The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy

Abstract

OBJECTIVES:To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy.METHODS:High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505.RESULTS:Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values.CONCLUSIONS:The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.

<p>Evaluation Of The Timing Of Intravitreal Bevacizumab Injection As Adjuvant Therapy To Panretinal Photocoagulation In Patients With Diabetic Macular Edema Secondary To Diabetic Retinopathy</p>

“…CMT was evaluated before and 1 month after injection. CMT reduction of eyes in group A was consistent with previous studies 21. Bevacizumab prevented ME secondary to PRP in these patients.…”

Effectiveness of Panretinal Photocoagulation Plus Intravitreal Anti-VEGF Treatment Against PRP Alone for Diabetic Retinopathy: A Systematic Review With Meta-Analysis

“…9 studies ( 7 , 8 , 11 – 17 ) reported changes of BCVA, among which 4 studies ( 7 , 12 , 16 , 17 ) specified the changes of BCVA in logMAR and 5 studies ( 8 , 11 , 13 – 15 ) in letters. 7 studies ( 9 – 11 , 13 , 15 – 17 ) measured the changes of CMT. 2 studies ( 7 , 16 ) reported changes of NVD and NVE, which were specified in DD% and DD.…”

Intravitreal bevacizumab versus intravitreal triamcinolone for diabetic macular edema–Systematic review, meta-analysis and meta-regression

“…Pappas et al concluded that IVT+Laser is better than IVB alone in reducing CMT, which went against the findings of Lam et al who indicated that IVT+Laser has no better CMT reduction at 24 weeks than IVT alone; and laser alone was significantly worse than the 2 aforementioned groups [ 55 , 56 ]. Surprisingly, Preti et al concluded that IVB+Laser may significantly increase the thickness compared with laser alone at a 4-week follow-up, however, they investigated macular choroidal thickness and not CMT [ 57 ]. It was proposed that IVT+laser might be superior due to its coupled anti-inflammatory and anti-angiogenic effects [ 13 ].…”