Perception of, and anxiety levels induced by, laser treatment in patients with sight‐threatening diabetic retinopathy. A multicentre study

Trento, Marina; Tomelini, M.; Lattanzio, Rosangela; Brancato, Rosario; Coggiola, A.; Benecchi, R.; Scoccianti, L; Insacco, Chiara; Bandello, Francesco; Montanaro, Marcello; Cavallo, Franco; Porta, Massimo

doi:10.1111/j.1464-5491.2006.01957.x

Cited by 20 publications

(24 citation statements)

References 16 publications

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“…Several previous papers emphasize that various factors, such as operator experience, intellectual level of the patients, previous intervention history, number of biopsy samples, and prostate volume, may have a positive or negative effect on patient tolerance and pain perception (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). However, as far as we could tell from the web-based English language literature, the present study is the first one that investigated the potential correlation between the pre-procedural waiting period, anxiety level and pain perception for TRUS-Bx.…”

Section: Discussionmentioning

confidence: 99%

The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound guided prostate biopsy

Saracoglu

Ünsal²,

Taşkın³

et al. 2011

Diagn Interv Radiol

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Section: Discussionmentioning

confidence: 99%

The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound guided prostate biopsy

Saracoglu

Ünsal²,

Taşkın³

et al. 2011

Diagn Interv Radiol

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“…One of the studies was excluded because it was a letter/reply to an article that was already included in category B. 133 In total, five articles [134][135][136][137][138] were retained for data extraction. …”

Section: Resultsmentioning

confidence: 99%

“…The smallest sample size was 20 patients 135 and the largest sample size was 259 patients. 138 Three studies assessed patients who were undergoing laser treatment for the first time. 134,137,138 The main limitations of the studies were the small sample sizes; 135 and the short durations of follow-up.…”

Section: Systematic Review Of Existing Cost-effectiveness Evidencementioning

confidence: 99%

“…138 Three studies assessed patients who were undergoing laser treatment for the first time. 134,137,138 The main limitations of the studies were the small sample sizes; 135 and the short durations of follow-up. 134,136 Most patients were generally satisfied with laser treatment.…”

Section: Systematic Review Of Existing Cost-effectiveness Evidencementioning

confidence: 99%

“…The five studies [134][135][136][137][138] were conducted in different countries: UK, Crete, Canada, Austria and Italy. The smallest sample size was 20 patients 135 and the largest sample size was 259 patients.…”

Section: Systematic Review Of Existing Cost-effectiveness Evidencementioning

confidence: 99%

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Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy: systematic review and economic evaluation

Royle

Mistry

Auguste

et al. 2015

Health Technol Assess

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BackgroundDiabetic retinopathy is an important cause of visual loss. Laser photocoagulation preserves vision in diabetic retinopathy but is currently used at the stage of proliferative diabetic retinopathy (PDR).ObjectivesThe primary aim was to assess the clinical effectiveness and cost-effectiveness of pan-retinal photocoagulation (PRP) given at the non-proliferative stage of diabetic retinopathy (NPDR) compared with waiting until the high-risk PDR (HR-PDR) stage was reached. There have been recent advances in laser photocoagulation techniques, and in the use of laser treatments combined with anti-vascular endothelial growth factor (VEGF) drugs or injected steroids. Our secondary questions were: (1) If PRP were to be used in NPDR, which form of laser treatment should be used? and (2) Is adjuvant therapy with intravitreal drugs clinically effective and cost-effective in PRP?Eligibility criteriaRandomised controlled trials (RCTs) for efficacy but other designs also used.Data sourcesMEDLINE and EMBASE to February 2014, Web of Science.Review methodsSystematic review and economic modelling.ResultsThe Early Treatment Diabetic Retinopathy Study (ETDRS), published in 1991, was the only trial designed to determine the best time to initiate PRP. It randomised one eye of 3711 patients with mild-to-severe NPDR or early PDR to early photocoagulation, and the other to deferral of PRP until HR-PDR developed. The risk of severe visual loss after 5 years for eyes assigned to PRP for NPDR or early PDR compared with deferral of PRP was reduced by 23% (relative risk 0.77, 99% confidence interval 0.56 to 1.06). However, the ETDRS did not provide results separately for NPDR and early PDR. In economic modelling, the base case found that early PRP could be more effective and less costly than deferred PRP. Sensitivity analyses gave similar results, with early PRP continuing to dominate or having low incremental cost-effectiveness ratio. However, there are substantial uncertainties. For our secondary aims we found 12 trials of lasers in DR, with 982 patients in total, ranging from 40 to 150. Most were in PDR but five included some patients with severe NPDR. Three compared multi-spot pattern lasers against argon laser. RCTs comparing laser applied in a lighter manner (less-intensive burns) with conventional methods (more intense burns) reported little difference in efficacy but fewer adverse effects. One RCT suggested that selective laser treatment targeting only ischaemic areas was effective. Observational studies showed that the most important adverse effect of PRP was macular oedema (MO), which can cause visual impairment, usually temporary. Ten trials of laser and anti-VEGF or steroid drug combinations were consistent in reporting a reduction in risk of PRP-induced MO.LimitationThe current evidence is insufficient to recommend PRP for severe NPDR.ConclusionsThere is, as yet, no convincing evidence that modern laser systems are more effective than the argon laser used in ETDRS, but they appear to have fewer adverse effects. We recommend a trial of PRP for severe NPDR and early PDR compared with deferring PRP till the HR-PDR stage. The trial would use modern laser technologies, and investigate the value adjuvant prophylactic anti-VEGF or steroid drugs.Study registrationThis study is registered as PROSPERO CRD42013005408.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Current literature in diabetes

2007

Diabetes Metabolism Res

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Perception of, and anxiety levels induced by, laser treatment in patients with sight‐threatening diabetic retinopathy. A multicentre study

Abstract: These data suggest that laser treatment is experienced as an event that causes anxiety. Preoperative education and counselling may help to reduce fear and patients' avoidance of treatment.

Cited by 20 publications

References 16 publications

The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound guided prostate biopsy

The impact of pre-procedural waiting period and anxiety level on pain perception in patients undergoing transrectal ultrasound guided prostate biopsy

Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy: systematic review and economic evaluation

Current literature in diabetes

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