ABSTRACT
AIM: To observe the therapeutic effect and safety of improved extra panretinal photocoagulation ( E - PRP) in the treatment of high risk proliferative diabetic retinopathy (hsPDR). METHODS: A total of 88 consecutive cases (102 eyes) with hsPDR were diagnosed by fundus fluorescein angiography(FFA) from February 2011 to December 2014 in our hospital . Fifty two eyes had been treated by improved E - PRP with 532nm frequency - doubled laser. Fifty eyes had been treated by standard PRP. All cases were checked by FFA and fundus photocoagulation every 3mo. Patients with persisting neovascularization or non perfusion area were treated with laser again. All cases were followed up 6-36mo. RESULTS: The postoperative visual acuity had no statistical difference between two groups ( P > 0. 05). In improved E - PRP group, retinal non perfusion area and neovascularization disappeared in 35 eyes ( 67%). Effective rate was 88%. Six eyes (12%) underwent pars plana vitrectomy because of vitreous hemorrhage, fiberosis and stretched retinal detachment. In standard PRP group, retinal nonperfusion area and neovascularization disappeared in 23 eyes ( 46%). Effective rate was 66%. Seventeen eyes(34%) underwent pars plana vitrectomy because of anterior retina bleeding or vitreous hemorrhage. The rate of neovascularization disappeared and effective rate had statistical difference between two groups (P CONCLUSION: It is a safe and effective methods to treat hsPDR by improved E-PRP and it was more effective than traditional PRP.
ABSTRACT
PURPOSE: To evaluate long-term effects and usefulness of combined intravitreal injection of bevacizumab and panretinal photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy. METHODS: The authors retrospectively reviewed the records of 40 patients (40 eyes) with high-risk proliferative diabetic retinopathy who had been treated with PRP alone (laser treatment group, n=20) or intravitreal bevacizumab before PRP (combined treatment group, n=20). Changes in best corrected visual acuity (BCVA), central macular thickness (CMT) and the total area of leakage from active new vessels (NVs) were compared between the groups at one, three, and six months and at one year post-treatment. RESULTS: In the combined treatment group, CMT decreased significantly at one month (p=0.021), and the areas of active NVs decreased significantly at one month (p=0.001) and three months (p=0.014) compared to those of the laser treatment group. However, there were no differences between the two groups after three months. In the combined treatment group, elevated intraocular pressures were found in three cases after one month, and there were vitreous hemorrhages in two cases after three months. CONCLUSIONS: The combined treatment showed significant early improvements in BCVA, CMT, and NVs regression for up to three months. However, long-term follow-up and additional treatment was necessary in the patients with persistent or recurred NVs and macular edema after three months.