المؤلفون: Diabetic Retinopathy Clinical Research Network

المصدر: Archives of Ophthalmology, 127(2)

مصطلحات موضوعية: Diabète, Pathologie de l'oeil, Oftalmología, Chirurgie, Retinal edema, Eye disease, Diabetes mellitus, Fotocoagulación, Retinopathy, Endocrinopathie, Développement, Tratamiento, Rétine, Photocoagulation, Rétinopathie, Ophthalmology, Endocrinopathy, Etude observationnelle, Traitement, Surgery, Retina, Ophtalmologie, Oedème de la rétine, Treatment, Observational study, Development

الوصف: Purpose—To compare the effects of single-sitting vs. four-sitting panretinal photocoagulation (PRP) on macular edema in subjects with severe non-proliferative or early proliferative diabetic retinopathy with relatively good visual acuity and no or mild center involved macular edema. Method—Subjects were treated with one sitting or 4 sittings of PRP in a non-randomized, prospective, multi-centered clinical trial. Main Outcome Measures—Central subfield thickness on optical coherence tomography (OCT). Results—Central subfield thickness was slightly greater in the 1 sitting group (n=84) than in the 4 sitting group (n=71) at the 3-day (P=0.01) and 4-week visits (P=0.003). At the 34-week primary outcome visit, the slight differences had reversed, with the thickness being slightly greater in the 4- sitting group than in the 1-sitting group (P=0.06). Visual acuity differences paralleled OCT differences. Conclusions—Our results suggest that clinically meaningful differences are unlikely in OCT thickness or visual acuity following application of PRP in 1 sitting compared with 4 sittings in subjects in this cohort. More definitive results would require a large randomized trial. Application to Clinical Practice—These results suggest PRP costs to some patients, in terms of travel and lost productivity, as well as to eye care providers, could be reduced.

العلاقة: https://doi.org/10.17615/9gxm-pq83Test; https://cdr.lib.unc.edu/downloads/zc77sx19p?file=thumbnailTest; https://cdr.lib.unc.edu/downloads/zc77sx19pTest

الإتاحة: https://doi.org/10.17615/9gxm-pq83Test
https://cdr.lib.unc.edu/downloads/zc77sx19p?file=thumbnailTest
https://cdr.lib.unc.edu/downloads/zc77sx19pTest

المؤلفون: Diabetic Retinopathy Clinical Research Network

المصدر: Archives of Ophthalmology, 125(4)

مصطلحات موضوعية: Ophthalmology, Surgery, Laser, Diabetes mellitus, Macula, Chirurgie, Etude comparative, Photocoagulation, Endocrinopathie, Early stage, Endocrinopathy, Oeil pathologie, Treatment, Stratégie, Oftalmología, Strategy, Eye disease, Rétinopathie, Retinopathy, Stade précoce, Diabète, Comparative study, Edema, Ophtalmologie, Oedème, Traitement, Tratamiento

الوصف: OBJECTIVE: To compare 2 laser photocoagulation techniques for treatment of diabetic macular edema: the modified Early Treatment Diabetic Retinopathy Study (ETDRS) direct/grid photocoagulation technique and a potentially milder (but potentially more extensive) mild macular grid (MMG) laser technique in which microaneurysms are not treated directly and small mild burns are placed throughout the macula, whether or not edema is present. METHODS: Two hundred sixty-three subjects (mean age, 59 years) with previously untreated diabetic macular edema were randomly assigned to receive laser photocoagulation by either the modified ETDRS (162 eyes) or MMG (161 eyes) technique. Visual acuity, fundus photographs, and optical coherence tomography measurements were obtained at baseline and at 3.5, 8, and 12 months. Treatment was repeated if diabetic macular edema persisted. MAIN OUTCOME MEASURE: Change in optical coherence tomography measurements at 12-month follow-up. RESULTS: Among eyes with a baseline central subfield thickness of 250 microm or greater, central subfield thickening decreased by an average of 88 microm in the modified ETDRS group and by 49 microm in the MMG group at 12-month follow-up (adjusted mean difference, 33 microm; 95% confidence interval, 5-61 microm; P = .02). Weighted inner zone thickening by optical coherence tomography decreased by 42 microm in the modified ETDRS group and by 28 microm in the MMG group (adjusted mean difference, 14 microm; 95% confidence interval, 1-27 microm; P = .04); maximum retinal thickening (maximum thickening of the central and 4 inner subfields) decreased by 66 and 39 microm, respectively (adjusted mean difference, 27 microm; 95% confidence interval, 6-47 microm; P = .01), and retinal volume decreased by 0.8 and 0.4 mm3, respectively (adjusted mean difference, 0.3 mm3; 95% confidence interval, 0.02-0.53 mm3; P = .03). At 12 months, the mean change in visual acuity was 0 letters in the modified ETDRS group and 2 letters worse in the MMG group (adjusted mean difference, 2 ...

العلاقة: https://doi.org/10.17615/nat6-2p24Test; https://cdr.lib.unc.edu/downloads/gm80j2320?file=thumbnailTest; https://cdr.lib.unc.edu/downloads/gm80j2320Test

الإتاحة: https://doi.org/10.17615/nat6-2p24Test
https://cdr.lib.unc.edu/downloads/gm80j2320?file=thumbnailTest
https://cdr.lib.unc.edu/downloads/gm80j2320Test