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Andre Messias, Katharina Messias, Rafael de Montier Barroso, Amanda Marega, Rodrigo Jorge; Full-field Stimulus Threshold (FST) Changes After Intravitreal Ranibizumab and Single or Multiple Spot Panphotocoagulation in Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1776.
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To describe changes on full-field stimulus threshold (FST) after one-year treatment with intravitreal ranibizumab (IVR) associated to panphotocoagulation (PRP), using single (EDTRS) or multiple spot (PASCAL) for proliferative diabetic retinopathy (PDR).
Randomized, prospective clinical trial. Patients were assigned to treatment with only IVR, PASCAL or EDTRS. PRP was performed exclusively at baseline in 2 sessions. In eyes with macular edema, macular short-pulse grid laser was associated to IVR at baseline. IVR was repeated monthly if central subfield macular thickness (CSMT) measured with SDOCT was higher than 300 µm, or quarterly if neovascularization was detected by angiography. Comprehensive ophthalmological evaluations, including best-corrected visual acuity (BCVA) measurement, OCT to determine central subfield macular thickness were performed at baseline and every 4 weeks. FST was performed after 25 minutes dark adaptation, using Espion E2 system with the ColorDome LED full-field stimulator (Diagnosys LLC, Lowell, MA), first using red (635 to 638 nm), then blue (465 to 470 nm), and then white (6500 K) stimulus, with 5 minutes inter-session interval, at baseline and one year after treatment.
EDTRS n= 10; PASCAL n= 9; and IVR = 8 patients were evaluated with FST until week 48. No significant difference was observed between groups for CSMT, FST or BCVA at baseline. Within-group analysis showed significant lower CSMT in groups IVR and PASCAL at 48 weeks, but this was not observed for group EDTRS; and significant worsen FST was observed using blue, white and red stimuli at week 48 for EDTRS, but not for IVR or PASCAL. No significant correlations were found between FST and BCVA changes, and no significant changes were observed on between-group analysis.
Chromatic FST changes after PRP for PDR is certainly multifactorial, involving functional loss due to direct retinal damage and/or macular edema. These data suggest that PRP is associated with worsen FST after one year follow-up.
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