Ranibizumab for High-Risk Proliferative Diabetic Retinopathy: An Exploratory Randomized Controlled Trial

2015 ◽  
Vol 235 (1) ◽  
pp. 34-41 ◽  
Author(s):  
João Figueira ◽  
Rufino Silva ◽  
José Henriques ◽  
Paulo Caldeira Rosa ◽  
Inês Laíns ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Proliferative Diabetic Retinopathy ◽  
Controlled Trial ◽  
Combined Treatment ◽  
Panretinal Photocoagulation ◽  
Complete Regression ◽  
Duration Of Treatment ◽  
Intravitreal Ranibizumab ◽  
Rescue Treatment

Purpose: To compare the efficacy and safety of intravitreal ranibizumab (IVR) in monotherapy or associated with panretinal photocoagulation (PRP) versus conventional PRP, for high-risk proliferative diabetic retinopathy (PDR) without vitreoretinal traction. Procedures: Multicenter randomized trial, with 3 treatment arms: PRP versus IVR alone and PRP + IVR combined treatment. Follow-up was performed at months 3, 6 and 12. Results: Thirty-five subjects were randomized and 32 used for analysis. Complete regression of neovessels elsewhere occurred in 100% (PRP + IVR), 75% (IVR) and 69.2% (PRP) and for neovessels of the disk in 44.4% (PRP + IVR), 37.5% (IVR) and 30.8% (PRP). During the 1-year duration of treatment, there was no need for laser rescue treatment in IVR-treated eyes. Conclusions: This trial suggests that the use of IVR is safe and may have a beneficial effect in the treatment of eyes with high-risk PDR. Message: Ranibizumab appears to have a place in the treatment of PDR.

Sequence effect in the treatment of proliferative diabetic retinopathy with intravitreal ranibizumab and panretinal photocoagulation

2018 ◽  
Vol 30 (1) ◽  
pp. 34-39
Author(s):  
Guofan Cao ◽  
Xiangzhong Xu ◽  
Chenghu Wang ◽  
Shu Zhang
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Proliferative Diabetic Retinopathy ◽  
Additional Treatment ◽  
Macular Thickness ◽  
Panretinal Photocoagulation ◽  
Central Macular Thickness ◽  
Fundus Fluorescein Angiography ◽  
Intravitreal Ranibizumab ◽  
The Status

Purpose: To compare the outcome of the sequence in the two treatments (intravitreal ranibizumab and panretinal photocoagulation) in high-risk proliferative diabetic retinopathy. Methods: This retrospective study included 35 patients with newly diagnosed high-risk proliferative diabetic retinopathy in 43 eyes; 18 (22 eyes) received intravitreal ranibizumab before panretinal photocoagulation (intravitreal ranibizumab+ group), while the other 17 (21 eyes) received panretinal photocoagulation before intravitreal ranibizumab (panretinal photocoagulation+ group). Each subject received three intravitreal ranibizumabs that were interleaved with three panretinal photocoagulations. The first treatment (either intravitreal ranibizumab or panretinal photocoagulation) was done 1 week before the second one. The interval between intravitreal ranibizumabs was 4 weeks, panretinal photocoagulation was 2 weeks. The power and pulse duration were determined based upon the status of each retinal spot before each panretinal photocoagulation. The retinal non-perfusion region was measured with fundus fluorescein angiography before and 1 month after the final treatment. The central macular thickness was measured with optical coherence tomography within 1 week before the first treatment, before each panretinal photocoagulation, and 1 month after the final intravitreal ranibizumab. Results: The panretinal photocoagulation energy required for effective treatment was lower in intravitreal ranibizumab+ group in the first and second sessions and in total energy (p < 0.05). Central macular thickness reduction before the second panretinal photocoagulation session was significant in the intravitreal ranibizumab+ group (p < 0.05). Conclusion: The sequence used in intravitreal ranibizumab+ group showed clear advantages over that in panretinal photocoagulation+ group in the treatment of proliferative diabetic retinopathy, not only in the use of lower energy for panretinal photocoagulation but also in the more rapid regression of neovascularization and less need of additional treatment.

Panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab for high-risk proliferative diabetic retinopathy

2011 ◽  
Vol 89 (7) ◽  
pp. e567-e572 ◽  
Author(s):  
José A. R. Filho ◽  
André Messias ◽  
Felipe P. P. Almeida ◽  
Jefferson A. S. Ribeiro ◽  
Rogério A. Costa ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Proliferative Diabetic Retinopathy ◽  
Panretinal Photocoagulation ◽  
Intravitreal Ranibizumab

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.

Ranibizumab Plus Panretinal Photocoagulation versus Panretinal Photocoagulation Alone for High-Risk Proliferative Diabetic Retinopathy (PROTEUS Study)

Ophthalmology ◽  
2018 ◽  
Vol 125 (5) ◽  
pp. 691-700 ◽  
Author(s):  
João Figueira ◽  
Emily Fletcher ◽  
Pascale Massin ◽  
Rufino Silva ◽  
Francesco Bandello ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Proliferative Diabetic Retinopathy ◽  
Panretinal Photocoagulation

scholarly journals Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy

2013 ◽  
Vol 76 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Célia Regina Farias de Araújo Lucena ◽  
José Afonso Ramos Filho ◽  
André Márcio Vieira Messias ◽  
José Aparecido da Silva ◽  
Felipe Piacentini Paes de Almeida ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
High Risk ◽  
Intravitreal Injection ◽  
Proliferative Diabetic Retinopathy ◽  
Panretinal Photocoagulation
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