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 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 Intravitreal aflibercept partially reverses severe non-proliferative diabetic retinopathy in treatment-naïve patients

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098536
Author(s):  
Yuan Tao ◽  
Pengfei Jiang ◽  
Min Liu ◽  
Ying Liu ◽  
Lihua Song ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Intravitreal Injection ◽  
Proliferative Diabetic Retinopathy ◽  
Posterior Pole ◽  
Foveal Thickness ◽  
Hard Exudates ◽  
Central Foveal Thickness ◽  
Treatment Naïve ◽  
The Mean ◽  
Retinal Microaneurysms

Objective To evaluate whether diabetic retinopathy can be reversed after aflibercept, based on improvements in diabetic macular edema, hard exudates (HEs) of the posterior pole, and retinal microaneurysms (MAs). Methods This was a single-center retrospective study of 30 patients (34 eyes) with severe non-proliferative diabetic retinopathy (NPDR) who were treated between August and October 2018. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), area of HEs, and number of MAs were compared before and after treatment. Results The mean patient age was 61.4 ± 7.1 years; 14 patients (46.7%) were men. The mean number of injections per patient was 3.5 ± 0.5. The time between the last injection and the last follow-up was 82 days (range, 78–110 days). Six months after the first intravitreal injection, significant improvement was observed in BCVA (from 0.70 ± 0.18 to 0.42 ± 0.19 logMAR), CFT (from 377.17 ± 60.41 to 261.21 ± 31.50 µm), and number of MAs (from 182.2 ± 77.4 to 101.5 ± 59.6). Observations over 6 months after the first intravitreal injection showed a statistically significant reduction in the area of HEs (P = 0.007). No adverse events occurred during the treatment period. Conclusion Diabetic retinopathy might be partially reversed by aflibercept treatment, as indicated by BCVA, CFT, number of MAs, and area of HEs.

Impact and Characterization of Delayed Pan-Retinal Photocoagulation in Proliferative Diabetic Retinopathy

2021 ◽  
Vol 223 ◽  
pp. 267-274
Author(s):  
Marc Ohlhausen ◽  
Carter Payne ◽  
Tyler Greenlee ◽  
Andrew X. Chen ◽  
Thais Conti ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Pan Retinal Photocoagulation ◽  
Retinal Photocoagulation

scholarly journals Subthreshold Pan-retinal Photocoagulation Using Endpoint Management Algorithm for Severe Non-proliferative Diabetic Retinopathy: A Paired Controlled Pilot Prospective Study

2020 ◽  
Author(s):  
Kunbei Lai ◽  
Hongkun Zhao ◽  
Lijun Zhou ◽  
Chuangxin Huang ◽  
Xiaojing Zhong ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Outcome Measures ◽  
Proliferative Diabetic Retinopathy ◽  
Controlled Trial ◽  
Alternative Treatment Option ◽  
Pan Retinal Photocoagulation ◽  
Risk Of Progression ◽  
One Year ◽  
Retinal Photocoagulation

Purpose: To report the efficacy and safety profile of subthreshold pan-retinal photocoagulation (PRP) using endpoint management (EPM) algorithm compared with conventional threshold PASCAL PRP for the treatment of severe non-proliferative diabetic retinopathy (NPDR). Methods: This was a prospective, single center, paired randomized controlled trial of fifty-six eyes of twenty-eight participants with bilateral symmetric severe NPDR. One eye of the participant was randomly assigned to receive the subthreshold EPM PRP, while the other eye of the same participant received the threshold PASCAL PRP. The primary outcome measures included the difference in the one-year risk of progression to PDR between two groups, and mean changes of the logarithm of the minimal angle of resolution (logMAR) visual acuity (VA). The second outcome measures included central foveal thickness (CFT), one-year risk of progression to PDR, and visual field (VF) parameters. Results: The subthreshold EPM PRP group and the threshold PASCAL PRP group had similar one-year risk of progression to PDR during the 12-month follow-up visits (17.86% vs 14.29%, P>0.05). Slightly decreased VA was found in both groups (0.08 vs 0.09 logMAR VA), however, no statistical difference was found for neither group (P>0.05). Similar results were found for thickened CFT for both groups (23.59μm vs 28.34μm, P>0.05). Specifically, although substantial loss of VF was found in the threshold PASCAL PRP group (P<0.05), no obvious damage to VF was seen in the subthreshold EPM PRP group (P>0.05). Conclusion: The subthreshold EPM PRP is non-inferior to the conventional threshold PASCAL PRP in the treatment of severe NPDR during 12-month follow-up and could be an alternative treatment option for patients with severe NPDR.

scholarly journals Effect of Bevacizumab Injection before Vitrectomy on Intravitreal Hemorrhage in Pseudophakic Patients with Proliferative Diabetic Retinopathy

2013 ◽  
Vol 5 ◽  
pp. OED.S12352 ◽  
Author(s):  
Mehmet Demir ◽  
Ersin Oba ◽  
Efe Can ◽  
Orhan Kara ◽  
Sonmez Cinar
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Intravitreal Bevacizumab ◽  
Central Macular Thickness ◽  
Intraoperative Bleeding ◽  
Corrected Visual Acuity ◽  
Pars Plana ◽  
The Mean

We evaluated the effect of intravitreal bevacizumab (IVB) injection before pars plana vitrectomy (PPV) on intravitreal hemorrhage (VH) during and after vitrectomy for postoperative the first day and the first month in pseudophakic patients with proliferative diabetic retinopathy (PDR). This retrospective study was performed on 44 eyes of 44 patients who underwent vitrectomy for PDR. Patients were divided into PPV (n = 22 eyes) and PPV + IVB (n = 22 eyes) groups. Injection of bevacizumab (1.25 mg/0.05 mL) was performed 3 days before vitrectomy. Outcomes of visual acuity as well as intraoperative and postoperative VH were compared between the two groups. One month after surgery, visual acuity improved in PPV and PPV + IVB groups ( P = 0.005, P = 0.006), respectively. There was no difference between the two groups in best corrected visual acuity at baseline and after vitrectomy ( P = 0.71). Intraoperative bleeding into the vitreous was recorded in 14 (63.6%) cases in the PPV group and in 7 (31.8%) cases in the PPV + IVB group. The first month, intravitreal hemorrhage was recorded in six patients in the PPV group and in two patients in the PPV + IVB group ( P = 0.03). The mean pre-postoperative central macular thickness was similar in both groups. Intravitreal injection of IVB before vitrectomy decreased the rate of VH at the time of surgery and at the first postoperative month in patients with PDR.

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