| Objective:To evaluate the efficacy of Difrarel on the prevention of diabetic retinopathy(DR) patients occur to diabetic macular edema (DME) after panretinal photocoagulation(PRP).Design:Randomized,controlledmulticenter,double-masked,parallel-group.Participants:39patients with diabetic retinopathy(DR)and impaired vision resulting from diffuse DME in at least1eye (the study eye) were enrolled.Methods:This prospective interventional case series study was conducted at jinan Hospital, Between December2010to June2014.Patients were randomized to three Groups.The control group is8eyes of8patients only with panretinal photocoagulation(PRP)therapy.15eyes of15patients with Duobeisi therapy (Group A),16eyes of16patients with Difaming therapy (Group B).all patients mast be control there Blood glucose at a normal level. To check the best corrected visual acuity (BCVA),CMT on optical coherence tomography (OCT)and Fundus fluorescein angiography (FFA) after one week,two week, three week,four week and two months.Results1:The basic situation of three groups of patients before treatment:Three groups of patients before treatment, DR stage, age, duration of DME clinical classification, preoperative visual acuity, central foveal thickness of CRT had no significant difference, comparable.2:best corrected visual acuity changes:Photocoagulation in three groups before the average best corrected visual acuity of A group was0.93±0.32; B group was0.80±0.26; C group was0.86±0.21; data statistically, there were no significant differences between the three groups before operation (P>0.05). Comparable. After treatment, A group and B group best corrected visual acuity decreased, especially in the first months. In group C, PRP postoperative visual acuity was not decreased but increased. One month after operation, in group A, the average best corrected visual acuity was0.63±0.17; group B, the average best corrected visual acuity was0.75±0.18; group C, the average best corrected visual acuity was0.87±0.193; data after statistics processing, compared with A group, and B group F=0.17, P>0.05; there was no significant difference in A; compared with group C, F2=0.325, P2<0.01, the difference has statistical significance. Compared with B group and C group, F3=0.15, P3=0.026. have significant difference (P<0.05).After second months of treatment, A group of average best corrected visual acuity was0.56±0.16; group B, the average best corrected visual acuity was0.79±0.13; group C, the average best corrected visual acuity was0.93±0.17; data after statistics processing, compared with A group, and B group F1=0.12, P>0.05; no significant difference; compared with A group, and C group F2=0.32, P2±<0.001.3:After treatment by fundus fluorescein angiography (FFA) resolution check non perfusion and neovascularization was improved in7eyes in group A, complete regression,1eyes remaining; group B:13eyes disappeared completely,2eyes with residual; group C:14eyes disappeared completely,2eyes with residual, three groups of statistics no significant difference (P>0.05).4:foveal thickness variation:Preoperative A group of foveal thickness was (290.8±10.2) μ m, B group (308.1μ13.3) μm, C group (312.5±8.3) μm, statistical analysis, no significant difference between three groups before operation (P>0.05), with comparable, In1W,2W,3W,4W and two months to measure and calculate the difference between CRT and CRT before operation. Data were treated statistically, A between group B and group P were>0.05there was no significant difference in P; compared with A group and C group<0.05; the differences were statistically significant (P<0.05), to compare the differences between B group and C group were statistically significant (P<0.05),this study showed that the addition of interventions difaming, during PRP operation, the foveal thickness was not obvious, significantly better than the laser group and laser combined with calcium dobesilate group had significant difference. The B group is better than the A group in the prevention of edema, but the difference was not statistically significant.Conclusion:1:laser photocoagulation postoperative foveal thickness increase.2:difaming reduce diabetic macular edema, prevent caused by retinal laser vision decreased effective drugs, curative effect is better than that of calcium dobesilate, worthy of recommendation. |
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