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Evaluation of New Therapeutic Combination Efficacy in Diabetic Macular Edema

تقييم فعالية مشاركة علاجية جديدة في وذمة اللطخة الصفراء السكرية

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 Publication date 2015
and research's language is العربية
 Created by Shamra Editor




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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.


Artificial intelligence review:
Research summary
تناولت الدراسة تقييم فعالية مزيج علاجي جديد في علاج وذمة اللطخة الصفراء السكرية (DME) لدى مرضى السكري. يعاني مرضى السكري من زيادة في نفاذية الأوعية الدموية بسبب انهيار الحاجز الشبكي الدموي (BRB)، مما يؤدي إلى وذمة اللطخة. العلاج التقليدي يتضمن التخثير بالليزر وقطع الزجاجي، لكن هذه العلاجات تستهدف المراحل المتقدمة من المرض ولا تمنع فقدان البصر التدريجي. تم استخدام مزيج من العلاجات يشمل التخثير بالليزر، التريامسينولون، البيفاسيزوماب، ودوبسيلات الكالسيوم. أظهرت النتائج أن هذا المزيج كان فعالاً في تقليل الآفات التشريحية والوظيفية في الشبكية، وتحسين حدة البصر وجودة الحياة لدى المرضى. استخدمت تقنيات التصوير البصري المقطعي (OCT) وتخطيط الشبكية الكهربائي (ERG) لتقييم التغيرات قبل وبعد العلاج. أظهرت النتائج تحسنًا ملحوظًا في سمك الشبكية ووظائفها الكهربائية بعد العلاج بالمزيج العلاجي مقارنة بالعلاجات الفردية.
Critical review
دراسة نقدية: الدراسة قدمت نتائج مشجعة حول فعالية المزيج العلاجي الجديد في علاج وذمة اللطخة الصفراء السكرية، ولكن هناك بعض النقاط التي تحتاج إلى مزيد من التوضيح. أولاً، فترة المتابعة كانت قصيرة نسبياً (7 أشهر)، مما يجعل من الصعب تقييم الفعالية طويلة الأمد والسلامة للعلاج. ثانياً، الدراسة لم تتناول بشكل كافٍ الآثار الجانبية المحتملة للعلاجات المستخدمة، خاصة مع الاستخدام المتكرر للحقن داخل الزجاجي. ثالثاً، العينة المستخدمة في الدراسة كانت محدودة (71 مريضاً)، مما قد يؤثر على تعميم النتائج. من المهم إجراء دراسات مستقبلية تشمل عينات أكبر وفترات متابعة أطول لتأكيد النتائج وتقييم السلامة بشكل أفضل.
Questions related to the research
  1. ما هو الهدف الرئيسي من الدراسة؟

    الهدف الرئيسي من الدراسة هو تقييم فعالية مزيج علاجي جديد يشمل التخثير بالليزر، التريامسينولون، البيفاسيزوماب، ودوبسيلات الكالسيوم في علاج وذمة اللطخة الصفراء السكرية لدى مرضى السكري.

  2. ما هي التقنيات المستخدمة لتقييم فعالية العلاج؟

    استخدمت الدراسة تقنيات التصوير البصري المقطعي (OCT) وتخطيط الشبكية الكهربائي (ERG) لتقييم التغيرات في سمك الشبكية ووظائفها الكهربائية قبل وبعد العلاج.

  3. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    أظهرت الدراسة أن المزيج العلاجي كان فعالاً في تقليل الآفات التشريحية والوظيفية في الشبكية، وتحسين حدة البصر وجودة الحياة لدى المرضى.

  4. ما هي النقاط النقدية التي يمكن توجيهها للدراسة؟

    النقاط النقدية تشمل فترة المتابعة القصيرة، عدم تناول الآثار الجانبية بشكل كافٍ، والعينة المحدودة المستخدمة في الدراسة.


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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