Table of Contents - WOC 2012

FP-RET-FR 98 (5)
Intravitreal (IVT) as Compared to Posterior Sub-Tenon (PST) Injection
of Triamcinolone Acetonide (Kenacort) for Diffuse Diabetic Macular
Edema
Qamar Muhammad Rashad (1)
1. Quaid e Azam Medical College
Purpose: To assess the safety and efficacy of the intravitreal (IVT) injection as
compared to posterior subtenon (PST) injection of Triamcinolone
Acetonide(Kenacort) for the treatment of diffuse diabetic macular edema.
Methods: We selected sixty cases with diffuse diabetic macular edema with the
mean age fifty two years. All focal leaks were treated by laser photocoagulation.
In the same patients, after taking written consent, one eye was assigned to 4
mg IVT injection and the fellow eye was then treated with 40 mg PST injection
of Kenacort.
Results: BCVA improved in 80 % patients of IVT group as compared to 100%
in PST group along with decrease in retinal thickness but it was more rapid
and then recurred in IVT group at the end of 6-months.IOP was increased
significantly in 30% of cases where intravitreal injection of Kenacort was used
and none of the patients with posterior sub-tenon injection. Raised IOP was
treated with topical anti- glaucoma medication without any permanent damage
to the visual function. No other intraocular or extra ocular complications were
noted.
Conclusion: Posterior Sub-Tenon injection is an easy, safe and valid alternative
to intravitreal one for the treatment of diffuse Diabetic Macular Edema.
FP-RET-FR 98 (6)
Analgesic Effect of Topical Sodium Diclofenac during Retinal
Photocoagulation for Diabetic Retinopathy; A Randomized Double-
Masked Placebo-Controlled Crossover Clinical Trial
Ramezani Alireza (1) , Entezari Morteza (1) , Shahbazi Mahdi (1) ,
Semnani Yosef (1, 2) , Rajavi Zhaleh (1)
1. Ophthalmic Research Center, Imam Hossein Medical Center, Shahid Beheshti
University
2. Imam Hossein Medical center, Shahid Beheshti University of Medical Sciences
Purpose: To evaluate the analgesic effect of topical sodium diclofenac during
retinal laser photocoagulation for diabetic retinopathy.
Methods: In a randomized placebo-controlled intra-individual two-period crossover
clinical trial, patients with diabetic retinopathy candidate for retinal
laser photocoagulation were included. At the first session, one eye received
topical sodium diclofenac 0.1% and the other placebo drop 3 times, about 60
minutes before laser treatment. At the second session, the eyes were given
the alternate drug. Patients scored their pain using a visual analogue scale
(max=10cm) at both stages. The patients, nurse, and the surgeons were all
masked to the drops given. The difference of the pain level was compared.
Results: A total of 200 eyes of 100 patients (63 female) with mean age of 54±10
years were enrolled. Both treatments were matched regarding the applied
laser. The mean of pain scoring reported by the patients at first stage was
5.8±3.1 and 5.3±2.7 for the eyes receiving topical diclofenac and placebo,
respectively. Corresponding features were 5.2±3.0 and 5.0±2.4 for the second
stage. There was no significant difference between the treatments.
Conclusion: Pretreatment with topical sodium diclofenac 0.1% does not have
any analgesic effect during peripheral retinal laser photocoagulation in diabetic
cases.
WOC2012 Abstract Book
FP-RET-FR 98 (7)
Long-Term Safety and Efficacy of 0.5 mg Ranibizumab in Patients
with Visual Impairment Due to Diabetic Macular Edema: The
RESTORE Extension Study
Lang on behalf of the RESTORE Gabriele E. (1)
1. Department of Ophthalmology, University Eye Hospital
Objective/Purpose: To evaluate the long-term safety and efficacy of 0.5 mg
ranibizumab (RBZ) in patients with visual impairment due to diabetic macular
edema (DME) who completed the 12-month RESTORE core study.
Methods: In the 2-year RESTORE extension study, RBZ was given open-label
pro-re-nata (PRN) according to pre-specified criteria based on monthly
best-corrected visual acuity (BCVA) assessments; monthly injections were
suspended when BCVA was stable or better than 83 letters and reinitiated
when BCVA decreased. Primary endpoint: incidences of ocular and non-ocular
adverse events (AEs) during the 2-year extension period.
Results: 240 (79%) of 303 patients, who completed the core study, were
followed up. Key patients characteristics (mean±SD) at extension baseline:
62.6±8.8 years of age, 7.5±1.2% HbA1c, BCVA of 70.4±11.1 letters, central
retinal thickness of 309.5±111.3 µm. Demographic and disease characteristics
at extension baseline were comparable to the entire core study patient
population. Treatment numbers, AE incidences, and mean BCVA change were
assessed during the 2-year extension and over the total 3-year treatment
exposure period (including the core study).
Conclusion: With the clinical trial outcomes of up to 3 years of RBZ treatment,
the RESTORE extension study provides further evidence for long-term safety
and efficacy of RBZ PRN treatment in DME.
FP-RET-FR 98 (8)
Association between HLA-DQB1 and Diabetic Retinopathy in Iranian
Pateints with Type I Diabetes Mellitus
Daneshvar Ramin (1) , Khazaei Mohammad Hassan (1) , Tavakol Afshari Jalil (1) ,
Khazaei Bahram (1) , Ganjali Rashin (1)
1. Mashhad University of Medical Sciences
Purpose: Investigation of human leukocyte antigen (HLA) in diabetic patients
with long disease duration and without retinopathy.
Methods: In a retrospective, non-randomized study, two subsets of type 1
diabetic patients were included in the study: Group 1: those who developed
diabetic retinopathy with disease duration less than 20 years (23 patients);
Group 2: those without diabetic retinopathy despite passing more than 20 years
of diabetes (19 patients). HLA-DQB1 typing was done using a polymerase
chain reaction with sequence-specific primer (PCR-SSP) method.
Results: Diabetic groups were matched with regard to level of glycemic control,
blood pressure, and lipid profile. HLA-DQB1*0201/ HLA-DQB1*0501and HLA-
DQB1*0201/ HLA-DQB1*0504 haplotypes were more common in Group 1 than
Group 2 [26.1% vs. 0.0%; p= 0.019]. HLA-DQB1*0301 and HLA-DQB1*0304
were less common among Group 1 than Group 2 [63.2% vs. 34.8%, p=0.067].
Conclusion: HLA-DQB1 is associated with diabetic retinopathy in Iranian type
1 diabetic patients. HLA typing may be beneficial for predicting the prognosis
of diabetic retinopathy in younger diabetic patients. Study was previously
presented in ‹European Journal of Ophthalmology›; however, the study results
would be nice to present to the ophthalmologist in the MEACO region.
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