Advertisement

Topics

Early Treatment Diabetic Retinopathy Study (ETDRS)

2014-08-27 04:00:16 | BioPortfolio

Summary

To evaluate the effectiveness of both argon laser photocoagulation and aspirin therapy in delaying or preventing progression of early diabetic retinopathy to more severe stages of visual loss and blindness.

To help determine the best time to initiate photocoagulation treatment in diabetic retinopathy.

To monitor closely the effects of diabetes mellitus and of photocoagulation on visual function.

To produce natural history data that can be used to identify risk factors and test etiologic hypotheses in diabetic retinopathy.

Description

ETDRS was a multicenter, randomized clinical trial designed to evaluate argon laser photocoagulation and aspirin treatment in the management of patients with nonproliferative or early proliferative diabetic retinopathy. A total of 3,711 patients were recruited to be followed for a minimum of 4 years to provide long-term information on the risks and benefits of the treatments under study.

The eligibility criteria for the ETDRS were designed to include a broad range of macular edema severity, from a few small hard exudates within a disc diameter of the fovea with normal visual acuity to extensive cystoid spaces with a visual acuity of 20/200. All study patients had one eye randomly assigned to immediate photocoagulation and the other eye to deferral of photocoagulation until high-risk proliferative retinopathy developed. During followup, additional photocoagulation was allowed for any degree of macular edema within the eligibility range, but additional photocoagulation was required only for edema involving or threatening the center of the macula. The term "clinically significant macular edema" was coined to designate this level of severity.

The trial use of aspirin therapy was based on clinical observation and on aspirin's possible mechanisms of action. Previous observations of diabetic patients who were taking large doses of aspirin for rheumatoid arthritis showed that the prevalence of retinopathy in this group was lower than the prevalence that would be expected in the diabetic population at large. Evidence suggested that diabetic patients have altered platelet aggregation and disaggregation, which may contribute to the capillary closure seen in retinopathy. This abnormality is reversed by aspirin in vitro . However, because of aspirin's other possible mechanisms of action and its well-known side effects, such as allergic, idiosyncratic, and intolerance reactions, the use of this therapy in the ETDRS was carefully controlled and monitored.

Study Design

Allocation: Randomized, Primary Purpose: Treatment

Conditions

Blindness

Intervention

Aspirin, Argon Laser Photocoagulation

Status

Completed

Source

National Eye Institute (NEI)

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T04:00:16-0400

Clinical Trials [1116 Associated Clinical Trials listed on BioPortfolio]

Branch Vein Occlusion Study

To determine whether scatter argon laser photocoagulation can prevent the development of neovascularization. To determine whether peripheral scatter argon laser photocoagulation can preve...

Micropulse 810 Nanomolar (nm), Diode Laser for Diffuse Diabetic Macular Edema

Objective: To compare micropulse 810nm diode laser photocoagulation versus argon laser photocoagulation for treatment of diabetic macular edema. Micropulse laser technique will be determi...

Treatment of Primary Type I Pterygia With Argon Laser

Introduction: Pterygium is a wing shape degenerative and hyperplastic growth of the bulbar conjunctiva extending onto the cornea, most commonly on the nasal side. Management of pterygium c...

Macular Photocoagulation Study (MPS)

To evaluate laser treatment of choroidal neovascularization (CNV) through randomized, controlled clinical trials. The Macular Photocoagulation Study (MPS) consisted of three sets of random...

Krypton-Argon Regression of Neovascularization Study (KARNS)

To evaluate whether red krypton laser treatment is as effective at causing regression of diabetic disc neovascularization as treatment with the blue-green argon laser, when both lasers are...

PubMed Articles [2438 Associated PubMed Articles listed on BioPortfolio]

Subthreshold diode micropulse laser versus conventional laser photocoagulation monotherapy or combined with anti-VEGF therapy for diabetic macular edema: A Bayesian network meta-analysis.

To assess the effects of laser photocoagulation as monotherapy or adjuvant therapy for the treatment of DME.

Confluent Endpoint Subthreshold Argon Laser for Serous Macular Detachment in Tilted Disc Syndrome Refractory to Anti-VEGF.

A 70-year-old woman presented with 20/200 visual acuity in the right eye. Multimodal imaging revealed tilted disc syndrome (TDS) with macular serous detachment (MSD) and pigmentary changes at the temp...

Hereditary hemorrhagic telangiectasia-laser treatment of epistaxis.

Hereditary hemorrhagic telangiectasia (HHT) is a rare, autosomal dominant disorder characterized by recurrent epistaxis, telangiectasias, and multiorgan vascular dysplasia. Various modalities exist fo...

Femtosecond laser tagging for velocimetry in argon and nitrogen gas mixtures.

Tagging is demonstrated in argon and nitrogen gases using a femtosecond laser with pulse energies of approximately 70 μJ through a nonresonant ionization process at 267 nm. The signal fluorescence ...

Single-Spot Yellow Laser Versus Conventional Green Laser on Panretinal Photocoagulation: Patient Pain Scores and Preferences.

Panretinal photocoagulation (PRP) is the mainstay therapy for proliferative diabetic retinopathy. Pain during and after its application is a complication that affects patients' therapeutic adherence. ...

Medical and Biotech [MESH] Definitions

A method of tissue ablation and bleeding control that uses argon plasma (ionized argon gas) to deliver a current of thermocoagulating energy to the area of tissue to be coagulated.

A technique utilizing a laser coupled to a catheter which is used in the dilatation of occluded blood vessels. This includes laser thermal angioplasty where the laser energy heats up a metal tip, and direct laser angioplasty where the laser energy directly ablates the occlusion. One form of the latter approach uses an EXCIMER LASER which creates microscopically precise cuts without thermal injury. When laser angioplasty is performed in combination with balloon angioplasty it is called laser-assisted balloon angioplasty (ANGIOPLASTY, BALLOON, LASER-ASSISTED).

A non-steroidal anti-inflammatory agent that is less effective than equal doses of ASPIRIN in relieving pain and reducing fever. However, individuals who are hypersensitive to ASPIRIN may tolerate sodium salicylate. In general, this salicylate produces the same adverse reactions as ASPIRIN, but there is less occult gastrointestinal bleeding. (From AMA Drug Evaluations Annual, 1992, p120)

Asthmatic adverse reaction (e.g., BRONCHOCONSTRICTION) to conventional NSAIDS including aspirin use.

Argon. A noble gas with the atomic symbol Ar, atomic number 18, and atomic weight 39.948. It is used in fluorescent tubes and wherever an inert atmosphere is desired and nitrogen cannot be used.

More From BioPortfolio on "Early Treatment Diabetic Retinopathy Study (ETDRS)"

Advertisement
Quick Search
Advertisement
Advertisement

 

Relevant Topic

Diabetes
Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. The two main types of diabetes are: type 1 diabetes type 2 diabetes In the UK, diabetes affects approximately 2.9 million people. There are a...


Searches Linking to this Trial