scholarly journals OC14.06: The risks of the Solomon technique of fetoscopic laser photocoagulation for Twin-twin transfusion syndrome

2018 ◽  
Vol 52 ◽  
pp. 34-34
Author(s):  
S. Kanazawa ◽  
R. Sugibayashi ◽  
K. Ozawa ◽  
S. Wada ◽  
Y. Ito ◽  
...  
Keyword(s):  
Laser Photocoagulation ◽  
Solomon Technique

scholarly journals Ultrasound Assessment and Surgical Treatment of Twin-Twin Transfusion Syndrome

2013 ◽  
Vol 7 (4) ◽  
pp. 415-425
Author(s):  
Eftichia V Kontopoulos ◽  
Rubén A Quintero
Keyword(s):  
Surgical Treatment ◽  
Laser Photocoagulation ◽  
Laser Technique ◽  
Sonographic Examination ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Fundamental Laser ◽  
Ultrasound Assessment ◽  
Outcome Differences ◽  
Solomon Technique

ABSTRACT The ultrasound diagnosis, management and treatment of twintwin transfusion syndrome (TTTS) have had a remarkable number of positive developments in the last 20 years. Together, they have resulted in TTTS being the most common condition seen and treated in fetal therapy centers today. This chapter discusses the basic ultrasound assessment of TTTS patients in a step-by-step fashion, to provide a structure to the sonographic examination. This includes review of the diagnostic criteria, the sonographic assessment of disease severity and preoperative ultrasound assessment. The chapter also reviews the rationale for, as well as the fundamental laser technique and its variations, including the nonselective technique, selective laser photocoagulation of communicating vessels (SLPCV), sequential selective laser photocoagulation of the communicating vessels (SQLPCV) and the ‘Solomon’ technique, and provides potential explanations for the outcome differences of each technique. Future developments in terms of surgical technique and long-term outcome studies are also discussed. How to cite this article Quintero RA, Kontopoulos EV. Ultrasound Assessment and Surgical Treatment of Twin-Twin Transfusion Syndrome. Donald School J Ultrasound Obstet Gynecol 2013;7(4):415-425.

Current Therapy of Diabetic Macular Edema Bevacizumab, Triamcinolone Acetonide, and Laser Photocoagulation

2019 ◽  
Vol 45 (1) ◽  
pp. 13
Author(s):  
Gladys Kusumowidagdo ◽  
Randy Sarayar ◽  
Kartika Rahayu ◽  
Gitalisa Andayani
Keyword(s):  
Macular Edema ◽  
Triamcinolone Acetonide ◽  
Diabetic Macular Edema ◽  
Systematic Reviews ◽  
Laser Photocoagulation ◽  
Meta Analysis ◽  
Intravitreal Bevacizumab ◽  
Current Therapy ◽  
Intravitreal Triamcinolone ◽  
Mesh Terms

Background: Diabetic macular edema (DME) is the main cause of visual impairment in diabetic retinopathy (DR). Current gold standard therapy of DME is macular laser photocoagulation (MPC). Growing evidences have shown benefits of intravitreal anti-VEGF agents (i.e bevacizumab) and intravitreal corticosteroids (i.e triamcinolone acetonide). Aim: To compare the visual acuity (VA) improvement of patients with DME, treated with intravitreal bevacizumab (IVB), a combination of IVB and intravitreal triamcinolone (IVB/IVT), and MPC. Method: A comprehensive PubMed® and Cochrane® databases search was conducted on May 4th, 2017 using appropriate keywords (diabetic macular edema, bevacizumab, triamcinolone, and laser photocoagulation using their MeSH terms). Studies were filtered using inclusion criterions (clinical trials, RCT, meta-analysis, systematic review, English, humans, and publication within 10 years) Results: Three studies (2 systematic reviews and 1 RCT) were found suitable. From these results, all studies showed favoring effects of IVB when compared to IVB/IVT combination and MPC in short term period (up to 6 months). However, there was no significant improvement of VA beyond this period in all groups. Conclusion: IVB appears to be superior to IVB/IVT and MPC in improving VA during 6 months follow- up period. Future systematic reviews and meta-analysis are required on the effect of IVB and MPC combination in cases of DME.

Laser photocoagulation for diabetic retinopathy

2008 ◽  
Author(s):  
Brendan Dineen ◽  
Frank Waldron-Lynch ◽  
Fiona Harney ◽  
Sean F Dinneen ◽  
Andrew Murphy
Keyword(s):  
Diabetic Retinopathy ◽  
Laser Photocoagulation

scholarly journals Intravitreal conbercept for diabetic macular oedema: 2-year results from a randomised controlled trial and open-label extension study

2021 ◽  
pp. bjophthalmol-2020-318690
Author(s):  
Kun Liu ◽  
Hanying Wang ◽  
Wei He ◽  
Jian Ye ◽  
Yanping Song ◽  
...  
Keyword(s):  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Sham Group ◽  
Controlled Trial ◽  
Diabetic Macular Oedema ◽  
Intravitreal Injections ◽  
Phase Iii ◽  
Extension Study ◽  
Open Label ◽  
Open Label Extension

BackgroundTo demonstrate the efficacy and safety of intravitreal injections of conbercept versus laser photocoagulation in the treatment of diabetic macular oedema (DME).MethodsA 12-month multicentre, randomised, double-masked, double-sham, parallel controlled, phase III trial (Sailing Study), followed by a 12-month open-label extension study. Patients with centre-involved DME were randomly assigned to receive either laser photocoagulation followed by pro re nata (PRN) sham intravitreal injections (laser/sham) or sham laser photocoagulation followed by PRN 0.5 mg conbercept intravitreal injections (sham/conbercept). Patients who entered the extension study received PRN conbercept treatment. The primary endpoint was the changes in best-corrected visual acuity (BCVA) from baseline.ResultsA total of 248 eyes were included in the full analysis set and 157 eyes continued in the extension study. Significant improvement in mean change in BCVA from baseline to month 12 was observed in the sham/conbercept group (8.2±9.5 letters), whereas no improvement was observed in the laser/sham group (0.3±12.0 letters). Patients in the laser/sham group showed a marked improvement in BCVA after the switch to conbercept in the extension study, and there was no difference in BCVA between the two groups at the end of the extension study.ConclusionThe use of a conbercept PRN intravitreal injection regimen improved the BCVA of patients with DME, and its efficacy was better than that of laser photocoagulations, and the same efficacy was observed when the eyes treated with laser alone were switched to conbercept.Trial registration numberNCT02194634.

scholarly journals Cost-effectiveness analysis of ranibizumab for retinal vein occlusion patients in China from the societal perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Weiyi Ni ◽  
Jia Liu ◽  
Yawen Jiang ◽  
Jing Wu
Keyword(s):  
Cost Effectiveness ◽  
Retinal Vein Occlusion ◽  
Societal Perspective ◽  
Laser Photocoagulation ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Gdp Per Capita ◽  
Base Case ◽  
Vein Occlusion ◽  
Per Capita

Abstract Background Clinical trials in China have demonstrated that ranibizumab can improve the clinical outcomes of branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). However, no economic evaluation of ranibizumab has been conducted among Chinese patient population. Methods To provide insights into the economic profile of ranibizumab among Chinese RVO population, a Markov state-transition model was used to predict the outcomes of ranibizumab comparing to laser photocoagulation and observational-only care from the societal perspective. This model simulated changes in patient visuality, quality-adjusted of life years (QALY), medical costs, and direct non-medical costs of individuals with visual impairment due to BRVO or CRVO in lifetime. The base-case analysis used an annual discount rate of 5% for costs and benefits following the China Guidelines for Pharmacoeconomic Evaluations. Deterministic and probabilistic sensitivity analyses were performed to test the robustness of the model. Results The base-case incremental cost-effectiveness ratio (ICER) comparing ranibizumab to laser photocoagulation was ¥65,008/QALY among BRVO patients and was ¥65,815/QALY among CRVO patients, respectively. Comparing to the 2019 gross domestic product (GDP) per capita of ¥71,000, both two ICERs were far below the cost-effective threshold at three times of GDP per capita (¥213,000). The deterministic and probabilistic sensitivity analyses demonstrated the base-case results were robust in most of the simulation scenarios. Conclusion The current Markov model demonstrated that ranibizumab may be cost-effective compared with laser photocoagulation to treat BRVO and cost-effective compared to observation-only care to treat CRVO in China from the societal perspective.

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