Laser Treatment of Proliferative Diabetic Retinopathy: Why, When, How?

2015 ◽  
pp. 221-226
Author(s):  
Rosario Brancato ◽  
Francesco Bandello ◽  
Rosangela Lattanzio
Keyword(s):  
Diabetic Retinopathy ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy

scholarly journals Treatment of cystoid macular edema in a patient with primary open angle glaucoma and diabetic retinopathy by withdrawal of travoprost

2021 ◽  
Vol 7 (2) ◽  
pp. 180-183
Author(s):  
Shiv Sagar N ◽  
BN Kalpana ◽  
Shilpa YD
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Cystoid Macular Edema ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Antiglaucoma Medication ◽  
Micropulse Laser

To study the association of cystoid macular edema (CME) and Travoprost eye drops in a patient with diabetic retinopathy (DR).The study was carried out on a 65yr old patient on a regular follow up from 2009-2018.A 65yr old patient of a DR of both eyes who had received 3 sittings of pan retinal photocoagulation (PRP) laser in both eyes and grid laser to his right eye. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Patient was also on topical antiglaucoma medication and had prophylactic YAG-PI done both eyes. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Right eye showed macular edema (ME) in 2014 and underwent OCT and FFA. Patient refused for intravitreal injection and preferred laser treatment, so patient underwent micropulse laser treatment in 2014. His edema persisted even after micropulse treatment. His systemic control was good and patient continued to use Travoprost eye drops. So in 2017 suspected CME secondary to topical prostaglandin (PG) analogue as he had strict glycemic control and was no fluctuation in ME. Hence topical PG analogue was withdrawn and stopped. On subsequent follow up after 2 months CME had completely disappeared and the foveal contour returned to normal on OCT. LE was status quo. Patient was followed up for more than 1 year and continuously followed up, 15 days back in June 2018 had no evidence of CME and vision was 6/9 in both eyes.: Differentiation of DME and CME secondary to PG analogue should be made at the earliest.

Proliferative Diabetic Retinopathy: Laser Treatment and Intravitreal Medication

2012 ◽  
pp. 58-64
Author(s):  
Francesco Bandello ◽  
Maurizio Battaglia Parodi ◽  
Rosangela Lattanzio ◽  
Anders Knutsson
Keyword(s):  
Diabetic Retinopathy ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy

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.

scholarly journals Retinal vascular oxygen saturation in response to a less extensive laser treatment in proliferative diabetic retinopathy

2020 ◽  
Author(s):  
Anna Stage Vergmann ◽  
Thomas Lee Torp ◽  
Ryo Kawasaki ◽  
Danjal Hofgaard Hestoy ◽  
Tien Yin Wong ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Oxygen Saturation ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy

Statin reduces the incidence of diabetic retinopathy and its need for intervention: A systematic review and meta-analysis

2020 ◽  
pp. 112067212092244 ◽  
Author(s):  
Raymond Pranata ◽  
Rachel Vania ◽  
Andi Arus Victor
Keyword(s):  
Diabetic Retinopathy ◽  
Intravitreal Injection ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Literature Search ◽  
Meta Analysis ◽  
Hazard Ratio ◽  
Systematic Literature Search ◽  
Comprehensive Search

Purpose: We aimed to perform a systematic literature search on the latest evidence of the role of statin in reducing diabetic retinopathy and its need for intervention. Methods: A comprehensive search on cohort studies/clinical trials that assess statins and diabetic retinopathy up until August 2019 was performed. The outcome measured was the incidence of diabetic retinopathy and its need for intervention. Results: There were 558.177 patients from six studies. Statin was associated with a lower incidence of diabetic retinopathy (hazard ratio: 0.68 (0.55, 0.84), p < 0.001; I2: 95%). For the subtypes of diabetic retinopathy, statin lowers the incidence of proliferative diabetic retinopathy (hazard ratio: 0.69 (0.51, 0.93), p = 0.01; I2: 90%), non-proliferative diabetic retinopathy (hazard ratio: 0.80 (0.66, 0.96), p = 0.02; I2: 93%), and diabetic macular edema (hazard ratio: 0.56 (0.39, 0.80), p = 0.002; I2: 82%). Statin was associated with a reduced need for retinal laser treatment with a hazard ratio of 0.70 (0.64, 0.76) (p < 0.001; I2: 0%), intravitreal injection with a hazard ratio of 0.82 (0.79, 0.85) (p < 0.001; I2: 0%), and vitrectomy with a hazard ratio of 0.64 (0.48, 0.85) (p < 0.001; I2: 75%). Overall, statin was associated with a reduced need for intervention for diabetic retinopathy with a hazard ratio of 0.72 (0.64, 0.80) (p < 0.001; I2: 73%). The regression-based Egger’s test showed statistically significant small-study effects for non-proliferative diabetic retinopathy (p = 0.011) outcomes. Conclusion: Statin was associated with a decreased risk of diabetic retinopathy and its subtypes. Statin also reduced the need for intervention with retinal laser treatment, intravitreal injection, and vitrectomy.

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.

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