Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept

Ahmad M Mansour,1,2 Khalil El Jawhari,3 J Fernando Arevalo4 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon; 3Medical School, Medical University of Lodz, Lodz, Poland; 4Wilmer Eye Institute...

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Autores principales:	Mansour AM, El Jawhari K, Arevalo JF
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	scatter laser photocoagulation vascular growth factor Ziv-aflibercept Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/0e28e4006096471c93582a536b5cbcba
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spelling	oai:doaj.org-article:0e28e4006096471c93582a536b5cbcba2021-12-02T07:53:35ZRole of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept1177-5483https://doaj.org/article/0e28e4006096471c93582a536b5cbcba2019-04-01T00:00:00Zhttps://www.dovepress.com/role-of-peripheral-pan-retinal-photocoagulation-in-diabetic-macular-ed-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Ahmad M Mansour,1,2 Khalil El Jawhari,3 J Fernando Arevalo4 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon; 3Medical School, Medical University of Lodz, Lodz, Poland; 4Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA Purpose: The aim of this study was to investigate the possibility of decreasing the number of intravitreal anti-VEGF by peripheral pan-retinal photocoagulation (PPRP) in managing diabetic macular edema (DME) in a subcategory of patients who cannot comply to strict anti-VEGF follow-up protocols.Materials and methods: This is a pilot prospective study. Consecutive patients with naïve DME were offered the choice of treatment and extend intravitreal ziv-aflibercept if they showed willingness for good compliance or PPRP with modified pro re nata intravitreal injections.Results: Six eyes of 3 patients had PPRP versus 4 eyes of 4 patients had injections only. The number of anti-VEGF injections was markedly decreased when PPRP was administered from a mean number of injections of 16.8 (range 13–21; mean follow-up 24.3 months) to a mean number of 4.5 (range 0–8; mean follow-up 33.7 months). Mean initial central macular thickness (CMT) was 462.0 mm in the injection only group vs 457.3 mm in the PPRP group. Mean final CMT was 462.0 in the injection only group vs 350.0 in the PPRP group. Baseline and final mean logMAR (Snellen equivalent) best-corrected visual acuity was initially and finally 0.84 (20/137) and 0.60 (20/80) in the injection only group and 0.70 (20/100) and 0.69 (20/98) in the PPRP group, respectively. The monthly cost for the PPRP group was one-third of the monthly cost for the injection only group.Conclusion: PPRP allowed for a decrease in the number of intravitreal anti-VEGF injections in selected DME patients (sick, difficult to ambulate, financial burden, and fear of injections). Keywords: vascular endothelial growth factor, laser therapy, diabetic retinopathyMansour AMEl Jawhari KArevalo JFDove Medical Pressarticlescatter laser photocoagulationvascular growth factorZiv-afliberceptOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 695-700 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	scatter laser photocoagulation vascular growth factor Ziv-aflibercept Ophthalmology RE1-994
spellingShingle	scatter laser photocoagulation vascular growth factor Ziv-aflibercept Ophthalmology RE1-994 Mansour AM El Jawhari K Arevalo JF Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
description	Ahmad M Mansour,1,2 Khalil El Jawhari,3 J Fernando Arevalo4 1Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; 2Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon; 3Medical School, Medical University of Lodz, Lodz, Poland; 4Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA Purpose: The aim of this study was to investigate the possibility of decreasing the number of intravitreal anti-VEGF by peripheral pan-retinal photocoagulation (PPRP) in managing diabetic macular edema (DME) in a subcategory of patients who cannot comply to strict anti-VEGF follow-up protocols.Materials and methods: This is a pilot prospective study. Consecutive patients with naïve DME were offered the choice of treatment and extend intravitreal ziv-aflibercept if they showed willingness for good compliance or PPRP with modified pro re nata intravitreal injections.Results: Six eyes of 3 patients had PPRP versus 4 eyes of 4 patients had injections only. The number of anti-VEGF injections was markedly decreased when PPRP was administered from a mean number of injections of 16.8 (range 13–21; mean follow-up 24.3 months) to a mean number of 4.5 (range 0–8; mean follow-up 33.7 months). Mean initial central macular thickness (CMT) was 462.0 mm in the injection only group vs 457.3 mm in the PPRP group. Mean final CMT was 462.0 in the injection only group vs 350.0 in the PPRP group. Baseline and final mean logMAR (Snellen equivalent) best-corrected visual acuity was initially and finally 0.84 (20/137) and 0.60 (20/80) in the injection only group and 0.70 (20/100) and 0.69 (20/98) in the PPRP group, respectively. The monthly cost for the PPRP group was one-third of the monthly cost for the injection only group.Conclusion: PPRP allowed for a decrease in the number of intravitreal anti-VEGF injections in selected DME patients (sick, difficult to ambulate, financial burden, and fear of injections). Keywords: vascular endothelial growth factor, laser therapy, diabetic retinopathy
format	article
author	Mansour AM El Jawhari K Arevalo JF
author_facet	Mansour AM El Jawhari K Arevalo JF
author_sort	Mansour AM
title	Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
title_short	Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
title_full	Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
title_fullStr	Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
title_full_unstemmed	Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
title_sort	role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/0e28e4006096471c93582a536b5cbcba
work_keys_str_mv	AT mansouram roleofperipheralpanretinalphotocoagulationindiabeticmacularedematreatedwithintravitrealzivaflibercept AT eljawharik roleofperipheralpanretinalphotocoagulationindiabeticmacularedematreatedwithintravitrealzivaflibercept AT arevalojf roleofperipheralpanretinalphotocoagulationindiabeticmacularedematreatedwithintravitrealzivaflibercept
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Role of peripheral pan-retinal photocoagulation in diabetic macular edema treated with intravitreal ziv-aflibercept

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