1.
Intravitreal triamcinolone as an adjunct in the treatment of concomitant proliferative diabetic retinopathy and diffuse diabetic macular oedema. Combined IVTA and laser treatment for PDR with CSMO.
Kaderli, B, Avci, R, Gelisken, O, Yucel, AA
International ophthalmology. 2005;(6):207-14
Abstract
PURPOSE To investigate if triamcinolone acetonide (TA) can be an adjunct to laser treatment in patients with concomitant non-high-risk proliferative diabetic retinopathy (PDR) and diffuse clinically significant diabetic macular oedema (CSMO). METHODS This prospective, interventional and comparative clinical study included 32 eyes of 16 patients with bilateral concomitant non-high-risk PDR and diffuse CSMO. Each patient received 4 mg intravitreal TA for the eye with worse visual acuity (study group) and macular focal and grid laser photocoagulation (MP) for the other eye (control group). One month later, each patient received four sessions of panretinal photocoagulation for both eyes plus MP for the eyes in the study group. The visual and angiographic results of both groups were compared. RESULTS In the study group, the mean visual acuity (VA) improved from 0.12 +/- 2.3 lines at the baseline to 0.19 +/- 3.1 (P = 0.004), 0.20 +/- 3.2 (P = 0.004), 0.19 +/- 3.6 (P = 0.009) and 0.19 +/- 3.3 lines (P = 0.091) at the 1-, 3-, 6- and 9-month follow-up intervals, respectively. The macular oedema was found to be resolved in 11 eyes (69%) and decreased in five eyes (31%). In the control group, the mean VA deteriorated progressively from 0.41 +/- 3.1 lines at the baseline to 0.20 +/- 3.1 lines (P = 0.026) at the end of the study and the macular oedema decreased only in three eyes (19%) at the sixth follow-up month. CONCLUSIONS During the follow-up period of the study, intravitreal TA as an adjunct in the treatment of concomitant non-high-risk PDR and diffuse CSMO led to a more-favourable clinical outcome than conventional laser treatment.
2.
Does macular laser alter the refraction in a diabetic with maculopathy? A pilot study.
Sim, KT, Tong, L, Vernon, SA
Eye (London, England). 2001;(Pt 5):591-4
Abstract
PURPOSE To determine whether macular photocoagulation has any effect on refraction in diabetics. METHODS This was a prospective study of 12 eyes of 12 diabetics with refraction at 2 weeks before and at 4 weeks and 4 months after argon laser. This was combined with a questionnaire survey of attitude among ophthalmologists on prescribing spectacles for diabetics awaiting macular laser. The main outcome measure was the spherical equivalents (SEQ) before and after treatment. RESULTS Only 36% of ophthalmologists surveyed would prescribe corrective lenses in patients waiting for macular photocoagulation. The median change in magnitude of SEQ at 4-6 weeks post-laser compared to pre-laser was 0.36 D (interquartile range 0.18-0.50 D). The median change in SEQ at 4 months was 0.25 D (interquartile range 0.12-0.56 D). These changes in SEQ from pretreatment values were not statistically significant on Wilcoxon signed-rank test (p = 0.17 and 0.10, respectively). The correlation coefficient between difference and average SEQ was 0.02 (95% CI -0.14 to 0.19, p = 0.75) at 4 weeks and 0.11 (95% CI -0.06 to 0.275, p = 0.17) at 4 months, indicating no tendency for change in refraction with increasing ametropia. CONCLUSION This pilot study implies that argon laser photocoagulation in diabetic maculopathy does not alter refraction. Prescription of corrective lenses can be performed prior to laser therapy, if required.