scholarly journals Diabetic Retinopathy Treated with Laser Photocoagulation and the Indirect Effect on Glycaemic Control

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Anna Praidou ◽  
Sofia Androudi ◽  
Periklis Brazitikos ◽  
George Karakiulakis ◽  
Eleni Papakonstantinou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Glycaemic Control ◽  
Laser Treatment ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Previous Treatment ◽  
Blood Levels ◽  
Patients With Diabetes ◽  
Group A ◽  
Group B

Purpose. To identify any possible relation between glycaemic control and previous laser photocoagulation for diabetic retinopathy.Methods. Seventy-two patients with diabetes were included in the study and were separated into 2 groups according to previous treatment (group A) or not (group B) with argon laser photocoagulation. Glycaemic control was estimated by measuring blood levels of HbA1c in four consecutive measurements.Results. Blood levels of HbA1c in group A were significantly lower 3, 6, and 12 months after laser treatment as compared to blood levels of HbA1c before laser treatment (7.1±0.4% versus7.6±0.9%,7.2±0.2% versus7.6±0.9%, and7.1±0.2% versus7.6±0.9%, resp., allP<0.05). Blood levels of HbA1c in group B did not differ significantly in four consecutive measurements.Conclusion. Our results suggest that we should anticipate a better glycaemic control in cases of patients with diabetes previously treated with laser photocoagulation.

scholarly journals Argon laser photocoagulation for treatment of presumed trematode-induced granulomatous anterior uveitis in children

2021 ◽  
pp. bjophthalmol-2021-318796
Author(s):  
Alahmady Hamad Alsmman ◽  
Abdelsalam Abdalla ◽  
Mohammed Ezzeldawla ◽  
Elshimaa A Mateen Mossa ◽  
Mortada Abozaid
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Anterior Uveitis ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Argon Laser Photocoagulation ◽  
Group A ◽  
Group B ◽  
Granulomatous Anterior Uveitis

Background/AimsTo assess the safety and efficacy of argon laser photocoagulation as a new modality for the treatment of presumed trematode-induced granulomatous anterior uveitis (PTGAU) in children.MethodsForty-eight eyes of 48 children with PTGAU with pearl-like nodule(s) in the anterior chamber were included in this prospective non-randomised controlled clinical trial. The patients were divided into two groups: those in Group A (23 eyes) were treated with one session of argon laser applied to the anterior chamber nodules and those in Group B (25 eyes) received medical treatment in the form of topical steroid and cycloplegic eye drops with trans-septal triamcinolone injections. All cases were followed up for 3 months with measurement of visual acuity (VA), assessment of the anterior chamber reaction and measurement of the pearl-like nodule size.ResultsIn Group A, 22 eyes (95.65%) showed regression of the pearl-like nodules with resolution of the anterior chamber reaction (flare and cells) and improvement in visual acuity from 0.52±0.12 to 0.06±0.08 logMAR (p<0.001). Such improvement was maintained within the 3-month follow-up period. In Group B, 23 eyes (92%) showed initial regression of the granulomas, which was maintained in only 14 eyes (56%),with nine eyes experiencing recurrence after 3 months of follow-up.ConclusionArgon laser photocoagulation is a safe and effective novel treatment for PTGAU with pearl-like nodules in the anterior chamber in children. Larger studies with longer follow-up periods are needed to confirm these results.

scholarly journals A comparative study of anaemia with the degree of glycaemic control in type 2 diabetes mellitus

2019 ◽  
Vol 6 (4) ◽  
pp. 1231
Author(s):  
Prabhu S. ◽  
Balakrishna Teli
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Diabetic Nephropathy ◽  
Glycaemic Control ◽  
Common Finding ◽  
Poor Glycaemic Control ◽  
Good Glycaemic Control ◽  
Patients With Diabetes ◽  
Group A ◽  
Group B

Background: Anaemia is one of the world’s most common preventable condition yet it is often overlooked especially in people with Diabetes Mellitus. Anaemia is a common finding in patients with diabetes. Anaemia in patients with diabetes mellitus might contribute to the pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. This aims to study the correlation between HbA1c and blood glucose levels in anaemic diabetics in order to assess the influence of anaemia on HbA1c and the effect of severity and type of anaemia on HbA1c.Methods: It’s a case control study, 200 Diabetic subjects were divided into two groups of 100 each based on their HbA1c levels group A, with good glycaemic control (HbA1c<7) and group B with poor glycaemic control (HbA1c>7), incidence of anaemia was measured and compared among them and also with 100 age and sex matched healthy non Diabetic controls. Results: In this study, it was found that high incidence of anaemia was found significantly higher in diabetics group with poor glycaemic control. Anemia was detected in 55% of patients among diabetic patients. Anaemia was seen in 71% of patients in group B with poor glycaemic control as compared to group A with good glycaemic control, in which only 39% of patients had anaemia. Mean haemoglobin was significantly lower that is, 10.81±3.0 in group with poor glycaemic control as compared to group with good glycaemic control i.e. 13.04±2.02. There was a statistically significant negative correllation between Haemoglobin percentage and HbA1c.Conclusion: Anaemia is a common finding in patients with diabetes. Diabetes related chronic hyperglycaemia can lead to a hypoxic environment in the renal interstitium which results in impaired production of erythropoietin by the peritubular fibroblasts and subsequently anaemia occurs. Anaemia in patients with diabetes mellitus might contribute to pathogenesis and progression of cardiovascular disease and aggravate diabetic nephropathy and retinopathy. However, an emphasis on regular screening for anaemia, alongside that for other diabetes related complications, might help to delay the progression of vascular complication in these patients.

scholarly journals Argon Laser Photocoagulation for Treatment of Presumed Trematode-induced Granulomatous Anterior Uveitis in Children

2021 ◽  
Author(s):  
Alahmady Alsmman ◽  
Abdelsalam Abdalla ◽  
Mohammed Ezzeldawla ◽  
Elshimaa Mateen ◽  
Mortada Abozaid
Keyword(s):  
Anterior Chamber ◽  
Anterior Uveitis ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Eye Drops ◽  
Argon Laser Photocoagulation ◽  
Group A ◽  
Group B ◽  
Granulomatous Anterior Uveitis

Background/Aims: To assess the safety and efficacy of argon laser photocoagulation as a new modality for the treatment of presumed trematode-induced granulomatous anterior uveitis (PTGAU) in children. Methods: Forty-eight eyes of 48 children with PTGAU with pearl-like nodule(s) in the anterior chamber were included in this prospective non-randomised controlled clinical trial. Patients were divided into two groups: group A (23 eyes) was treated with one session of argon laser applied to the anterior chamber nodules, and group B (25 eyes) received medical treatment in the form of topical steroid and cycloplegic eye drops with trans-septal triamcinolone injection.All cases were followed up for 3 monthswith measurement of VA, assessment of anterior chamber reaction, and size of the pearl-like nodules. Results: In group A, 22 eyes (95.65%) showed regression of the pearl-like nodules with resolution of the anterior chamber reaction (flare and cells) and improvement in visual acuity from 0.52 0.12 to 0.06 0.08logMAR (p value <0.001). Such improvement was maintained within the 3-month follow-up period. In group B, 23 eyes (92%) showed initial regression of the granulomas,whichwas maintained in only 14 eyes (56%),with 9 eyes experiencing recurrence after 3 months of follow-up. Conclusion: Argon laser photocoagulation is a safe and effective novel treatment for PTGAU with pearl-like nodules in the anterior chamber in children. Larger studies with longer follow-up periods are needed to confirm these results.

scholarly journals Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy: systematic review and economic evaluation

2015 ◽  
Vol 19 (51) ◽  
pp. 1-248 ◽  
Author(s):  
Pamela Royle ◽  
Hema Mistry ◽  
Peter Auguste ◽  
Deepson Shyangdan ◽  
Karoline Freeman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Cost Effectiveness ◽  
Laser Treatment ◽  
Laser Photocoagulation ◽  
Visual Loss ◽  
Argon Laser ◽  
Economic Modelling ◽  
Pan Retinal Photocoagulation ◽  
Retinal Photocoagulation

BackgroundDiabetic retinopathy is an important cause of visual loss. Laser photocoagulation preserves vision in diabetic retinopathy but is currently used at the stage of proliferative diabetic retinopathy (PDR).ObjectivesThe primary aim was to assess the clinical effectiveness and cost-effectiveness of pan-retinal photocoagulation (PRP) given at the non-proliferative stage of diabetic retinopathy (NPDR) compared with waiting until the high-risk PDR (HR-PDR) stage was reached. There have been recent advances in laser photocoagulation techniques, and in the use of laser treatments combined with anti-vascular endothelial growth factor (VEGF) drugs or injected steroids. Our secondary questions were: (1) If PRP were to be used in NPDR, which form of laser treatment should be used? and (2) Is adjuvant therapy with intravitreal drugs clinically effective and cost-effective in PRP?Eligibility criteriaRandomised controlled trials (RCTs) for efficacy but other designs also used.Data sourcesMEDLINE and EMBASE to February 2014, Web of Science.Review methodsSystematic review and economic modelling.ResultsThe Early Treatment Diabetic Retinopathy Study (ETDRS), published in 1991, was the only trial designed to determine the best time to initiate PRP. It randomised one eye of 3711 patients with mild-to-severe NPDR or early PDR to early photocoagulation, and the other to deferral of PRP until HR-PDR developed. The risk of severe visual loss after 5 years for eyes assigned to PRP for NPDR or early PDR compared with deferral of PRP was reduced by 23% (relative risk 0.77, 99% confidence interval 0.56 to 1.06). However, the ETDRS did not provide results separately for NPDR and early PDR. In economic modelling, the base case found that early PRP could be more effective and less costly than deferred PRP. Sensitivity analyses gave similar results, with early PRP continuing to dominate or having low incremental cost-effectiveness ratio. However, there are substantial uncertainties. For our secondary aims we found 12 trials of lasers in DR, with 982 patients in total, ranging from 40 to 150. Most were in PDR but five included some patients with severe NPDR. Three compared multi-spot pattern lasers against argon laser. RCTs comparing laser applied in a lighter manner (less-intensive burns) with conventional methods (more intense burns) reported little difference in efficacy but fewer adverse effects. One RCT suggested that selective laser treatment targeting only ischaemic areas was effective. Observational studies showed that the most important adverse effect of PRP was macular oedema (MO), which can cause visual impairment, usually temporary. Ten trials of laser and anti-VEGF or steroid drug combinations were consistent in reporting a reduction in risk of PRP-induced MO.LimitationThe current evidence is insufficient to recommend PRP for severe NPDR.ConclusionsThere is, as yet, no convincing evidence that modern laser systems are more effective than the argon laser used in ETDRS, but they appear to have fewer adverse effects. We recommend a trial of PRP for severe NPDR and early PDR compared with deferring PRP till the HR-PDR stage. The trial would use modern laser technologies, and investigate the value adjuvant prophylactic anti-VEGF or steroid drugs.Study registrationThis study is registered as PROSPERO CRD42013005408.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Clinical efficacy of different dosage forms containing vitamin D: design and study outcomes of a randomized, comparative clinical trial

2020 ◽  
Vol 7 (3) ◽  
pp. 176
Author(s):  
Nidhi Sapkal ◽  
Gaurav Chhaya ◽  
Milan Satya ◽  
Dhara Shah
Keyword(s):  
Vitamin D ◽  
Clinical Efficacy ◽  
Dosage Forms ◽  
Oral Solution ◽  
Blood Levels ◽  
Open Label ◽  
Soft Gelatin Capsules ◽  
25 Hydroxy Vitamin D ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Different dosage forms of vitamin D like tablets, soft gelatin capsules, oral granules, powders, solutions and thin films are available. The objective of the present study was to evaluate and compare the clinical efficacy of three different dosage forms of vitamin D3 namely, orally disintegrating strips, oral granules and oral solution.</p><p class="abstract"><strong>Methods:</strong> An open label, single centre, prospective, randomized, parallel group, comparative study was conducted for a period of 4 months. The study participants were divided into three groups (A, B, C) and received the respective treatments (orally disintegrating strips, n=20; granules, n=20; oral nano solution, n=10) for the study period. The estimation of blood levels of 25-hydroxy vitamin D [25(OH)D<sub>3</sub>] in all the subjects at day 0, 60 and 120 was carried out.</p><p class="abstract"><strong>Results:</strong> The normalization level of 25(OH)D<sub>3 </sub>achieved by the subjects in group A, group B and group C was 100%, 83.3% and 90% respectively after 90 days. Comparison of 25(OH)D<sub>3 </sub>level in all three groups showed significant increase at day 60. The levels were maintained at day 90 and 120 even after drastic reduction in dosage in Group A and group C. On day 120, the dose reduction was in the order of group A&gt;group C&gt;group B.</p><p class="abstract"><strong>Conclusions: </strong>All the three formulations showed increase in the level of 25(OH)D<sub>3. </sub>It can be concluded that oral disintegrating strips of 25(OH)D<sub>3</sub> are clinically more efficient than other conventional dosage forms.</p>

Bevacizumab-Augmented Retinal Laser Photocoagulation in Proliferative Diabetic Retinopathy: A Randomized Double-Masked Clinical Trial

2008 ◽  
Vol 18 (2) ◽  
pp. 263-269 ◽  
Author(s):  
A. Mirshahi ◽  
R. Roohipoor ◽  
A. Lashay ◽  
S.-F. Mohammadi ◽  
A. Abdoallahi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Retinopathy ◽  
High Risk ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Intravitreal Bevacizumab ◽  
Complete Regression ◽  
Standard Laser ◽  
Risk Characteristic

Purpose To evaluate the additional therapeutic effect of single intravitreal bevacizumab injection on standard laser treatment in the management of proliferative diabetic retinopathy. Methods A prospective, fellow-eye sham controlled clinical trial was conducted on 80 eyes of 40 high-risk characteristic proliferative diabetic retinopathy type II diabetics. All cases received standard laser treatment according to Early Treatment Diabetic Retinopathy Study protocol. Avastin-assigned eyes received 1.25 mg intravitreal bevacizumab (Genentech Inc., San Francisco, CA) on the first session of their laser treatments. Fluorescein angiography was performed at baseline and at weeks 6 and 16, and proliferative diabetic retinopathy regression was evaluated in a masked fashion. Results The median age was 52 years (range: 39–68) and 30% of the participants were male. All patients were followed for 16 weeks. A total of 87.5% of Avastin-injected eyes and 25% of sham group showed complete regression at week 6 of follow-up (pp<0.005). However, at week 16, PDR recurred in a sizable number of the Avastin-treated eyes, and the complete regression rate in the two groups became identical (25%; p=1.000); partial regression rates were 70% vs 65%. In the subgroup of Avastin-treated eyes, multivariate analysis identified hemoglobin A1c as the strongest predictor of proliferative diabetic retinopathy recurrence (p=0.033). Conclusions Intravitreal bevacizumab remarkably augmented the short-term response to scatter panretinal laser photocoagulation in high-risk characteristic proliferative diabetic retinopathy but the effect was short-lived, as many of the eyes showed rapid recurrence. Alternative dosing (multiple and/or periodic intravitreal Avastin injections) is recommended for further evaluation.

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