TY - JOUR
T1 - Combined Laser and Intravitreal Triamcinolone for Proliferative Diabetic Retinopathy and Macular Edema
T2 - One-year Results of a Randomized Clinical Trial
AU - Maia, Otacilio O.
AU - Takahashi, Beatriz S.
AU - Costa, Rogerio A.
AU - Scott, Ingrid U.
AU - Takahashi, Walter Y.
N1 - Funding Information:
This study was supported in part by CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Brazil). The authors indicate no financial conflict of interest. Involved in conception and design of study (O.O.M.J., R.A.C., W.Y.T.); analysis and interpretation of data (O.O.M.J., R.A.C., I.U.S., W.Y.T.); writing the article (O.O.M.J., B.S.T., R.A.C., I.U.S., W.Y.T.); critical revision of the article (O.O.M.J., B.S.T., R.A.C., I.U.S., W.Y.T.); final approval of the article (O.O.M.J., B.S.T., R.A.C., I.U.S., W.Y.T.); data collection (O.O.M.J.); supply of materials, patients, or resources (O.O.M.J., W.Y.T.); literature search (O.O.M.J., R.A.C., I.U.S., W.Y.T.); and administrative, technical, or logistical support (O.O.M.J., B.S.T., R.A.C., W.Y.T.). The protocol has been approved by the Institutional Review Board of the University of São Paulo (“Comitê de Ética em Pesquisa do Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo – HC-FMUSP”). The patients signed a written consent form. Clinical trial identifier ( www.ClinicalTrials.gov ): NCT00443521 .
PY - 2009/2
Y1 - 2009/2
N2 - Purpose: To evaluate laser combined with intravitreal triamcinolone acetonide (IVTA) for the management of patients with proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME). Design: Randomized clinical trial. Methods: settings: Single center. study population: Twenty-two patients with bilateral treatment-naïve moderate PDR and CSME. intervention: Laser (panretinal and macular) photocoagulation was performed in each eye, followed by IVTA in one randomly assigned eye. Best-corrected visual acuity (BCVA), fundus photography, and optical coherence tomography were performed at baseline and at months 1, 3, 6, 9, and 12. main outcome measures: Changes in BCVA, central macular thickness (CMT), and total macular volume (TMV). Results: The mean logarithm of the minimal angle of resolution (logMAR) BCVA improved significantly, and mean CMT and TMV were significantly reduced in the IVTA group compared with the laser-only group (controls) at all study follow-up visits (P < .001). The mean logMAR BCVA (Snellen equivalent) was 0.44 (20/50-2) for the IVTA group and 0.38 (20/50+1) for the controls at baseline, and 0.12 (20/25-1) for the IVTA group and 0.32 (20/40-1) for the controls at 12 months (P < .001). The mean CMT and TMV were, respectively, 360 μm and 8.59 mm3 for the IVTA group and 331 μm and 8.44 mm3 for the controls at baseline, and 236 μm and 7.32 mm3 for the IVTA group and 266 μm and 7.78 mm3 for the controls at 12 months (P < .001). Conclusions: The combination of laser photocoagulation with IVTA was associated with improved BCVA and decreased CMT and TMV when compared with laser photocoagulation alone for the treatment of moderate PDR with CSME.
AB - Purpose: To evaluate laser combined with intravitreal triamcinolone acetonide (IVTA) for the management of patients with proliferative diabetic retinopathy (PDR) and clinically significant macular edema (CSME). Design: Randomized clinical trial. Methods: settings: Single center. study population: Twenty-two patients with bilateral treatment-naïve moderate PDR and CSME. intervention: Laser (panretinal and macular) photocoagulation was performed in each eye, followed by IVTA in one randomly assigned eye. Best-corrected visual acuity (BCVA), fundus photography, and optical coherence tomography were performed at baseline and at months 1, 3, 6, 9, and 12. main outcome measures: Changes in BCVA, central macular thickness (CMT), and total macular volume (TMV). Results: The mean logarithm of the minimal angle of resolution (logMAR) BCVA improved significantly, and mean CMT and TMV were significantly reduced in the IVTA group compared with the laser-only group (controls) at all study follow-up visits (P < .001). The mean logMAR BCVA (Snellen equivalent) was 0.44 (20/50-2) for the IVTA group and 0.38 (20/50+1) for the controls at baseline, and 0.12 (20/25-1) for the IVTA group and 0.32 (20/40-1) for the controls at 12 months (P < .001). The mean CMT and TMV were, respectively, 360 μm and 8.59 mm3 for the IVTA group and 331 μm and 8.44 mm3 for the controls at baseline, and 236 μm and 7.32 mm3 for the IVTA group and 266 μm and 7.78 mm3 for the controls at 12 months (P < .001). Conclusions: The combination of laser photocoagulation with IVTA was associated with improved BCVA and decreased CMT and TMV when compared with laser photocoagulation alone for the treatment of moderate PDR with CSME.
UR - http://www.scopus.com/inward/record.url?scp=58249105907&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58249105907&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2008.08.024
DO - 10.1016/j.ajo.2008.08.024
M3 - Article
C2 - 18929352
AN - SCOPUS:58249105907
SN - 0002-9394
VL - 147
SP - 291-297.e2
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
IS - 2
ER -
