Abstract:AIM: To explore the clinical effect of leizhumab combined with 577nm multi-point scanning matrix laser photocoagulation in the treatment of diabetic macular edema(DME).
METHODS:Totally 127 eyes of 94 patients(January 2017-June 2018)with DME were selected. According to the different treatment methods, RA group was divided into two groups. RA group was only treated with razumab group: the patients in this group were treated with razumab injection; RL group: razumab combined with 577nm multi-point scanning matrix laser group: the patients in this group were treated with razumab combined with 577nm multi-point scanning matrix laser photocoagulation. To observe the treatment effect of RA group and RL group 1mo after three times of leizhumab injection; to check the visual improvement of RA group and RL group before treatment and 1mo, 3mo and 6mo after three times of leizhumab injection; to detect the macular fovea thickness(CMT)of RA group and RL group by optical coherence tomography(OCT); to detect the retinal neogenesis by FFA Vascular leakage area and postoperative complications.
RESULTS: The effective rate(100%)of the patients in the combined group was higher than that in the single group(97%), but the difference was not statistically significant(P>0.05). Before treatment, the BCVA of the two groups of patients were 0.57±0.20 and 0.56±0.18(P>0.05). After completing three injections of ranibizumab, the BCVA of the single group of patients at 1, 3, and 6mo were 0.39±0.05, 0.23±0.06,0.18±0.05, the BCVA of the combined group were 0.28±0.08,0.18±0.07, 0.12±0.06, the BCVA of the combined group was better than the control group(P<0.001). Before treatment, the CMT of the two groups of patients were 389±42.54 and 386±38.25, respectively(P>0.05).After completing three injections of ranibizumab, the CMT of the single group at 1, 3,and 6mo were 333.84±38.18, 297.12±27.10, 278.15±26.24μm, the CMT of the combined group were 315.04±39.07, 274.35±28.63, 253.65±25.91μm, the improvement of the CMT of the combined group was better than that of the single group(P<0.001). Before treatment, the leakage area of retinal neovascularization in the two groups was 22.31±3.26 and 21.98±3.18mm2(P>0.05). After the injection of ranibizumab was completed 3 and 6mo, the single group leaked The areas were 18.34±2.19, 7.81±1.28mm2, and the leakage area of the combined group were 14.92±1.98, 5.39±1.42mm2, respectively(P<0.001). Complications occurred in 3 eyes of a single group of patients and complications in 4 eyes of a combined group(P>0.05).
CONCLUSION: Leizhumab and 577nm multi-point scanning matrix laser photocoagulation are effective and safe in the treatment of DME patients, but the long-term effect of leizhumab combined with 577nm multi-point scanning matrix laser group is better than that of single line intravitreal injection of leizhumab.
