Effect of Pan Retinal Photocoagulation on Central Macular Thickness and Visual Acuity in Proliferative Diabetic Retinopathy

Mukhtar, Ahsan; Khan, Muhammad Saim; Junejo, Murtaza Sameen; Ishaq, Mazhar; Akbar, Bushra

doi:10.12669/pjms.321.8758

Cited by 12 publications

(12 citation statements)

References 20 publications

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“…Alagozetal C demonstrated in their study that in VH secondary to PDR IVB reduces requirement for surgery and increases the number of patients in which PRP could have applied in early period but no impact on vision. 20 , 21 Whereas in our study we found a better visual outcome with PRP plus group.…”

Section: Discussionsupporting

confidence: 41%

Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy

Rebecca¹,

Shaikh²,

Jatoi³

2020

Pak J Med Sci

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Objective: To compare efficacy of intravitreal bevacizumab augmented with Panretinal photocoagulation versus Panretinal photocoagulation alone in high risk proliferative diabetic retinopathy. Methods: This is Randomized clinical control trial study conducted at ISRA University Hospital, Hyderabad from July 2018 to December 2018. A total of 76 eyes were randomized into two groups, 38 eyes undergone PRP plus intravitreal bevacizumab, while 38 eyes had PRP alone. Status of neovessels was assessed before and after treatment with the help of fundus fluorescein angiography. Neovessels at disc (NVD’s) and neovessels elsewhere (NVE’s) were assessed with the disc surface diameter. Results: Seventy-six eyes were enrolled in this randomized clinical trial into two groups consecutively, that all completed the six months follow-up. In the PRP group mean BCVA (logMAR) worsened significantly from mean 0.30±0.07 to mean 0.40±0.04 at a 30th day and mean 0.40±0.04 at day 90. While BCVA become improved from 0.30±0.05 to 0.1±0.03 at week four and 0.1±0.02 at week 12 in PRP-Plus group. There was significant change in regression of NVES in PRP only group at week 4 is 2.25±0.75 (p=0.00004) and at 12 weeks 2.00±0.50 (p=0.00002), while in PRP + intravitreal bevacizumab group at 4th week was 1±0.5 (p =0.0001) and at 12th week was 0.75±0.25 (p=0.0001). Conclusion: Intravitreal Bevacizumab augmented with PRP is more effective in early regression of neovessels in high risk PDR patients. doi: https://doi.org/10.12669/pjms.37.1.3141 How to cite this:Rebecca, Shaikh FF, Jatoi SM. Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy. Pak J Med Sci. 2021;37(1):157-161. doi: https://doi.org/10.12669/pjms.37.1.3141 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionsupporting

confidence: 41%

Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy

Rebecca¹,

Shaikh²,

Jatoi³

2020

Pak J Med Sci

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“…On the other hand laser photocoagulation has been used in the treatment of PDR for the last couple of decades and the proposed mechanism is decreasing ischemic drive, converting ischemic to anoxic retina and therefore, leading to regression of retinal new vessels. The recent use of Pattern scan laser (PASCAL) which has a short pulse duration has shown beneficial effect on DME when used for combined presentation of PDR with DME 5,6,12,18,19…”

Section: Discussionmentioning

confidence: 99%

“…Some authors claim, PRP alone with short pulse lasers can not only treat PDR but also significantly reduce the DME 12,13…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intravitreal bevacizumab combined with pan retinal photocoagulation versus panretinal photocoagulation alone in treatment of proliferative diabetic retinopathy

Sameen¹,

Khan²,

Mukhtar³

et al. 2017

Pak J Med Sci

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Objective:To compare effectiveness of pan-retinal photocoagulation alone versus panretinal photocoagulation combined with intravitreal bevacizumab on visual acuity and central macular thickness in patients presenting with proliferative diabetic retinopathy.Methods:This Randomized controlled trial was carried out at Armed Forces Institute of ophthalmology, Pakistan from Jan 2016 to Aug 2016. Seventy six eyes of 50 patients having proliferative diabetic retinopathy and diabetic macular edema were included in the study. All the patients were subjected to detailed clinical examination that included Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), slit lamp examination of anterior and posterior segments. Optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were carried out and patients were divided in two groups (GP and GI). Three monthly sessions of Pan retinal photocoagulation (PRP) using Pattern Scan Laser (PASCAL) alone was performed in group GP while PRP along with three monthly intravitreal bevacizumab (IVB) was performed in group GI. BCVA and CMT was recorded 04 weeks after the third PRP session in both the groups.Results:Seventy six eyes of 50 patients (38 in each group) were treated with three sessions of PRP alone and PRP with IVB in Group GP and GI respectively. Mean age of the patient in group GP was 57.47± 6.08 years while that in group GI was 55.69 ±6.58. The magnitude of induced change in BCVA was 0.09 ± 0.15 in GP while 0.22 + 0.04 in GI groups while mean induced change in CMT after treatment was 77.44 ± 92.30 um and 117.50 ± 93.82 um in group GP and GI.Conclusion:Laser PRP combined with IVB has superior visual and anatomical outcome than PRP alone in patients with combined presentation of PDR and DME.

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“…Dow Medical University study reported visual acuity improvement in 40.2% (147) eyes, deterioration in 36.9% (183) 16. Study from Armed Forces Institute of ophthalmology Rawalpindi17 concluded that Laser PRP with Pattern scan laser is safe and effective in patients with combined presentation of PDR and DME. Present study has shown that laser therapy alone is quite effective in CSME.…”

Section: Discussionmentioning

confidence: 99%

“…This makes laser application still the treatment of choice in CSME and PDR when affordability and follow up is always a problem. Several national studies have shown effectivity of laser therapy in PDR 15-17. This study, intends to see effectivity of laser therapy in CSME.…”

Section: Introductionmentioning

confidence: 89%

Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center

et al. 2016

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Objective:To determine the visual outcome of laser treatment in clinically significant macular edema.Methods:This interventional and qausi experimental study was carried out at Diabetic Association of Pakistan (DAP) during January 2011 and December 2012. Approval was taken from Research Ethical Committee of Isra Postgraduate Institute of Ophthalmology. Records of 925 eyes of 464 patients with “Clinical Significant macular edema” (CSME), treated with laser photocoagulation were analyzed. Best-corrected visual acuity (BCVA) at the time of presentation and at the last follow up, minimum of one year and maximum of 45 months was recorded and compared. SPSS version 20.0 was used to analyze the data.Results:Diabetic retinopathy was found in 20.3% (1777) of 8742 diabetic attending DAP Hospital” amongst whom 39.6% (705) had Sight threatening diabetic retinopathy. Laser was advised in 96.4% (680) individuals, accepted by 70.5% (480) individuals. Amongst 960 eyes of 480 patients who accepted laser, 925 eyes had clinically significant macular edema and 35 eyes had PDR who are not included in this study. Amongst 925 eyes with CSME, Grid laser was done in 913 eyes (99%) and focal laser was done in 12 eyes (1%). After a follow up of 12 to 45 months, it was found that best corrected visual acuity had declined in 2.4% (22) eyes, stabilized in 67% (619) eyes and improved in 30.7% (284) eyes. One line improvement on Snellen’s chart was fond in 21.3% (197) eyes, 2 lines in 8% (74) eyes, 3 lines in 1.2% (12) eyes and 4 lines in one (0.1%) eye with p-value of 0.000.Conclusion:Laser therapy is an effective treatment in stabilizing/improving the vision in diabetic macular edema particularly at those centers where only Argon Laser is available and OCF, FFA facilities do not exist.

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Effect of Pan Retinal Photocoagulation on Central Macular Thickness and Visual Acuity in Proliferative Diabetic Retinopathy

Cited by 12 publications

References 20 publications

Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy

Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy

Efficacy of intravitreal bevacizumab combined with pan retinal photocoagulation versus panretinal photocoagulation alone in treatment of proliferative diabetic retinopathy

Visual outcome of laser treatment in diabetic macular edema: Study from an Urban Diabetes Care Center

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