الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Diabetic macular edema (DME) is a complex disease that is due to a multifactorial process involving the breakdown of the blood-retinal barrier and an abnormal accumulation of fluid in the retinal tissue of the macula. Treatment of DME has been transformed in recent years by an improved understanding of the pathophysiological mechanisms leading to the condition, as well as by the development of effective treatments such as anti-vascular endothelial growth factor (VEGF) therapies, which can stabilize or improve vision in many patients. Ranibizumabis approved for the treatment of visual impairment due to DME. This study was conducted to evaluate response of intravitreal injection of ranibizumab in diabetic macular edema at Mansoura ophthalmology center. This study included 50 diabetic patients with diabetic macular edema who were recruited in outpatient clinic of Mansoura university Ophthalmic Center over one year. After obtaining a written informed consent, the cases were subjected to full history taking and full ophthalmological examination including assessment of visual acuity, slit lamp examination, measurement of intraocular pressure and posterior segment examination using indirect ophthalmoscope. In all the cases, the macular retinal maps were assessed using optical coherence tomography (OCT) (Spectral domain OCT 2000). Three intravitreal consecutive monthly injections of anti-VEGF of ranibizumab at a dose of 0.5 mg/0.05 ml were administered to all the cases. The cases were followed up at 1 month & 3 months to assess the visual acuity and macular thickness. The results of this study showed that: 1. The mean age in the cases was 56.92 ± 7.27 years. There is 28 males (56%) and 22 females (44%). 2. There was a highly statistically significant improvement in the VA in the included cases after one month and after three months as compared with before treatment value. 3. There was a highly statistically significant improvement in the VA after three months of treatment as compared with at 1 month value. 4. There was a highly statistically significant decrease in the macular thickness in the included cases after one month and after three months as compared with before treatment value. 5. There was a highly statistically significant decrease in the macular thickness after three months of treatment as compared with at 1 month value. 6. There was no statistically significant difference in the percent of change of macular thickness at 1 moth and 3 months between the cases with controlled and uncontrolled diabetes. 7. There was a statistically significant positive correlation between change of visual acuity with cholesterol and change of macular thickness. Conclusion: from the results of the current study, it could be concluded that: 1. The current findings suggested that intravitreal ranibizumab effectively decreased macular thickness and improved visual acuity. 2. The results were maintained up to 3 months after the last dose of ranibizumab. 3. Structural and functional effects of intravitreal ranibizumab injection might be detectable as early as 1 month after treatment. 4. The degree of diabetic control didn’t affect the degree of change of visual acuity and macular thickness.