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Sandeep Saxena - One of the best experts on this subject based on the ideXlab platform.
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Sequential restoration of External Limiting Membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema
Eye, 2020Co-Authors: Sandeep Saxena, Carsten H. Meyer, Apjit Kaur, Abbas Ali Mahdi, Arvind Misra, Malvika Singh, Levent AkdumanAbstract:To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Forty-four consecutive patients aged 40–65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), External Limiting Membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p
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sequential restoration of External Limiting Membrane and ellipsoid zone after intravitreal anti vegf therapy in diabetic macular oedema
Eye, 2020Co-Authors: Sandeep Saxena, Carsten H. Meyer, Apjit Kaur, Abbas Ali Mahdi, Arvind Misra, Malvika Singh, Levent AkdumanAbstract:To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Forty-four consecutive patients aged 40–65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), External Limiting Membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p < 0.001). Similarly, CST reduced from 354.23 ± 15.0 µm pre-intervention to 233.18 ± 7.88 µm post intervention (p < 0.001). Among qualitative variables, DRIL decreased from 93.2% pre-intervention to 13.6% post intervention. Likewise, global ELM disruption reduced from 81.8 to 9.1% and global EZ disruption reduced from 79.5 to 11.4%. ELM restoration preceded EZ restoration. Anti-VEGF therapy restores the barrier effect of ELM. It causes ELM to restore first followed by EZ restoration in DMO.
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INCREASED SERUM LEVELS OF UREA AND CREATININE ARE SURROGATE MARKERS FOR DISRUPTION OF RETINAL PHOTORECEPTOR External Limiting Membrane AND INNER SEGMENT ELLIPSOID ZONE IN TYPE 2 DIABETES MELLITUS.
Retina, 2017Co-Authors: Sandeep Saxena, Astha Jain, Carsten H. Meyer, Surabhi Ruia, S.m. Natu, Senthamizh Prasad, Nibha Mishra, Jagjit S Gilhotra, Peter Kruzliak, Levent AkdumanAbstract:PURPOSE To evaluate the role of serum urea and creatinine as surrogate markers for disruption of retinal photoreceptor External Limiting Membrane (ELM) and inner segment ellipsoid zone (EZ) in Type 2 diabetic retinopathy (DR) using spectral-domain optical coherence tomography, for the first time. METHODS One hundred and seventeen consecutive cases of Type 2 diabetes mellitus (diabetes without retinopathy [No DR; n = 39], nonproliferative diabetic retinopathy [NPDR; n = 39], proliferative diabetic retinopathy [PDR; n = 39]) and 40 healthy control subjects were included. Serum levels of urea and creatinine were assessed using standard protocol. Spectral-domain optical coherence tomography was used to grade the disruption of ELM and EZ as follows: Grade 0, no disruption of ELM and EZ; Grade 1, ELM disrupted, EZ intact; Grade 2, ELM and EZ disrupted. Data were analyzed statistically. RESULTS Increase in serum levels of urea (F = 22.93) and creatinine (F = 15.82) and increased grades of disruption of ELM and EZ (γ = 116.3) were observed with increased severity of DR (P < 0.001). Increase in serum levels of urea (F = 10.45) and creatinine (F = 6.89) was observed with increased grades of disruption of ELM and EZ (P = 0.001). CONCLUSION Serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor ELM and EZ on spectral-domain optical coherence tomography in DR.
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Retinal Photoreceptor Ellipsoid Zone Integrity in Diabetic Macular Edema
Spectral Domain Optical Coherence Tomography in Macular Diseases, 2016Co-Authors: Sandeep Saxena, Surabhi Ruia, Khushboo Srivastav, Prateep Phadikar, Levent AkdumanAbstract:Spectral domain optical coherence tomography (SD-OCT) and further advances in OCT technology have enabled higher resolution retinal imaging. With the delineation of the four hyperreflective bands in the outer retina, retinal microstructural changes have been documented in diabetic retinopathy. The integrity of photoreceptor External Limiting Membrane and inner segment ellipsoid zone, in particular, has been correlated with disease severity and visual acuity. Various OCT-based grading systems with regard to disruption of photoreceptor External Limiting Membrane and inner segment ellipsoid zone have been proposed. The pretreatment status of photoreceptor layer is also useful in predicting the post-treatment recovery of inner segment ellipsoid zone and visual acuity.
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Altered Lipid Profile is Associated with External Limiting Membrane and Inner Segment Ellipsoid Band Disruption in Type 2 Diabetes Mellitus: A Preliminary Study
Science Journal of Clinical Medicine, 2015Co-Authors: Astha Jain, Sandeep Saxena, Surabhi Ruia, Khushboo Srivastav, S.m. NatuAbstract:Aims: To establish a correlation between lipid profile and disruption of External Limiting Membrane (ELM) and inner segment ellipsoid band (ISel) in type 2 diabetes mellitus (DM), for the first time. Method: Study subjects included 60 cases of type 2 DM [no diabetic retinopathy (No DR) (n=20); non proliferative DR (NPDR, n=20); proliferative DR (PDR, n=20)] and 20 healthy controls. Best corrected visual acuity was measured on logMAR scale. Spectral domain optical coherence tomography (SD-OCT) was used to grade the disruption of ELM and ISel as: grade 0 - No disruption of ELM and ISel; grade 1 - ELM disrupted, ISel intact; grade 2 - ELM and ISel disrupted. Serum was analyzed for levels of cholesterol, triglycerides and lipoproteins. Data was analyzed statistically. Results: Macular edema was observed in 17 cases of NPDR and in all cases of PDR. The ELM and ISel disruption correlated significantly with increased levels of cholesterol (r=0.35), triglycerides (r=0.28) and low density lipoprotein (r=0.34). ELM and ISel disruption was associated with decrease in visual acuity. Conclusion: Deranged lipid profile correlates with the progression of diabetic retinopathy, disruption of ELM and ISel on SD-OCT and decrease in visual acuity.
Malgorzata Woronkowicz - One of the best experts on this subject based on the ideXlab platform.
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The prognostic value of total macular External Limiting Membrane and ellipsoid zone damage for clinical outcome in treatment-resistant neovascular age-related macular degeneration
Graefe's Archive for Clinical and Experimental Ophthalmology, 2020Co-Authors: Malgorzata Woronkowicz, Sue Lightman, Oren Tomkins-netzerAbstract:Purpose To examine the prognostic value of the extent of damage to the ellipsoid zone (EZ) and External Limiting Membrane (ELM) in response to the treatment of age-related macular degeneration (AMD) eyes switched from ranibizumab to aflibercept. Methods This is a retrospective study of patients with neovascular AMD resistant to ranibizumab defined as having persistent intra- or subretinal fluid on OCT scans despite at least 6-month treatment and switched to aflibercept. Clinical data was collected and quantitative measurements of the area of EZ and ELM damage were obtained, on en-face optical coherence tomography images, at the time of switch to aflibercept (baseline) and up to 6 months of follow-up. Results The study included 71 eyes (52.1% right eye) of 71 patients. At baseline, there was a correlation between the size of the EZ and ELM damaged area and BCVA ( R = −0.39, p = 0.001 and R = −0.47, p
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The prognostic value of total macular External Limiting Membrane and ellipsoid zone damage for clinical outcome in treatment-resistant neovascular age-related macular degeneration.
Graefe's Archive for Clinical and Experimental Ophthalmology, 2020Co-Authors: Malgorzata Woronkowicz, Sue Lightman, Oren Tomkins-netzerAbstract:To examine the prognostic value of the extent of damage to the ellipsoid zone (EZ) and External Limiting Membrane (ELM) in response to the treatment of age-related macular degeneration (AMD) eyes switched from ranibizumab to aflibercept. This is a retrospective study of patients with neovascular AMD resistant to ranibizumab defined as having persistent intra- or subretinal fluid on OCT scans despite at least 6-month treatment and switched to aflibercept. Clinical data was collected and quantitative measurements of the area of EZ and ELM damage were obtained, on en-face optical coherence tomography images, at the time of switch to aflibercept (baseline) and up to 6 months of follow-up. The study included 71 eyes (52.1% right eye) of 71 patients. At baseline, there was a correlation between the size of the EZ and ELM damaged area and BCVA (R = −0.39, p = 0.001 and R = −0.47, p
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the prognostic value of total macular External Limiting Membrane and ellipsoid zone damage for clinical outcome in treatment resistant neovascular age related macular degeneration
Graefes Archive for Clinical and Experimental Ophthalmology, 2020Co-Authors: Malgorzata Woronkowicz, Sue Lightman, Oren TomkinsnetzerAbstract:To examine the prognostic value of the extent of damage to the ellipsoid zone (EZ) and External Limiting Membrane (ELM) in response to the treatment of age-related macular degeneration (AMD) eyes switched from ranibizumab to aflibercept. This is a retrospective study of patients with neovascular AMD resistant to ranibizumab defined as having persistent intra- or subretinal fluid on OCT scans despite at least 6-month treatment and switched to aflibercept. Clinical data was collected and quantitative measurements of the area of EZ and ELM damage were obtained, on en-face optical coherence tomography images, at the time of switch to aflibercept (baseline) and up to 6 months of follow-up. The study included 71 eyes (52.1% right eye) of 71 patients. At baseline, there was a correlation between the size of the EZ and ELM damaged area and BCVA (R = −0.39, p = 0.001 and R = −0.47, p < 0.001, respectively). The EZ and ELM damaged areas maintained correlation with BCVA at 6 months (R = −0.28, p = 0.01 and R = −0.39, p = 0.001, respectively). Central retinal thickness did not correlate with BCVA at the time of switch (p = 0.38) or at 6 months (p = 0.36). The extent of damage to the EZ and ELM correlates with BCVA following a switch in treatment.
Levent Akduman - One of the best experts on this subject based on the ideXlab platform.
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Sequential restoration of External Limiting Membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema
Eye, 2020Co-Authors: Sandeep Saxena, Carsten H. Meyer, Apjit Kaur, Abbas Ali Mahdi, Arvind Misra, Malvika Singh, Levent AkdumanAbstract:To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Forty-four consecutive patients aged 40–65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), External Limiting Membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p
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sequential restoration of External Limiting Membrane and ellipsoid zone after intravitreal anti vegf therapy in diabetic macular oedema
Eye, 2020Co-Authors: Sandeep Saxena, Carsten H. Meyer, Apjit Kaur, Abbas Ali Mahdi, Arvind Misra, Malvika Singh, Levent AkdumanAbstract:To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Forty-four consecutive patients aged 40–65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), External Limiting Membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p < 0.001). Similarly, CST reduced from 354.23 ± 15.0 µm pre-intervention to 233.18 ± 7.88 µm post intervention (p < 0.001). Among qualitative variables, DRIL decreased from 93.2% pre-intervention to 13.6% post intervention. Likewise, global ELM disruption reduced from 81.8 to 9.1% and global EZ disruption reduced from 79.5 to 11.4%. ELM restoration preceded EZ restoration. Anti-VEGF therapy restores the barrier effect of ELM. It causes ELM to restore first followed by EZ restoration in DMO.
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INCREASED SERUM LEVELS OF UREA AND CREATININE ARE SURROGATE MARKERS FOR DISRUPTION OF RETINAL PHOTORECEPTOR External Limiting Membrane AND INNER SEGMENT ELLIPSOID ZONE IN TYPE 2 DIABETES MELLITUS.
Retina, 2017Co-Authors: Sandeep Saxena, Astha Jain, Carsten H. Meyer, Surabhi Ruia, S.m. Natu, Senthamizh Prasad, Nibha Mishra, Jagjit S Gilhotra, Peter Kruzliak, Levent AkdumanAbstract:PURPOSE To evaluate the role of serum urea and creatinine as surrogate markers for disruption of retinal photoreceptor External Limiting Membrane (ELM) and inner segment ellipsoid zone (EZ) in Type 2 diabetic retinopathy (DR) using spectral-domain optical coherence tomography, for the first time. METHODS One hundred and seventeen consecutive cases of Type 2 diabetes mellitus (diabetes without retinopathy [No DR; n = 39], nonproliferative diabetic retinopathy [NPDR; n = 39], proliferative diabetic retinopathy [PDR; n = 39]) and 40 healthy control subjects were included. Serum levels of urea and creatinine were assessed using standard protocol. Spectral-domain optical coherence tomography was used to grade the disruption of ELM and EZ as follows: Grade 0, no disruption of ELM and EZ; Grade 1, ELM disrupted, EZ intact; Grade 2, ELM and EZ disrupted. Data were analyzed statistically. RESULTS Increase in serum levels of urea (F = 22.93) and creatinine (F = 15.82) and increased grades of disruption of ELM and EZ (γ = 116.3) were observed with increased severity of DR (P < 0.001). Increase in serum levels of urea (F = 10.45) and creatinine (F = 6.89) was observed with increased grades of disruption of ELM and EZ (P = 0.001). CONCLUSION Serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor ELM and EZ on spectral-domain optical coherence tomography in DR.
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Retinal Photoreceptor Ellipsoid Zone Integrity in Diabetic Macular Edema
Spectral Domain Optical Coherence Tomography in Macular Diseases, 2016Co-Authors: Sandeep Saxena, Surabhi Ruia, Khushboo Srivastav, Prateep Phadikar, Levent AkdumanAbstract:Spectral domain optical coherence tomography (SD-OCT) and further advances in OCT technology have enabled higher resolution retinal imaging. With the delineation of the four hyperreflective bands in the outer retina, retinal microstructural changes have been documented in diabetic retinopathy. The integrity of photoreceptor External Limiting Membrane and inner segment ellipsoid zone, in particular, has been correlated with disease severity and visual acuity. Various OCT-based grading systems with regard to disruption of photoreceptor External Limiting Membrane and inner segment ellipsoid zone have been proposed. The pretreatment status of photoreceptor layer is also useful in predicting the post-treatment recovery of inner segment ellipsoid zone and visual acuity.
Carsten H. Meyer - One of the best experts on this subject based on the ideXlab platform.
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sequential restoration of External Limiting Membrane and ellipsoid zone after intravitreal anti vegf therapy in diabetic macular oedema
Eye, 2020Co-Authors: Sandeep Saxena, Carsten H. Meyer, Apjit Kaur, Abbas Ali Mahdi, Arvind Misra, Malvika Singh, Levent AkdumanAbstract:To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Forty-four consecutive patients aged 40–65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), External Limiting Membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p < 0.001). Similarly, CST reduced from 354.23 ± 15.0 µm pre-intervention to 233.18 ± 7.88 µm post intervention (p < 0.001). Among qualitative variables, DRIL decreased from 93.2% pre-intervention to 13.6% post intervention. Likewise, global ELM disruption reduced from 81.8 to 9.1% and global EZ disruption reduced from 79.5 to 11.4%. ELM restoration preceded EZ restoration. Anti-VEGF therapy restores the barrier effect of ELM. It causes ELM to restore first followed by EZ restoration in DMO.
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Sequential restoration of External Limiting Membrane and ellipsoid zone after intravitreal anti-VEGF therapy in diabetic macular oedema
Eye, 2020Co-Authors: Sandeep Saxena, Carsten H. Meyer, Apjit Kaur, Abbas Ali Mahdi, Arvind Misra, Malvika Singh, Levent AkdumanAbstract:To study the mechanism of restoration of retinal photoreceptor ellipsoid zone (EZ), after intravitreal bevacizumab (IVB) therapy, in diabetic macular oedema (DMO). Forty-four consecutive patients aged 40–65 years having type 2 diabetes mellitus (DM) with DMO were prospectively recruited for IVB therapy. It comprised of three doses (1.25 mg in 0.05 ml) of IVB at monthly intervals. Patients with other ocular and systemic diseases affecting retinal vessels and earlier ophthalmological interventions were excluded. Visual acuity (logMAR VA) was recorded. Spectral domain optical coherence tomography (SD-OCT) was performed pre and post intervention. Central sub-foveal thickness (CST) and grades of disorganization of retinal inner layers (DRIL), External Limiting Membrane (ELM) and EZ were assessed. Data were statistically analysed on SPSS software. Clinical trials registry: CTRI/2019/03/018135. Mean logMAR VA decreased after IVB therapy from 1.78 ± 0.07 pre-intervention to 0.42 ± 0.05 post intervention (p
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INCREASED SERUM LEVELS OF UREA AND CREATININE ARE SURROGATE MARKERS FOR DISRUPTION OF RETINAL PHOTORECEPTOR External Limiting Membrane AND INNER SEGMENT ELLIPSOID ZONE IN TYPE 2 DIABETES MELLITUS.
Retina, 2017Co-Authors: Sandeep Saxena, Astha Jain, Carsten H. Meyer, Surabhi Ruia, S.m. Natu, Senthamizh Prasad, Nibha Mishra, Jagjit S Gilhotra, Peter Kruzliak, Levent AkdumanAbstract:PURPOSE To evaluate the role of serum urea and creatinine as surrogate markers for disruption of retinal photoreceptor External Limiting Membrane (ELM) and inner segment ellipsoid zone (EZ) in Type 2 diabetic retinopathy (DR) using spectral-domain optical coherence tomography, for the first time. METHODS One hundred and seventeen consecutive cases of Type 2 diabetes mellitus (diabetes without retinopathy [No DR; n = 39], nonproliferative diabetic retinopathy [NPDR; n = 39], proliferative diabetic retinopathy [PDR; n = 39]) and 40 healthy control subjects were included. Serum levels of urea and creatinine were assessed using standard protocol. Spectral-domain optical coherence tomography was used to grade the disruption of ELM and EZ as follows: Grade 0, no disruption of ELM and EZ; Grade 1, ELM disrupted, EZ intact; Grade 2, ELM and EZ disrupted. Data were analyzed statistically. RESULTS Increase in serum levels of urea (F = 22.93) and creatinine (F = 15.82) and increased grades of disruption of ELM and EZ (γ = 116.3) were observed with increased severity of DR (P < 0.001). Increase in serum levels of urea (F = 10.45) and creatinine (F = 6.89) was observed with increased grades of disruption of ELM and EZ (P = 0.001). CONCLUSION Serum levels of urea and creatinine are surrogate markers for disruption of retinal photoreceptor ELM and EZ on spectral-domain optical coherence tomography in DR.
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Status of serum VEGF and ICAM-1 and its association with External Limiting Membrane and inner segment-outer segment junction disruption in type 2 diabetes mellitus
Molecular vision, 2013Co-Authors: Astha Jain, Sandeep Saxena, Vinay K. Khanna, Rajendra K. Shukla, Carsten H. MeyerAbstract:Purpose To correlate the serum levels of vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) with the severity of retinopathy and disruption of the External Limiting Membrane (ELM) and inner segment-outer segment (IS-OS) junction in type 2 diabetes mellitus (DM).
Nehal M. Samy El Gendy - One of the best experts on this subject based on the ideXlab platform.
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Outer Retinal Healing After Internal Limiting Membrane Peeling in Diabetic Macular Oedema with Vitreomacular Interface Abnormality Using Three Different Dyes.
Seminars in Ophthalmology, 2019Co-Authors: Nehal M. Samy El GendyAbstract:ABSTRACTPurpose: To evaluate the difference in ellipsoid zone and External Limiting Membrane (EZ/ELM) restoration after vitrectomy with internal Limiting Membrane (ILM) peeling in diabetic macular ...
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retinal ellipsoid zone External Limiting Membrane restoration after diabetic macular edema treatment
Delta Journal of Ophthalmology, 2017Co-Authors: Nehal M. Samy El GendyAbstract:Purpose The aim of this study was to determine which clinically significant diabetic macular edema treatment modality results in early restoration of the ellipsoid zone and External Limiting Membrane (EZ/ELM). Patients and methods This was a retrospective study where the medical records of patients with type 2 diabetes mellitus and clinically significant diabetic macular edema were reviewed. Patients who had valid scans before treatment and 6 months after treatment were included. Disruption of EZ/ELM was graded and compared. Patients were divided into six groups according to the treatment received: group A received argon laser treatment; group B received micropulse diode laser treatment; group C received antivascular endothelial growth factor (anti-VEGF) treatment; group D received anti-VEGF+laser therapy; group E received triamcinolone acetonide injection (TAI); and group F received TAI+laser therapy. Results A total of 293 eyes of 200 patients were included (group A: 47, group B: 40, group C: 52, group D: 54, group E: 51, and group F: 49 eyes). Improvement in EZ/ELM integrity was 38.3% in group A, 45% in group B, 59.6% in group C, 37% in group D, 54.9% in group E, and 44.9% in group F. The difference between groups A and B was not statistically significant (P=0.3). The differences between group A and groups C, D, and E were statistically significant (P=0.002, 0.006, and 0.02, respectively). The difference between groups A and F was not significant (P=0.2). The difference between groups C and D was significant (P=0.001), whereas the difference between groups E and F was not significant (P=0.15). Conclusion Anti-VEGF monotherapy showed the highest percentage of early EZ/ELM restoration. Argon laser alone or argon laser combined with anti-VEGF delayed EZ/ELM healing. Micropulse laser therapy was equivalent to argon laser therapy. TAI results were comparable with anti-VEGF results. Laser addition did not compromise TAI results.
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Retinal ellipsoid zone/External Limiting Membrane restoration after diabetic macular edema treatment
Delta Journal of Ophthalmology, 2017Co-Authors: Nehal M. Samy El GendyAbstract:Purpose The aim of this study was to determine which clinically significant diabetic macular edema treatment modality results in early restoration of the ellipsoid zone and External Limiting Membrane (EZ/ELM). Patients and methods This was a retrospective study where the medical records of patients with type 2 diabetes mellitus and clinically significant diabetic macular edema were reviewed. Patients who had valid scans before treatment and 6 months after treatment were included. Disruption of EZ/ELM was graded and compared. Patients were divided into six groups according to the treatment received: group A received argon laser treatment; group B received micropulse diode laser treatment; group C received antivascular endothelial growth factor (anti-VEGF) treatment; group D received anti-VEGF+laser therapy; group E received triamcinolone acetonide injection (TAI); and group F received TAI+laser therapy. Results A total of 293 eyes of 200 patients were included (group A: 47, group B: 40, group C: 52, group D: 54, group E: 51, and group F: 49 eyes). Improvement in EZ/ELM integrity was 38.3% in group A, 45% in group B, 59.6% in group C, 37% in group D, 54.9% in group E, and 44.9% in group F. The difference between groups A and B was not statistically significant (P=0.3). The differences between group A and groups C, D, and E were statistically significant (P=0.002, 0.006, and 0.02, respectively). The difference between groups A and F was not significant (P=0.2). The difference between groups C and D was significant (P=0.001), whereas the difference between groups E and F was not significant (P=0.15). Conclusion Anti-VEGF monotherapy showed the highest percentage of early EZ/ELM restoration. Argon laser alone or argon laser combined with anti-VEGF delayed EZ/ELM healing. Micropulse laser therapy was equivalent to argon laser therapy. TAI results were comparable with anti-VEGF results. Laser addition did not compromise TAI results.
