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Comparison of Mild Macular Photocoagulation & Intravitreal Bevacizumab and Mild Macular Photocoagulation & Intravitreal Ranibizumab Combined Treatment in Patients with Diffuse Diabetic Macular Edema

Session Details

Session Title: Quick Fire Free Paper 5

Session Date/Time: Sunday 14/09/2014 | 11:00-13:00

Paper Time: 11:55

Venue: Boulevard B

First Author: : M.Guzey TURKEY

Co Author(s): :    Y. Isik   O.F. Yilmaz           

Abstract Details

Purpose:

To compare the short term efficacy of mild macular photocoagulation & intravitreal bevacizumab (MMP&IVB) and mild macular photocoagulation & intravitreal ranibizumab (MMP&IVR) combined treatment modalities in diffuse diabetic macular edema (DDME).

Setting:

In a prospective, comparative effectiveness randomized clinical trial, 92 eyes of 83 patients with type 2 diabetes with DDME were included. Eligible eyes were randomly assigned to MMP and 1.25 mg IVB (47 eyes) or combination of MMP and 0.5 mg IVR (45 eyes).

Methods:

MMP is a mild macular laser technique in which grid pattern small burns are placed throughout the macula using a 532 nm Frequency Doubled Nd: YAG laser. Study groups matched for best corrected visual acuity (BCVA) and Heidelberg Retinal Tomograph III (HRT III) Macular Edema Module based central macular edema index (CMEI). Primary outcome measure was change in CMEI at 2 months follow-up.

Results:

2 month after the treatment both of the treatment groups showed significantly reduction in CMEI values but the reductions for MMP&IVR treatment group were significantly more than MMP&IVB (p<0.01). No patient developed endophthalmitis, uveitis or intraocular pressure elevation higher than 21 mmHg.

Conclusions:

MMP&IVB or MMP&IVR brought about significant macular edema reduction. But short term results of the MMP&IVR combined treatment seem to be more favorable in the treatment of DDME. Further study is needed to assess the long term efficacy, safety and retreatment. We have also suggested a relatively simple method of documenting change in macular edema with HRT Macular Edema Module.

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