The Observation of Clinical Results for Macular Edema of Nonproliferative Diabetic Retinopathy by Multiwavelength Laser Combined with Retrobulbar Injection of Triamcinolone Acetonide

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.

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

Ophthalmic Research ◽

10.1159/000484666 ◽

2017 ◽

Vol 59 (2) ◽

pp. 59-67 ◽

Cited By ~ 3

Author(s):

Luísa Ribeiro ◽

Rajeev Pappuru ◽

Conceição Lobo ◽

Dalila Alves ◽

José Cunha-Vaz

Keyword(s):

Diabetic Retinopathy ◽

Macular Edema ◽

Tracer Study ◽

Nonproliferative Diabetic Retinopathy

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

Journal of Cataract & Refractive Surgery ◽

10.1016/j.jcrs.2006.03.039 ◽

2006 ◽

Vol 32 (9) ◽

pp. 1438-1444 ◽

Cited By ~ 48

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

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Effect of Adding Losartan to Bevacizumab for Treating Diabetic Macular Edema

Journal of Ophthalmology ◽

10.1155/2020/4528491 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Fariba Ghassemi ◽

Abdulrahim Amini ◽

Masoud Yasemi ◽

Amin Nabavi ◽

Mohammadkarim Johari

Keyword(s):

Blood Pressure ◽

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Glycosylated Hemoglobin ◽

Macular Thickness ◽

Central Macular Thickness ◽

Nonproliferative Diabetic Retinopathy ◽

Significant Difference

Introduction. Diabetic retinopathy is the most common cause of visual loss and blindness in the age group of 20 to 64 years. This study aimed to evaluate the efficacy of oral Losartan adjuvant therapy in combination with intravitreal injection of Bevacizumab in the treatment of diabetic macular edema. Methods. In this randomized clinical trial, 61 eyes of 47 patients with normal blood pressure and diabetic macular edema and nonproliferative diabetic retinopathy were studied. Patients were randomly divided into Losartan (n = 33) and control (n = 28) groups. All patients received 3–6 intravitreal injections of Bevacizumab over 6 months. General examination including blood pressure and glycosylated hemoglobin measurements were performed in all patients. Complete ophthalmologic examination and macular OCT were performed at the first, third, and sixth months of treatment in all patients. Results. The mean age of the patients studied was 57.1 ± 7.4 years and 37.7% of the patients were male. There was no significant difference between the two groups in terms of initial visual acuity, central macular thickness, and frequency of injections. There was no significant difference in visual acuity and central macular thickness between the two groups at the first, third, and sixth months of treatment. Age, frequency of injection, and initial macular thickness less than 450 microns were effective in patients’ final visual acuity. Conclusion. Short-term adjuvant treatment with Losartan in patients with diabetic macular edema and nonproliferative diabetic retinopathy has no greater effect than the standard treatment.

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Early Photocoagulation for Diabetic Retinopathy

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0030 ◽

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.

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Photocoagulation for Diabetic Macular Edema

50 Studies Every Ophthalmologist Should Know ◽

10.1093/med/9780190050726.003.0029 ◽

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.

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