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    Comparison of Monthly vs Treat-and-Extend Regimens for Individuals With Macular Edema Who Respond Well to Anti-Vascular Endothelial Growth Factor Medications: Secondary Outcomes From the SCORE2 Randomized Clinical Trial.
    JAMA Ophthalmol 2018 Feb 24. Epub 2018 Feb 24.
    The Retina Group of Washington, Fairfax, Virginia.
    Importance: Comparisons of monthly vs treat-and-extend anti-vascular endothelial growth factor (anti-VEGF) regimens for macular edema from central retinal vein occlusion or hemiretinal vein occlusion is needed.

    Objective: To compare visual acuity letter score and central subfield thickness outcomes of participants in the Study of Comparative Treatments for Retinal Vein Occlusion 2 (SCORE2) trial who then received either monthly injections or treat-and-extend (TAE) regimens of aflibercept or bevacizumab after a good response at month 6.

    Design, Setting, And Participants: This randomized clinical trial enrolled participants from 66 private practice or academic centers in the United States. Read More

    Identifying Medical Diagnoses and Treatable Diseases by Image-Based Deep Learning.
    Cell 2018 Feb;172(5):1122-1131.e9
    Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 510005 Guangzhou, China; Shiley Eye Institute, Institute for Engineering in Medicine, Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA 92093, USA; Molecular Medicine Research Center, State Key Laboratory of Biotherapy, The National Clinical Research Center of Senile Disease, West China Hospital, Sichuan University, Chengdu, China; Guangzhou Regenerative Medicine and Health Guangdong Laboratory, 510005 Guangzhou, China; Veterans Administration Healthcare System, San Diego, CA 92037, USA. Electronic address:
    The implementation of clinical-decision support algorithms for medical imaging faces challenges with reliability and interpretability. Here, we establish a diagnostic tool based on a deep-learning framework for the screening of patients with common treatable blinding retinal diseases. Our framework utilizes transfer learning, which trains a neural network with a fraction of the data of conventional approaches. Read More

    Retina 2018 Feb 22. Epub 2018 Feb 22.
    Department of Ophthalmology, Hospital Universitario Morales Meseguer, Murcia, Spain.
    Purpose: To report 3-year results of a randomized single-blind controlled trial of intravitreal ranibizumab combined with oral docosahexaenoic acid (DHA) supplementation versus ranibizumab alone in patients with diabetic macular edema.

    Methods: There were 26 patients (31 eyes) in the DHA group and 29 (38 eyes) in the control group. Ranibizumab (0. Read More

    Retina 2018 Feb 22. Epub 2018 Feb 22.
    Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, California.
    Purpose: This post hoc analysis explores the relationship between early retinal anatomical response and long-term anatomical and visual outcomes with ranibizumab in center-involved diabetic macular edema.

    Methods: Eyes randomized to the ranibizumab plus prompt laser and ranibizumab plus deferred laser treatment arms in the Protocol I study were categorized according to their proportional reduction (<20 vs. ≥20%) in central retinal thickness (CRT) after 12 weeks. Read More

    Diabetic Macular Edema: Current Understanding, Pharmacologic Treatment Options, and Developing Therapies.
    Asia Pac J Ophthalmol (Phila) 2018 Jan-Feb;7(1):28-35
    Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
    Diabetic retinopathy and diabetic macular edema comprise a major source of visual disability throughout the developed world. The etiology and pathogenesis of macular edema is intricate and multifactorial, in which the hyperglycemic state in diabetes induces a microangiopathy. Through several inflammatory and vasogenic mediators, including vascular endothelial growth factor (VEGF) upregulation and inflammatory cytokines and chemokines, pathologic changes are induced in the vascular endothelium triggering breakdown of the blood retinal barrier, causing extravasation of fluid into the extracellular space and manifesting clinically as macular edema, resulting in visual loss. Read More

    Retina 2018 Feb 21. Epub 2018 Feb 21.
    Department of Ophthalmology, Okayama University Medical School, Okayama, Japan.
    Purpose: To evaluate the efficacy and safety of intravitreal aflibercept injection (IAI) in Japanese patients with diabetic macular edema (DME).

    Methods: VIVID-DME was a Phase 3 study comprising patients with DME randomized 1:1:1 to IAI 2 mg every 4 weeks (2q4), IAI 2 mg every 4 weeks until Week 16 then 8-week dosing (2q8), and laser. A total of 403 patients (76 Japanese) were included in this study. Read More

    Ranibizumab-induced retinal reperfusion and regression of neovascularization in diabetic retinopathy: An angiographic illustration.
    Am J Ophthalmol Case Rep 2018 Mar 4;9:41-44. Epub 2018 Jan 4.
    Department of Vitreo-Retina, Giridhar Eye Institute, Ponneth Temple Road, Kadavanthara, Kochi, India.
    Purpose: To report regression of neovascularization and reperfusion of ischemic areas of the retina on Wide-field Digital Fluorescein Angiography following anti-vascular endothelial growth factor injections in a patient with active Proliferative Diabetic Retinopathy.

    Observations: Case report of sixty-one-year-old male patient with proliferative diabetic retinopathy and diabetic macular edema documented on wide field digital fluorescein angiography. The patient was treated with three intravitreal injections of ranibizumab given at monthly intervals. Read More

    Proteomic analysis of the human retina reveals region-specific susceptibilities to metabolic- and oxidative stress-related diseases.
    PLoS One 2018 21;13(2):e0193250. Epub 2018 Feb 21.
    Omics Laboratory, Stanford University, Palo Alto, California, United States of America.
    Differences in regional protein expression within the human retina may explain molecular predisposition of specific regions to ophthalmic diseases like age-related macular degeneration, cystoid macular edema, retinitis pigmentosa, and diabetic retinopathy. To quantify protein levels in the human retina and identify patterns of differentially-expressed proteins, we collected foveomacular, juxta-macular, and peripheral retina punch biopsies from healthy donor eyes and analyzed protein content by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Protein expression was analyzed with 1-way ANOVA, gene ontology, pathway representation, and network analysis. Read More

    A Clinical Decision Support System for Diabetic Retinopathy Screening: Creating a Clinical Support Application.
    Telemed J E Health 2018 Feb 21. Epub 2018 Feb 21.
    2 Department of Computer Engineering and Mathematics, Universitat Rovira & Virgili , Reus, Spain .
    Background: The aim of this study was to build a clinical decision support system (CDSS) in diabetic retinopathy (DR), based on type 2 diabetes mellitus (DM) patients.

    Method: We built a CDSS from a sample of 2,323 patients, divided into a training set of 1,212 patients, and a testing set of 1,111 patients. The CDSS is based on a fuzzy random forest, which is a set of fuzzy decision trees. Read More

    New model of proliferative vitreoretinopathy in rabbit for drug delivery and pharmacodynamic studies.
    Drug Deliv 2018 Jan;25(1):600-610
    a Department of Ophthalmology , Jacobs Retina Center at Shiley Eye Institute, University of California San Diego , La Jolla , CA , USA.
    Blinding retinal diseases become more epidemic as the population ages. These diseases, such as diabetic retinopathy and macular edema, are of chronic nature and require protracted drug presence at the disease site. A sustained intravitreal porous silicon delivery system with dexamethasone (pSiO-COO-DEX) was evaluated in a new rabbit model of proliferative vitreoretinopathy (PVR) in a real treatment design. Read More

    Association between characteristics of foveal cystoid spaces and short-term responsiveness to ranibizumab for diabetic macular edema.
    Jpn J Ophthalmol 2018 Feb 19. Epub 2018 Feb 19.
    Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaracho, Sakyo, Kyoto, 606-8507, Japan.
    Purpose: To investigate the association between the characteristics of foveal cystoid spaces and short-term responsiveness to ranibizumab treatment for diabetic macular edema (DME) at 3 months from the initial injection.

    Methods: We retrospectively reviewed 66 eyes of 61 patients with center-involved DME who received three consecutive ranibizumab injections and following as-needed administrations. We evaluated the relationship between visual improvement at 3 months and the preoperative optical coherence tomography (OCT) parameters including hyperreflective foci, heterogeneous OCT reflectivity, mean levels of OCT reflectivity and height of foveal cystoid spaces. Read More

    Strategies to Improve Prevention and Management in Diabetic Retinopathy: Qualitative Insights from a Mixed-Methods Study.
    Diabetes Spectr 2018 Feb;31(1):65-74
    Thistle Editorial, LLC, Snoqualmie, WA.
    Nonproliferative and proliferative diabetic retinopathy (DR) are common, progressive complications of diabetes with a rising incidence. Over time, patients with nonproliferative DR may progress to more advanced stages of DR, with an increased risk of vision-threatening conditions such as diabetic macular edema (DME). DME is the most frequent cause of vision loss in patients with diabetes and eventually can lead to blindness. Read More

    [Cost Comparison of Licensed Intravitreal Therapies for Insufficiently Anti-VEGF Responding Fovea Involving Diabetic Macular Edema in Germany].
    Klin Monbl Augenheilkd 2018 Feb 16. Epub 2018 Feb 16.
    Augenklinik, Klinikum rechts der Isar der Technischen Universität München.
    Background: In the treatment of center-involving diabetic macular edema, despite initial therapy with an anti-VEGF compound, an insufficient response may occur. Further therapy options include a switch of anti-VEGF products or to corticosteroid implants, such as Fluocinolone acetonide or Dexamethasone.

    Objectives: Firstly, to investigate systematically which evidence-based study data are available describing the efficacy of in-label treatments after primary anti-VEGF treatment, secondly, to investigate which costs go along for the healthcare provider. Read More

    Consequences of inadvertent intravitreal Mitomycin C injection.
    Int J Retina Vitreous 2018 12;4. Epub 2018 Feb 12.
    2Eye Research Center, Khatam Eye Hospital, Mashhad University of Medical Sciences, Qarani Blvd., Mashhad, 9195965919 Iran.
    Background: Mitomycin C (MMC) as an alkylating agent is miscellaneous an antineoplastic, antibiotic and ophthalmic agent. Here we aim to report a case of inadvertent intravitreal MMC injection instead of Avastin in case of diabetic macular edema.

    Case Presentation: A 53 years old woman was planned to receive intravitreal Avastin injection, but accidentally, 0. Read More

    Automated segmentation of hyperreflective foci in spectral domain optical coherence tomography with diabetic retinopathy.
    J Med Imaging (Bellingham) 2018 Jan 6;5(1):014002. Epub 2018 Feb 6.
    Nanjing University of Science and Technology, School of Computer Science and Engineering, Xiaolingwei, Nanjing, China.
    We propose an automated segmentation method to detect, segment, and quantify hyperreflective foci (HFs) in three-dimensional (3-D) spectral domain optical coherence tomography (SD-OCT). The algorithm is divided into three stages: preprocessing, layer segmentation, and HF segmentation. In this paper, a supervised classifier (random forest) was used to produce the set of boundary probabilities in which an optimal graph search method was then applied to identify and produce the layer segmentation using the Sobel edge algorithm. Read More

    Silymarin prevents diabetes-induced hyperpermeability in human retinal endothelial cells.
    Endocrinol Diabetes Nutr 2018 Feb 5. Epub 2018 Feb 5.
    Diabetes and Metabolism Research Unit. Vall d'Hebron Research Institute. Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Spain. Electronic address:
    Introduction: Vascular endothelial growth factor (VEGF) plays an essential role in development of diabetic macular edema (DME). While there is evidence suggesting that silymarin, a flavonoid extracted from Silybum marianum, could be useful for prevention and treatment of diabetic nephropathy, no studies have been conducted in diabetic retinopathy (DR). The aim of this study was to assess the effect of silymarin on disruption of inner blood retinal barrier (BRB), the primary cause of DME. Read More

    Retinal Nerve Fiber Layer Thickness in Various Retinal Diseases.
    Optom Vis Sci 2018 Mar;95(3):247-255
    Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Republic of Korea.
    Significance: Peripapillary retinal nerve fiber layer (RNFL) thickness measurements may be influenced by the range and severity of lesions that are observed distinctively in each retinal disease.

    Purpose: We investigated the effects of various macular (central serous chorioretinopathy, macular hole, epiretinal membrane, wet age-related macular degeneration) and retinal vascular (branch retinal vein occlusion, central retinal vein occlusion, diabetic macular edema) diseases on peripapillary RNFL thickness measurements using spectral-domain optical coherence tomography.

    Methods: Six hundred thirty-one eyes from 464 patients with various retinal diseases and 167 controls of similar age were included in this retrospective study. Read More

    Complications of Intravitreous Injections in Patients with Diabetes.
    Semin Ophthalmol 2018 ;33(1):42-50
    a Beetham Eye Institute, Joslin Diabetes Center , Boston , MA , USA.
    Intravitreous injections are presently the second most frequently performed ophthalmic procedure and the most common vitreoretinal procedure. In diabetic patients, intravitreous injections are frequently performed for the treatment of center-involved diabetic macular edema, proliferative diabetic retinopathy, or other co-existing retinal vascular disease. Diabetic patients may be at higher risk of adverse events compared to non-diabetic individuals, given frequent systemic comorbidities, such as cardiovascular and renal disease and increased susceptibility to infection. Read More

    A 10-year monitoring of the eyesight in patients after kidney transplantation.
    Medicine (Baltimore) 2018 Feb;97(6):e9822
    Department of Ophthalmology, Medical University of Gdansk.
    A pilot study of a 10-year analysis of the eyesight characteristics in patients after renal transplantation with a view to a later wider study of the same population.The study encompassed 50 eyes in 25 patients who underwent renal transplantation in the years 2007 and 2008. All patients underwent: visual acuity measurement, tonometry, slit lamp examination, and spectroscopic optical coherence tomography. Read More

    Region-specific ischemia, neovascularization and macular edema in treatment-naïve proliferative diabetic retinopathy.
    Clin Exp Ophthalmol 2018 Feb 7. Epub 2018 Feb 7.
    Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, PA, USA.
    Importance: Region-specific pathology in proliferative diabetic retinopathy enhances our understanding and management of this disease.

    Background: To investigate non-perfusion, neovascularization, and macular edema.

    Design: A cross-sectional, observational, non-randomized study. Read More

    Management of Retinopathy of Prematurity--Use of Anti-VEGF Therapy.
    Asia Pac J Ophthalmol (Phila) 2018 Jan-Feb;7(1):63-67. Epub 2018 Feb 1.
    Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Newark, New Jersey.
    Blockade of vascular endothelial growth factor (VEGF) signaling, whether via sequestration of free VEGF or via inhibition of the tyrosine kinases activated by VEGF, is associated with decreased nitric oxide (NO) and prostaglandin-I 2 (PG-I 2) production along with vascular endothelial cell death. Systemic administration of drugs that block VEGF signaling (eg, for cancer treatment) is associated with systemic complications such as hypertension and thrombosis. Evidence regarding the risk of systemic serious adverse events after intravitreal injection of anti-VEGF agents in patients with diabetic macular edema or neovascular age-related macular degeneration is inconsistent, in part because of study design limitations (eg, bias of ascertainment through strict enrollment criteria and/or inadequate power to identify the risk of low frequency events). Read More

    Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab.
    Clin Ophthalmol 2018 22;12:191-197. Epub 2018 Jan 22.
    Trimed Eye Center, Barrie, ON, Canada.
    Purpose: This study aims to investigate changes in contrast sensitivity (CS), visual acuity (VA), central retinal thickness (CRT), and vision-related quality of life in subjects with recalcitrant diabetic macular edema switched from long-term ranibizumab treatment to aflibercept.

    Patients And Methods: In this prospective, investigator-masked, single-center study, 40 patients with persistent fluid, despite previous ranibizumab treatment, were switched to aflibercept with 5 consecutive monthly doses. The primary outcome was mean change from baseline to week 20 in Pelli-Robson CS. Read More

    Mesenchymal stromal/stem cells as potential therapy in diabetic retinopathy.
    Immunobiology 2018 Feb 2. Epub 2018 Feb 2.
    Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, Germany. Electronic address:
    Diabetic retinopathy (DR) is a multifactorial microvascular disease induced by hyperglycemia and subsequent metabolic abnormalities. The resulting cell stress causes a sequela of events that ultimately can lead to severe vision impairment and blindness. The early stages are characterized by activation of glia and loss of pericytes, endothelial cells (EC) and neuronal cells. Read More

    Clinical pharmacology of intravitreal anti-VEGF drugs.
    Eye (Lond) 2018 Feb 5. Epub 2018 Feb 5.
    Clinical Pharmacology and Pharmacogenetics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
    Clinical efficacy of intravitreal anti-VEGF drugs has been widely demonstrated in several angiogenesis-driven eye diseases including diabetic macular edema and the neovascular form of age-related macular degeneration. Pegaptanib, ranibizumab, and aflibercept have been approved for use in the eye, whereas bevacizumab is widely used by ophthalmologists to treat patients "off-label". These drugs are active in the nanomolar to picomolar range; however, caution is required when establishing the rank order of affinity and potency due to in vitro inter-experimental variation. Read More

    Ranibizumab Plus Panretinal Photocoagulation versus Panretinal Photocoagulation Alone for High-Risk Proliferative Diabetic Retinopathy (PROTEUS Study).
    Ophthalmology 2018 Jan 27. Epub 2018 Jan 27.
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal.
    Purpose: Comparison of the efficacy of ranibizumab (RBZ) 0.5 mg intravitreal injections plus panretinal photocoagulation (PRP) versus PRP alone in the regression of the neovascularization (NV) area in subjects with high-risk proliferative diabetic retinopathy (HR-PDR) over a 12-month period.

    Design: Prospective, randomized, multicenter, open-label, phase II/III study. Read More

    Choroidal thickness measured using swept-source optical coherence tomography is reduced in patients with type 2 diabetes.
    PLoS One 2018 2;13(2):e0191977. Epub 2018 Feb 2.
    IIS-Aragon, Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain.
    Objective: To compare choroidal thickness between patients with type 2 diabetes (T2D) and healthy controls measured using swept-source optical coherence tomography (SS-OCT).

    Methods: The sample comprised 157 eyes of 94 T2D patients, 48 eyes of which had diabetic macular edema (DME), and 71 normal eyes of 38 healthy patients. Subfoveal (SF) choroidal thickness, and choroidal thickness at 500-μm intervals up to 2500 μm nasal and temporal from the fovea were measured using the SS-OCT. Read More

    Association Between Soluble CD14 in the Aqueous Humor and Hyperreflective Foci on Optical Coherence Tomography in Patients With Diabetic Macular Edema.
    Invest Ophthalmol Vis Sci 2018 Feb;59(2):715-721
    Department of Ophthalmology, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
    Purpose: To investigate the associations between soluble CD14 (sCD14), a cytokine released by microglia and macrophages, and hyperreflective foci (HF) and various characteristics of spectral-domain optical coherence tomography (SD-OCT) in diabetic macular edema (DME).

    Methods: Sixty-nine eyes from 51 patients with DME and 28 eyes from 28 control subjects were studied. sCD14 levels in the aqueous humor (AH) were measured using ELISA before bevacizumab injection (IVB), and the associations between sCD14 and visual acuity, the number of HF, retinal volume, and the DME pattern were assessed. Read More

    Persistent Macular Thickening Following Intravitreous Aflibercept, Bevacizumab, or Ranibizumab for Central-Involved Diabetic Macular Edema With Vision Impairment: A Secondary Analysis of a Randomized Clinical Trial.
    JAMA Ophthalmol 2018 Feb 1. Epub 2018 Feb 1.
    Palmetto Retina Center, Columbia, South Carolina.
    Importance: Prevalence of persistent central-involved diabetic macular edema (DME) through 24 weeks of anti-vascular endothelial growth factor therapy and its longer-term outcomes may be relevant to treatment.

    Objective: To assess outcomes of DME persisting at least 24 weeks after randomization to treatment with 2.0-mg aflibercept, 1. Read More

    Comparison of Intravitreal Bevacizumab and Intravitreal Diclofenac in the Treatment of Diabetic Macular Edema: a 6-month Follow-up.
    Med Hypothesis Discov Innov Ophthalmol 2017 ;6(3):67-75
    Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
    The aim of this study was to compare the effect of intravitreal diclofenac, a non-steroidal anti-inflammatory drug (NSAID), with that of bevacizumab, a well-known anti-vascular endothelial growth factor (VEGF) drug, in the treatment of diabetic macular edema (DME). Diclofenac was chosen in this study because it has both features of NSAIDs and corticosteroids by inhibiting the cyclooxygenase (COX) and lipoxygenase pathways, respectively. In this non-randomized comparative interventional case series, 64 eyes from 32 patients with bilateral naïve DME were selected and every eye was randomly assigned to intravitreal injection of bevacizumab (IVB) or diclofenac (IVD). Read More

    Aflibercept for clinically significant diabetic macular edema: 12-month results in daily clinical practice.
    Clin Ophthalmol 2018 8;12:99-104. Epub 2018 Jan 8.
    Unit of Retina, Department of Ophthalmology, Hospital Virgen del Puerto, Plasencia, Cáceres, Spain.
    Purpose: To assess the effectiveness and safety of intravitreal aflibercept in clinically significant diabetic macular edema (DME) in daily clinical practice.

    Methods: Prospective, open-label, single-center study. Anti-vascular endothelial growth factor naïve patients with clinically significant DME received intravitreal injections of aflibercept 2 mg, five monthly doses followed by a fixed schedule every 2 months for 12 months. Read More

    Cataract in patients with diabetes mellitus-incidence rates in the UK and risk factors.
    Eye (Lond) 2018 Feb 1. Epub 2018 Feb 1.
    Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
    Aims: To analyze the risk of incident cataract (diagnosis or extraction) in patients with or without diabetes focusing on other comorbid conditions, antidiabetic drug use, and diabetes duration.

    Methods: The study population comprised newly diagnosed diabetes patients (≥40 years) from the UK-based Clinical Practice Research Datalink (CPRD) between 2000 and 2015, and a random sample of the general population matched for age, sex, general practice, and year of diabetes diagnosis. We assessed cataract incidence rates (IRs) and performed a nested case-control analysis in the diabetic cohort to assess potential risk factors for a cataract. Read More

    Visualization of microaneurysms using optical coherence tomography angiography: comparison of OCTA en face, OCT B-scan, OCT en face, FA, and IA images.
    Jpn J Ophthalmol 2018 Jan 30. Epub 2018 Jan 30.
    Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
    Purpose: To compare the visualization of microaneurysms (MAs) in patients with diabetic retinopathy (DR) using optical coherence tomography angiography (OCTA) with that using fluorescein angiography (FA).

    Study Design: Prospective, clinical, and experimental.

    Methods: This study was a prospective evaluation of imaging technology. Read More

    Extended Duration Vascular Endothelial Growth Factor Inhibition in the Eye: Failures, Successes, and Future Possibilities.
    Pharmaceutics 2018 Jan 27;10(1). Epub 2018 Jan 27.
    Department of Ophthalmology, Mayo Clinic School of Medicine, 4500 San Pablo Rd., Jacksonville, FL 32224, USA.
    Vascular endothelial growth factor (VEGF) plays a pivotal role in the development of neovascularization and edema from several common chorioretinal vascular conditions. The intravitreally injected drugs (aflibercept, bevacizumab, conbercept, pegaptanib, and ranibizumab) used to treat these conditions improve the visual acuity and macular morphology in most patients. Monthly or bimonthly injections were administered in the phase III pivotal trials but physicians usually individualize therapy with(PRN) or treat and extend regimens. Read More

    Analysis of yield of retinal imaging in a rural diabetes eye care model.
    Indian J Ophthalmol 2018 Feb;66(2):233-237
    LILAC- LV Prasad Eye Institute Image Laboratory and Analysis Center, L V Prasad Eye Institute, Hyderabad, Telangana, India.
    Purpose: The aim of this study is to analyze the yield of retinal images obtained in a rural diabetes eye care model.

    Methods: An analysis of a sample of nonmydriatic fundus photography (NMFP) of posterior segment ophthalmic images, obtained by an indigenous equipment (3 nethra-Forus Royal), was done in a district-wide rural diabetic retinopathy (DR) screening program; a trained optometrist did the initial image grading. DR and diabetic macular edema (DME) were classified based on international DR and DME severity scale. Read More

    Multimodal Imaging in Diabetic Macular Edema.
    Asia Pac J Ophthalmol (Phila) 2018 Jan-Feb;7(1):22-27. Epub 2017 Jan 29.
    Asociados de Mácula, Vítreo y Retina de Costa Rica, San José, Costa Rica.
    Throughout ophthalmic history it has been shown that progress has gone hand in hand with technological breakthroughs. In the past, fluorescein angiography and fundus photographs were the most commonly used imaging modalities in the management of diabetic macular edema (DME). Today, despite the moderate correlation between macular thickness and functional outcomes, spectral domain optical coherence tomography (SD-OCT) has become the DME workhorse in clinical practice. Read More

    Intravitreal dexamethasone implants for diabetic macular edema.
    Int J Ophthalmol 2018 18;11(1):77-82. Epub 2018 Jan 18.
    University Hospital Sant Joan de Reus, Tarragona 43204, Spain.
    Aim: To evaluate the safety and efficacy of a dexamethasone (DEX) intravitreal implant for diabetic macular edema (DME).

    Methods: Totally 113 eyes of 84 patients were divided in three subgroups: naive patients (=11), pseudophakic patients (=72) and phakic patients (=30). Inclusive criterion comprised adult diabetic patients with central fovea thickening and impaired visual acuity resulting from DME for whom previous standard treatments showed no improvement in both central macular thickness (CMT) and best corrected visual acuity (BCVA) after at least 3mo of treatment. Read More

    Approach for a Clinically Useful Comprehensive Classification of Vascular and Neural Aspects of Diabetic Retinal Disease.
    Invest Ophthalmol Vis Sci 2018 Jan;59(1):519-527
    Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, United States.
    The Early Treatment Diabetic Retinopathy Study (ETDRS) and other standardized classification schemes have laid a foundation for tremendous advances in the understanding and management of diabetic retinopathy (DR). However, technological advances in optics and image analysis, especially optical coherence tomography (OCT), OCT angiography (OCTa), and ultra-widefield imaging, as well as new discoveries in diabetic retinal neuropathy (DRN), are exposing the limitations of ETDRS and other classification systems to completely characterize retinal changes in diabetes, which we term diabetic retinal disease (DRD). While it may be most straightforward to add axes to existing classification schemes, as diabetic macular edema (DME) was added as an axis to earlier DR classifications, doing so may make these classifications increasingly complicated and thus clinically intractable. Read More

    Efficacy and Safety of Ranibizumab 0.5 mg for the Treatment of Macular Edema Resulting from Uncommon Causes: Twelve-Month Findings from PROMETHEUS.
    Ophthalmology 2018 Jan 19. Epub 2018 Jan 19.
    Moorfields Eye Hospital, London, United Kingdom.
    Purpose: To evaluate the efficacy and safety of ranibizumab 0.5 mg in adult patients with macular edema (ME) resulting from any cause other than diabetes, retinal vein occlusion, or neovascular age-related macular degeneration.

    Design: A phase 3, 12-month, double-masked, randomized, sham-controlled, multicenter study. Read More

    Short-term effects and safety of an acute increase of intraocular pressure after intravitreal bevacizumab injection on corneal endothelial cells.
    BMC Ophthalmol 2018 Jan 25;18(1):17. Epub 2018 Jan 25.
    Department of Ophthalmology, College of Medicine, Dankook University, 119, Dandae-ro, Dnognam-gu, Cheonan-si, Chungchungnam-do, Republic of Korea.
    Background: The purpose of this study is to evaluate short-term effects and safety of an acute increase of intraocular pressure (IOP) after single-dose intravitreal bevacizumab injection on corneal endothelial cells and central corneal thickness.

    Methods: Forty-two patients who underwent intravitreal injection of 2.5 mg/0. Read More

    Efficacy of One-Year Treatment with Aflibercept for Diabetic Macular Edema with Practical Protocol.
    Biomed Res Int 2017 4;2017:7879691. Epub 2017 Dec 4.
    Department of Ophthalmology and Visual Science, Chiba University, Graduate School of Medicine, Chiba, Japan.
    The purpose of this study was to determine the efficacy of one-year treatment of diabetic macular edema (DME) with intravitreal aflibercept (IVA) injections on a practical protocol. The medical records of 51 eyes of 43 patients who were diagnosed with DME and had received IVA treatments were reviewed. The best-corrected visual acuity (BCVA) and the central macular thickness (CMT) were measured at the baseline and at 1, 3, 6, and 12 months after the IVA. Read More

    Repeatability and Agreement of Visual Acuity Using the ETDRS Number Chart, Landolt C Chart, or ETDRS Alphabet Chart in Eyes With or Without Sight-Threatening Diseases.
    JAMA Ophthalmol 2018 Jan 18. Epub 2018 Jan 18.
    Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
    Importance: The Early Treatment Diabetic Retinopathy Study (ETDRS) alphabet chart is not feasible for measuring best-corrected visual acuity (BCVA) for individuals who are unfamiliar with the Roman alphabet. The ETDRS Landolt C chart is an alternative, but it may not reflect true BCVA among those with confusion between left and right. The ETDRS number chart might overcome these limitations, but little is known regarding its reliability. Read More

    Effect of oral tranexamic acid on macular edema associated with retinal vein occlusion or diabetes.
    Clin Ophthalmol 2018 20;12:35-41. Epub 2017 Dec 20.
    Department of Ophthalmology, Aichi Medical University, Nagakute.
    Purpose: Tranexamic acid (TXA) is a widely used antifibrinolytic agent that can also cause a decrease in vascular permeability. We hypothesized that TXA could improve macular edema (ME) that is caused by an increase in retinal vascular permeability. The aim of this study is to evaluate the efficacy of oral TXA for ME associated with retinal vein occlusion (RVO) or diabetic ME (DME). Read More

    Association of treatment adherence with real-life VA outcomes in AMD, DME, and BRVO patients.
    Clin Ophthalmol 2018 20;12:13-20. Epub 2017 Dec 20.
    Ophthalmology, Eye Center, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau.
    Purpose: Real-life clinical outcomes of patients treated with anti-VEGF drugs for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), or macular edema secondary to branch retinal vein occlusion (BRVO) are often inferior to results from randomized clinical trials. This observational cohort study investigates treatment adherence and real-life clinical outcomes within the first year of treatment.

    Patients And Methods: A total of 708 treatment-naïve patients (466 nAMD, 134 DME, and 108 BRVO) were included. Read More

    Automated Screening for Diabetic Retinopathy - A Systematic Review.
    Ophthalmic Res 2018 Jan 16. Epub 2018 Jan 16.
    Department of Ophthalmology, Odense University Hospital, Odense, Denmark.
    Purpose: Worldwide ophthalmologists are challenged by the rapid rise in the prevalence of diabetes. Diabetic retinopathy (DR) is the most common complication in diabetes, and possible consequences range from mild visual impairment to blindness. Repetitive screening for DR is cost-effective, but it is also a costly and strenuous affair. Read More

    Evolution of Intravitreal Therapy for Retinal Diseases-From CMV to CNV: The LXXIV Edward Jackson Memorial Lecture.
    Am J Ophthalmol 2018 Jan 12. Epub 2018 Jan 12.
    Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address:
    Purpose: To present the evolution of intravitreal therapy for retinal diseases and its impact on clinical practice.

    Design: Retrospective literature review and personal perspective.

    Methods: Retrospective literature review and personal perspective. Read More

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