Diabetic Retinopathy & Medical Retina - aioseducation

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Diabetic Retinopathy and Medical Retina Free Papers RESULTS 90 eyes of 150 patients were enrolled within a study period of 2 years from March 2009-2011. The mean age of the patients was 61.2±6.1 years with 77 female (55.67%) and 73 male (54.33%) subjects. Out of the 90 patients, 30 each were randomized into the Bevacizmuab group, combined IVB/IVTA group and in the Laser group. The severity of retinopathy did not vary among the 3 groups 55% of the study population had focal type of DME, which 45% had diffuse DME. Except for the duration of CSME, there were no clinically significant differences observed at baseline between treatment groups. The mean ETDRS BCVA was 6/12 to 6/60 in all the 3 groups with the mean CRT being 440±20 (range: 280 to 800 in group 1, 468 micron ±19 micron (253 micron – 856 micron) in group 2 and 464 micron ± 22 micron (281 micron – 846 micron). Retreatment was given on a prn basis if there was loss of atleast 2 lines of vision between 2 consecutive follow-up or if CRT was ≥ 300 µm. Analysis of Results All 3 groups are similar with respect to age, sex, diabetic age, HbA1C, pre treatment vision, baseline central retinal thickness on OCT. Effectiveness of Treatment on Vision There was no statistically significant difference between the increase in visual scores in the 3 groups by Anova test and hence all three modalities are equally effective wrt visual gain. The difference between the 3 groups was also apparent with respect to CRT (in OCT). In group I, CRT had significantly decreased from 540µm (range 280 to 900 µm) at baseline to 376 µm (range: 167 to 698 µm) at 12 months (p
70th AIOC Proceedings, Cochin 2012 Major Ocular Adverse Effects Criteria Laser BVZ BVZ+IVTA Endophthalmitis 1% 0% 1% Pseudoendophthalmitis 1% 0% 2% Ocular Vascular Event 1% 1% 2% RD 0% 0% 0% Vitrectomy 5% 2% 1% Vit HgE 9% 3% 4% Cummulative Probability of Cat Sx • BVZ + TA : 59% • BVZ : 14% • LASER : 14% The number of repeat injections was 4 in the Bevacizumab group and 2 in the combination group. The mean change in visual acuity at 24 months was an improvement in all 3 groups (+7.2 letter VS +6.2 letters VS +5.1 letters in the Bevacizumab, combination and laser groups respectively. IOP Profile Elevated IOP Laser BVZ BVZ+IVTA Increase>10mm 8% 9% 42% IOP > 30 3% 2% 27% Initiation of IOP Lowering 5% 5% 28% Medications at any Visit Eyes with >1 of above 11% 11% 50% Glaucoma Surgery 0% 0% 0% Cardiovascular and Cerebrovascular Events Disease Laser RBZ BVZ+IVTA Non-Fatal Mi 3% 1% 3% Non-Fatal CVA 6% 2% 2% Summary of Results At primary end point (month 6) bvz monotherapy resulted in superior bcva (+6.50 letters) compared to laser (+0.50) or combination (+3.80 letters). During months 6-24 PRN bevacizumab injection /repeat laser in the mpc group resulted in maintenance of visual benefits. there was no statistically significant difference in the 24 m outcome between both groups. Combination therapy was associated with poorer ocular safety profile and less favourable outcome at 24 months. 872
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