MACULAR LASER GRID ALONE VERSUS COMBINED WITH INTRAVITREAL TRIAMCINOLONE PLUS BEVACIZUMAB FOR DIABETIC MACULAR EDEMA

Diabetic retinopathy is the leading cause of blindness among individuals of working age in advanced societies, most of the vision loss resulting from diabetic macular edema (DME). Macular laser photocoagulation or intravitreal tiamcinolone or anti-vascular endothelial growth factor injection are modalities of therapy for diabetic macular edema. This study aim was to present the clinical outcomes of 60 eyes of 41 patients with diffuse DME who treated with macular laser grid (MLG) alone or combined with intravitreal triamcinolone (IVTA) and intravitreal bevacizumab (IVB) injection. Thirty eyes (group1) treated with MLG and 30 eyes (group 2) treated with MLG + IVB + IVTA. The values of BCVA, central macular thickness (CMT), intraocular pressure (IOP) and complications were compared between two groups. At baseline, BCVA was 0.35 ± 0,18 LogMAR (logarithm of the minimum angle of resolution) in the group 1 and 0.36 ± 0.36 ± 0.14 logMAR in the group 2. At 6 and 20 months after initial treatment in both groups had no significant improvement in BCVA, whereas had a significant improvement in CMT (p < 0.001) compared with baseline. An increase in IOP was present in 13 % and cataract was developed in 6.7 % in the group 2. At 6th and 20th month, MLG and MLG + IVTA + IVB provided improvement of BCVA and CMT in the both groups. There was no significant difference in BCVA and CMT between two groups. Increased IOP and development of cataract was recorded in the group 2 secondary to IVTA. MLG may be preffered for treatment of DME because of side events of IVTA + IVB