Study on Precision Treatment of Diabetic Retinopathy Macular Edema Guided by Real-time OCT During Operation
Study Details
Study Description
Brief Summary
Select Proliferative Proliferative diabetic retinopathy(PDR) patients who are planning to undergo vitrectomy for informed notification. After obtaining informed consent, vitrectomy will be performed. After hemorrhage is removed, the macular shape can be obtained through intraoperative optical coherence tomography (iOCT) real-time scanning. If the central Macular Thickness (CMT) of the patient is ≥250μm, random Enter the Anti-vascular endothelial growth factor (anti-VEGF) treatment group, the internal limiting membrane stripping group and the glucocorticoid treatment group for treatment, and compare the patients' visual acuity (1 day, 7 days, 1 month, 3 months, 6 months) and The thickness of the center of the macula, compare and observe its treatment effect.
Condition or Disease | Intervention/Treatment | Phase |
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Phase 3 |
Detailed Description
- Test method:
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Include suitable cases of diabetic retinopathy and macular edema Inclusion criteria: a. PDR patients with severe vitreous hemorrhage who cannot collect oct images and require vitrectomy b. Type 2 diabetes, aged 18~80 years old c. Good blood sugar control (glycated hemoglobin <8.3%) d. Sign the informed consent form voluntarily, and are willing and able to follow the outpatient visits and research procedures within the time specified in the trial Exclusion criteria: a. Exclude severe infections of conjunctiva, cornea, and sclera b. Combined with other retinal vascular diseases such as retinal vein occlusion c. Cardiorenal insufficiency d. Myocardial infarction or stroke occurred within 6 months ②Intraoperative real-time operation All patients underwent 25Gauge(25G) transplanter three-channel vitrectomy to remove cloudy vitreous or vitreous hemorrhage and posterior vitreous cortex. Through intraoperative oct, the macular area was observed in real time and the central macular thickness was measured. If central macular thickness (CMT) ≥ 250 μm, anti-VEGF, glucocorticoid, or internal limiting membrane peeling was randomly selected to treat macular edema.
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Re-examine the effect of surgery after operation The visual acuity and the thickness of the center of the macula were reviewed at 1 day, 7 days, 1 month, 3 months, and 6 months after the operation to compare the effect of the operation, and observe the cornea, anterior chamber, vitreous cavity, and intraocular pressure.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
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Experimental: Anti-VEGF treatment group Visual acuity and center thickness of the macula |
Drug: Ranibizumab Injection [Lucentis]
The visual acuity and the thickness of the center of the macula were reviewed at 1 day, 7 days, 1 month, 3 months, and 6 months after the operation to compare the effect of the operation, and observe the cornea, anterior chamber, vitreous cavity, and intraocular pressure.
Other Names:
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Experimental: Inner limiting membrane stripping group Visual acuity and center thickness of the macula |
Procedure: Inner limiting membrane stripping
The visual acuity and the thickness of the center of the macula were reviewed at 1 day, 7 days, 1 month, 3 months, and 6 months after the operation to compare the effect of the operation, and observe the cornea, anterior chamber, vitreous cavity, and intraocular pressure.
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Experimental: Glucocorticoid treatment group Visual acuity and center thickness of the macula |
Drug: Dexamethasone intravitreal implant
The visual acuity and the thickness of the center of the macula were reviewed at 1 day, 7 days, 1 month, 3 months, and 6 months after the operation to compare the effect of the operation, and observe the cornea, anterior chamber, vitreous cavity, and intraocular pressure.
Other Names:
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Outcome Measures
Primary Outcome Measures
- Review the patient's vision before surgery [The day before the patient's surgery]
Optical Coherence Tomography (OCT) is currently the main examination method for measuring retinal thickness and evaluating DME morphology and fine structure. DME OCT examination has a variety of morphological manifestations and accompanying images, and various manifestations reflect different pathological basis.
Secondary Outcome Measures
- Review the patient's vision for one day after surgery [The patient's first day after surgery]
Optical Coherence Tomography (OCT) is currently the main examination method for measuring retinal thickness and evaluating DME morphology and fine structure. DME OCT examination has a variety of morphological manifestations and accompanying images, and various manifestations reflect different pathological basis.
- Review the patient's vision for 7 days after surgery [1st week after surgery]
Optical Coherence Tomography (OCT) is currently the main examination method for measuring retinal thickness and evaluating DME morphology and fine structure. DME OCT examination has a variety of morphological manifestations and accompanying images, and various manifestations reflect different pathological basis.
- Review the patient's vision for 1 month after surgery [4th week after surgery]
Optical Coherence Tomography (OCT) is currently the main examination method for measuring retinal thickness and evaluating DME morphology and fine structure. DME OCT examination has a variety of morphological manifestations and accompanying images, and various manifestations reflect different pathological basis.
- Review the patient's vision for 3 months after surgery [12th week after surgery]
Optical Coherence Tomography (OCT) is currently the main examination method for measuring retinal thickness and evaluating DME morphology and fine structure. DME OCT examination has a variety of morphological manifestations and accompanying images, and various manifestations reflect different pathological basis.
- Review the patient's vision for 6 months after surgery [24th week after surgery]
Optical Coherence Tomography (OCT) is currently the main examination method for measuring retinal thickness and evaluating DME morphology and fine structure. DME OCT examination has a variety of morphological manifestations and accompanying images, and various manifestations reflect different pathological basis.
Eligibility Criteria
Criteria
Inclusion Criteria:
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PDR patients with severe vitreous hemorrhage who cannot collect oct images and need vitrectomy
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Type 2 diabetes, aged 18~80 years old
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Good blood sugar control (glycated hemoglobin <8.3%)
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Sign the informed consent form voluntarily, and are willing and able to follow the outpatient visits and research procedures within the time specified in the trial
Exclusion Criteria:
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Exclude severe infections of conjunctiva, cornea, and sclera
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Combined with other retinal vascular diseases such as retinal vein occlusion
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Cardiorenal insufficiency
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Myocardial infarction or stroke occurred within 6 months.
Contacts and Locations
Locations
Site | City | State | Country | Postal Code | |
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1 | Affiliated Hospital of Nantong University | Nantong | Jiangsu | China | 226001 |
Sponsors and Collaborators
- Affiliated Hospital of Nantong University
Investigators
- Principal Investigator: Rongrong Zhu, master, Affiliated Hospital of Nantong University
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- MSZ20180