الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetic macular edema is a manifestation of diabetic retinopathy that produces loss of central vision. Although several treatment modalities are under investigation, the only demonstrated means to reduce the risk of vision loss from DME are laser photocoagulation, as demonstrated by the ETDRS; intensive glycemic and blood pressure control, as demonstrated by the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study. Given that most eyes with DME that are treated with laser photocoagulation do not have an improvement in VA, there has been an interest in other treatment modalities such as pharmacologic therapy with oral protein kinase C inhibitors and the use of intravitreal corticosteroids. The use of antibodies targeted at VEGF is another treatment modality that has generated considerable interest and is being investigated.
Ranibizumab is a recombinant humanized IgG1 kappa isotype monoclonal antibody fragment designed for intraocular use. It is designed to target VEGF-A and prevent the proliferation of new choroidal vessels. It is indicated in the treatment of macular oedema after retinal vein occlusion, age-related macular degeneration (wet variant), and diabetic macular edema. Ranibizumab is administered via intravitreal injection.
Given that most of the studies addressing intravitreal injection of ranibizumab in eyes with DME, examine the effects of injections after at least 6 months up to 2 years of follow up. No data are available reporting the short term effects after one month of injection. So, the aim of our study was to evaluate the short term effect of Ranibizumab on best corrected visual acuity and central macular thickness in diabetic macular edema up to first month post injection.
The present study included a total of Seventy one eyes of sixty two patients (20 males and 51 females) with diabetic macular edema with no other macular diseases.The mean age of the subjects was 57.23 ± 8.07 years. The study included 38 right eyes and 33 left eyes.the patients are subdivided according to the central macular edema pattern into four groups Cystic (42 patients), Serous retinal detachment(14 patients), Spongiform(13 patients) and Tractional (2 patients).
Patients were subjected to full history taking, full ophthalmic examination, Best corrected visual acuity (BCVA),Optical coherence topography (OCT, Heidelberg Spectralis,Germany) examination For assessment of central macular thickness. . All patients were subjected to intravitreal injection of 0.05 ml of ranibizumab (Lucentis, Genentech,USA).
All cases followed up after 1week and 1month post injection. Previous examinations were repeated including best corrected visual acuity (BCVA), Optical coherence topography examination For assessment of central macular thickness. Data analysis was performed using the software SPSS for Windows version 20 (IBM, Armonk, NY, USA).
We found that the improvement of central macular thickness to all subjects was 11.54% after one week and 17.96 % after one month and best corrected visual acuity improved by 6.65% after one week and 19.31% after one month for all subjects