Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Arquivos brasileiros de oftalmologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492013000100006 |
Resumo: | PURPOSE: To compare pain related to intravitreal injection and panretinal photocoagulation in the management of patients with high-risk proliferative diabetic retinopathy. METHODS: Prospective study including patients with high-risk proliferative diabetic retinopathy and no prior laser treatment randomly assigned to receive panretinal photocoagulation (PRP group) or panretinal photocoagulation plus intravitreal ranibizumab (PRPplus group). In all patients, panretinal photocoagulation was administered in two sessions (weeks 0 and 2), and intravitreal ranibizumab was administered at the end of the first laser session in the PRPplus group. Retreatment was performed at weeks 16 and 32 if active new vessels were detected at fluorescein angiography. Patients in the PRPplus group received intravitreal ranibizumab and patients in the PRP group received 500-µm additional spots per quadrant of active new vessels. After the end of retreatment, a 100-degree Visual Analog Scale was used for pain score estimation. The patient was asked about the intensity of pain during the whole procedure (retinal photocoagulation session or intravitreal ranibizumab injection). Statistics for pain score comparison were performed using a non-parametric test (Wilcoxon rank sums). RESULTS: Seventeen patients from PRPplus and 14 from PRP group were evaluated for pain scores. There were no significant differences between both groups regarding gender, glycosylated hemoglobin and disease duration. Mean intravitreal injection pain (±SEM) was 4.7 ± 2.1 and was significantly lower (p<0.0001) than mean panretinal photocoagulation pain (60.8 ± 7.8). Twelve out of 17 patients from the PRPplus group referred intensity pain score of zero, while the minimal score found in PRP group was found in one patient with 10.5. CONCLUSION: In patients with high-risk proliferative diabetic retinopathy who needed retreatment for persistent new vessels, there was more comfort for the patient when retreatment was performed with an intravitreal injection in comparison with retinal photocoagulation. Further larger studies are necessary to confirm our preliminary findings. |
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Arquivos brasileiros de oftalmologia (Online) |
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Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathyPainIntravitreal injectionsDiabetic retinopathyLight coagulationVascular endothelial growth factor APURPOSE: To compare pain related to intravitreal injection and panretinal photocoagulation in the management of patients with high-risk proliferative diabetic retinopathy. METHODS: Prospective study including patients with high-risk proliferative diabetic retinopathy and no prior laser treatment randomly assigned to receive panretinal photocoagulation (PRP group) or panretinal photocoagulation plus intravitreal ranibizumab (PRPplus group). In all patients, panretinal photocoagulation was administered in two sessions (weeks 0 and 2), and intravitreal ranibizumab was administered at the end of the first laser session in the PRPplus group. Retreatment was performed at weeks 16 and 32 if active new vessels were detected at fluorescein angiography. Patients in the PRPplus group received intravitreal ranibizumab and patients in the PRP group received 500-µm additional spots per quadrant of active new vessels. After the end of retreatment, a 100-degree Visual Analog Scale was used for pain score estimation. The patient was asked about the intensity of pain during the whole procedure (retinal photocoagulation session or intravitreal ranibizumab injection). Statistics for pain score comparison were performed using a non-parametric test (Wilcoxon rank sums). RESULTS: Seventeen patients from PRPplus and 14 from PRP group were evaluated for pain scores. There were no significant differences between both groups regarding gender, glycosylated hemoglobin and disease duration. Mean intravitreal injection pain (±SEM) was 4.7 ± 2.1 and was significantly lower (p<0.0001) than mean panretinal photocoagulation pain (60.8 ± 7.8). Twelve out of 17 patients from the PRPplus group referred intensity pain score of zero, while the minimal score found in PRP group was found in one patient with 10.5. CONCLUSION: In patients with high-risk proliferative diabetic retinopathy who needed retreatment for persistent new vessels, there was more comfort for the patient when retreatment was performed with an intravitreal injection in comparison with retinal photocoagulation. Further larger studies are necessary to confirm our preliminary findings.Conselho Brasileiro de Oftalmologia2013-02-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492013000100006Arquivos Brasileiros de Oftalmologia v.76 n.1 2013reponame:Arquivos brasileiros de oftalmologia (Online)instname:Conselho Brasileiro de Oftalmologia (CBO)instacron:CBO10.1590/S0004-27492013000100006info:eu-repo/semantics/openAccessLucena,Célia Regina Farias de AraújoRamos Filho,José AfonsoMessias,André Márcio VieiraSilva,José Aparecido daAlmeida,Felipe Piacentini Paes deScott,Ingrid UrsulaRibeiro,Jefferson Augusto SantanaJorge,Rodrigoeng2013-06-25T00:00:00Zoai:scielo:S0004-27492013000100006Revistahttp://aboonline.org.br/https://old.scielo.br/oai/scielo-oai.phpaboonline@cbo.com.br||abo@cbo.com.br1678-29250004-2749opendoar:2013-06-25T00:00Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO)false |
dc.title.none.fl_str_mv |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
title |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
spellingShingle |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy Lucena,Célia Regina Farias de Araújo Pain Intravitreal injections Diabetic retinopathy Light coagulation Vascular endothelial growth factor A |
title_short |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
title_full |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
title_fullStr |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
title_full_unstemmed |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
title_sort |
Panretinal photocoagulation versus intravitreal injection retreatment pain in high-risk proliferative diabetic retinopathy |
author |
Lucena,Célia Regina Farias de Araújo |
author_facet |
Lucena,Célia Regina Farias de Araújo Ramos Filho,José Afonso Messias,André Márcio Vieira Silva,José Aparecido da Almeida,Felipe Piacentini Paes de Scott,Ingrid Ursula Ribeiro,Jefferson Augusto Santana Jorge,Rodrigo |
author_role |
author |
author2 |
Ramos Filho,José Afonso Messias,André Márcio Vieira Silva,José Aparecido da Almeida,Felipe Piacentini Paes de Scott,Ingrid Ursula Ribeiro,Jefferson Augusto Santana Jorge,Rodrigo |
author2_role |
author author author author author author author |
dc.contributor.author.fl_str_mv |
Lucena,Célia Regina Farias de Araújo Ramos Filho,José Afonso Messias,André Márcio Vieira Silva,José Aparecido da Almeida,Felipe Piacentini Paes de Scott,Ingrid Ursula Ribeiro,Jefferson Augusto Santana Jorge,Rodrigo |
dc.subject.por.fl_str_mv |
Pain Intravitreal injections Diabetic retinopathy Light coagulation Vascular endothelial growth factor A |
topic |
Pain Intravitreal injections Diabetic retinopathy Light coagulation Vascular endothelial growth factor A |
description |
PURPOSE: To compare pain related to intravitreal injection and panretinal photocoagulation in the management of patients with high-risk proliferative diabetic retinopathy. METHODS: Prospective study including patients with high-risk proliferative diabetic retinopathy and no prior laser treatment randomly assigned to receive panretinal photocoagulation (PRP group) or panretinal photocoagulation plus intravitreal ranibizumab (PRPplus group). In all patients, panretinal photocoagulation was administered in two sessions (weeks 0 and 2), and intravitreal ranibizumab was administered at the end of the first laser session in the PRPplus group. Retreatment was performed at weeks 16 and 32 if active new vessels were detected at fluorescein angiography. Patients in the PRPplus group received intravitreal ranibizumab and patients in the PRP group received 500-µm additional spots per quadrant of active new vessels. After the end of retreatment, a 100-degree Visual Analog Scale was used for pain score estimation. The patient was asked about the intensity of pain during the whole procedure (retinal photocoagulation session or intravitreal ranibizumab injection). Statistics for pain score comparison were performed using a non-parametric test (Wilcoxon rank sums). RESULTS: Seventeen patients from PRPplus and 14 from PRP group were evaluated for pain scores. There were no significant differences between both groups regarding gender, glycosylated hemoglobin and disease duration. Mean intravitreal injection pain (±SEM) was 4.7 ± 2.1 and was significantly lower (p<0.0001) than mean panretinal photocoagulation pain (60.8 ± 7.8). Twelve out of 17 patients from the PRPplus group referred intensity pain score of zero, while the minimal score found in PRP group was found in one patient with 10.5. CONCLUSION: In patients with high-risk proliferative diabetic retinopathy who needed retreatment for persistent new vessels, there was more comfort for the patient when retreatment was performed with an intravitreal injection in comparison with retinal photocoagulation. Further larger studies are necessary to confirm our preliminary findings. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-02-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492013000100006 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492013000100006 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/S0004-27492013000100006 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Conselho Brasileiro de Oftalmologia |
publisher.none.fl_str_mv |
Conselho Brasileiro de Oftalmologia |
dc.source.none.fl_str_mv |
Arquivos Brasileiros de Oftalmologia v.76 n.1 2013 reponame:Arquivos brasileiros de oftalmologia (Online) instname:Conselho Brasileiro de Oftalmologia (CBO) instacron:CBO |
instname_str |
Conselho Brasileiro de Oftalmologia (CBO) |
instacron_str |
CBO |
institution |
CBO |
reponame_str |
Arquivos brasileiros de oftalmologia (Online) |
collection |
Arquivos brasileiros de oftalmologia (Online) |
repository.name.fl_str_mv |
Arquivos brasileiros de oftalmologia (Online) - Conselho Brasileiro de Oftalmologia (CBO) |
repository.mail.fl_str_mv |
aboonline@cbo.com.br||abo@cbo.com.br |
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1754209027649175552 |