F Bıçak1, Ö R Kayıkçıoğlu2, M Altınışık2, S Doğruya3, E Kurt2. 1. Department of Ophthalmology, University of Health Sciences Bozyaka Training and Research Hospital, Izmir, Turkey. 2. Faculty of Medicine, Department of Ophthalmology, Manisa Celal Bayar University, Manisa, Turkey. 3. Ophthalmology, Uşak University Training And Research Hospital, Uşak, Turkey. sdogruya@hotmail.com.
Abstract
PURPOSE: In this study, we aimed to evaluate and compare the visual acuity, macular volume, central macular thickness, change in number of intravitreal ranibizumab injections with micropulse laser applications after loading dose of anti-VEGF to DME patients. STUDY DESIGN: Retrospective study. METHODS: This study was carried out on 97 patients (45 ranibizumab and 52 micropulse grid laser+ranibizumab) with diabetic macular edema patients who were followed in the Retina Unit. At the control visit after three loading ranibizumab injections administered once a month, micropulse grid laser was applied to one group and ranibizumab injection was continued PRN to both groups for an average of 9.27 ± 2.42 months and central macular thickness, macular volume and visual acuity were recorded. RESULTS: There was no significant difference between the groups in terms of gender, smoking and systemic diseases, initial central macular thickness, macular volume and visual acuity measurements (p > 0.05). Central macular thickness, macular volume and visual acuity values measured at the last follow-up of the patients were not significantly different between the groups (p > 0.05). The mean post-treatment injection requirement was 4.19 ± 1.01 for the ranibizumab with micropulse laser combination group and 5.53 ± 1.14 for the ranibizumab group (p < 0.001). CONCLUSION: Micropulse laser treatment after initial loading doses reduces the need for anti-VEGF injections. There is no deleterious effect on visual acuity and retinal imagings. Therefore, while combination therapy provides an effective treatment, it can also reduce the risk of complications of intravitreal anti-VEGF injections. Studies with the participation of more patients may help in the selection of treatment methods by comparing micropulse laser combined with different injection protocols.
PURPOSE: In this study, we aimed to evaluate and compare the visual acuity, macular volume, central macular thickness, change in number of intravitreal ranibizumab injections with micropulse laser applications after loading dose of anti-VEGF to DME patients. STUDY DESIGN: Retrospective study. METHODS: This study was carried out on 97 patients (45 ranibizumab and 52 micropulse grid laser+ranibizumab) with diabetic macular edema patients who were followed in the Retina Unit. At the control visit after three loading ranibizumab injections administered once a month, micropulse grid laser was applied to one group and ranibizumab injection was continued PRN to both groups for an average of 9.27 ± 2.42 months and central macular thickness, macular volume and visual acuity were recorded. RESULTS: There was no significant difference between the groups in terms of gender, smoking and systemic diseases, initial central macular thickness, macular volume and visual acuity measurements (p > 0.05). Central macular thickness, macular volume and visual acuity values measured at the last follow-up of the patients were not significantly different between the groups (p > 0.05). The mean post-treatment injection requirement was 4.19 ± 1.01 for the ranibizumab with micropulse laser combination group and 5.53 ± 1.14 for the ranibizumab group (p < 0.001). CONCLUSION: Micropulse laser treatment after initial loading doses reduces the need for anti-VEGF injections. There is no deleterious effect on visual acuity and retinal imagings. Therefore, while combination therapy provides an effective treatment, it can also reduce the risk of complications of intravitreal anti-VEGF injections. Studies with the participation of more patients may help in the selection of treatment methods by comparing micropulse laser combined with different injection protocols.
Authors: Michael J Elman; Lloyd Paul Aiello; Roy W Beck; Neil M Bressler; Susan B Bressler; Allison R Edwards; Frederick L Ferris; Scott M Friedman; Adam R Glassman; Kellee M Miller; Ingrid U Scott; Cynthia R Stockdale; Jennifer K Sun Journal: Ophthalmology Date: 2010-04-28 Impact factor: 12.079
Authors: H Lewis; A P Schachat; M H Haimann; J A Haller; P Quinlan; M A von Fricken; S L Fine; R P Murphy Journal: Ophthalmology Date: 1990-04 Impact factor: 12.079
Authors: Michael J Elman; Neil M Bressler; Haijing Qin; Roy W Beck; Frederick L Ferris; Scott M Friedman; Adam R Glassman; Ingrid U Scott; Cynthia R Stockdale; Jennifer K Sun Journal: Ophthalmology Date: 2011-04 Impact factor: 12.079
Authors: Pascale Massin; Francesco Bandello; Justus G Garweg; Lutz L Hansen; Simon P Harding; Michael Larsen; Paul Mitchell; Dianne Sharp; U E K Wolf-Schnurrbusch; Margarita Gekkieva; Andreas Weichselberger; Sebastian Wolf Journal: Diabetes Care Date: 2010-11 Impact factor: 19.112
Authors: Donald S Fong; Samara F Strauber; Lloyd Paul Aiello; Roy W Beck; David G Callanan; Ronald P Danis; Matthew D Davis; Stephen S Feman; Frederick Ferris; Scott M Friedman; Charles A Garcia; Adam R Glassman; Dennis P Han; Darma Le; Craig Kollman; Andreas K Lauer; Franco M Recchia; Sharon D Solomon Journal: Arch Ophthalmol Date: 2007-04