if vision not affected and if no macular traction.
Going to the third weapon Intra Vitreal injections when edema is affecting vision or severe from the start because it will not respond to laser or persistent not responding edema after laser.
Intra vitreal triamicolone injection was the first one coming to light followed by anti vaso active factors Ranibizumab (Lucentis) and Bevacisumab (Avastin) which more effective on long term multiple injections ,more anti vaso active Intra Vitreal Injections under investigation as VEGF Trap Eye, Sirolimus , Bevasiranib and Extended Release Corticosteroids Delivery Systems which reduce the need for multiple injections as Flucinolone Acetonide-eluting intra vitreal implant, Triamicolone –eluting intra vitreal implant and Dexamethasone-eluting implant Osurdex .
Vitro macular traction as well as persistent edema after laser and injections shift the treatment way in the direction of vitrectomy.
Other data
| Title | Recent advances in the treatment of diabetic Macular edema | Other Titles | الطرق الحديثه في علاج إرتشاح المقولا السكري | Authors | Heba Abu Alhemam Alkenany | Issue Date | 2014 |
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