Top PDF Effect of retinal laser photocoagulation on contrast sensitivity and visual acuity in patients of diabetic retinopathy

Effect of retinal laser photocoagulation on contrast sensitivity and visual acuity in patients of diabetic retinopathy

Effect of retinal laser photocoagulation on contrast sensitivity and visual acuity in patients of diabetic retinopathy

In the study we found that around 38% of the eyes treated with laser photocoagulation had an improvement in BCVA compared to the baseline, while 40% maintained a stable vision. Remaining 23% had a drop in the post laser BCVA in the final follow up. CS improved from the baseline in 49.1% (26 eyes) of the eyes out of which 61.5% (16 eyes) had undergone focal laser for DME. A decrease in CS compared to baseline was observed in 20% of the eyes undergoing PRP which is more as compared to that with focal laser (9%). Lövestam-Adrian et al. 15 in their study in 20 eyes treated with PRP for proliferative diabetic retinopathy too noted a loss in CS following PRP compared to the untreated eyes. Despite of the fact that focal laser has its maximum effect on the cones at macula, CS improves the most after focal laser due to the resolution of macular edema following treatment.
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A study of effect on visual acuity and contrast sensitivity following Nd-YAG laser capsulotomy in patients with posterior capsular opacification

A study of effect on visual acuity and contrast sensitivity following Nd-YAG laser capsulotomy in patients with posterior capsular opacification

acuity on Day1 was found to be statistically significant (p value= .001) indicating an immediate improvement in visual acuity after this procedure. Visual acuity done on D7 of capsulotomy showed that the improvement of visual acuity was also found to be statistically significant (p value=.000). Visual acuity done at 1 month of capsulotomy showed the improvement of visual acuity when compared to pre-laser values was found to be statistically significant (p value=.000). Visual acuity done at 3 months of capsulotomy remained same as at 1 month. This improvement when compared to pre-laser visual acuity was found to be statistically significant (p value=.0.000). Mean value of pre-laser contrast sensitivity was compared with contrast sensitivity at D1, D7, 1month and 3months. Pre-laser mean value of contrast sensitivity was 1.1538 which was compared with mean value during follow up (mean value 1.5235). The improvement in contrast sensitivity was found to be statistically significant (p value=0.000). Conclusion: Nd-YAG capsulotomy definitely improves both visual acuity and contrast sensitivity in patients with significant PCO and maximum improvement occurs within first month following Nd-YAG capsulotomy.
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The effects of macular ischemia on visual acuity in diabetic retinopathy

The effects of macular ischemia on visual acuity in diabetic retinopathy

a large sample size, in an area with a relative paucity of data. We used FA grading software, equipped with standard planimetric tools, which allowed quantification of novel morphological parameters, and combined these measurements with detailed statistical analysis. As anticipated, data regarding VA and areas of ischemia were negatively skewed, with 39.7% of patients in our cohort not having any evidence of DMI. As a result, the application of linear regression would have a substantial leverage on the slope of mean regression lines. Our application of quantile regression is more robust to outliers and allowed for an increased depth of analysis in the examination of an inferential target, such as VA, in a given proportion of the population. For example, patients with small or large FAZ areas may respond differently to ischemia with corresponding changes to visual acuity. Multivariable quantile regression analysis also accounted for concurrent DME, a confounder of the relationship between DMI and VA, often overlooked in other studies.
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PREDICTIVE MODELLING OF VISUAL ACUITY UPON DIABETIC RETINOPATHY IN TYPE 2 DIABETES MELLITUS

PREDICTIVE MODELLING OF VISUAL ACUITY UPON DIABETIC RETINOPATHY IN TYPE 2 DIABETES MELLITUS

The worldwide upsurge of Type 2 Diabetes Mellitus (T2DM) warrants the attention of public health, especially in complications. Diabetic Retinopathy (DR), the commonest ocular complication, contributes to the growing incidence of blindness. Recommendations that the visual acuity (VA) assessment guidelines should be used in DR screening was not routinely practiced. This study aims to model the predictive effect of VA - a simple economic clinical assessment - upon DR in patients with T2DM. A case-control study was conducted in Hospital Universiti Sains Malaysia with subjects recruited from the ophthalmology clinic. The primary variable during analysis was VA, and the outcome variable was DR. Models with eight control variables which included age, gender, and duration of DM were developed. The predictive effect measured by logistic regression showed that when unadjusted; four variables had a significant association with DR, at p-value<0.25; they were the duration of DM, systolic blood pressure, glycosylated haemoglobin and VA. From the eight different predictive models, the estimated adjusted odds ratio produced ranges from 6.09 to 11.64. Our study shows that VA has a predictive effect upon DR in T2DM patients. We suggest VA assessment, to be on par with the monitoring of blood pressure and blood glucose.
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Diabetic retinopathy and the use of laser photocoagulation : is it cost effective to treat early?

Diabetic retinopathy and the use of laser photocoagulation : is it cost effective to treat early?

However, the evaluation has various shortcomings. First and most notably is the use of progression data mainly from the ETDRS trial. 6 More recent studies have been conducted but they have not addressed the issue of early versus delayed PRP (timing). Due to improved treatments, better blood glucose control and population screening, monitoring and intervention, there has been a reduction in the incidence of severe vision loss/blindness from DR. 2 4 Second, even though we conducted a thorough search of the literature, we did not identify any studies with health state utility values by the detailed severity levels that we have in our model or data on disutilities associated with progressing through all the different stages of DR, or data on the disutilities after PRP, especially following the use of modern laser delivery devices. We had to rely heavily on two papers 9 10 to characterise the different visual acuity levels into health states and link them to the utility values for patients with DR as reported in Brown et al . 8 The key limitation from this
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Diabetic retinopathy and the use of laser photocoagulation: is it cost-effective to treat early?

Diabetic retinopathy and the use of laser photocoagulation: is it cost-effective to treat early?

However, the evaluation has various shortcomings. First and most notably is the use of progression data mainly from the ETDRS trial. 6 More recent studies have been conducted but they have not addressed the issue of early versus delayed PRP (timing). Due to improved treatments, better blood glucose control and population screening, monitoring and intervention, there has been a reduction in the incidence of severe vision loss/blindness from DR. 2 4 Second, even though we conducted a thorough search of the literature, we did not identify any studies with health state utility values by the detailed severity levels that we have in our model or data on disutilities associated with progressing through all the different stages of DR, or data on the disutilities after PRP, especially following the use of modern laser delivery devices. We had to rely heavily on two papers 9 10 to characterise the different visual acuity levels into health states and link them to the utility values for patients with DR as reported in Brown et al . 8 The key limitation from this
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Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

Intravitreal bevacizumab improves the clearance of vitreous haemorrhage and visual outcomes in patients with proliferative diabetic retinopathy

In the 1980s, the Diabetic Retinopathy Vitrectomy Study showed that 80% of VHs secondary to PDR did not clear spontaneously and required surgical intervention. The management of diabetes mellitus along with treatments for PDR and VHs has improved thereafter. Still, VH may prolong without spontaneous resorption and PPV may be required. PRP has been the golden standard for treating PDR for decades. Although successful at preventing blind- ness, however, PRP commonly causes retinal damage and visual side effects, including constricted visual fields, reduced visual acuity, altered colour vision, impaired dark adaptation and decreased contrast sensitivity. 19 20
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Study of the effect of grid laser photocoagulation on contrast sensitivity in patients with diabetic macular odema.

Study of the effect of grid laser photocoagulation on contrast sensitivity in patients with diabetic macular odema.

The rationale for the use of corticosteroids in CSME is it stabilises blood retinal barrier. It inhibits VEGF and other Cytokines growth factors that regulate endothelial tight cell junctions. They also reduce the synthesis of prostaglandins and leukotrine, two potent inflammatory mediators. The resultant anti inflammatory effect contributes to the reduction of macular odema. Increased diffusion by modulation of calcium channels could also account for the efficacy of corticosteroids reducing of macular odema. IVTA reduces retinal thickeneing on OCT and improves vision in a substantial number of patients. Patients with cystoids macular odema respond better.
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Retinal Nerve Fibre Layer Thickness Changes after Pan-Retinal Photocoagulation in Diabetic Retinopathy

Retinal Nerve Fibre Layer Thickness Changes after Pan-Retinal Photocoagulation in Diabetic Retinopathy

PRP was performed by single trained personnel. An argon green 532 nm (Ellex SOLITAIRE, FL, USA) laser machine was used. A total of 900 to 1200 laser spots were required for each setting. Spot size was 200 µm and pulse duration 100 milliseconds. Power was adjusted to attain grey burns and spots were placed one spot distance apart. Repeated PRP lasering was performed in two to four sessions until the new vessels regressed. Fundus was reviewed by another qualified observer to determine the sufficiency of treatment. Intervals between the laser sessions were fixed at 1 to 2 weeks. The total laser spots over the entire treatment period ranged from 2,000 to 2,500 shots. Repeat OCT was performed 2 and 4 months after treatment.
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Analysis of visual function and quality of life in patients with uveitis

Analysis of visual function and quality of life in patients with uveitis

The level at which light can just barely be detected is only one billionth of the level at which exposure to light may cause injury.There is different level of illuminaton in normal life,human eye has to adapt and function normally.It has both light and dark adaptation . The terms light and dark adaptation are relative and indicate the change in sensitivity which the retina is making, rather than any static condition. For example, if the illumination in a room is that of moderate daylight than and a room is that of moderate daylight and person goes not into the sunshine, his retina undergoes light adaptation. On the contrary, if the person form same room with moderate day light illumination goes into a dark room, his retina under goes dark adaptation. The change which takes place is always that which best enables the retina to function under the new condition.
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Efficacy of single bevacizumab injection as adjuvant therapy to laser photocoagulation in macular edema secondary to branch retinal vein occlusion

Efficacy of single bevacizumab injection as adjuvant therapy to laser photocoagulation in macular edema secondary to branch retinal vein occlusion

This was a clinical trial study of 19 patients diagnosed with macular edema secondary to BRVO. Subjects were recruited after ethical clearance was obtained from The Ethical Committee of Padjadjaran University. Subjects were recruited consecutively. Inclusion criteria were patients (less than 3 months of onset) with diagnosis of macular edema second- ary to BRVO, age .20 years, intraocular pressure less than 21 mmHg, adequate pupillary dilation, clear ocular media adequate for optical coherence tomography (OCT) exami- nation, and central macular thickness greater than 250 µ m. Exclusion criteria were history of other retinal diseases that could cause macular edema, history of intraocular surgery, retinal laser therapy, intravitreal triamcinolone injection or anti-VEGF injection, and macular ischemia. After signing the written informed consent, 19 subjects were chosen and divided into two groups based on block randomization. Group A (n = 9) was treated with laser photocoagulation therapy in combination with intravitreal bevacizumab injection, while Group B (n = 10) was treated with laser photocoagulation therapy alone.
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Serous retinal detachment after panretinal photocoagulation for proliferative diabetic retinopathy: a case report

Serous retinal detachment after panretinal photocoagulation for proliferative diabetic retinopathy: a case report

Background: Proliferative diabetic retinopathy is a major cause of visual impairment in working-age adults worldwide. Panretinal photocoagulation is a cornerstone in its management; however, it may include a range of side effects and complications, one of these being serous retinal detachment. To the best of our knowledge, this is the first report of the use of intravitreal injection of bevacizumab for serous retinal detachment after panretinal photocoagulation. Case presentation: A 24-year-old Saudi man with poorly controlled type 1 diabetes presented with bilateral progressive proliferative retinopathy in spite of several sessions of panretinal photocoagulation. After one additional such session, he developed bilateral serous retinal detachment and vision loss, which was managed with a single bilateral intravitreal bevacizumab injection. The serous retinal detachment subsided with partial recovery of vision. Conclusions: Serous retinal detachment after panretinal photocoagulation for proliferative diabetic retinopathy is a rare complication nowadays. In this case, it seems that excessive photocoagulation exceeded the energy-absorbing capacity of the retinal pigment epithelium, leading to a disruption of the blood – retinal barrier. A single injection of bilateral intravitreal bevacizumab was sufficient to control the serous retinal detachment. This effect may have been due to a reduction of vascular leakage resulting from the mechanism of action of this drug. No complications were noted from the injection. Caution should be exerted when attempting bilateral panretinal photocoagulation.
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Influence of probucol-assisted retinal photocoagulation 
						therapy on the visual performance
						and serum biochemical indexes in patients with early 
						proliferative diabetic retinopathy

Influence of probucol-assisted retinal photocoagulation therapy on the visual performance and serum biochemical indexes in patients with early proliferative diabetic retinopathy

There is obvious systemic micro-inflammation and oxidative stress status in DR patients, and the accumulation of inflammatory factors in the retina can further damage the vascular endothelial cells and cause tissue leakage and no-perfusion zone formation. It has been proven in different studies that ICAM-1, IL-2, IL-23 and TNF-α are the inflammatory mediators directly related to DR, and their expression can indirectly reflect the severity of the disease [17,18] . Persistent micro-inflammation state and high blood glucose environment can both promote oxidative stress formation, retinal tissue is rich in polyunsaturated acid and highly susceptible to damage in the process of oxidative stress, and domestic and foreign researches have also confirmed that the anti-oxidative stress treatment is effective for the optimization of illness in DR patients [19,20] . In this
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The effects of macular ischemia on visual acuity in diabetic retinopathy

The effects of macular ischemia on visual acuity in diabetic retinopathy

Permanent repository link: http://openaccess.city.ac.uk/15237/ Link to published version: http://dx.doi.org/10.1167/iovs.12-11103 Copyright and reuse: City Research Online aims to make r[r]

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Retinal Laser Photocoagulation

Retinal Laser Photocoagulation

The ever-evolving realm of laser technology has propelled the refinement of retinal laser therapy. Whereas, availability, size of units and cost effectiveness have previously limited clinical application of certain wavelengths and delivery methods, these are now more accessible. Laser wavelengths are an important variable and our understanding of their attributes and pitfalls continues to grow. Green laser has superseded blue-green laser, and now yellow laser threatens to overshadow the green laser with its superior safety profile and wider clinical application. We even have new delivery methods that promise greater efficiency, increased accuracy, minimised collateral damage and even detailed pre-planning of laser spot application.
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Non-paraneoplastic autoimmune retinopathy: multimodal testing characteristics of 13 cases

Non-paraneoplastic autoimmune retinopathy: multimodal testing characteristics of 13 cases

Based on our findings from ophthalmic examination, patient symptoms, multimodal imaging, and laboratory testing, we propose a straightforward algorithm for use in clinical practice to determine diagnosis and initiation of treatment for npAIR (Fig. 10). There should be at least two abnormal, correlated test results that are suspi- cious of the condition. Specifically, there should be evidence of pathognomonic findings from at least one objective, structural test (SD-OCT and/or FAF) and one objective, functional test (ERG taking preference to VF, if available). Because antibody testing is cost-prohibitive, takes time, and is not always specific, it should not be used for routine screening, but should be ordered when there is clinical suspicion in the presence of equivocal multimodal testing. Clinicians should make this diag- nosis in the absence of both inherited retinal disease (e.g., retinitis pigmentosa) and concurrent use of retino- toxic medications (e.g., chloroquine and hydroxychloro- quine) which can confound the diagnosis and make it even more challenging. Findings should be consistently documented on two separate, consecutive visits at least 1 month apart, although in this condition, long-term follow-up to detect subtle, real trends is important. Upon diagnosis, systemic work-up should be completed first, followed by initiation of treatment, in the form of oral immunosuppression, in the presence of progression documented on consecutive visits. As shown in our npAIR cohort, treatment ensures stability of symptoms, prevents progression and involvement of the second eye in unilateral cases.
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Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab

Evaluation of contrast sensitivity and other visual function outcomes in diabetic macular edema patients following treatment switch to aflibercept from ranibizumab

When assessing the relationship between anatomic and visual function response to treatment, we observed a statisti- cally significant relationship between a decrease in CRT and an improvement in CS; in comparison, a relatively weaker relationship between changes in CRT and BCVA was seen. This suggests that the inclusion of CS as a measurable endpoint of visual function may yield a more complete understanding of treatment outcomes than that obtained by using VA measurements alone. A similar study evaluating outcomes in patients with recalcitrant neovascular age-related macular degeneration switched to aflibercept from ranibi- zumab also used CS as the main visual outcome measure. 40
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Development of appropriateness explicit criteria for cataract extraction by phacoemulsification

Development of appropriateness explicit criteria for cataract extraction by phacoemulsification

ical practice were very few. We found that only 27% of all indications were used, and the percentages varied consid- erably among the three diagnosis groups, from 73% in simple cataract to 7.2% in cataract with diabetic retinopa- thy. This means that we asked the panel of experts to score an large number of indications that were unlikely to be present in clinical practice. This can bias the scoring of such indications because no evidence can be found in the literature about the efficacy of phacoemulsification for those indications due to the low prevalence, and because the panelists probably have no experience with them [19]. For this reason, we recommend to future developers of explicit criteria using this methodology to, first, study the prevalence of the different diagnostic groups that lead to the intervention and then develop the theoretical indica- tions that are more likely to be found in clinical practice. Additional criteria also should be the presence of impor- tant variability in the use of the procedure or the absence of evidence.
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A clinical analysis of vitrectomy for severe vitreoretinopathy in patients with chronic renal

A clinical analysis of vitrectomy for severe vitreoretinopathy in patients with chronic renal

Methods: In this retrospective study, 16 eyes of 16 CRF patients with severe vitreoretinopathy were undergone 25-guage vitrectomy in the department of Ophthalmology of the Second Hospital of Tianjin Medical University from February 2015 to April 2017. The visual outcome, complications and perioperative medical management were documented and analyzed. Results: The best-corrected visual acuity(BCVA)of fourteen eyes were lower than 20/200 preoperatively. Surgery duration ranged from 28 to 72 min, with a mean of 48.4 ± 13.6 min. During the surgery, 12 eyes were diagnosed with DR, while two them were complicated with tractional retinal detachment and one with branch retinal vein occlusion. Three eyes were diagnosed with branch retinal vein occlusion, and one eye was diagnosed with hypertensive retinopathy. Postoperative BCVA of six eyes ≥ 20/40, seven eyes ≥ 20/200, and three eyes < 20/200. BCVA of eight eyes improved more than three lines, three eyes improved two lines, and four eyes improved one line. BCVA decreased from hand movement to light perception in one patient who developed neovascular glaucoma two weeks after surgery.
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Intravitreal bevacizumab alone or combined with triamcinolone acetonide as the primary treatment for diabetic macular edema

Intravitreal bevacizumab alone or combined with triamcinolone acetonide as the primary treatment for diabetic macular edema

Complete ocular examination in the form of measurement of the best corrected visual acuity, intraocular pressure (IOP), slit lamp biomicroscopy, funduscopy, and central macular thickness (CMT) measurement using optical coherence tomography (Stratus OCT, version 4.0.7, Carl Ziess Meditec Inc, Jena, Germany).

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