الفهرس 
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Abstract
Diabetic macular edema is a sight-threatening complication, and it is the most prevalent cause of visual loss in diabetic patients. The study aimed to evaluate the efficacy of intravitreal injections of ranibizumab in eye with diabetic macular edema with and without posterior sub-Tenon injection of triamcinolone acetonide. The study included 40 eyes of 40 diabetic patients -#102;-#114;-#111;-#109; both sexes. Patients were divided into 2 groups. -#103;-#114;-#111;-#117;-#112; A (control group);Included patients treated with pro re nata (PRN) intravitreal injection of ranibizumab only. -#103;-#114;-#111;-#117;-#112; B (combined group);Included patients treated with pro re nata (PRN) intravitreal injection of ranibizumab combined with posterior sub-Tenon injection of TA. All patients had complete ophthalmic examination, followed by IVR.Posterior sub-Tenon triamcinolone acetonide was injected in -#103;-#114;-#111;-#117;-#112; B at (0,4-8) months. They were investigated by OCT preoperatively and monthly for one year. Throughout the period of the study, the BCVA in each -#103;-#114;-#111;-#117;-#112; individually was statistically highly improved than preoperative BCVA. Improvement of BCVA in -#103;-#114;-#111;-#117;-#112; B was more than the improvement of BCVA in -#103;-#114;-#111;-#117;-#112; A at 1st month only but, there was no statistically significant difference in BCVA improvement between the two groups after the 1st month. As regard the CMT, there was statistically significant reduction in CMT in both groups along the whole periods of the study. There was statistically significant difference in reduction of CMT in -#103;-#114;-#111;-#117;-#112; B more than the reduction of thickness in -#103;-#114;-#111;-#117;-#112; A during the first month but, there was no statistically significant difference in CMT reduction between both groups after the 1st month. Combination of STTA with IVR didn’t reduce the number of intra-vitreal injections, there was no statistically significant difference in number of IVR injection between both groups. As regard complications, there was only transient slight increase of IOP in -#103;-#114;-#111;-#117;-#112; B, its maximum was at 6th month of the clinical course, while the IOP in -#103;-#114;-#111;-#117;-#112; A didn’t change during the clinical course. However, the IOP in all eyes didn’t exceed 21 mmHg without antiglucoma drugs throughout the clinical course.