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Tytuł:
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Sequence effect in the treatment of proliferative diabetic retinopathy with intravitreal ranibizumab and panretinal photocoagulation.
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Autorzy:
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Cao G; In-Patient Department 2, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China.
Xu X; In-Patient Department 2, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China.
Wang C; In-Patient Department 2, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China.
Zhang S; In-Patient Department 2, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China.
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Źródło:
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European journal of ophthalmology [Eur J Ophthalmol] 2020 Jan; Vol. 30 (1), pp. 34-39. Date of Electronic Publication: 2018 Dec 12.
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Typ publikacji:
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Comparative Study; Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2018- : Thousand Oaks, CA : SAGE Publishing
Original Publication: Milano ; Birmingham, AL : Wichtig, c1991-
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MeSH Terms:
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Laser Coagulation*
Angiogenesis Inhibitors/*therapeutic use
Diabetic Retinopathy/*therapy
Ranibizumab/*therapeutic use
Adult ; Clinical Protocols ; Combined Modality Therapy ; Diabetic Retinopathy/drug therapy ; Diabetic Retinopathy/physiopathology ; Diabetic Retinopathy/surgery ; Female ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Retina/physiopathology ; Retrospective Studies ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity
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Contributed Indexing:
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Keywords: Intravitreal ranibizumab; panretinal photocoagulation; proliferative diabetic retinopathy; treatment sequence
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Substance Nomenclature:
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0 (Angiogenesis Inhibitors)
0 (VEGFA protein, human)
0 (Vascular Endothelial Growth Factor A)
ZL1R02VT79 (Ranibizumab)
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Entry Date(s):
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Date Created: 20181213 Date Completed: 20200214 Latest Revision: 20220411
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Update Code:
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20240105
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DOI:
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10.1177/1120672118812270
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PMID:
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30539668
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Purpose: To compare the outcome of the sequence in the two treatments (intravitreal ranibizumab and panretinal photocoagulation) in high-risk proliferative diabetic retinopathy.
Methods: This retrospective study included 35 patients with newly diagnosed high-risk proliferative diabetic retinopathy in 43 eyes; 18 (22 eyes) received intravitreal ranibizumab before panretinal photocoagulation (intravitreal ranibizumab+ group), while the other 17 (21 eyes) received panretinal photocoagulation before intravitreal ranibizumab (panretinal photocoagulation+ group). Each subject received three intravitreal ranibizumabs that were interleaved with three panretinal photocoagulations. The first treatment (either intravitreal ranibizumab or panretinal photocoagulation) was done 1 week before the second one. The interval between intravitreal ranibizumabs was 4 weeks, panretinal photocoagulation was 2 weeks. The power and pulse duration were determined based upon the status of each retinal spot before each panretinal photocoagulation. The retinal non-perfusion region was measured with fundus fluorescein angiography before and 1 month after the final treatment. The central macular thickness was measured with optical coherence tomography within 1 week before the first treatment, before each panretinal photocoagulation, and 1 month after the final intravitreal ranibizumab.
Results: The panretinal photocoagulation energy required for effective treatment was lower in intravitreal ranibizumab+ group in the first and second sessions and in total energy (p < 0.05). Central macular thickness reduction before the second panretinal photocoagulation session was significant in the intravitreal ranibizumab+ group (p < 0.05).
Conclusion: The sequence used in intravitreal ranibizumab+ group showed clear advantages over that in panretinal photocoagulation+ group in the treatment of proliferative diabetic retinopathy, not only in the use of lower energy for panretinal photocoagulation but also in the more rapid regression of neovascularization and less need of additional treatment.
