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Morphological and functional evaluation of the macula of patients presenting proliferative diabetic retinopathy treated with pan-photocoagulation and bevacizumab

Grant number: 09/08895-1
Support Opportunities:Regular Research Grants
Duration: November 01, 2010 - October 31, 2012
Field of knowledge:Health Sciences - Medicine
Principal Investigator:Walter Yukihiko Takahashi
Grantee:Walter Yukihiko Takahashi
Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil


Nowadays Brazil has approximately 5 million diabetic patients and it is estimated 11 million in 2025. The direct and indirect costs with the disease represent 5 to 14% of the economic sources Brazilian public health system. United States spends 138 billion dollars per year with diabetes mellitus (DM). One of the most important complication of DM is diabetic retinopathy (DR). It is the main cause of blindness in Americans between 20-64 years of age, causing 8000 new cases of blindness per year. In Brazil it is estimated that half of patients with DM are affected by DR, been responsible for 7,5% of the causes of laboral incapacity in adults. It is emphasized the importance of studies related to DR, to minimize the limitations caused by this disease. The purpose of this prospective, randomized and comparative study is to quantify the functional and structural alterations of the macula in patients with proliferative DR submitted to laser photocoagulation and to evaluate the efficacy of intravitreal bevacizumab as a adjuvant therapy in preventing the adverse events of that procedure. The study will be conducted in patients assisted at Clínica Oftalmológica of the HC-FMUSP. The patients with proliferative DR with indication of binocular laser photocoagulation will be examined by ophthalmologists who will measure the visual acuity, perform slit lamp examination, fundus examination, optic coherence tomography and eletroretinography before and after laser photocoagulation. Laser photocoagulation will be performed in both eyes according the multicentric study called "Early Treatment Diabetic Retinopathy Study" that advocate the realization of 3 episodes of laser photocoagulation in 3 weeks.This comparative study analyses the effect of intravitreal bevacizumab one week before laser photocoagulation and one month after the randomization visit. The fellow eye will be submitted only to laser photocoagulation and will be considered as control. It is estimated a sample of 30 patients. All procedures, purposes and methods will be explained to all patients. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
PRETI, RONY CARLOS; VASQUEZ RAMIREZ, LISA MARIE; RIBEIRO MONTEIRO, MARIO LUIZ; PELAYES, DAVID E.; TAKAHASHI, WALTER YUKIHIKO. Structural and Functional Assessment of Macula in Patients with High-Risk Proliferative Diabetic Retinopathy Submitted to Panretinal Photocoagulation and Associated Intravitreal Bevacizumab Injections: A Comparative, Randomised, Controlled Trial. OPHTHALMOLOGICA, v. 230, n. 1, p. 1-8, . (09/08895-1)
PRETI, RONY CARLOS; VASQUEZ RAMIREZ, LISA MARIEL; RIBEIRO MONTEIRO, MARIO LUIZ; CARRA, MARIO KEHDI; PELAYES, DAVID E.; TAKAHASHI, WALTER YUKIHIKO. Contrast sensitivity evaluation in high risk proliferative diabetic retinopathy treated with panretinal photocoagulation associated or not with intravitreal bevacizumab injections: a randomised clinical trial. BRITISH JOURNAL OF OPHTHALMOLOGY, v. 97, n. 7, p. 885-889, . (09/08895-1)
PRETI, RONY C.; MUTTI, ANIBAL; FERRAZ, DANIEL A.; ZACHARIAS, LEANDRO C.; NAKASHIMA, YOSHITAKA; TAKAHASHI, WALTER Y.; MONTEIRO, MARIO L. R.. The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy. Clinics, v. 72, n. 2, p. 81-86, . (09/08895-1)

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