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Aflibercept and navigated versus conventional laser in diabetic macular oedema: a 12‐month randomized clinical trial
摘要： Purpose: To examine the efficacy of intravitreal aflibercept and navigated laser as compared to intravitreal aflibercept and conventional laser in diabetic macular oedema (DME) treatment. Methods: In 12-month randomized clinical trial, 48 eyes of 37 patients with centre-involved DME at Odense University Hospital were randomized 1:1 to receive three monthly injections of aflibercept followed by navigated (group A) or conventional (group B) focal/grid laser. From month four through twelve, patients were examined monthly, and additional injections were given pro re nata (PRN) (central retinal thickness [CRT]>20% from lowest measurement or loss in visual acuity [VA]>5 Early Treatment Diabetic Retinopathy Study [ETDRS] letters compared with baseline).Outcome measures; (1) percentage of eyes that needed additional injections after laser in group A and B, (2) mean number of injections in group A and B, and (3) mean change in VA and CRT in group A and B. Results: In the PRN phase, 60.5% of patients needed additional injections without differences between groups A and B (58.3 versus 63.2%, p > 0.99). The mean number of injections between baseline and month 12 was 4.4 (4.2 versus 4.6, p = 0.41). From baseline to month 12, VA improved by 8.4 ETDRS letters, and CRT was reduced by 97.4 lm (+9.4 versus +7.1 letters, p = 0.17, and (cid:1)83.2 versus (cid:1)115.4 lm, p = 0.21). Conclusion: No difference in need for retreatment was detected between treatment arms of aflibercept and navigated versus conventional laser.
关键词： randomized clinical trial,diabetic macular oedema,focal/grid laser photocoagulation,anti-VEGF
更新于2025-09-11 14:15:04
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Granular lesions of short-wavelength and near-infrared autofluorescence in diabetic macular oedema
摘要： Objectives To document and characterise hyper- and hypo-re?ective lesions, which we describe as ‘granular’ on short-wavelength auto?uorescence (SW-AF) and near-infrared (NIR)-AF images in diabetic macular oedema (DMO). Methods Consecutive 103 eyes of 78 patients suffering from centre-involving DMO were reviewed retrospectively. Mosaics of hyper- and hypo-?uorescent dots on both SW-AF and NIR-AF signals were delineated and de?ned as granular lesions in the macula. We evaluated the association of such lesions with the logarithm of the minimum angle of resolution visual acuity (logMAR VA) and spectral-domain optical coherence tomography (SD-OCT) images. Results Diffuse mosaics of hyper- and hypo-?uorescent dots were delineated in 36 and 45 eyes on SW-AF and NIR-AF images, respectively, and both AF images de?ned granular lesions in 33 eyes. These lesions were delineated in both the fovea and extrafoveal areas on NIR-AF images but were limited to the parafoveal and perifoveal sub?elds on SW-AF images. There was a signi?cant difference in logMAR VA between eyes with and without granular lesions (0.358 ± 0.269 vs. 0.185 ± 0.234; P = 0.001). Granular lesions were associated with the mosaic pattern on NIR-AF images (P < 0.001) but not with other parameters on SW-AF and NIR-AF images. The retinal thickness in the central sub?eld was greater in eyes with granular lesions (538.0 ± 163.6 μm vs. 448.8 ± 120.2 μm; P = 0.003). Granular lesions were associated with ELM disruption and hyper-re?ective foci in the outer retinal layers (P = 0.004 and P = 0.037, respectively). Conclusions Granular lesions de?ned on both SW-AF and NIR-AF images were related to retinal oedema with photoreceptor damage and concomitant VA reduction in DMO.
关键词： diabetic macular oedema,photoreceptor damage,near-infrared auto?uorescence,granular lesions,short-wavelength auto?uorescence
更新于2025-09-09 09:28:46