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      • The long-term anatomical and visual effect of intravitreal triamcinolone injection during vitrectomy for the treatment of idiopathic macular epiretinal membrane

        Lai, Chi-Chun,Wang, Nan-Kai,Wu, Wei-Chi,Yeung, Ling,Hwang, Yih-Shiou,Chen, Kuan-Jen,Chen, Tun-Lu,Chuang, Lan-Hsin Informa Healthcare 2011 Cutaneous and ocular toxicology Vol.30 No.4

        <P><I>Purpose</I>: To compare the long-term anatomical and visual outcomes of patients with idiopathic epiretinal membrane (ERM) removed by vitrectomy and membrane peeling with or without the use of intravitreal injection of triamcinolone acetonide (IVTA).</P><P><I>Methods</I>: A retrospective chart review was performed. Subjects who underwent vitrectomy and who were followed over 12 months were included. The study included two groups of patients. In group 1 (71 eyes), the patients underwent vitrectomy and membrane peeling without the use of IVTA. In group 2 (27 eyes), 2 mg of IVTA was given at the end of the surgery. The main outcome measures were best-corrected visual acuity (BCVA), central foveal thickness (CFT) determined by optical coherence tomography (OCT), the number of cataract surgeries, and the use of anti-glaucomatous drugs during the follow-up period.</P><P><I>Results</I>: This study included 98 eyes with ERM from 98 patients. There was no significant difference between the two groups with respect to age, gender, pre- and postoperative lens status, BCVA, CFT, or length of the follow-up period. The mean age for all of the patients was 62.45 ± 10.01 (mean ± SD) years, and the mean follow-up length was 20.58 ± 9.64 (mean ± SD) months. In all cases, the mean best-corrected logarithm of minimum angle of resolution (logMAR) acuity improved from a preoperative value of 0.91 ± 0.32 [Snellen equivalent (SE), 0.16 ± 0.14] to a postoperative value of 0.46 ± 0.36 (SE, 0.46 ± 0.29) (<I>P</I> < 0.0001). The CFT was reduced from a preoperative value of 473.46 ± 96.91 μm to a postoperative value of 302.44 ± 69.80 μm (<I>P</I> < 0.0001). Six patients (22.2%) in group 2 required anti-glaucomatous drugs to control intraocular pressure (IOP) during the follow-up period, and three patients (4.2%) in group 1 required drugs to control IOP (<I>P</I> == 0.012).</P><P><I>Conclusions</I>: The postoperative visual outcomes for patients with idiopathic ERM were favorable, but CFT did not return to a normal level, even in eyes in which 2 mg IVTA was used. The IVTA use after ERM removal produced no significant benefits during long-term follow-up, but IVTA did increase the risk of increased IOP.</P>

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        Risk of Diabetic Retinopathy between Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

        Tzu-Yi Lin,Eugene Yu-Chuan Kang,Shih-Chieh Shao,Edward Chia-Cheng Lai,Sunir J. Garg,Kuan-Jen Chen,Je-Ho Kang,Wei-Chi Wu,Chi-Chun Lai,Yih-Shiou Hwang 대한당뇨병학회 2023 Diabetes and Metabolism Journal Vol.47 No.3

        Background: To compare risk of diabetic retinopathy (DR) between patients taking sodium-glucose cotransporter-2 inhibitors (SGLT2is) and those taking glucagon-like peptide-1 receptor agonists (GLP1-RAs) in routine care.Methods: This retrospective cohort study emulating a target trial included patient data from the multi-institutional Chang Gung Research Database in Taiwan. Totally, 33,021 patients with type 2 diabetes mellitus using SGLT2is and GLP1-RAs between 2016 and 2019 were identified. 3,249 patients were excluded due to missing demographics, age <40 years, prior use of any study drug, a diagnosis of retinal disorders, a history of receiving vitreoretinal procedure, no baseline glycosylated hemoglobin, or no follow-up data. Baseline characteristics were balanced using inverse probability of treatment weighting with propensity scores. DR diagnoses and vitreoretinal interventions served as the primary outcomes. Occurrence of proliferative DR and DR receiving vitreoretinal interventions were regarded as vision-threatening DR.Results: There were 21,491 SGLT2i and 1,887 GLP1-RA users included for the analysis. Patients receiving SGLT2is and GLP-1 RAs exhibited comparable rate of any DR (subdistribution hazard ratio [SHR], 0.90; 95% confidence interval [CI], 0.79 to 1.03), whereas the rate of proliferative DR (SHR, 0.53; 95% CI, 0.42 to 0.68) was significantly lower in the SGLT2i group. Also, SGLT2i users showed significantly reduced risk of composite surgical outcome (SHR, 0.58; 95% CI, 0.48 to 0.70).Conclusion: Compared to those taking GLP1-RAs, patients receiving SGLT2is had a lower risk of proliferative DR and vitreoretinal interventions, although the rate of any DR was comparable between the SGLT2i and GLP1-RA groups. Thus, SGLT2is may be associated with a lower risk of vision-threatening DR but not DR development.

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