scholarly journals Combined triamcinolone acetonide injection and grid laser photocoagulation: a promising treatment for diffuse diabetic macular oedema?

2007 ◽  
Vol 91 (4) ◽  
pp. 407-408 ◽  
Author(s):  
T. Iida
Keyword(s):  
Triamcinolone Acetonide ◽  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Diabetic Macular Oedema ◽  
Promising Treatment

Comparison of Safety and Efficacy of Grid Laser Versus Combination of Sequential Intravitreal Triamcinolone Acetonide and Grid Laser in Treatment of Diabetic Macular Oedema - Randomized Open Label Study, Bangalore, Karnataka

2021 ◽  
Vol 8 (27) ◽  
pp. 2451-2456
Author(s):  
Shashidhar S ◽  
Sachin M. Kasbe ◽  
Adhar V. Nayak ◽  
Shivakumar D
Keyword(s):  
Visual Acuity ◽  
Triamcinolone Acetonide ◽  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Diabetic Macular Oedema ◽  
Synergistic Action ◽  
Intravitreal Triamcinolone ◽  
Intravitreal Triamcinolone Acetonide ◽  
Group 2 ◽  
Group 1

BACKGROUND The reported prevalence of diabetic retinopathy in diabetics is around 40 %. Diabetic macular oedema (DME) is defined as macular thickening resulting from diabetic retinopathy, due to leakage from micro aneurysms, or from a diffuse leakage of hyper permeable capillaries. Intravitreal injection of triamcinolone acetonide (IVTA) has gained considerable interest and clinical use because it often has beneficial effect on retinal thickening in DME. The synergistic action of IVTA and laser photocoagulation might increase and prolong the beneficial effects of IVTA in reducing ME. Hence the need for a study to compare efficacies of grid laser, and combination of sequential IVTA and grid laser in treating patients with DME. We wanted to evaluate functional and morphological outcome of grid laser versus combination of sequential intravitreal triamcinolone acetonide and grid laser in treatment of diabetic macular oedema. METHODS The study included 62 eyes with DME. There were 31 eyes which received grid laser photocoagulation (group 1) and 31 eyes which received grid laser photocoagulation following IVTA (group 2) and visual acuity, CMT on OCT was compared at baseline and after day 1, 1st week, 4th week and 12th week. Outcome and comparative efficacies were evaluated. RESULTS Our study shows reduced macular thickness and improved visual acuity in group 2 compared to group 1 in all follow ups. On intragroup analysis, we found a significant reduction in CMT in both groups at 1 week, 4 weeks and 12 weeks as compared to baseline. In our study we also compared CMT between group 1 and group 2 which did not show significant difference at baseline. But, difference in CMT from baseline at each follow up which is at 1 week, 4 weeks and 12 weeks between two groups showed more reduction in CMT in group 2 compared to group 1. CONCLUSIONS There was a significant reduction in CMT in all the follow ups of both groups, but group 2 had more reduction in CMT compared to group 1. The synergistic action of IVTA and laser photocoagulation might increase and prolong the beneficial effect of IVTA in reducing ME. This study found evidence of synergistic effects of IVTA and laser photocoagulation in DME in terms of improving visual acuity and in reducing CMT compared to grid laser alone and should be tried as a modality of treatment in DME. KEYWORDS DME, IVTA, CMT, Macular grid laser, OCT

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 Argon laser photocoagulation for diabetic macular oedema

Eye ◽  
2006 ◽  
Vol 20 (12) ◽  
pp. 1471-1472
Author(s):  
N E Sinclair ◽  
A Booth ◽  
A Clover ◽  
R Newsom
Keyword(s):  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Diabetic Macular Oedema ◽  
Argon Laser ◽  
Argon Laser Photocoagulation

scholarly journals The predictive value of optical coherence tomography after grid laser photocoagulation for diffuse diabetic macular oedema

2007 ◽  
Vol 86 (3) ◽  
pp. 284-291 ◽  
Author(s):  
Wael Soliman ◽  
Birgit Sander ◽  
Kamell Abd El-Naser Soliman ◽  
Sameer Yehya ◽  
Mohamed Saad Abdel Rahamn ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Macular Oedema ◽  
Predictive Value ◽  
Laser Photocoagulation ◽  
Diabetic Macular Oedema ◽  
Optical Coherence

scholarly journals Subthreshold 577 nm laser photocoagulation vesus conventional 532 nm laser photocoagulation for diabetic macular oedema

2021 ◽  
Vol 3 (3) ◽  
pp. 123-140
Author(s):  
Linda Sui-Lin Ong ◽  
Tajunisah Mohd Iqbal ◽  
Kenneth Choong-Sian Fong
Keyword(s):  
Diode Laser ◽  
Macular Oedema ◽  
Laser Photocoagulation ◽  
Retinal Thickness ◽  
Diabetic Macular Oedema ◽  
Macular Thickness ◽  
Clinically Significant ◽  
Clinically Significant Macular Oedema ◽  
532 Nm

Purpose: To evaluate the visual and anatomic outcomes of the subthreshold micropulse 577 nm yellow diode laser (MYL) and to compare its efficacy with the conventional green 532 nm diode laser (CGL) in Asian eyes with diabetic macular oedema (DME).Study design: Prospective randomized controlled clinical trialMethods: Sixty-seven eyes of 43 patients with clinically significant macular oedema (CSME) were randomized to receive either MYL (n = 37) or CGL (n = 30) at baseline and were followed up for 12 months. Titration in the MYL group was performed with 15% duty cycle, 300 ms duration, and double the threshold power, while the modified Early Treatment of Diabetic Retinopathy Study (mETDRS) protocol was used for the CGL arm with the power titrated to a barely visible burn. Parameters noted included best-corrected visual acuity (BCVA) (logMAR), central subfoveal thickness (CST), macular volume (MV), and average macular thickness (AMT) using optical coherence tomography, and presence of visible laser scars on colour fundus photographs and fundus autofluorescence, at baseline and at 12 months.Results: At 12 months follow-up, BCVA improved by 4.7 and 8.8 letters, respectively, for the MYL and CGL treatment arms (p < 0.05). There was a significant reduction in all retinal thickness parameters (CST, MV, and AMT) when compared to baseline in both laser treatment arms at 12 months. There was no significant difference in either BCVA or retinal thickness parameters between the two treatment arms at 1, 3, 6, 9, or 12-month follow-up. Laser scars were observed in 26.7% of patients in the MYL group compared to 75% of patients in the CGL group (p = 0.029).Conclusions: MYL is an effective, safe, and patient-friendly treatment option for clinically significant macular oedema, with improvement in BCVA, reduction in macular thickness, and less scarring after treatment at 12 months.

scholarly journals Triamcinolone Acetonide for the Treatment of Diabetic Macular Oedema

2010 ◽  
Vol 8 (1) ◽  
pp. 42
Author(s):  
Valentina Sarao ◽  
Daniele Veritti ◽  
Paolo Lanzetta ◽  
◽  
◽  
...  
Keyword(s):  
Triamcinolone Acetonide ◽  
Macular Oedema ◽  
Diabetic Macular Oedema ◽  
Standard Of Care ◽  
Blood Retinal Barrier ◽  
Intravitreal Triamcinolone ◽  
Duration Of Action ◽  
Routes Of Administration ◽  
Severe Visual Loss ◽  
Randomised Controlled

Diabetic macular oedema is a major cause of severe visual loss whose pathogenesis appears to be complex and multifactorial. For many years laser photocoagulation has been the standard of care for the treatment of this condition. Emerging pharmacologic approaches are being evaluated through randomised controlled trials. Triamcinolone acetonide has been proposed as a promising option, due to its well-known anti-inflammatory, anti-permeability and anti-angiogenic properties. Intravitreal delivery allows bypassing of the blood–retinal barrier to achieve a more concentrated dose of steroid in the vitreal cavity for a prolonged time. Intravitreal triamcinolone acetonide is effective in reducing central macular thickness and improving visual acuity, even if the duration of action is often provisional and requires repeated injections. Drug-related and injection-related side effects have been reported; the most common are induced cataract and increased intraocular pressure. To extend the duration of steroid effects and to minimise the risk of complications, alternative routes of administration and extend-release implants are being investigated.

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