Early Photocoagulation for Diabetic Retinopathy

2020 ◽  
pp. 177-184
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Diabetic Retinopathy ◽  
High Risk ◽  
Macular Edema ◽  
Proliferative Retinopathy ◽  
Diabetic Patients ◽  
Nonproliferative Diabetic Retinopathy ◽  
Proliferative Stage ◽  
Focal Treatment ◽  
Photocoagulation Therapy

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 9) examined the question of when in the course of diabetic retinopathy it is most effective to initiate photocoagulation therapy. Based on the study findings, the authors recommended that panretinal scatter photocoagulation not be carried out in eyes with mild or moderate nonproliferative diabetic retinopathy; when retinopathy is more severe, however, panretinal scatter photocoagulation usually should not be delayed if the eye has reached the high-risk proliferative stage. Focal treatment should be considered for eyes with macular edema that involves or threatens the center of the macula, preferably before scatter photocoagulation for high-risk proliferative retinopathy becomes urgent.

Photocoagulation for Diabetic Macular Edema

2020 ◽  
pp. 169-176
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Diabetic Patients ◽  
Nonproliferative Diabetic Retinopathy ◽  
Argon Laser Photocoagulation ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 1) describes the findings in the subgroup of eyes in the ETDRS that were identified as having mild to moderate nonproliferative diabetic retinopathy and macular edema. The analysis showed that immediate focal argon laser photocoagulation of “clinically significant” diabetic macular edema substantially reduced the risk of visual loss, increased the chance of visual improvement, decreased the frequency of persistent macular edema, and caused only minor visual field losses. The authors recommended immediate focal argon laser photocoagulation for all eyes with clinically significant macular edema and mild or moderate nonproliferative diabetic retinopathy, regardless of the level of visual acuity.

Efficacy of Intravitreal Triamcinolone after or Concomitant with Laser Photocoagulation in Nonproliferative Diabetic Retinopathy with Macular Edema

2009 ◽  
Vol 19 (4) ◽  
pp. 630-637 ◽  
Author(s):  
Erdinc Aydin ◽  
Helin Deniz Demir ◽  
Huseyin Yardim ◽  
Unal Erkorkmaz
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Photocoagulation ◽  
Control Group ◽  
Clinical Effects ◽  
Intravitreal Triamcinolone ◽  
Nonproliferative Diabetic Retinopathy ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean

Purpose To investigate the clinical effects and outcomes of intravitreal injection of 4 mg of triamcinolone acetonide (IVTA) after or concomitant with macular laser photocoagulation (MP) for clinically significant macular edema (CSME). Methods Forty-nine eyes of 49 patients with nonproliferative diabetic retinopathy and CSME were randomized into three groups. The eyes in the laser group (n=17), group 1, were subjected to MP 3 weeks after IVTA; the eyes in the IVTA group (n=13), group 2, were subjected to MP, concomitant with IVTA; the eyes in the control group (n=19), group 3, underwent only IVTA application. Visual acuity (VA), fundus fluorescein angiography, and photography were performed in each group. Results In the first group, the mean VA improved from 0.17±0.09 at baseline to 0.28±0.15 (p=0.114) and in the second group, deteriorated from 0.19±0.08 at baseline to 0.14±0.08 at the sixth month (p=0.141), respectively. In Group 3, the mean VA improved from 0.16±0.08 at baseline to 0.28±0.18 (p=0.118) at the end of the follow-up. When VA was compared between the control and study groups, significant difference was detected at the sixth month (p=0.038). Conclusions MP after IVTA improved VA, rather than MP concomitant with IVTA, and only IVTA application for CSME. MP after IVTA may reduce the recurrence of CSME and needs further investigations in a longer period.

scholarly journals Diabetic retinopathy with or without clinically significant macular edema: The influencing factors

2016 ◽  
Vol 7 (2) ◽  
pp. 142-147
Author(s):  
Barsha Suwal ◽  
Jeevan Kumar Shrestha ◽  
Sagun Narayan Joshi ◽  
Ananda Kumar Sharma
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Macular Edema ◽  
Total Cholesterol ◽  
Cholesterol Level ◽  
Total Cholesterol Level ◽  
Density Lipoprotein ◽  
Diabetic Patients ◽  
Clinically Significant Macular Edema ◽  
Clinically Significant

Introduction: Diabetic retinopathy is the commonest micro vascular complication in patients with diabetes and remains a leading cause of blindness in people of working age group. Objective: to determine the prevalence of clinically significant macular edema (CSME) and the influence of systemic risk factors Materials and methods: It is a hospital based comparative study conducted in 220 eyes of 110 diabetic patients. DR was graded according to International Clinical Diabetic Retinopathy Severity Scale and CSME was defined according to Early Treatment Diabetic Retinopathy Study (ETDRS) system. The patients were grouped as 1) CSME group (DR and CSME in one or both eyes) and 2) Non- CSME group(CSME in none of the eyes but with any grade of DR).Level of glycosylated hemoglobin (HbA1C), serum total cholesterol, triglyceride (TG), low density lipoprotein (LDL), high density lipoprotein (HDL) and urine for albumin were studied in both groups. Results: CSME was present in 36% of 110 patients. Poor glycemic control and high total cholesterol level showed positive association with CSME (p<0.05). LDL and TG levels were higher and HDL lower in CSME group. However, no statistical significance was found. Conclusion: The CSME is significantly associated with poorer glycemic control and elevated total cholesterol level.

scholarly journals Comparative study of optical coherence tomographic analysis of macula in preoperative and postoperative diabetic patients undergoing small incision cataract surgery

2021 ◽  
Vol 7 (2) ◽  
pp. 352-357
Author(s):  
Shruthi Marati ◽  
Vallabha K
Keyword(s):  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Macular Thickness ◽  
Diabetic Patients ◽  
Optical Coherence ◽  
Small Incision Cataract Surgery ◽  
Small Incision ◽  
Spectral Domain Oct ◽  
Quantitative Changes

The clinical evaluation of macular edema has been difficult to characterize, but evaluation has become more precise with the help of optical coherence tomography (OCT). This study is undertaken to evaluate the quantitative changes in macular thickness using spectral domain OCT in diabetic patients undergoing cataract surgery pre and post operatively and its relation with diabetic retinopathy (DR). Study participants included 65 diabetic patients irrespective of presence or absence of retinopathy who underwent cataract surgery. Each eye underwent fundus examination with indirect ophthalmoscopy and OCT of macula i.e.,preoperatively and at postoperatively at day 1, 1 week, 4 weeks and at 12 weeks. Best-corrected visual acuity (BCVA) was recorded at each visit. The central subfield macular thickness (CSMT) increased in all patients irrespective of presence or absence of diabetic retinopathy of about 17.4±25.3µm and 29µm±38.8 at 1 month and 3 month follow up. There was a statistically significant increase seen in CSMT after cataract surgery especially in patients with preoperatively diagnosed macular edema. Associated retinopathy also acts as a risk factor. But there was no statistically significant increase in mild and moderate NPDR preoperatively and also in postoperative period after uncomplicated small incision cataract surgery.

Ophthalmic treatment of diabetic retinopathy

2020 ◽  
pp. 171-178
Author(s):  
Ramesh R. Sivaraj ◽  
Jonathan M. Gibson
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Group Intervention ◽  
Laser Photocoagulation ◽  
Interdisciplinary Approach ◽  
High Risk Group ◽  
Diabetic Patients ◽  
Diabetic Maculopathy ◽  
Operative Assessment ◽  
Ophthalmic Treatment

The ophthalmic treatment of diabetic retinopathy is aimed at preserving vision and requires an interdisciplinary approach. The main treatments used for proliferative retinopathy and diabetic maculopathy include laser photocoagulation, intra-vitreal, and peri-ocular drug injections, or a combination of both. In advanced cases of diabetic retinopathy (DR), vitrectomy and retinal surgery may help preserve vision. Cataract surgery in diabetic patients is extremely successful, but overall these patients are usually considered to be at risk of more complications than the general population. Those patients with pre-existing DR at the time of surgery should be regarded as a high risk group and will require careful pre-operative assessment and post-operative review. In this group, intervention with laser photocoagulation and intra-vitreal pharmacotherapy may be necessary.

Different Phenotypes of Mild Nonproliferative Diabetic Retinopathy with Different Risks for Development of Macular Edema (C-TRACER Study)

2017 ◽  
Vol 59 (2) ◽  
pp. 59-67 ◽  
Author(s):  
Luísa Ribeiro ◽  
Rajeev Pappuru ◽  
Conceição Lobo ◽  
Dalila Alves ◽  
José Cunha-Vaz
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Tracer Study ◽  
Nonproliferative Diabetic Retinopathy

Nonproliferative diabetic retinopathy and macular edema progression after phacoemulsification: Prospective study

2006 ◽  
Vol 32 (9) ◽  
pp. 1438-1444 ◽  
Author(s):  
Pedro Romero-Aroca ◽  
Juan Fernández-Ballart ◽  
Matias Almena-Garcia ◽  
Isabel Méndez-Marín ◽  
Merce Salvat-Serra ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Prospective Study ◽  
Macular Edema ◽  
Nonproliferative Diabetic Retinopathy

scholarly journals Ocular Rigidity and Outflow Facility in Nonproliferative Diabetic Retinopathy

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Theonitsa Panagiotoglou ◽  
Miltiadis Tsilimbaris ◽  
Harilaos Ginis ◽  
Nikos Karyotakis ◽  
Vaggelis Georgiou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Anterior Chamber ◽  
Control Group ◽  
Diabetic Patients ◽  
Outflow Facility ◽  
Nonproliferative Diabetic Retinopathy ◽  
Computer Controlled ◽  
And Control

Purpose.To compare ocular rigidity (OR) and outflow facility (C) in patients with nonproliferative diabetic retinopathy (NPDR) and control subjects.Methods. Twenty-four patients with NPDR (NPDR group) and 24 controls (control group) undergoing cataract surgery were enrolled. NPDR group was further divided into patients with mild NPDR (NPDR1-group) and patients with moderate and/or severe NPDR (NPDR2-group). After cannulation of the anterior chamber, a computer-controlled device was used to infuse saline and increase the intraocular pressure (IOP) in a stepping procedure from 15 to 40 mmHg. Ocular rigidity and outflow facility coefficients were estimated from IOP and volume recordings.Results. Ocular rigidity was 0.0205 μL−1in NPDR group and 0.0202 μL−1in control group (P=0.942). In NPDR1-group, OR was 0.017 μL−1and in NPDR2-group it was 0.025μL−1(P=0.192). Outflow facility was 0.120 μL/min/mmHg in NPDR-group compared to 0.153 μL/min/mmHg in the control group at an IOP of 35 mmHg (P=0.151). There was no difference in C between NPDR1-group and NPDR2-group (P=0.709).Conclusions. No statistically significant differences in ocular rigidity and outflow facility could be documented between diabetic patients and controls. No difference in OR and C was detected between mild NPDR and severe NPDR.

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