The Prognostic Value of Post-Treatment Retinopathy after Panretinal Photocoagulation for Proliferative Diabetic Retinopathy in Type 1 Diabetes
6
Citation
11
Reference
10
Related Paper
Citation Trend
Abstract:
Purpose To study the prognostic value of post-treatment retinopathy after panretinal laser photocoagulation for proliferative diabetic retinopathy in type 1 diabetes mellitus. Proliferative diabetic retinopathy is treated with panretinal photocoagulation, which significantly reduces the risk of visual loss from this complication. However, no parameters are presently known that can be used to define an optimal control interval after the initial panretinal photocoagulation treatment that ensures enhancement of the treatment in cases where this is needed. Methods In this retrospective cohort study, 85 eyes from 56 type 1 diabetic patients were identified who had been subjected to panretinal photocoagulation for proliferative diabetic retinopathy before 1990. The patients were divided into two groups: Group 1 had four or fewer microaneurysms only at the first post-treatment examination whereas Group 2 had more retinopathy. Results At the first photographic examination after treatment the eyes in Group 1 had a significantly lower visual acuity (VA) (mean=0.23, range: 0.01–1.00) than the patients in Group 2 (mean=0.48, range: 0.01–1.6). During the follow-up period the VA was further reduced in Group 2 but not in Group 1. Three eyes out of six in Group 1 had improvement of VA from below to above 0.1, whereas 6 eyes out of 12 in Group 2 experienced progression of retinopathy with a consequent worsening of VA to below 0.1 after a mean of 10.8 years (range: 6.8–15.9) after treatment. Conclusions The severity of post-treatment retinopathy can be used to assess the need for enhancing photocoagulation of proliferative diabetic retinopathy in type 1 diabetes. The interval between post-treatment examinations can be increased to several years when the initial treatment has reduced retinopathy to a minimal level.Keywords:
Panretinal photocoagulation
Panretinal photocoagulation
Pain control
Cite
Citations (3)
Background: Diabetic retinopathy is leading cause of blindness, is preventable, in whole of the world. Panretinal photocoagulation is a well-established treatment to induce regression of new blood vessels in diabetic retinopathy. This study to assess effectiveness of panretinal photocoagulation in treatment of diabetic retinopathy.Methods: We enrolled in retrospective study, using data from medical records of patients with proliferative diabetic retinopathy and severe non proliferative diabetic retinopathy between 2009 and 2011, and were assessed for visual acuity and fundus stability minimal 6 weeks after panretinal photocoagulation complete.Results: Panretinal photocoagulation was perfomed in 435 eyes (295 patients), with proliferative diabetic retinopathy was recognized in 245 eyes, and severe non proliferative diabetic retinopathy in 190 eyes. In cases of patients with proliferative diabetic retinopathy stabilization of visual acuity was observed in 137 (55,92%) of eyes and stabilization of the eye fundus in 119 (48,57%) of eyes. In patients with severe non proliferative diabetic retinopathy stabilization of visual acuity was found in 141 (74,21%) of eyes and stabilization of state of the eye fundus in 147 (77,37%) of eyes.Conclusion: Panretinal photocoagulation as gold standart therapy effectiveness to treatment proliferative diabetic retinopathy and severe non proliferative diabetic retinopathy to adhered visual acuity stability dan fundus stability.
Panretinal photocoagulation
Fundus (uterus)
Vitreous hemorrhage
Cite
Citations (4)
Panretinal photocoagulation
Cite
Citations (19)
BACKGROUND: There is a global epidemic of diabetes mellitus. Diabetes mellitus causes a myriad of microvascular and macrovascular complications.
Diabetic retinopathy is one of the main microvascular complications. It is preventable. However the extent of diabetic retinopathy in Zimbabwe is unknown.
METHODS: This was a cross-sectional study carried out on consenting participants, = 18years old at Parirenyatwa Group of Hospitals Diabetic Clinic. Retinopathy was assessed taking retinal photographs using an iExaminer ® which is a device comprising of a Welch Allyn Pan-optic, an indirect ophthalmoscope attached to an iPhone 4 using an adapter. Retinopathy was classified as: No Retinopathy, Non-proliferative Diabetic Retinopathy and Proliferative Diabetic Retinopathy.
RESULTS: 150 study participants were recruited with a mean age of 52.6 ± 16.4 years. The prevalence of diabetic retinopathy was observed to be 38% (n = 57) with 30.7% (n = 46) having non-proliferative diabetic retinopathy and 7.3% (n = 11) with proliferative retinopathy. Significant risk factors for diabetic retinopathy were hypertension OR 2.8 (95% CI 1.23 – 6.42), p = 0.015; age O.R 1.02 (95% CI 1.00 -1.04), p = 0.048; Diet OR 4.71 (95% CI 1.80 – 12.34), p = 0.002 and Exercise OR 11.33 (95% CI 2.62 – 49.05), p =
0.001.
CONCLUSION: The prevalence of diabetic retinopathy was 38%. Diabetic retinopathy is therefore common and largely unrecognised. Regular and appropriate easy to use screening methods are highly recommended for early detection of diabetic retinopathy so as to reduce progressive visual impairment.
Cite
Citations (2)
The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 9) examined the question of when in the course of diabetic retinopathy it is most effective to initiate photocoagulation therapy. Based on the study findings, the authors recommended that panretinal scatter photocoagulation not be carried out in eyes with mild or moderate nonproliferative diabetic retinopathy; when retinopathy is more severe, however, panretinal scatter photocoagulation usually should not be delayed if the eye has reached the high-risk proliferative stage. Focal treatment should be considered for eyes with macular edema that involves or threatens the center of the macula, preferably before scatter photocoagulation for high-risk proliferative retinopathy becomes urgent.
Panretinal photocoagulation
Diabetic macular edema
Cite
Citations (0)
Panretinal photocoagulation in diabetic retinopathy improves oxygen saturation in the retina which results in regression of neovascularisation. This study is aimed at evaluating the plasma levels of angiogenic and angiostatic factors after panretinal photocoagulation for retinopathy. Thirty controls and 29 proliferative diabetic retinopathy subjects who were advised panretinal photocoagulation were recruited for the study. Plasma was collected both before and four weeks after the last dose of the therapy and analysed for angiogenic and angiostatic factors using ELISA technique. The plasma concentration of HIF-1α and VEGF were significantly decreased after laser therapy compared to baseline levels. The plasma concentration of MMP-9 and PEDF was increased significantly after photocoagulation. A significant improvement in the visual acuity was also observed following laser therapy. Panretinal photocoagulation significantly reduced plasma angiogenic and angiostatic factors. These factors may be used to assess therapeutic outcomes in proliferative retinopathy.
Panretinal photocoagulation
PEDF
Cite
Citations (1)
Purpose To study the prognostic value of post-treatment retinopathy after panretinal laser photocoagulation for proliferative diabetic retinopathy in type 1 diabetes mellitus. Proliferative diabetic retinopathy is treated with panretinal photocoagulation, which significantly reduces the risk of visual loss from this complication. However, no parameters are presently known that can be used to define an optimal control interval after the initial panretinal photocoagulation treatment that ensures enhancement of the treatment in cases where this is needed. Methods In this retrospective cohort study, 85 eyes from 56 type 1 diabetic patients were identified who had been subjected to panretinal photocoagulation for proliferative diabetic retinopathy before 1990. The patients were divided into two groups: Group 1 had four or fewer microaneurysms only at the first post-treatment examination whereas Group 2 had more retinopathy. Results At the first photographic examination after treatment the eyes in Group 1 had a significantly lower visual acuity (VA) (mean=0.23, range: 0.01–1.00) than the patients in Group 2 (mean=0.48, range: 0.01–1.6). During the follow-up period the VA was further reduced in Group 2 but not in Group 1. Three eyes out of six in Group 1 had improvement of VA from below to above 0.1, whereas 6 eyes out of 12 in Group 2 experienced progression of retinopathy with a consequent worsening of VA to below 0.1 after a mean of 10.8 years (range: 6.8–15.9) after treatment. Conclusions The severity of post-treatment retinopathy can be used to assess the need for enhancing photocoagulation of proliferative diabetic retinopathy in type 1 diabetes. The interval between post-treatment examinations can be increased to several years when the initial treatment has reduced retinopathy to a minimal level.
Panretinal photocoagulation
Cite
Citations (6)
Objective To investigate the relationship of the levels of serum 8-hydroxydeoxyguanosin (8-OHdG) to diabetic retinopathy (DR) in subjects with type 2 diabetes (T2DM).Methods The patients were classified into groups according to retinopathy (no signs of diabetic retinopathy [DM],nonproliferative diabetic retinopathy [NPDR],and proliferative diabetic retinopathy [PDR]).The concentration of serum 8-OHdG were measured with enzyme-linked immunosorbent assay (ELISA) in all 49 patients with diabetes mellitus and 22 normal control subjects.The correlation between 8-OHdG and diabetic retinopathy were analyzed in all patients with T2DM.Results The concentration of serum 8-OHdG in patients with T2DM were significantly higher than those in the control subjects (Willcoxon W Test,Z =-6.70,P =0.00; Mean Rank of T2DM group and normal control subjects are 47.00 and 11.50 respectively).There was statistical difference in the levels of serum 8-OHdG in the PDR,NPDR,and DM groups (Kruskal Wallis Test,x2=59.50,P =0.00).The levels of serum 8-OHdG was much higher in the patients with PDR than that in patients with diabetes without retinopathy and with NPDR,The concentration of serum 8-OHdG was higher in the patients with NPDR than that in patients with diabetes without retinopathy.The degree of 8-OHdG was correlated with the degree of DR (Spearman correlation coefficients=0.94,P =0.00).Conclusions The elevated serum 8-OHdG may be one of probable risk factors in the diabetic retinopathy in the patients with T2DM.
Key words:
Type 2 diabetes mellitus; 8-hydroxydeoxyguanosin; Diabetic retinopathy
Rank correlation
Cite
Citations (0)
To evaluate the difference in intravitreal bevacizumab (IVB) injection timing as adjuvant therapy to panretinal photocoagulation in patients with diabetic retinopathy combined with diabetic macular edema.This was a retrospective nonrandomized study. Forty eyes with severe non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) were divided into two groups; the IVB injection prior to, or after, panretinal photocoagulation. Changes in central macular thickness between the two groups were measured.There was no significant difference in change in central macular thickness between two groups after treatment (p=0.66), neither in eyes with severe NPDR groups (p=0.48) nor eyes with PDR (p=0.82).IVB injection after panretinal photocoagulation gives insignificant difference in changes in central macular thickness with injection prior to laser treatment in patients with diabetic retinopathy combined with diabetic macular edema.
Panretinal photocoagulation
Diabetic macular edema
Cite
Citations (2)