Changes in macular thickness post uncomplicated MSICS & phacoemulsification surgery

To evaluate changes in macular thickness via-a-vis visual acuity post uncomplicated manual small incision cataract surgery (MSICS) & phacoemulsification surgery Prospective clinical study on 160 patients of uncomplicated immature senile cataract, aged 40-70yrs, patients were randomised into two groups, MSICS & phacoemulsification, by simple 1:1 randomization, who underwent uncomplicated cataract surgery with posterior chamber intraocular lens (PCIOL). Post-operatively, the patients were evaluated for best corrected visual acuity (BCVA) and changes in macular thickness by optical coherence tomography (OCT) at post-op Day 1, 7, 21, 48, and 12 weeks. Paired t-test was used for comparison across follow up. : At 12 weeks post-operative, mean logMAR BCVA was 0.01±0.02 for MSICS group and 0±0.02 for Phacoemulsification group. Macular thickness was not statistically significant (p=0.342) between MSICS group (219.19±17.88µm) and Phacoemlusification group (215.61±16.21µm), at the end of 12 weeks post-operative. Clinically significant macular oedema was not diagnosed in any of the patients at the follow-ups.: Both procedures achieved good post-operative Best Corrected visual acuity without significant differences in BCVA between both the groups at the end of 12 weeks.

Subthreshold 577 nm laser photocoagulation vesus conventional 532 nm laser photocoagulation for diabetic macular oedema

Purpose: To evaluate the visual and anatomic outcomes of the subthreshold micropulse 577 nm yellow diode laser (MYL) and to compare its efficacy with the conventional green 532 nm diode laser (CGL) in Asian eyes with diabetic macular oedema (DME).Study design: Prospective randomized controlled clinical trialMethods: Sixty-seven eyes of 43 patients with clinically significant macular oedema (CSME) were randomized to receive either MYL (n = 37) or CGL (n = 30) at baseline and were followed up for 12 months. Titration in the MYL group was performed with 15% duty cycle, 300 ms duration, and double the threshold power, while the modified Early Treatment of Diabetic Retinopathy Study (mETDRS) protocol was used for the CGL arm with the power titrated to a barely visible burn. Parameters noted included best-corrected visual acuity (BCVA) (logMAR), central subfoveal thickness (CST), macular volume (MV), and average macular thickness (AMT) using optical coherence tomography, and presence of visible laser scars on colour fundus photographs and fundus autofluorescence, at baseline and at 12 months.Results: At 12 months follow-up, BCVA improved by 4.7 and 8.8 letters, respectively, for the MYL and CGL treatment arms (p < 0.05). There was a significant reduction in all retinal thickness parameters (CST, MV, and AMT) when compared to baseline in both laser treatment arms at 12 months. There was no significant difference in either BCVA or retinal thickness parameters between the two treatment arms at 1, 3, 6, 9, or 12-month follow-up. Laser scars were observed in 26.7% of patients in the MYL group compared to 75% of patients in the CGL group (p = 0.029).Conclusions: MYL is an effective, safe, and patient-friendly treatment option for clinically significant macular oedema, with improvement in BCVA, reduction in macular thickness, and less scarring after treatment at 12 months.

Alpha-lipoic acid in non-proliferative diabetic retinopathy treatment

Aim. The aim of this study is to assess the therapeutic efficacy of alpha-lipoic acid in patients with type 2 diabetes mellitus (DM) and non-proliferativediabetic retinopathy. Materials and methods. 47 patients with mild to moderate non-proliferative diabetic retinopathy were included in this trial. Dynamics of ophthalmologicparameters were assessed by means of stereoscopic photography of ocular fundus. Patients were examined every 6 months in order to registernew cases of clinically significant macular oedema. Results. During 24 months follow-up period, patients treated with 600 mg of alpha-lipoic acid showed stabilization in development of diabetic retinopathy.New cases of macular oedema, as well as transition into a more severe stage of retonopathy were less common in those patients. Vision andcontrast sensation also remained stable in the majority of participants from experimental group.Conclusions. 600 mg of alpha-lipoic acid may be recommended for patients with type 2 DM as part of complex therapy