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.

A Clinical Study of Diabetic Retinopathy

2003 ◽  
Vol 42 (148) ◽  
Author(s):  
KJD Karki
Keyword(s):  
Diabetic Retinopathy ◽  
Clinical Study ◽  
High Risk ◽  
Key Words ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Visual Loss ◽  
Diabetic Patients ◽  
Vitrectomy Surgery

A clinical study of diabetic retinopathy was conducted from March- May 2002 to diagnose a patient’sdiabetic retinopathy level and identify eyes of proliferative diabetic retinopathy and maculopathy so thatthese patients could get appropriate and timely laser photocoagulation surgery and other surgical modalitiesto reduce the risk of visual loss. This study shows that out of 248 diabetic patients examined, 45.9% patientshad retinal changes. The potential candidates for panretinal and focal laser treatment were the patientswith very severe non-proliferative diabetic retinopathy (NPDR) (3.5%), early proliferative diabeticretinopathy (PDR) or high-risk PDR (3.5%), and maculopathy (8.8%).Key Words: Diabetic retinopathy, Laser photocoagulation surgery and vitrectomy Surgery.

Ranibizumab for High-Risk Proliferative Diabetic Retinopathy: An Exploratory Randomized Controlled Trial

2015 ◽  
Vol 235 (1) ◽  
pp. 34-41 ◽  
Author(s):  
João Figueira ◽  
Rufino Silva ◽  
José Henriques ◽  
Paulo Caldeira Rosa ◽  
Inês Laíns ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Proliferative Diabetic Retinopathy ◽  
Controlled Trial ◽  
Combined Treatment ◽  
Panretinal Photocoagulation ◽  
Complete Regression ◽  
Duration Of Treatment ◽  
Intravitreal Ranibizumab ◽  
Rescue Treatment

Purpose: To compare the efficacy and safety of intravitreal ranibizumab (IVR) in monotherapy or associated with panretinal photocoagulation (PRP) versus conventional PRP, for high-risk proliferative diabetic retinopathy (PDR) without vitreoretinal traction. Procedures: Multicenter randomized trial, with 3 treatment arms: PRP versus IVR alone and PRP + IVR combined treatment. Follow-up was performed at months 3, 6 and 12. Results: Thirty-five subjects were randomized and 32 used for analysis. Complete regression of neovessels elsewhere occurred in 100% (PRP + IVR), 75% (IVR) and 69.2% (PRP) and for neovessels of the disk in 44.4% (PRP + IVR), 37.5% (IVR) and 30.8% (PRP). During the 1-year duration of treatment, there was no need for laser rescue treatment in IVR-treated eyes. Conclusions: This trial suggests that the use of IVR is safe and may have a beneficial effect in the treatment of eyes with high-risk PDR. Message: Ranibizumab appears to have a place in the treatment of PDR.

scholarly journals The Role of Angiogenesis in the Development of Proliferative Diabetic Retinopathy: Impact of Intravitreal Anti-VEGF Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Gemma Tremolada ◽  
Claudia Del Turco ◽  
Rosangela Lattanzio ◽  
Silvia Maestroni ◽  
Anna Maestroni ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Blood Vessels ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Antiangiogenic Treatment ◽  
Future Role ◽  
Therapeutic Protocol ◽  
Molecular Bases

Although cellular and molecular bases of proliferative diabetic retinopathy are only partially understood, it is evident that this complication of diabetes is characterized by the formation of new vessels inside the retina showing abnormal architecture and permeability. This process, if not controlled by selective laser photocoagulation, leads to irreversible retinal damages and loss of vision. Angiogenesis, that is, the condition characterized by the growth of new blood vessels originated from preexisting ones, was shown to have a major role in the pathogenesis of proliferative retinopathy and, as a consequence, intravitreal antiangiogenic injection was suggested as a feasible treatment for this disease. Here, we describe the different antiangiogenic approaches used to treat this disease along with the respective advantages and limitations when compared to laser treatment. Altogether, even though further and longer studies are still needed to clarify the best possible therapeutic protocol, the antiangiogenic treatment will reasonably have a future role in the therapy and prevention of proliferative diabetic retinopathy.

scholarly journals Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Rebecca Murtaza Rajar ◽  
Fahad Feroz Shaikh ◽  
Shafi Muhammad Jatoi
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Combination Therapy ◽  
Intravitreal Injection ◽  
Proliferative Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
University Hospital ◽  
Panretinal Photocoagulation ◽  
Pan Retinal Photocoagulation ◽  
Retinal Photocoagulation

Objective: To compare efficacy of intravitreal bevacizumab augmented with Panretinal photocoagulation versus Panretinal photocoagulation alone in high risk proliferative diabetic retinopathy. Methods: This is Randomized clinical control trial study conducted at ISRA University Hospital, Hyderabad from July 2018 to December 2018. A total of 76 eyes were randomized into two groups, 38 eyes undergone PRP plus intravitreal bevacizumab, while 38 eyes had PRP alone. Status of neovessels was assessed before and after treatment with the help of fundus fluorescein angiography. Neovessels at disc (NVD’s) and neovessels elsewhere (NVE’s) were assessed with the disc surface diameter. Results: Seventy-six eyes were enrolled in this randomized clinical trial into two groups consecutively, that all completed the six months follow-up. In the PRP group mean BCVA (logMAR) worsened significantly from mean 0.30±0.07 to mean 0.40±0.04 at a 30th day and mean 0.40±0.04 at day 90. While BCVA become improved from 0.30±0.05 to 0.1±0.03 at week four and 0.1±0.02 at week 12 in PRP-Plus group. There was significant change in regression of NVES in PRP only group at week 4 is 2.25±0.75 (p=0.00004) and at 12 weeks 2.00±0.50 (p=0.00002), while in PRP + intravitreal bevacizumab group at 4th week was 1±0.5 (p =0.0001) and at 12th week was 0.75±0.25 (p=0.0001). Conclusion: Intravitreal Bevacizumab augmented with PRP is more effective in early regression of neovessels in high risk PDR patients. doi: https://doi.org/10.12669/pjms.37.1.3141 How to cite this:Rebecca, Shaikh FF, Jatoi SM. Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy. Pak J Med Sci. 2021;37(1):157-161. doi: https://doi.org/10.12669/pjms.37.1.3141 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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