The effect of intravitreal injection on macular thickness on visual acuity and status of intra ocular pressure with diabetic macular edema

Intravitreal ranibizumab injection very common in treatment of diabetic macular edema also helpful in decreasing the changes caused due to Diabetic Macular Edema, associated with different types of diabetes and works well in overall improvement of visual outcomes. To assess changes in macular thickness using OCT MACULA and intraocular pressure using a noncontact tonometer (NCT) before and after intravitreal ranibizumab injection in diabetic macular edema patients. : This was observational study done on 60 patients. The assessment of macular thickness changes done with the help of optical coherence tomography (OCT) and intraocular pressure monitored with non-contact tonometer (NCT) whereas visual acuity assessment was recorded with Snellen’s chart. Intravitreal injection of 1.25 mg of Ranibizumab was injected 3.5 mm from the limbus under topical anaesthetic drops. Post injection follow up was scheduled on 1st post procedure day and after one month. Post procedure Optical coherence tomography (OCT) was performed in all patients 1 week before and 1 month after 1st injection : Out of a total of 60 eyes, 38 patients had poor control of diabetes, whereas in 22 (64%) patients’ diabetes was under control with treatment. IOP recorded had a mean value of 17mmHg in 95% of cases and 5% had gone to higher side 30mmHg to 45mmHg. The mean Central Macular Thickness pre intravitreal Ranibizumab injection thickness was 385.40 ± 42.25 um. After giving injection, on the final visit after 1 month, the mean thickness had gradually decreased by 324.22 ± 33.55 um. 53patients out of 60 (88%) had Insulin Dependent Diabetic Mellitus whereas 7 cases (12%) had Non-Insulin Dependent Diabetic Mellitus : Ranibizumab intravitreal injection is effective in cases of DME. This is also effective to improve visual outcome. NPDR was most commonly found in Insulin Dependent Diabetic Mellitus and in cases of Proliferative diabetic Retinopathy -Non-Insulin Dependent Diabetic Mellitus was more commonly observed. Central macular thickness after 1 month of injection was reduced in 57 cases 95% whereas the visual acuity improvement also seen in these patients and increased. In 57 / 60 cases (95%) visual acuity was improved, In 2/60 (3.34%) visual acuity remained as it is and in 1/60 (1.66%). case it was decreased. In 95% of cases the IOP maintained under normal limits. In 5% cases it had gone to the higher side.