Abstract
Purpose:
To evaluate retinal sensitivity in the macular area in patientes treated for proliferative diabetic retinopathy (PDR) using a modified pharmacologic approach versus drug induction combined with selective laser.
Methods:
Prospective longitudinal 54 week follow-up of patients enrolled in an open label clinical trial. Twenty eyes (20 patients) with high-risk PDR were enrolled. Ten eyes (Group A) received 3 intravitreal injections of Pegaptanib at 6 week intervals, then 3 additional injections at 12 week intervals. Ten eyes (Group B) received selective laser photocoagulation after 3 intravitreal injections of Pegaptanib at 6 week intervals. The fellow eye of each patient was treated with standard panretinal photocoagulation serving as control. Retinal sensitivity in the central 8 degrees was evaluated by MP-1 microperimeter at baseline and at 1 year after treatment.
Results:
At 1 year, mean retinal sensitivity within the central 8 degrees field of the study eye in Group A improved from 14.5 ± 5.5 to 15 ± 4.9 (P = 0.823) and the fellow eye improved from 10.5 ± 7.5 to 12.8 ± 6.6 (P = 0.135). In Group B, the central retinal sensitivity of the study eye improved from 9.4 ± 6.1 to 11.4 ± 5.8 (P = 0.237) and the fellow eye improved from 9.4 ± 5.3 to 10.8 ± 4.7 (P = 0.405). Mean change in best corrected visual acuity at 1 year from baseline in the study eye of Group A was +7.9 letters (P = 0.016) on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and -2.7 (P = 0.351) in the study eye of Group B.
Conclusions:
Results show a tendency of improvement in central retinal sensitivity in all groups after 1 year of treatment. The administration of Pegaptanib alone resulted in higher gain of letters on ETDRS chart as opposed to a combined treatment with selective laser photocoagulation. A larger sample and further follow-up are needed.
Keywords: 499 diabetic retinopathy •
642 perimetry