Título

RETINAL FUNCTION IN EYES WITH PROLIFERATIVE DIABETIC RETINOPATHY TREATED WITH INTRAVITREAL RANIBIZUMAB AND/OR LASER PANRETINAL PHOTOCOAGULATION

Objetivo

Treating proliferative diabetic retinopathy (PDR) with intravitreal Ranibizumab (IVR), or combining IVR to conventional (ETDRS) or Multispot Laser Panretinal(PASCAL) photocoagulation(PRP), permits the use of less extensive PRP which can prevent retinal function loss. This study aimed to compare retinal function changes in eyes with PDR after IVR, combined or not with PRP

Método

Prospective study included laser-naive PDR patients that required PRP. Eyes were randomly assigned to receive IVR or IVR combined to PASCAL or EDTRS. PRP was performed at baseline in 1(PASCAL) or 2(ETDRS) sessions. In eyes with macular edema, macular short pulse grid laser was associated to IVR at baseline and IVR was repeated monthly if CSFT>300μm, or quarterly if neovascularization was detected on angiography. Evaluations, including SD-OCT, were performed at baseline and every 4 weeks after treatment. Full-field electroretinography (ERG: extended ISCEV standard) was performed at baseline and at 12, 24 and 48 weeks

Resultado

IVR=13, PASCAL=15, and ETDRS=15 eyes finished one-year follow-up. There was a statistically significant BCVA improvement of 0.1 to 0.3 logMAR in all groups, and new vessels area reduced to approximately 38%,28%, and33% of baseline for ETDRS, IVR and PASCAL respectively, up to 48 weeks without significant differences between groups(P>0.05). A significant a- and b-wave amplitude reduction was observed for dark- and light-adapted ERG for ETDRS and PASCAL, but only minor dark-adapted b-wave reduction was found for IVR, up to 1 year. As an example, at week 48, combined response b-wave amplitude reduced in 181.5 ± 31.4 µV, 128.0±27.9 µV and 82.4±15.2 µV for ETDRS, PASCAL and IVR(P<0.05 each group) respectively. No significant difference was observed between ETDRS and PASCAL for any ERG parameter

Conclusão

IVR plus single or multiple spot PRP causes similar retinal function changes during a 48-week follow-up. IVR alone seems to be similarly effective for new vessels control and substantially spare retinal function