Abstract:AIM: To investigate the clinical efficacy of Ranibizumab combined with laser photocoagulation in the treatment of diabetic macular edema(DME).
METHODS: The clinical data of 190 patients(190 eyes)with DME treated in our hospital from June 2014 to June 2016 were retrospectively analyzed; 90 patients(90 eyes)received intravitreal ranibizumab injections were included into control group, and 100 patients(100 eyes)received the combination of intravitreal ranibizumab injections and laser photocoagulation were included into observation group. The best corrected visual acuity(BCVA)between the two groups before and after operation was compared. The central macular thickness(CMT)and the leakage of macular edema of the two groups were measured by the optical coherence tomography(OCT)and fundus fluorescein angiography(FFA)respectively. The number of drug injection between the two groups was recorded. Then patients were followed up and the incidence of the complications was recorded. All the patients were followed up for 12mo.
RESULTS: The average BCVA scores in the observation group after operation were significantly higher than those before operation. The preoperative average BCVA scores in the control group were lower than those at 1, 3, 6 and 12mo after operation. The difference between the two groups was statistically significant at 6 and 12mo after treatment(P<0.05), and there was no statistically significant difference at 1 and 3mo after treatment(P>0.05). CMT significantly decreased in both groups after treatment. CMT of the observation group was significantly thinner than that of the control group after 1, 3, 6 and 12mo treatments, the difference was statistically significant(P<0.05). In the last follow-up, the no macular edema leakage rate of the observation group was 45.0%, which was significantly higher than that of the control group(30.0%), the difference was statistically significant(P<0.05). The number of drug injection in the observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05), and there was no obvious complication in the two groups after the operation.
CONCLUSION: Compared with ranibizumab treatment alone, the combination of laser photocoagulation has better long-term vision improvement and better reduction of CMT. The combination treatment can also improve the condition of macular edema with less number of drug injection.