Polypill for Recalcitrant
CSME: A prospective
case series
Aditya Sudhalkar
Tejas Desai
Jay Trivedi
Bakulesh Khamar
Usha Vy...
Introduction
• Recalcitrant CSME: Most prevalent cause for
persistent visual loss in Diabetic retinopathy
• Hemodynamics a...
Purpose
• To determine the utility and safety of the polycap in the treatment of
recalcitrant CSME in patients with type 2...
Methods
 Exclusion Criteria:
• PDR
• Macular ischemia
• Unwilling patient
• Any treatment within the past 3 months prior ...
Methods
 Data collected:
• Complete ocular and systemic exam
• Details of pharmacotherapy and ocular treatment
• Baseline...
Statistical analysis
• Paired t-test to measure change in VA and central
macular thickness with therapy
• Paired t-test to...
Results
• 30 patients(17 males) with a median age of were
included
• Median follow up:
• Median duration of diabetes:
• Me...
Results
• All patients with dyslipidemia were on a statin
• All patients with hypertension were on at least two
drugs; fiv...
Results
• VA improved from to over one year
• CMT decreased from to over one year
 At one year:
• Blood pressure decrease...
Discussion
• Our study shows good results in patients who
were otherwise non responders
• All patients had well controlled...
Discussion
• Several studies have demonstrated the value of
good systemic control in DME
• We speculate that compliance wi...
Conclusion
• Polypill helps improve recalcitrant CSME
• No adverse events were noted
• Future trials are warranted to dete...
Polypill poster Istanbul, Nov 2014
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Polypill poster Istanbul, Nov 2014

Published on: Mar 4, 2016
Published in: Health & Medicine      
Source: www.slideshare.net


Transcripts - Polypill poster Istanbul, Nov 2014

  • 1. Polypill for Recalcitrant CSME: A prospective case series Aditya Sudhalkar Tejas Desai Jay Trivedi Bakulesh Khamar Usha Vyas
  • 2. Introduction • Recalcitrant CSME: Most prevalent cause for persistent visual loss in Diabetic retinopathy • Hemodynamics and co-morbidities may play an important role in its treatment • Polypill therapy ensures compliance
  • 3. Purpose • To determine the utility and safety of the polycap in the treatment of recalcitrant CSME in patients with type 2 diabetes mellitus  Prospective case series  Inclusion Criteria(DM type 2 in patients>18y): • NPDR with diffuse CSME non responsive to: • At least 2 intravitreal anti-VEGF injections and/or two intravitreal steroid injections(appropriate intervals) WITH at least two sessions of laser photocoagulation
  • 4. Methods  Exclusion Criteria: • PDR • Macular ischemia • Unwilling patient • Any treatment within the past 3 months prior to inclusion • Follow up of less than 1 year
  • 5. Methods  Data collected: • Complete ocular and systemic exam • Details of pharmacotherapy and ocular treatment • Baseline FFA and OCT performed for all patients • Polypill initated on a once daily basis • Follow ups on days 30, 60, 90, 120, 180, 270, 365 • BCVA, OCT scans recorded at each visit • FFA was repeated at physician’s discretion
  • 6. Statistical analysis • Paired t-test to measure change in VA and central macular thickness with therapy • Paired t-test to measure change in blood pressure and lipid profile  Outcome measures: • Primary: Change in VA with therapy • Secondary: Change in CMT, proportion of patients with a two line gain in VA and complications
  • 7. Results • 30 patients(17 males) with a median age of were included • Median follow up: • Median duration of diabetes: • Median duration of hypertension • Median duration of dyslipidemia • Patients with co-existent hypertension: • Patients with co-existent dyslipidemia:
  • 8. Results • All patients with dyslipidemia were on a statin • All patients with hypertension were on at least two drugs; five were on three • Median duration of CSME: • Median number of anti-VEGF injections( patients) • Median number of steroid injections:
  • 9. Results • VA improved from to over one year • CMT decreased from to over one year  At one year: • Blood pressure decreased from to • Serum cholesterol from to • Serum triglycerides from to • Serum LDL from to • No adverse events were noted
  • 10. Discussion • Our study shows good results in patients who were otherwise non responders • All patients had well controlled systemic parameters and yet they responded to poly pill therapy • This suggests that polypill probably improves compliance. • One off measurements may serve to mislead the treating physician
  • 11. Discussion • Several studies have demonstrated the value of good systemic control in DME • We speculate that compliance will improve microcirculation and aid the resolution of recalcitrant CSME
  • 12. Conclusion • Polypill helps improve recalcitrant CSME • No adverse events were noted • Future trials are warranted to determine its utility as an adjunct to local therapy for CSME

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