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The most common cause of visual deterioration among diabetic mellitus patients is diabetic macular edema. The study included treatment naive DME patients who were treated with anti-VEGF. For predicting responses to anti-VEGF injections among patients with DME, a novel improved U-net DL model for image segmentation and another DL EfficientNet-B3 framework for response classification were developed and introduced. Finally, the classification DL model was compared to various levels of ophthalmology residents and specialists in terms of response classification accuracy. With a granularity of 98. 9% and a sensitivity of 89. 9%, the segmentation deep learning model resulted in segmentation accuracy of 95. 9%, with a sensitivity of 89. 9% and a sensitivity of 87. 9%. The latest DL models can segment and forecast responses among DME patients with similar sensitivity to general ophthalmologists.
Source link: https://doi.org/10.3390/diagnostics12020312
In a real-life setting, the aim of this research was to determine the long-term success and safety of 577-nm subthreshold micropulse laser therapy in a large population of patients affected by mild diabetic macular edema. According to this report, 577-nm SMPL is a safe and repeatable treatment for mild DME that may be used in real-life clinical settings using set parameters and protocols.
Source link: https://doi.org/10.3390/jpm11050405
A systematic literature review was carried out on PubMed to identify papers assessing the efficacy and safety of the FAc implant in daily practice in diabetic macular edema. Mean peak visual growth was +8. 7 letters, but it was higher for lower baseline best corrected visual acuity and more recent DME. In 20% of patients, FAc-induced ocular hypertension was reported, but only 0. 6% required surgery. In 43. 2 percent of phakic patients, cataract extraction was performed.
Source link: https://doi.org/10.3390/pharmaceutics13010072
Diabetic macular edema is a common cause of visual impairment in diabetic patients. Although intravitreal anti-vascular endothelial growth factor injections were highly effective in clinical trials, several patients had a poor response, as shown by several patients. This research was designed to compare clinical characteristics between patients who were allergic to intravitreal anti-VEGF injections for DME and those who were not. In poorer people than in prompt responders, the foveal avascular zone was higher. In poorer than in prompt responders, the number of microaneurysms in the pericapillary network was higher in poor than in prompt responders. The short-term reaction to intravitreal anti-VEGF injections may be related to baseline glycemic control and macular ischemia.
Source link: https://doi.org/10.3390/life11020083
Using optical coherence tomography angiography, the aim was to investigate the changes in foveal avascular zone area, perimeter, and circularity in the superficial and deep plexuses in eyes with diabetic macular edema treated with intravitreal anti-VEGF. Methods This prospective observational study included 56 eyes from 32 patients with DME who had intravitreal anti-VEGF. Results The mean number of intravitreal anti-VEGF injections received during the study period was 4. 60 u00b1 0. 82, which was the same as 0. 8 u00b1 0. 82. Despite having no change in the FAZ parameters, there was nevertheless a statistically significant decrease in CST as well as a statistically significant rise in BCVA during the observation period. Conclusions The FAZ area, perimeter, and circularity in the SCP and DCP were unchanged during the first six months of intravitreal anti-VEGF therapy in eyes with DME, as determined by OCTA.
Source link: https://doi.org/10.1186/s40942-022-00406-z
Metabolic macular edema patients treated with insulin-resistant diabetic edema patients transitioned from intravitreal aflibercept to intravitreal faricimab in a single private hospital. Methods: A retrospective review was carried out to determine the short-term effects in treatment-resistant diabetic macular edema patients. At the end of the 4-month experiment, there were 37. 5% in the study group and 37. 7% in the control group, with a CMT of less than 300 bcm without retinal fluid on OCT at the end of the experiment. Conclusion: IVF can have a short-term visual and anatomic outcomes in treatment-resistant DME patients who were previously treated with IVA in the study group, and 11. 1% in the control group, who had two or three lines of visual acuity at the end of the 4-month study.
Introduction and Objectives : vascular endothelial growth factor inhibitors are inactivated drugs for diabetic macular edema. Our aim is to compare changes in glycated hemoglobin A1c and estimated glomerular filtration rate among patients treated with IVI ranibizumab and aflibercept therapy and patients who have not received IVI drugs. In the China Medical University Hospital-Clinical Research Data Repository, there were 17,165 DME patients with documented ophthalmology visits. HbA1c and eGFR at baseline and 3 and 12 months after the index date between the two groups was established, the difference between the two groups was discovered. eGFR decreased with age and time, but not in our tertiary referral hospital, according to this report, and it was not connected to IVI anti-VEGF drugs. DME patients can be given intravitreal VEGF inhibitors without raising renal impairment, according to this review.
Source link: https://doi.org/10.3390/medicina58081081
After starting VEGF treatment for DME on the basis of a questionnaire and changes in hemoglobin A1c, we'll investigate its effect on glycemic control. HbA1c changes in two years were analyzed by a retrospective multicenter study involving 112 patients with DME who received anti-VEGF therapy and their changes in HbA1c over two years. Patients with a significantly lower HbA1c at 6, 12, and 18 months than patients who did not. After initiating therapy, a total of 59. 8% of patients became more involved in glycemic control through exercise and diet therapy, resulting in a significantly lower HbA1c at 6, 12, and 18 months compared to patients who did not.
Source link: https://doi.org/10.3390/jcm11164659
The most blinding in the working-age and elderly populations of industrial countries are caused by common retinal disorders. Diabetic macular edema and neovascular age-related macular degeneration are common retinal disorders that account for the majority of blindness. Faricimab is the first monoclonal antibody developed for intravitreal use that can neutralize VEGF and Ang-2. Faricimab's prolonged use in nAMD and DME patients, which can be a significant benefit for patients and an alternative to implanted drug delivery systems.
Source link: https://doi.org/10.3390/ijms23169424
The aim of this meta-analysis was to determine the effectiveness and safety of dexamethasone intravitreal implant for the treatment of diabetic macular edema secondary to macular edema. The study found that DEX therapy of RVO-ME resulted in an increase in best corrected visual acuity and central retinal thickness, which was shown by the study. In terms of CRT reduction, DEX treatment of DME was considerably better than anti-VEGF therapy in terms of CRT reduction. The risk of cataract from RVO-ME and the prevalence of elevated intraocular pressure were both significantly higher with DEX than with anti-VEGF therapy, according to a safety report. With DEX and anti-VEGF therapy, the risk of cataracts from DME was significantly higher than with anti-VEGF therapy. With DEX, the incidence of elevated IOP was significantly higher than with anti-VEGF therapy. DEX was more effective than RVO-ME therapy in patients with DME and RVO-ME, but it was marginally less safe than anti-VEGF therapy.
Source link: https://doi.org/10.1155/2022/4007002
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