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

Filho, José Afonso Ramos; Messias, André; Almeida, Felipe P.; Ribeiro, J.A.; Costa, Rogério A.; Scott, Ingrid U.; Jorge, Rodrigo

doi:10.1111/j.1755-3768.2011.02184.x

Cited by 64 publications

(58 citation statements)

References 38 publications

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“…[13][14][15][16][17][18][19] The majority of studies on antiVEGF agents for PDR have been trials of bevacizumab. In Thailand, the National List of Essential Medicine Committee recently announced the inclusion of IVB injection for the treatment of age-related macular degeneration and diabetic macular edema.…”

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

Sinawat

Rattanapakorn

Sanguansak

et al. 2013

Eye

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Purpose To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) injections for the treatment of proliferative diabetic retinopathy (PDR) with new dense vitreous hemorrhage (VH) after previous full panretinal photocoagulation (PRP). Methods Prospective study of consecutive PDR with prior complete PRP patients, who presented with new dense VH, were treated with IVB injection. Complete ophthalmic examination and/or ocular ultrasonography were performed at baseline and 1, 6, and 12 weeks and 6, 9, and 12 months after the first injection. Reinjection was done in non-clearing and recurrent VH. Results Eighteen eyes of 18 patients, mean age 47.7±12.69 years were included. In all, 14 (77.78%) patients had type 2 diabetes mellitus. Systemic hypertension and dyslipidemia were the most common systemic diseases. All cases were phakic eye with previous complete PRP. Patients received 1.6±0.42 intravitreal injections over a 12-month period. VH cleared completely in 7 (38.89%), 9 (50%), and 13 (72.22%) eyes after 6 weeks, 6 months, and 12 months, respectively. Re-bleeding, however, occurred in 10 (56%) eyes during the follow-up period, and 5 (28%) eyes still had residual VH at the last visit. Statistically significant visual gain was observed in 9 (50%) eyes. Unfortunately, 2 (11%) eyes had severe visual loss because of the tractional retinal detachment (TRD). Mild ocular complication was detected in one patient.Conclusion IVB injection had good efficacy and safety for treatment of new VH in patients with PDR and prior complete PRP. This procedure may be especially relevant for diabetic patients at high-risk for surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

Sinawat

Rattanapakorn

Sanguansak

et al. 2013

Eye

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“…One eye (0.9%; 95% confidence interval, 0.02-4.7%) developed endophthalmitis after receiving ranibizumab. 64 Filho et al 88 and Cho et al 89 compared PRP alone with PRP and ranibizumab or bevacizumab, respectively, for patients with high-risk PDR. In these studies, the adjunctive use of ranibizumab/bevacizumab protected against the macular swelling observed in eyes treated with PRP alone.…”

Section: Indications Of Anti-vegf Treatment For Pdrmentioning

confidence: 99%

A review of anti-VEGF agents for proliferative diabetic retinopathy

Osaadon

Fagan

Lifshitz

et al. 2014

Eye

209

140

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“…37,39,40 Combination treatment supplementing pan-retinal photocoagulation with anti-VEGF injections has consistently demonstrated greater vascularization regression and leakage reduction than laser treatment alone. 41,42 In fact, comparative studies even suggest that the efficacy of injection-only treatment surpasses that of the more damaging laser option in patients with DME. 43,44 There are a number of molecular agents under investigation that act to inhibit VEGF in different ways, including full and fragmented antibodies, small interfering RNAs (siRNAs), and recombinant fusion proteins, although most remain in developmental or trial phases.…”

Section: 36mentioning

confidence: 99%

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads

Marozas

Fort

2014

US Endocrinology

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Diabetes is a metabolic disease resulting from the body's insufficient production or use of insulin, a peptide hormone responsible for regulating glucose levels in the blood and tissues. Especially when improperly managed, diabetes results in a number of complications over time, affecting nearly every organ system, including the ocular tissue. In addition to increased risk for glaucoma and cataracts, the most threatening ocular implication of diabetes is diabetic retinopathy, an aggressive disorder historically clinically associated with a variety of retinal microvascular abnormalities. Disease severity is typically classified into two types: nonproliferative diabetic retinopathy (NPDR), marked by microaneurysms, intraretinal hemorrhaging, and other microvascular aberrations, and proliferative diabetic retinopathy (PDR), characterized by the onset of neovascularization and vitreal hemorrhaging.1 Diabetic macular edema (DME), another manifestation of diabetic retinopathy involving macular thickening due to fluid accumulation, is accountable for a great proportion of diabetes-related vision loss. 2 While advanced stages of PDR have classically been regarded as the most threatening to sight, visual dysfunction at all stages, even those deemed mild by clinical evaluation, is now apparent. As the leading cause of blindness in US working-age adults, 3 diabetic retinopathy has many economic implications for healthcare systems and the overall population, 4 as well as a variety of personal consequences on patient quality of life. 5,6 However, if addressed early and proactively, the incidence of severe vision loss from diabetic retinopathy can be significantly reduced. This review will discuss the systemic measures necessary for diabetic retinopathy prevention, as well as interventions currently available to delay or stop retinopathy progression once diagnosed. The limitations of present treatment options will also be addressed, as well as current developments in the search for new endpoints and technologies that may allow for earlier detection.Finally, investigations of some of the new therapies and future approaches to diabetic retinopathy research will be reviewed. Systemic Control and Preventive InterventionAs the prevalence of diabetes worldwide continuously increases, incidence of vision-threatening diabetic retinopathy is projected to nearly triple in the next 40 years. 7 For patients diagnosed with diabetes, the most important method of preventing visual complications, such as retinopathy, is to control the diabetes at a systemic level. Tight regulation of glycemia via intensive insulin therapy significantly reduces the risk for retinopathy prevalence and progression. 8 In addition to its effect on glycemic and circulating insulin levels, systemic insulin therapy has been shown to have a local impact on ocular tissue as well, including restoration of retinal insulin receptor signaling cascade and rod photoreceptor function. 9,10We recently demonstrated that both components of systemic insulin treatment-normaliza...

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

Cited by 64 publications

References 38 publications

Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

A review of anti-VEGF agents for proliferative diabetic retinopathy

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads

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

Cited by 64 publications

References 38 publications

Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

A review of anti-VEGF agents for proliferative diabetic retinopathy

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads

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Product

Resources

About

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads