Soal Post Test Elvioza

Which of the following mechanisms best explains why TRP can reduce the recurrence of diabetic macular edema after anti-VEGF therapy?

• By directly stimulating Müller cells to absorb fluid

• By ablating ischemic areas that trigger VEGF production

• By increasing the oxygen demand of the retina

• By dilating retinal arteries to enhance perfusion

In comparative studies, why is pain perception during TRP significantly lower compared to PRP?

• TRP uses infrared laser which is less absorbed by the retina

• TRP applies shorter pulse durations and fewer laser burns

• TRP targets the macula instead of the periphery

• TRP is usually performed under systemic anesthesia

Which imaging modality has been shown to detect approximately 3.9 times more capillary non-perfusion in DR compared to conventional angiography?

• Wide-field OCT-A

• Ultra-widefield fluorescein angiography (UWFFA)

• Confocal scanning ophthalmoscopy

• Adaptive optics fundus imaging

The DAVE trial (3-year RCT) investigating TRP + ranibizumab for DME concluded that:

• Combination therapy significantly reduces the injection burden compared to ranibizumab alone

• Combination therapy does not provide better visual or anatomical outcomes compared to anti-VEGF monotherapy

• TRP completely eliminates the need for repeated injections

• TRP is associated with a higher rate of endophthalmitis

Extended TRP (ETRP) differs from conventional PRP because:

• It only targets the macula and posterior pole

• It spares the ischemic zone and only treats the perfused retina

• It expands coverage to the ischemic zone behind the equator and retina in front of the equator

• It eliminates the need for angiography guidance

Which clinical trial shows that UWFFA-guided TRP achieved 76% regression of PDR within 12 weeks and 37% complete regression within 24 weeks?

• DAVE Trial (2018)

• Muqit et al. (2013, Acta Ophthalmologica)

• Kernt et al. (2012, Clin Ophthalmol.)

• Takamura et al. (2014, IOVS)

Which of the following best summarizes the safety profile of TRP relative to PRP in various studies?

• Higher rates of retinal bleeding and tractional detachment

• Comparable efficacy with fewer adverse events such as night blindness and field loss

• Superior efficacy but more frequent macular edema

• Inferior efficacy but fewer laser-induced scars

In the context of retinal vein occlusion (RVO), which significant benefit does TRP combined with anti-VEGF therapy show?

• Higher final BCVA than anti-VEGF alone

• Reduced number of intravitreal injections needed while maintaining similar visual outcomes

• Prevention of ischemia progression beyond the equator

• Complete elimination of macular edema in all patients

Radiation retinopathy treated with TRP + ranibizumab shows:

• Clear advantages of combination therapy compared to ranibizumab monotherapy

• No significant additional anatomical or functional benefits, but may prevent severe complications

• Complete resolution of ischemia after 12 months

• Higher rates of vitreous hemorrhage compared to monotherapy

Based on the overall evidence, which of the following most accurately represents the current clinical position of TRP?

• TRP has completely replaced PRP in all clinical guidelines

• TRP is an experimental technique without evidence base

• TRP is a promising alternative to PRP, highly valuable in combination with anti-VEGF therapy, although long-term advantages remain unproven

• TRP is limited to research settings and not applicable to routine practice