RESUMEN
To evaluate the effects of Pan retinal photocoagulation [PRP] alone as a treatment of high risk Proliferative diabetic retinopathy [PDR] compared to the intravitreal Avastin injection in combination with PRP for the same cases. 60 patients were enrolled in this prospective randomized study as all patients were diagnosed as high risk PDR. The right eyes of all patients were treated by PRP full scatter and the left eyes were treated by 1.25 mg. Avastin injection in 0.1 ml two days prior also to full scatter PRP treatment in two sessions two weeks apart. Pre-treatment as well as post-treatment full ophthalmological assessment was done for all eyes in the two groups in the form of best corrected visual acuity[BCVA], Fluorescein Angiography, and also central foveal thickness by optical coherence tomography[OCT], all eyes were followed-up for one year. There was a significant difference between the PRP and the PRP assisted group in the area of fluorescein leakage from active neovascularization elsewhere [NVE]. As regards BCVA, there was a significant difference between the two groups at the end of follow-up period, favoring the PRP assisted group by at least two lines [P=0.05]. Also, the total area of actively leaking NVE's was significantly lower in PRP assisted group compared to the PRP group only [P<0.001]. The rate of complication in the form of vitreous hemorrhage and epiretinal membrane formation was also higher in the PRP group only but it was not statistically significant. The combined used of intravitreal Avastin with PRP for the high risk cases of PDR seems to give a more stabilized effect on the degree of PDR as well as on vision compared to the PRP treatment alone
Asunto(s)
Humanos , Masculino , Femenino , Anticuerpos Monoclonales , Fotocoagulación/estadística & datos numéricos , Estudio Comparativo , Angiografía con Fluoresceína , Estudios de Seguimiento , Terapia Combinada , Resultado del TratamientoRESUMEN
Infrared photocoagulation is a new ambulatory therapy for 1st, 2nd and 3rd degree internal hemorrhoids. It is an effective method, comparable to others such as sclerotherapy or rubber band ligature. It is necessary to use multiple applications in several sessions in order to obtain good results. Patients with hemorrhoids grade IV are candidates for hemorrhoidectomy. The author did not observe minor nor serious complications with this new therapeutic modality. It is fast and easy to use by a single operator. The equipment is portable, easy to handle and long lasting, needing little maintenance. The anatomical results suggest that the progression of hemorrhoids and also, probably, surgery are prevented. Long-term follow up is necessary
Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Fotocoagulación/métodos , Hemorroides/cirugía , Rayos Infrarrojos/uso terapéutico , Complicaciones Posoperatorias/epidemiología , Fotocoagulación/estadística & datos numéricos , Reoperación , Estudios de SeguimientoRESUMEN
Se analizaron 171 pacientes con hemorroides sintomáticas, 129 de 1er y 2do grado y 42 de 3er grado, tratadas con fotocoagulación infrarroja (F.I.). Un 94.5%de 129 enfermos seguidos 6 meses, sobre 149 con esa evolución, se hallaban sin síntomas o muy aliviados. Esta proporción de buenos resultados se mantuvo en los 91 casos seguidos 1 año, sobre 112 posibles. Entre estos últimos, hubo 98%de buenos resultados en las hemorroides de 1er y 2do grado y 86%en las de 3er grado. Un 12.8%de la serie presentó dolor, proctorragia o trombosis hemorroidaria luego de alguna sesión del tratamiento, destacándose en varios casos la relación del dolor con la reapertura de una fisura anal recientemente cicatrizada y 1 proctorragia severa al 10 día de una fotocoagulación. Estos efectos desfavorables pueden disminuirse si no se efectúan más de 6 disparos del rojo infrarrojo en una misma hemorroide, ni más de 8 en total en 2 ó más hemorroides. La fotocoagulación infarroja es un método sencillo y rápido, no interrumpe las actividades habituales del paciente, produce pocos efectos colaterales, resultados muy efectivos en hemorroides de 1er y 2do grado y satisfactorios en hemorroides de 3er grado. Estos se logran cuando el tratamiento se prolonga hasta la desaparición o disminución satisfactoria de los síntomas