The Effect of Intravitreal Injection on Macular thickness in Visual Acuity and IOP with Diabetic Macular Edema and prevalence of Non proliferative and proliferative diabetic retinopathy in NIDDM and IDDM

• Aryantika Sharma,*  
• ANJU KUMARI,  
• Navneet Sharma,  
• shailesh Kumar

Abstract

Abstract: Background Intravitreal ranibizumab injection very common in treatment of diabetic macular edema which also helpful in decreasing the changes caused due to Diabetic Macular Edema, associated with different types of diabetes and works well in overall improvement of visual outcomes. Aim: To assess changes in macular thickness using OCT MACULA and intraocular pressure using a noncontact tonometer (NCT) before and after intravitreal ranibizumab injection in diabetic macular edema patients. Methodology: This was observational study done on 60 patients. Methods: The assessment of macular thickness changes done with the help of optical coherence or tomography (OCT) and Intra ocular pressure monitored with non-contact tonometer (NCT) whereas visual acuity assessment was done with Snellen’s chart. Intravitreal injection of 1.25 mg of Ranibizumab was injected 3.5 mm through the limbus under topical anaesthetic drops. Post injection follow up was scheduled on 1st post procedure day and after one month. Post procedure Optical Coherence tomography (OCT) was performed in all patients 1 week before and 1st month after 1st injection Result: From 60 eyes 38 had poor control on diabetes 22. (64%) whereas 22 patient diabetes is under control with the treatment they were taking (36%) IOP fluctuations have mean value of 17 in 95% of cases and in 5% of cases it shows fluctuations to higher side, Mean pre intravitreal Ranibizumab injection thickness was 385.40 ± 42.25 mm. After giving injection on the final visit after 1 month showed mean thickness were seen gradually decreased by 324.22 ± 33.55 mm. Conclusion: Ranibizumab intravitreal injection is effective in cases of DME. This is also effective to improve visual outcome. NPDR is most common found in IDDM and in cases of PDR -NIDDM is more commonly observed. Central macular thickness after 1 month of injection was reduced in 57 cases 95% whereas the visual acuity improvement also seen in these patients and increased. In 2 cases that was 3.34% .visual acuity of these 3.34% patients remained as it is and in 1 case it is decreased (1.66%).

Keywords

DME, intra ocular pressure, intra vitreal injection, Ranibizumab.