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Register a new userEvaluation of New Therapeutic Combination Efficacy in Diabetic Macular Edema
تقييم فعالية مشاركة علاجية جديدة في وذمة اللطخة الصفراء السكرية
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يتبين من العدد المتزايد للمصابين بداء السكري بأن اعتلال الشبكية السكري سبب أعظمي في فقدان البصر. المميزات البدئية للمرض هي زيادة النفوذية الوعائية ناجمة عن انكسار الحاجز الشبكي الدموي مسببا" وذمة اللطخة مترافق مع انسداد وتوعي وعائي جديد ثانويين لنقص التروية و الأكسدة. التخثير بالليزر و قطع الزجاجي يستهدفان فقط الحالات المتقدمة للمرض, لكن رغم العلاج بالليزر فإن مرضى الوذمة السكرية يشتكون من نقص القدرة البصرية التدريجي. يحمي حقن التريامسينولون في الزجاجي الحاجز الشبكي الدموي و ينظم إنتاج العامل المنمي للأوعية كما يحسّن القدرة البصرية بشكل معتدل لكن مؤقت في حالات وذمة اللطخة. تنقص العقاقير التي تثبط العامل المنمي للأوعية VEGF كالبيفاسيزوماب (أفاستين) النفوذية و التوعي الجديد. يؤدي حقن الأفاستين في الزجاجي إلى نقص وذمة اللطخة الثانوية للانسداد الوريدي الشبكي المركزي كما ينقص النفوذية الوعائية و تكاثر الألياف الوعائية. دوبيسيلات الكالسيوم, مضاد أكسدة قوي, يبطئ التكاثر الوعائي. تعود الآلية المضادة للأكسدة لدوبيسيلات الكالسيوم الفموي إلى بنية الهيدروكينون التي تتفاعل مع الجذور الحرة السامة الناجمة عن نقص التروية الشبكية.
The increasing number of individuals with diabetes suggests that diabetic retinopathy DR is a major contributor to vision loss. The initial disease is characterized by increased vascular permeability due to a breakdown in the blood-retinal barrier BRB, causing macular edema DME, with a progressive vascular occlusion and retinal neovascularization which are secondary to ischemia and oxidative stress. Laser photocoagulation and vitrectomy only target advanced stages of disease. However, despite laser treatment, patients with DME experienced gradual loss of vision. Intravitreal triamcinolone IVTA reduces the breakdown of BRB and down-regulates the production of vascular endothelial growth factor VEGF. IVTA may moderately but temporarily improves visual acuity in cases of DME. Agents that attenuate VEGF action such as bevacizumab are expected to reduce permeability and neovascularization. Intravitrealbevacizumab IVB reduces macular edema secondary to central retinal vein occlusion, vascular permeability and fibrovascular proliferationin. Calcium dobesilate CD is a potent antioxidant, slows vascular proliferation.
References used
RIORDAN-EVA, P. Eye. In Current Medical Diagnosis and Treatment. Lange Medical Books New York, 2003, p. 146–177
(AIELLO, L.P.; GARDNER, T.W.; KING, G.L.; BLANKENSHIP, G.; CAVALLERANO, J.D.; FERRIS, F.L.; KLEIN, R. Diabetic retinopathy. Technical review. Diabetes Care 21, 143–156 (1998
AIELLO, L. P.; CAHILL, M. T.; WONG, J. S. Systemic considerations in the management of diabetic retinopathy. American Journal of Ophthalmology, 2001, 132, 760- 776
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important in retinal diseases associated with macula..
Therefore, our objective is to study the statistical values of the measurements of the
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up disease progression, evaluate treatment and accurately diagnose lesions of visual
acuity.
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females. We find out that the visual ability declines with age. For both left and right eyes,
the thickness of the macula increases with age and the content of the macula correlates
with its thickness and the period of the disease. There are no statistically significant
differences of the thicknesses with different treatment types (insulin or pills),so we notice a
correlation between the visual acuity and the thickness of the macula in both eyes ,so that
the higher the thickness of the macula in diabetic patients ,the lower the visual acuity . In
the study of the different parts of the macula, the internal part is thicker than the external
part and the nasal part is thicker than the different parts of the macula, and the nasointernal
part is the thickest.
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Background & Objective: IV sedation has become established as an alternative to general anesthesia in dental treatment of patients with intellectual disability.
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