Steroid implant eye uveitis

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my dad(diabetic) had 140 fasting on the morning of diabetologist told the nurse on phone to give 4 units of he was given…and in an hour,his level came down to surgery was the night after surgery..his ocular pressure had increased,he had mannitol to reduce pressure was gvn only next day…when v reported agin to later tht day v came to knw tht diabetologist was denying tht he said the nurse to gv insulin to my mean he was like i first said the nurse to give bt then later dont know y he behaved tht day,isnt 140 more for fasting,n gvn insulin must have only benefitted him na??
Now 3 wks later,when he is facing probs with vision, n also floaters,doc(opthlmologist) has told he has gt retianl swelling,he was gvn tricot inj. n he is on acular eye drops now for gv info.

Several processes have been implicated in the breakdown of the blood-retinal barrier that leads to ME, including the production of inflammatory mediators (., prostaglandins and interleukin-6), increased amounts of vascular permeability factors (., vascular endothelial growth factor) and the loss of endothelial tight junction proteins.  Corticosteroids are thought to have beneficial effects on these processes, but delivering therapeutic concentrations of any medication to the retina while limiting systemic exposure presents a challenge.  Intra-vitreal injections of the corticosteroid triamcinolone have shown promise in the treatment of ME.  Dexamethasone, a more potent corticosteroid than triamcinolone, has been shown to produce high intra-vitreal levels of the drug, however, a short intra-ocular half-life after intra-vitreal injection (approximately 3 hours) has led to the investigation of other delivery methods.  

Submacular translocation surgery Although currently submacular translocation surgery is no longer advocated for ARMD related CNVM, recent studies have examined its use in a cohort of patients with progressive use from non-ARMD submacular diseases including PIC. They primarily examined final visual acuity and found a large percentage of subjects gained >3 lines of visual acuity (38%) and achieved a final visual acuity of ≥ 20/50 (31%) over a mean followup of 28 months 48 . The submacular surgery trial examined a cohort of patients following submacular surgery and recurrent CNV developed in 58 % of patients. One recent publication examined the ultrastructural and pathological features of CNVMs in PIC in a patient with PIC who initially had intravitreal bevacizumab followed by submacular surgery when this failed 50 . This study noted recurred in on eye of a PIC patient with bilateral CNVMs who had submacular surgery in both eyes. This was consistent with the study by Olsen et al in which four out of six eyes developed a recurrence of CNV following surgical excision 10 .

Shortly before moving to the operating room, a small tube (cannula) is placed into a vein in the back of your hand by the consultant anaesthetist and the anaesthetic drug is given through that. This is Propofol, a drug which is also used for general anaesthesia but, for conscious sedation, much lower doses are used. With conscious sedation there is no breathing tube or breathing machine, just a gentle flow of oxygen given through a plastic tube within a soft sponge protector inserted into one of your nostrils. Once the sedation has been commenced a local anaesthetic solution (a mixture of Marcaine and Lignocaine) is injected into the operative area to ensure a painless procedure. Typical side effects of general anaesthesia including a sore throat and nausea are avoided. Waking up takes only a few minutes at the completion of the surgery and is usually free of any “grogginess.” This type of anaesthesia has been used safely and successfully for our surgical procedures for over 20 years.

Steroid implant eye uveitis

steroid implant eye uveitis

Submacular translocation surgery Although currently submacular translocation surgery is no longer advocated for ARMD related CNVM, recent studies have examined its use in a cohort of patients with progressive use from non-ARMD submacular diseases including PIC. They primarily examined final visual acuity and found a large percentage of subjects gained >3 lines of visual acuity (38%) and achieved a final visual acuity of ≥ 20/50 (31%) over a mean followup of 28 months 48 . The submacular surgery trial examined a cohort of patients following submacular surgery and recurrent CNV developed in 58 % of patients. One recent publication examined the ultrastructural and pathological features of CNVMs in PIC in a patient with PIC who initially had intravitreal bevacizumab followed by submacular surgery when this failed 50 . This study noted recurred in on eye of a PIC patient with bilateral CNVMs who had submacular surgery in both eyes. This was consistent with the study by Olsen et al in which four out of six eyes developed a recurrence of CNV following surgical excision 10 .

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