Session Title: Vascular Diseases and Diabetic Retinopathy III
Session Date/Time: Saturday 19/09/2015 | 16:30-18:00
Paper Time: 16:46
First Author: : H.Canan TURKEY
Co Author(s): : R. AltanYaycioglu
PURPOSE:The aim of the study was to evaluate visual acuity and macular thickness alterations after intravitreal ranibizumab (IVR) monotherapy and İVR injection combined with laser therapy in treatment of diabetic macular edema (DME).
Baskent University Department of Ophthalmology
Clinical records were retrospectively reviewed of 80 patients (98 eyes) who underwent IVR therapy for DME at Başkent University Department of Ophthalmology, between May 2012 and May 2014. This study was approved by the institutional review board of the Başkent University Clinical Research Ethics Committee before performing this retrospective review (KA13/238). The patients were divided into 2 groups according to the treatment modality: Group I included 53 eyes treated with ranibizumab monotherapy and Group II included 45 eyes treated IVR with combination of focal/grid laser therapy. Patients were compared in terms of best-corrected visual acuity (BCVA) and central macular thickness (CMT) at 1st and 6th months.The intravitreal ranibizumab injections (0.5mg , Lucentis; Genentech, South San Francisco, CA) were administered all patients in an operating room. Laser treatment was performed with Iridex Oculight GL (frequency doubled diode pumped laser with wavelength 532 nm) and laser settings were 75 µm spot size, 50-100 ms pulse duration. Inclusion criteria for this study were the presence of CMT more than 250 µm on SD-OCT images in patients who had never previously underwent treatment with laser photocoagulation or intravitreal injections. Exclusion criteria included eyes with macular ischemia, vitreomacular traction and epiretinal membrane.
Mean follow-up period was 14.8± 5.4 (6-22) months. The mean age of the patients was 60.2±8.9 years (39-80). The median (minimum-maximum) BCVA before the treatment in Group I and Group II was 0.7 (0.1-1.3) logMAR and 1 (0.4-1.3) logMAR respectively. The visual acuity was 0.4 (0.1-1.3) logMAR and 0.7 (0.2-1.3) logMAR respectively at 6th month. The increase in BCVA was statistically significant in group I (p=0.0001). The median (minimum-maximum) CMT before the treatment in Group I and Group II was 487 (277-847) μm and 493 (289-843) μm respectively. The CMT was 284 (178-496) μm and 352 (220-921) μm respectively at 6th month. The decrease in CMT was statistically significant in group I (p=0.001). Recurrence of macular edema was significantly higher in group II (p=0.0001). No inflammation, infection, or ocular toxicity sign and systemic side effects was seen in both groups.
According to our study intravitreal ranibizumab monotherapy is more effective than combination of IVR with focal/grid laser therapy in the treatment of DME.