|Support type:||Scholarships in Brazil - Post-Doctorate|
|Effective date (Start):||June 01, 2013|
|Effective date (End):||September 30, 2015|
|Field of knowledge:||Health Sciences - Medicine|
|Principal Investigator:||Rodrigo Jorge|
|Grantee:||Katharina Vieira Messias|
|Home Institution:||Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil|
Introduction: Since 1976, panretinal photocoagulation (PRP) has been the preconized treatment for proliferative diabetic retinopathy (PDR). However, the procedure decreases the risk of severe vision loss by only 50%, and is associated with substantial burden and retinal damage. Therefore, alternative therapy modalities, such as association of intravitreal injection of anti-VEGF agents and pattern scan laser application (PASCAL) have been investigated to optimize the disease control with minimum retinal destruction.Objectives: To evaluate retinal function before and after PRP with single laser application (ETDRS) or PASCAL, associated or not with intravitreal injection of Ranibizumab (IVR), in order to estimate eventual correlations between the functional loss after treatment and the recurrence of new-vessels in the short-term follow-up.Methods: Prospective and randomized clinical trial with 45 patients with PDR divided into 3 groups according to the treatment: ETDRS + IVR (n=15), PASCAL + IVR (n=15) and IVR (n=15). Evaluations will include measurement of best-corrected visual acuity, ISCEV-Standard full-field electroretinogram (ERG), full-field scotopic threshold, visual field (30-2 - threshold), retinography and fluorescein angiography, and optical coherence tomography (OCT). Exams will be performed at baseline and 12, 24 and 48 weeks after treatment.Expected results: We expect to describe the changes in retinal function and morphology associated with the different treatment strategies, and to estimate their relationships with therapeutic efficiency.