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Intravitreal anti‐ VEGF treatment for refractory diabetic macular edema
Author(s) -
Papavasileiou E.,
Quijano C.,
Younis S.
Publication year - 2015
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2015.0402
Subject(s) - medicine , diabetic macular edema , refractory (planetary science) , ophthalmology , macular edema , ranibizumab , diabetic retinopathy , combination therapy , diabetes mellitus , retinal , bevacizumab , surgery , chemotherapy , endocrinology , physics , astrobiology
Purpose To compare anti‐ VEGF monotherapy with combination treatment of anti‐ VEGF injections plus macular laser (focal or modified grid) for refractory diabetic macular edema ( DMO ). Methods We included patients with DMO who had more than 6 anti‐ VEGF injections and were examined in the Macula clinic. Our outcomes were change in BCVA , CRT and number of anti‐ VEGF injections. Results We included 22 patients (13 males and 9 females) with a mean follow up of 24 months. Mean age was 63.18 years (range: 47–77 years). 4 patients had Type 1 and 18 had Type II diabetes. 86.36% had hypertension and 68.18% hyperlipidaemia on treatment. 22.72% were pseudophakic, 45.45% had bilateral DMO and 45.45% had PRP laser. 70% of patients had Lucentis injections and 30% had Avastin injections. 70% were on anti‐ VEGF monotherapy and 30% had combination therapy (macular laser plus anti‐ VEGF injections). Mean baseline BCVA (in letters) was 27.24 and improved to 30.27 on last visit (+6 letters gain). Mean baseline Central Retinal Thickness ( CRT ) was 518.33 µm and decreased to 356.24 µm (−162.08 µm) on last visit. Mean number of injections was 8.88. Subgroup analysis showed that those who had anti‐ VEGF monotherapy improved their BCVA during the follow up period to +7.6 letters and those on combination therapy improved to +5.82 letters. CRT decreased from baseline to last visit on both groups. Conclusions Both treatment groups improved their VA and CRT from baseline, however, anti‐ VEGF monotherapy had better visual outcomes compared to combination treatment.