Purchase this article with an account.
Rafael de Montier Barroso, Andre Messias, Rodrigo Jorge; PASCAL panretinal photocoagulation (PRP) versus ETDRS PRP associated with intravitreal Ranibizumab (IVR) versus only IVR for proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3904.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To compare the effects of ETDRS standard panretinal photocoagulation (Single Spot; SS-PRP group) plus intravitreal injection of 0.5 mg of ranibizumab (IVR) with PASCAL PRP (Multiple Spots; MS-PRP group) plus IVR with only IVR (IVR group) in patients with proliferative diabetic retinopathy (PDR).
Prospective study included patients with PDR and no prior laser treatment randomly assigned to receive ETDRS PRP plus IVR (SS-PRP group) or PASCAL PRP plus IVR (MS-PRP group) or only IVR (IVR group). ETDRS-PRP was administered in two sessions (weeks 0 and 1) and PASCAL-PRP one session (week 0). IVR was administered at the end of the first laser session in all laser groups and at week 0 in IVR group. Standardized ophthalmic evaluations including ETDRS best-corrected visual acuity (BCVA), fluorescein angiography to measure area of fluorescein leakage from active new vessels (FLA) and optical coherence tomography (OCT) for the assessment of central subfield macular thickness (CSFT), were performed at baseline and at weeks 4, 8, 12, 16, 20 and 24.
Thirty-one of 44 patients (n = 38 eyes) completed the 24-week study follow-up period. At baseline, mean ± SE FLA (mm2) was 17.41 ± 5.94; 14.24 ± 6.04 and 17.71 ± 5.83 (p ≥0,05); BCVA (logMAR) was 0.55 ± 0.07 , 0.34 ± 0.1 and 0.42 ± 0.09 (p ≥0,05); and CSFT (µm) was 286.5 ± 13.67 , 360.09 ± 46.8 and 280 ± 20.74 (p ≥0,05), in the SS-PRP, MS-PRP and IVR groups, respectively. There was a significant (p < 0.05) FLA reduction at all study visits in SS-PRP and IVR groups, and at weeks 4 and 8 in MS-PRP group. BCVA significantly improved at all visits in SS-PRP and IVR groups and at weeks 4, 8, 16, 20 and 24 in MS-PRP group. A significant CSFT decrease was observed in the MS-PRP group at weeks 8, 16 and 24, and in the IVR group at weeks 4, 8, 12, 20 and 24. There wasn`t significant difference among these groups regarding FLA reduction, CSFT reduction and BCVA change (p<0.05).
In this preliminary analysis, IVR alone or combined with single or multiple spot PRP had similar results regarding FLA, BCVA improvement and CSFT reduction at week 24.
This PDF is available to Subscribers Only