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Panretinal laser photocoagulation

Dilsher S Dhoot, Robert L Avery
The prevalence of diabetes is growing at epidemic rates in the USA. Diabetic retinopathy develops in a large proportion of patients and is a leading cause of blindness worldwide. Systemic management of diabetic retinopathy has included glycemic, hypertension, and lipid control. Local ophthalmic treatment in the form of focal/grid or panretinal laser photocoagulation has been shown to prevent vision loss in diabetic edema and proliferative diabetic retinopathy, respectively. The introduction of anti-vascular endothelial growth factor for diabetic macular edema and retinopathy has provided clinicians with improved clinical outcomes with potentially less damaging effects than laser...
December 2016: Current Diabetes Reports
Gülizar Demirok, Mehmet Fatih Kocamaz, Yasemin Topalak, Yeşim Altay, Burcu Tabakci, Ahmet Şengün
PURPOSE: To evaluate the changes in the macular ganglion cell complex (GCC) thickness and central macular thickness (CMT) as measured by spectral domain optical coherence tomography (OCT) post-argon laser panretinal photocoagulation (PRP). METHODS: The medical records of 25 patients with proliferative diabetic retinopathy (PDR) who underwent PRP, 29 patients with non-proliferative diabetic retinopathy (NPDR), and 29 patients with diabetes but without diabetic retinopathy (DR) were analyzed...
August 10, 2016: Seminars in Ophthalmology
Vinod Kumar, Shreyans Jain, Parijat Chandra, Atul Kumar
A 25-year-old man presented with retinal detachment in his right eye 20 days after pars plana vitrectomy, epiretinal membrane peeling and endolaser assisted panretinal photocoagulation performed for non-resolving vitreous haemorrhage secondary to Eales disease. Inferior retina of the right eye showed multiple (around 120) retinal holes in relation to the previous photocoagulation marks. The patient was managed with repeat vitrectomy, endolaser and silicone oil infusion. The aetiology of multiple holes, precautions to prevent them and their management are described...
2016: BMJ Case Reports
Kentaro Nishida, Hirokazu Sakaguchi, Motohiro Kamei, Nobuhiko Shiraki, Yoshihito Oura, Taku Wakabayashi, Chikako Hara, Yoko Fukushima, Tatsuhiko Sato, Kaori Sayanagi, Shigeru Sato, Masakatsu Fukuda, Kohji Nishida
PURPOSE: To establish geometrically based methods for simulating panretinal laser photocoagulation (PRP) for the photocoagulation index. METHODS: A formula for calculating the curved surface area of a spherical dome was used for the simulation. If the radius of the dome is c and the height of the dome is h, then the curved surface area (S) of the dome is S = π (c2 + h2). We calculated the area of the whole retina using this formula and the anatomical dimensions of the standard eyeball...
September 13, 2016: European Journal of Ophthalmology
Michael W Stewart
Diabetic retinopathy (DR) is the leading cause of blindness in industrialized countries. Remarkable advances in the diagnosis and treatment of DR have been made during the past 30 years, but several important management questions and treatment deficiencies remain unanswered. The global diabetes epidemic threatens to overwhelm resources and increase the incidence of blindness, necessitating the development of innovative programs to diagnose and treat patients. The introduction and rapid adoption of intravitreal pharmacologic agents, particularly drugs that block the actions of vascular endothelial growth factor (VEGF) and corticosteroids, have changed the goal of DR treatment from stabilization of vision to improvement...
August 25, 2016: World Journal of Diabetes
Pierluigi Iacono, Maurizio Battaglia Parodi, Matteo Scaramuzzi, Francesco Bandello
BACKGROUND: To evaluate the effects of dexamethasone implant in eyes affected by recalcitrant diabetic macular oedema (DME) associated with proliferative diabetic retinopathy (PDR). METHODS: Thirteen consecutive patients with centre-involving DME associated with PDR, central macular thickness (CMT) ≥300 µm, previous therapy with panretinal photocoagulation, focal/grid laser treatment and anti-vascular endothelial growth factor injection were prospectively enrolled...
September 13, 2016: British Journal of Ophthalmology
Ramak Roohipoor, Sina Dantism, Aliasghar Ahmadraji, Reza Karkhaneh, Mohammad Zarei, Fariba Ghasemi
Purpose. To compare subfoveal choroidal, central retinal, and peripapillary nerve fiber layer (RNFL) thickness after panretinal photocoagulation (PRP) with red and green laser in diabetic patients. Study Design. Randomized clinical trial. Methods. A total of 50 patients with bilateral proliferative diabetic retinopathy and no diabetic macular edema underwent PRP. One eye was randomly assigned to red or green laser. Subfoveal choroidal, central retinal, and RNFL thicknesses were evaluated at baseline and 6 weeks after treatment...
2016: Journal of Ophthalmology
Allen L Pelletier, Ledy Rojas-Roldan, Janis Coffin
Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults older than 65 years. However, family physicians play a critical role in identifying persons who are at risk of vision loss, counseling patients, and referring patients for disease-specific treatment. The conditions that cause most cases of vision loss in older patients are age-related macular degeneration, glaucoma, ocular complications of diabetes mellitus, and age-related cataracts...
August 1, 2016: American Family Physician
Mary Ho, Wilson W K Yip, Vesta C K Chan, Alvin L Young
PURPOSE: To describe a case of incontinentia pigmenti with proliferative retinopathy successfully treated by combination of repeated retinal laser photocoagulation and intravitreal ranibizumab injection. METHODS: Single interventional case report of a 4-year-old girl, known case of incontientia pigmenti, first screened at the age of two, presented with proliferative retinopathy. Sole treatment by panretinal laser photocoagulation failed to control the progression of retinal neovascularization...
July 28, 2016: Retinal Cases & Brief Reports
J Fernando Arevalo, Andres F Lasave, Lihteh Wu, Mauricio Maia, Manuel Diaz-Llopis, Arturo A Alezzandrini, Miguel Brito
PURPOSE: To evaluate the effects of intravitreal bevacizumab (IVB) on retinal neovascularization in patients with proliferative diabetic retinopathy (PDR). METHODS: Retrospective multicenter interventional case series. A chart review was performed of 81 consecutive patients (97 eyes) with retinal neovascularization due to PDR, who received at least 1 IVB injection. RESULTS: The mean age of the patients was 55.6 ± 11.6 years. The mean number of IVB injections was 4 ± 2...
July 14, 2016: Retina
Mark Saeger, Jan Heckmann, Konstantine Purtskhvanidze, Amke Caliebe, Johann Roider, Stefan Koinzer
BACKGROUND: Photocoagulation lesion intensity relies on the judgement of retinal blanching. Lesions turn out variable due to observer-dependent judgement and time dependency of blanching. We investigated lesion variability per patient and per physician in clinical routine treatments. METHODS: In this observational clinical trial, different physicians performed panretinal photocoagulation for diabetic retinopathy. Study eyes received 20-30 study lesions at 20 ms (three physicians, nine eyes) and 200 ms (four physicians, 12 eyes) irradiation time (532 nm continuous wave photocoagulator, 300 μm spot size)...
July 12, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
I Yilmaz, I Perente, B Saracoglu, A T Yazici, M Taskapili
PurposeTo evaluate and compare the possible changes in pupil size subsequent to panretinal laser photocoagulation (PRP) via conventional laser and pattern scan laser (PASCAL).Patients and methodsForty eyes of 40 patients with diabetic retinopathy were included. 20 eyes had a PRP via conventional laser and formed Group 1. 20 eyes had a PRP via PASCAL laser and formed Group 2. The participants underwent standard ophthalmologic examination at baseline. Automated infrared pupillometry were performed at baseline and month 1...
July 8, 2016: Eye
Mudit Tyagi, Vikas Ambiya, Padmaja Kumari Rani
We report the case of a 58-year-old man with proliferative diabetic retinopathy in both eyes, and a history of recurrent anterior uveitis in the right eye, who underwent panretinal laser photocoagulation (PRP) for the retinopathy in both eyes, following which he developed hypopyon uveitis in the right eye. The condition was managed with topical steroids and cycloplegics, to which he readily responded. The case highlights that there is a breakdown of the blood aqueous barrier consequent to PRP. Patients with a history of uveitis are predisposed to develop recurrent uveitis after the said procedure and should be closely watched for such complications...
2016: BMJ Case Reports
Hulya Gungel, Cigdem Altan, Deniz Oygar Baylancicek, Yesim Karagoz, Tanju Kisbet
PURPOSE: To evaluate using Doppler ultrasonography (DUS) how pars plana vitrectomy (PPV) affects orbital circulation in diffuse diabetic macular edema (DME) associated with either the epiretinal membrane (ERM) or taut posterior hyaloid (TPH). METHODS: The sample included 46 eyes of 42 patients with DME associated with the ERM (n = 22, Group 1) or TPH (n = 24, Group 2). All participants received panretinal laser photocoagulation and antivascular endothelial growth factor injections preoperatively and underwent 23-gauge PPV combined with ERM or TPH removal and internal limiting membrane (ILM) peeling...
June 1, 2016: Current Eye Research
Hoang-Ton Nguyen, Eelco van Duinkerken, Frank D Verbraak, Bettine C P Polak, Peter J Ringens, Michaela Diamant, Annette C Moll
BACKGROUND: Diabetic retinopathy (DRP) is a common microvascular complication seen in patients with type 1 diabetes mellitus (T1DM). The effects of T1DM and concomitant (proliferative) DRP on retinal blood flow are currently unclear. Therefore, we measured retinal vascular blood flow in T1DM patients with and without DRP and non-diabetic controls. We further assessed the acute effects of panretinal photocoagulation on retinal microvascular bloodflow in eight patients with diabetes. METHODS: Thirty-three T1DM patients with proliferative DRP, previously treated with panretinal photocoagulation (pDRP), 11 T1DM patients with untreated non-proliferative retinopathy (npDRP) and 32 T1DM patients without DRP (nDRP) were compared with 44 non-diabetic gender-matched controls...
2016: BMC Endocrine Disorders
Mala Subash, Oliver Comyn, Ahmed Samy, Dania Qatarneh, Serafeim Antonakis, Manjit Mehat, James Tee, Tatiana Mansour, Wen Xing, Catey Bunce, Ananth Viswanathan, Gary Rubin, Richard Weleber, Tunde Peto, Louisa Wickham, Michel Michaelides
IMPORTANCE: Panretinal photocoagulation (PRP) for proliferative diabetic retinopathy (PDR) may lead to peripheral field loss that prevents driving. Anti-vascular endothelial growth factor agents are proposed as treatments for PDR that spare peripheral vision. If multispot lasers cause less visual field loss, continuing to perform PRP may be justified. OBJECTIVE: To assess the effect of bilateral multispot laser PRP on retinal sensitivity and driving visual fields in PDR...
June 1, 2016: JAMA Ophthalmology
Anton M Kolomeyer, Alexander J Anetakis
PURPOSE: To report spontaneous closure of a tractional Stage III macular hole (MH) in a patient with proliferative diabetic retinopathy (PDR) after panretinal photocoagulation (PRP). METHODS: Case report of a 43-year-old man with poorly controlled Type I diabetes and bilateral severe proliferative diabetic retinopathy. RESULTS: On presentation, visual acuity was 20/400 and fundus examination was significant for a Stage III tractional MH in the left eye...
March 10, 2016: Retinal Cases & Brief Reports
Mohamed M Mahgoub, Tamer A Macky
PURPOSE: The aim of this study was to compare the effect of panretinal photocoagulation for proliferative diabetic retinopathy (PDR) on diabetic macular edema (DME) using a Pascal® Photocoagulator (PP) or a conventional argon laser photocoagulator (CALP). METHODS: Eighty eyes with PDR and center-involving DME were randomized to PP or CALP. Both groups had baseline assessment of best-corrected visual acuity (BCVA) and were examined with optical coherence tomography and fluorescein angiography...
2016: Ophthalmologica. Journal International D'ophtalmologie
Hardik A Parikh, Neil S Kalbag, Marco A Zarbin, Neelakshi Bhagat
PURPOSE: To describe the characteristics, demographics, anatomic and functional outcomes, and complications of diabetic eyes with traction retinal detachment (TRD) or combined traction/rhegmatogenous retinal detachment that underwent pars plana vitrectomy (PPV) silicone oil (SO) tamponade. METHODS: In this retrospective chart review, exclusion criteria included previous PPV. RESULTS: Forty eyes were identified. The mean preoperative complexity score (CS) of the TRDs was 5...
August 4, 2016: European Journal of Ophthalmology
Liuna Jang, Carl P Herbort
Management of diabetic retinopathy should follow more strict and aggressive rules in patients at risk for severe acute renal impairment. Such patients should be identified and possibly prophylactically laser treated to avoid the severe consequences demonstrated in this case report. A 34-year-old type 2 diabetes patient with a stabilized diabetic retinopathy developed acute and severe retinal decompensation within weeks after acute renal failure complicated his chronic stable renal impairment. Fluorescein angiographic and optical coherence tomographic illustrations of the rapid evolution of the retinal condition are presented...
February 20, 2016: International Ophthalmology
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