Diabetic Eye Disease Studies

Diabetic Retinopathy Study

• Inclusion criteria
• VA 20/100 or better
• Severe NPDR in both eyes
• PDR with active NV in one eye
• Four High-Risk Characteristics
  • Presence of vitreous or preretinal hemorrhage
  • Presence of neovascularization
  • Presence of NV on or within one DD or disc
  • Moderate or severe NVD > 1/3 disc area OR NVE > 1/2 disc area
• PRP if 3 or more HRCs
• PRP beneficial if 2 HRCs, but must weigh risks
• Argon less harmful than Xenon

 

Early Treatment Diabetic Retinopathy Study

• Evaluated photocoagulation and aspirin treatment in the management of patients with NPDR and PDR
• Clinically-Significant Macular Edema
  • Thickening of the retina at or within 500 microns of the center of the macula
  • Hard exudate at or within 500 microns of the center of the macula with thickening of the adjacent retina
  • A zone of retinal thickening equal to or larger than one disc area, any part of which is within one disc diameter of the center of the macula
• Eyes with CSME benefit from prompt focal argon laser treatment
  • Reduced risk of visual loss
  • Increased the likelihood of visual improvement
• Eyes with macular edema which is not CSME should be observed
• Focal macular laser treatment should be performed before scatter treatment for HRCs
• Systemic aspirin did not prevent progression to HRC or reduce the risk of visual loss, nor did it increase the risk of vitreous hemorrhage

 

Diabetic Retinopathy Vitrectomy Study

• Recent vitreous hemorrhage reducing VA to 5/200 or less for at least 1 month
• Early vitrectomy offered a greater likelihood of recovery of 10/100 or better at 3 months
• Early vitrectomy offered a greater likelihood of recovery of 10/20 or better at 2 years
• Long-term benefit of vitrectomy most apparent in Type I DM
• The advantage of early vitrectomy increased with severity of neovascularization

 

 

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