Tomographic optical-angiographic imaging changes following treatment of patients with diabetic retinopathy
Pejvak Azadi1 *
- kermanshah university of medical sciences
Abstract: Diabetic Retinopathy is one of the most common causes of vision loss in working age group. While the widely accepted treatment for proliferative diabetic retinopathy and diabetic macular edema are panretinal photocoagulation (PRP) and intravitreal anti vascular endothelial growth factor (Anti-VEGF) injections, they may induce undesired complications. In this randomized clinical trial, we compared different treatment modalities in terms of clinical and anatomical changes.
Methods: This study is a double-blinded randomized clinical trial conducted on 90 patients with proliferative diabetic retinopathy and diabetic macular edema referred to the Kermanshah University of Medical Sciences ophthalmology department from March 2020 to March 2022. The patients were randomly assigned to one of three therapeutic intervention groups:
A: Pan Retinal Photocoagulation (PRP) treatment with full-dose 1500 laser spots alongside monthly Intravitreal Bevacizumab (IVB) injection.
B: PRP treatment with half-dose 750 laser spots alongside bimonthly IVB injection.
C: PRP treatment with half-dose 750 laser spots alongside bimonthly Intravitreal Triamcinolone (IVT) injections and IVB injections.
Patients were compared through changes in best corrected visual acuity (BCVA), optical coherence tomography (OCT) and OCT angiography (OCTA) changes at baseline and 3-minth and 6-month follow up visits.
Results: in all groups the best corrected visual acuity (BCVA), central macular thickness (CMT), and OCTA parameters including foveal avascular zone (FAZ), flow area, macular vascular density, and optic nerve head vascular density improved clinically and statistically significant (P value < 0.05) in the 3- and 6-month follow up visits. While the parameters did not show statistically significant difference at the baseline between groups, but at the 3- and 6- month follow up visits the central macular thickness (CMT) was statistically better in the IVB/TA group compared the other 2 groups. Other parameters including BCVA and OCTA parameters did not show statistically significant difference in groups 2 and 3 compared to the first group.
Conclusion: This study showed that in combination therapy, halving the treatment dose could be noninferior to the standard treatment but adding IVTA did not improve the results significantly.
