الفهرس 
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Abstract
Abstract : Diabetic macular edema (DME) is a major complication of diabetic retinopathy (DR) and is the most frequent cause for preventable blindness in working adults in many countries. The beneficial effect of intravitreal ranibizumab injection in improving the visual acuity and retinal thickness in eyes with diabetic macular edema has been proved by many studies. Optical coherence tomography (OCT) added a high-resolution cross sectional scanning of the entire macular area. OCT can be fundamental in the diagnosis and follow up of DME, giving not only an objective measurement of the macular thickness with a resolution of 10 microns, but also an image of intraretinal structure and epiretinal tractions, This makes OCT the preferred indicator of therapeutic benefit of different treatment strategies. The aim of this study was evaluation of safety and efficacy of Ranibizumab intravitreal injection in diabetic macular edema (DME). This study was prospective study, carried out on 30 patients from Alexandria Police hospital, in the period from March 2020 till March 2021. The results of this study showed a significant improvement in CMT and VA all over the period of follow up. The IOP showed insignificant change all over the period of follow up after injections. The incidence of complication showed insignificant difference all over the period of follow up. The duration of disease show a significant relation with IOP. The level of HbA1c, FFA and initial CMT show a significant relation with CMT and VA. The results of this study showed that age was significantly positively correlated with CMT, percent of improvement of CMT, while correlate negatively with VA and percent of improvement of VA. There was a negative correlation between CMT and VA, also the percent of improvement of both CMT and VA was correlated negatively. CONCLUSIONS : Intra vitreal injection of (0.5 mg ranibizumab in.05ml) along three monthly injections led to significant and continuous improvements in both BCVA and CRT giving a promising treatment for DME. Intravitreal injection of ranibizumab is safe with simple complications as subconjunctival hemorrhage and cells without any significant increase in (IOP). Optical coherence tomography (OCT) offers an objective, sensitive, non-invasive and quantitative tool for the assessment of macular thickening as well as an excellent measure of follow up and monitoring the effect of ranibizumab in treatment of DME.