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Marisol Estudillo, Victor Gonzalez, Proliferative Diabetic Retinopathy; A comparison of anti-VGEF therapy and laser in preserving visual function in patients with proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5760.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect on visual acuity and visual field sensitivity in patients with proliferative diabetic retinopathy (PDR) treated with anti-VEGF monotheraphy versus combination of anti-VEGF induction and selective laser versus standard panretinal photocoagulation (PRP).
The patients were randomly assigned to three groups and treated and followed for one year. They were evaluated baseline, week 3, week 6, and every 6 weeks there after. Twenty eyes of 20 patients were included. Eight eyes in group A received 3 intravitreal pegaptanib (IVP) injections every 6 weeks (q6), then additional injections every 12 weeks. Eight eyes in Group B received 3 IVP q6 and after that selective laser treatment. Four eyes in group C received standard PRP only. Humphrey Visual Fields (30-2) were performed in all groups at baseline and at 1 year follow up visit. Changes in mean deviation (MD) on HVF over the time period were assessed. Best corrected visual acuity (BCVA) was assessed at every visit.
Group A) Baseline mean BCVA=77.25(20/32), MD= -9.63. One year visit mean BCVA=80.50(20/25), MD= -6.71. Group B) Baseline mean BCVA=78.56(20/32), MD= -6.10. One year visit mean BCVA=79.16(20/25), MD= -7.24. Group C) Baseline mean BCVA=66.16(20/50), MD=-10.08. One year visit mean BCVA=71.34(20/40), MD= -12.9.
The BCVA improved on average 3.25 letters at one year in group A, 0.6 letters in group B, and 5.18 letters in group C. The MD improved on average from baseline to one year after treatment in group A by 2.62 points. In group B it decreased by 1.14 points at one year, and group C got also worse at one year by 2.82 points. Although BCVA in group C improved by more letters than group A, baseline BCVA in group C was lower to begin with and the ceiling effect might be responsible for this finding.
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