A STUDY TO EVALUATE THE EFFICACY OF INTRAVITREAL ANTI-VEGF IN TREATMENT OF DIFFUSE DIABETIC MACULAR EDEMA WITH RESPECT TO VISUAL OUTCOME

Dr. PANKAJ BARUAH; Dr. GITIKASH PURKAYASTHA; Dr. BHARATI GOGOI; Dr. DIPALI C DEKA

Volume : X, Issue : VII, July - 2020

A STUDY TO EVALUATE THE EFFICACY OF INTRAVITREAL ANTI-VEGF IN TREATMENT OF DIFFUSE DIABETIC MACULAR EDEMA WITH RESPECT TO VISUAL OUTCOME

Dr. Pankaj Baruah, Dr. Gitikash Purkayastha, Dr. Bharati Gogoi, Dr. Dipali C Deka

Abstract :

PURPOSE: To evaluate the efficacy of intravitreal anti–VEGF in the reduction of foveal thickness using an interventional case series design and to see the visual prognosis using the LogMAR equivalent of standard Snellen’s chart. DESIGN: prospective, interventional MATERIALS AND METHODS: 49 eyes of 30 patients were selected for the study.2 injections of intravitreal bevacizumab is given at 6 weeks interval and the patients were followed up at 1 month,3 months and 6 months period from the last injection. The patients were evaluated by measuring the visual acuity and pinhole on each visit of the patient were recorded and then evaluated for any improvement. The macular edema was confirmed by measuring the visual acuity, indirect ophthalmoscopy, direct ophthalmoscopy,oct and fundus photography. RESULTS: The age of presentation varied from 40–78 years and most of the patients(43.33%) belonged to the age group of 51–60 years with the mean age of presentation 56.4 years. 30 patients that were included in the study had 19(63.33%) males and 11(36.66%) females which signify that males were more affected by the disease than females. 95.92% of eyes were associated with NPDR where as 4.08% had PDR. Most of the patients having difficulty of vision had DDME in mod NPDR group. In the study it was found that most of the patients had visual acuity(VA) between >0.3– 0.6 group(21 eyes;42.86%) of logMAR equivalent of snellen’s chart followed by >0.6–1 group(20 eyes;40.82%),>1 group(7 eyes;14.28%) and 0–0.3 group(1 eye;2.04%). In our study we found that the improvement of BCVA was significant throughout 6 month follow up following 2 injections of bevacizumab with maximum improvement at 3 months. At 1 month, visual acuity improved to logMAR (0.486±0.204) and at 3 months visual acuity was found to be improved to logMAR (0.345±0.155) which were statistically significant(p<0.001) CONCLUSION: DDME is considered as one of the most important cause of central visual loss in patients of diabetes mellitus. Intravitreal bevacizumab has a very important role in improving the visual acuity of the patients which is the sole important symptom which the patient experience so it adds on in the wellbeing of the patient and also help the ophthalmologists to see the progress of the therapy. There was a constant improvement of visual acuity in the patients at 1month,3 months and at 6 months follow up with maximum difference from baseline at 3 months and the least from 3 month to 6 month. Thus it can be concluded that detection of visual acuity is a very import and easy tool to detect as well as to see the improvement in symptoms in patients of Diffuse Diabetic Macular Edema(DDME).