Incidence and Sequelae of Macular Edema Post Pan-retinal Photocoagulation for Proliferative Diabetic Retinopathy

Purpose To study the incidence and sequelae of macular edema after Panretinal photocoagulation (PRP) for the treatment of proliferative diabetic retinopathy (PDR). Patients and Methods A prospective interventional clinical study included 42 eyes treated by PRP, for proliferative diabetic retinopathy over three sessions on three consecutive weeks. Baseline and 1-month postoperative data were collected including best-corrected visual acuity, detailed fundus examination and Spectral Domain Optical Coherence Tomography Macula (SD-OCT); to assess the Central Subfield Macular Thickness (CSMT) using the ETDRS Map. Results Forty-two eyes of 31 patients were included in the study with mean duration of diabetes of 16.9±5.7 years and mean HbA1c of 9.1±1.4. Mean pre-PRP vision was 0.44±0.2 log units, which improved to 0.41±0.2 log units (P=0.6). Mean pre-laser CSMT was 245.6±25.5 µm, which increased to 265.5±33.5 µm at 1-month follow-up after PRP (P=0.003). Four eyes (9.5%) had CSMT more than 300 µm with intraretinal edema. The mean change and percentage of change from baseline in CSMT between those patients and remaining patient were statistically insignificant (P=0.055 and 0.115 respectively). Changes in CSMT and changes in Log MAR BCVA at 4-week follow-up were inversely correlated. Conclusion Macular edema can be an unavoidable side effect of PRP especially in cases with baseline increased macular thickness. Vision is mostly not affected by PRP, however, changes in vision may be directly affected by macular thickness post-PRP

Oral supplementation of policosanol alleviates carbon tetrachloride-induced liver fibrosis in rats

Liver fibrosis is a prevalent liver disease that requires rapid and effective treatment prior to its progression to cirrhosis and liver damage. Recently, several reports have investigated the efficacy of phytotherapy using natural herbal extracts rather than synthetic drugs to treat several liver diseases. Policosanol is a herbal extract used to treat patients with cardiovascular. However, its therapeutic effect on liver fibrosis is still unknown. Therefore, the present study aimed to assess the potential antifibrotic effect of policosanol compared to silymarin and the possible underlying molecular mechanisms. Rats were categorized into four groups; negative control group NCG, the fibrotic group FG, silymarin treated group STG, and policosanol treated group PTG. Serum liver enzymes, oxidative stress markers, angiogenic growth factors, and pro-inflammatory cytokines were measured biochemically. The relative mRNA expressions of liver caspase-3 and alpha-smooth muscle actin (alpha-SMA) were assessed. Immunohistochemical staining was carried out using anti-alpha-SMA, and anti-caspase-3 antibodies. Compared to NCG, the FG group demonstrated a significant decrease in the level of serum liver enzymes GSH, TAC, and SDF. Nevertheless, it demonstrateda significant increase in the level of pro-inflammatory cytokines Il6, TNF; oxidative stress markers NO, MDA, and angiogenic growth factors VEGF and PDGF and the expression of alpha-SMA, and Caspase-3. Interestingly, the values of these measurements were restored to normal levels in the treated groups, particularly the PTG. In conclusion, our data revealed the beneficial effects of co administration of policosanol or silymarin on the fibrotic liver rat model and thus could be a promising natural therapeutic drug