scholarly journals Comparison of Visual Outcomes between Panretinal Photocoagulation and Panretinal Photocoagulation Plus Intravitreal Bevacizumab in Proliferative Diabetic Retinopathy Patients Treated at Northen Zonal Hospital

2020 ◽  
pp. 34-43
Author(s):  
Filemon Darabe ◽  
William Makupa
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Panretinal Photocoagulation ◽  
Pan Retinal Photocoagulation ◽  
The Mean ◽  
Retinal Photocoagulation

Introduction: Diabetic retinopathy is one of the rigorous microvascular complications of diabetes mellitus is the significant cause of visual impairment and consequently blindness affecting about 36% of the diabetic population. Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) are two prime manifestations of DR that are responsible for visual morbidity. The basis of the treatment in PDR is Laser photocoagulation as accomplished by Diabetic retinopathy treatment study (DRS) and early treatment diabetic retinopathy study (ETDRS) for the last two decades. The dawn of intravitreal anti-VEGF agents has revolutionized the management of diabetic eye disease for more than the last decade. The aim of the study is to compare the visual outcomes of diabetic retinopathy patients between pan-retinal photocoagulation and pan-retinal photocoagulation plus intravitreal Bevacizumab. Methodology: A hospital-based cross-section study using medical record information for all DR patients treated by PRP and IVB at the KCMC eye. Data were analyzed using SPSS version 20. Results: A number of 204 patients were included in the study. The mean age was 59.26 (SD=9.6) years; 75.4% were male. Most of the patients 71.1% are from Arusha and Kilimanjaro. Among all, 51% had PRP alone and the duration of Diabetes was 5-10 years in the majority. The mean VA for PRP alone was 0.89 (SD=0.89) before treatment while it was 1 (SD=0.99) in PRP plus Bevacizumab. At 3 months after treatment VA for PRP alone was 0.947 (SD=0.93) and 0.96 (SD=1.01) for PRP plus Bevacizumab. The mean difference was not statistically significant. VA improved by 49% and it deteriorated by 27.7%. The majority had early proliferated DR 49.7%, 42.8% high risk proliferated DR and advanced proliferated DR was 7.5%. The complications were found in 5.6% and they included: vitreous hemorrhage (4.6%) and retinal detachment (1%) in PRP plus Bevacizumab and none in PRP alone. Conclusion: With respect to this study there is no significant difference in visual outcome for PRP alone and PRP plus injection Bevacizumab, though PRP plus Bevacizumab in treatment of DR had better visual outcome over PRP alone. PRP plus injection Bevacizumab is associated with a higher and early rate of regression of active NVs than PRP alone in patients with PDR. Further studies will be needed to determine whether IVB plus PRP is a satisfactory treatment for the prevention of vision-threatening complications such as vitreous hemorrhage and tractional retinal detachment.

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.

scholarly journals Low Luminance Visual Acuity and Low Luminance Deficit in Proliferative Diabetic Retinopathy

2021 ◽  
Vol 10 (2) ◽  
pp. 358
Author(s):  
Eleni Karatsai ◽  
Piyali Sen ◽  
Sarega Gurudas ◽  
Sobha Sivaprasad
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Low Luminance ◽  
Pan Retinal Photocoagulation ◽  
Treatment Naïve ◽  
The Mean ◽  
Post Hoc ◽  
To Receive ◽  
Retinal Photocoagulation

This study aimed to determine the relation of best corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) in proliferative diabetic retinopathy (PDR) following treatment with either aflibercept or pan-retinal photocoagulation (PRP). The study was conducted as a post-hoc analysis of the CLARITY trial in which naïve and PRP treated PDR patients were randomised to receive either aflibercept or PRP. BCVA and LLVA were assessed at baseline and at week 52. Our analyses showed that the BCVA and LLVA correlate well in treatment naïve PDR with an average low luminance deficit of 11.79 Early Treatment Diabetic Retinopathy Score (ETDRS) letters. However, LLVA at lower levels of BCVA showed more variance. Post aflibercept therapy, the mean change in BCVA and LLVA at 52 weeks after aflibercept was +2.1 (SD 6.05) letters and +0.39 (SD 5.6) letters, respectively. Similarly, after PRP, it was −2.5 (SD 4.9) letters and −1.9 (SD 8.7) letters, respectively. When comparing treatment arms, BCVA change was found to be statistically significant (p < 0.001) whereas LLVA was not (p = 0.11). These findings show that LLVA does not respond as well as BCVA following any treatment for PDR, even though BCVA and LLVA both test foveal function.

scholarly journals Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

2019 ◽  
Vol 4 (1) ◽  
pp. e000390 ◽  
Author(s):  
Joonas Wirkkala ◽  
Risto Bloigu ◽  
Nina Maria Hautala
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Average Rate ◽  
Real Life ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Vitreous Haemorrhage ◽  
Panretinal Photocoagulation ◽  
Kaplan Meier ◽  
Real Life Data

ObjectiveTo evaluate the occurrence of vitreous haemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR) and the efficacy of intravitreal bevacizumab (IVB) for VH in 5-year real-life data.Methods and analysis850 adult patients with type 1 (T1D) or type 2 diabetes (T2D) with PDR were screened for VH. The effect of IVB was evaluated by the clearage of VH and the change in best corrected visual acuity (BCVA). The rates of VHs, reinjections, macular oedema, complications, additional treatments and outcomes of spontaneous resorption, panretinal photocoagulation or pars plana vitrectomy (PPV) for VH were also investigated.ResultsVH occurred in 16% of patients with T1D and 9% of patients with T2D with PDR. 336 VHs in 140 eyes of 103 patients were documented. VH was cleared in 92% of cases in less than 3 months by the initial IVB. IVB was superior to other treatment methods in shortening the time for clearance of VH (Kaplan-Meier, p<0.0001). The average rate of IVB reinjections was 1.7±1.1 and the reinjection interval was 7.2±3.9 weeks. BCVA increased 0.73±0.04 logarithm of the minimum angle of resolution units after IVB (generalised estimating equations, p=0.0004). In 5 years, the patients had 2.2±2.7 recurrence of VHs. A simultaneous 72% decrease in the rate of PPVs was documented (p<0.0001).ConclusionVH occurs mostly in patients with T1D. The therapeutic effect of IVB for VH was significant and led to improved clearance of VH and visual outcome. Moreover, IVB prevented persistent and recurrent VHs and decreased the need for costly PPV.

scholarly journals Effect of panretinal photocoagulation on optic nerve head blood flow with OCT angiography in patients with diabetic retinopathy

2020 ◽  
Vol 36 (5) ◽  
Author(s):  
Saher Akbar Amanat ◽  
Dr Asad Aslam Khan ◽  
Dr Haroon Tayyab ◽  
Dr Sohail Sarwar
Keyword(s):  
Blood Flow ◽  
Diabetic Retinopathy ◽  
Optic Nerve ◽  
Proliferative Diabetic Retinopathy ◽  
Optic Nerve Head ◽  
Ocular Blood Flow ◽  
Oct Angiography ◽  
Panretinal Photocoagulation ◽  
Pan Retinal Photocoagulation ◽  
Retinal Photocoagulation

Objective: To investigate the effect of pan retinal photocoagulation (PRP) on Optic nerve head blood flow with OCT angiography in patients with proliferative diabetic retinopathy. Methods: This prospective interventional study was conducted at Eye Unit III, Institute of Ophthalmology, Mayo Hospital, Lahore, over a period of seven months i.e. from 10th May 2019 to 10th November 2019. Thirty-five patients having proliferative diabetic retinopathy were included in this study. Ocular blood flow was measured with OCT Angiography, then pan retinal photocoagulation was performed and patients were called for follow-up after one month and ocular blood flow was measured again with OCT Angiography. The difference in the blood flow was calculated. Frequencies and percentages were calculated for the categorical data and mean and standard deviations were calculated for the continuous data. Wilcoxon matched-pairs signed rank test was performed and effects of PRP on blood flow were compared. Significance level was taken as p≤0.05. Results: Out of 35 patients, 30 patients (85.71%) had decreased post PRP blood flow, four patients (11.43%) had increased post PRP blood flow and one patient (2.86%) did not have any effect. Conclusion: OCT angiography revealed there is significantly reduced optic nerve head blood flow in PRP treated eyes compared to non-PRP treated eyes. doi: https://doi.org/10.12669/pjms.36.5.2190 How to cite this:Amanat SA, Khan AA, Tayyab H, Sarwar S. Effect of panretinal photocoagulation on optic nerve head blood flow with OCT angiography in patients with diabetic retinopathy. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2190 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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