| Objective:To evaluate the efficacy and safety of intravitreal ranibizumab for the treatment of diabetic macular edema. Diabetic macular edema (DME) is one of the main reasons leading to visual damage of diabetic patients. It is of great clinical significance to treat DME for patients to improve their visual acuity and life quantity. Intravitreal injection of ranibizumab is widely used to treatment macular edema associated with diabetes. As people of diabetic macular edema awareness of the dangers of its continued exploration of the treatment carried out.the current treatment methods are mainly laser photocoagulation, intravitreal injection,and vitreous surgery.For the retinal thickness more than450μm in patients with macular grid laser photocoagulation is not only ineffective samples, and even the original cause of diabetic macular edema worsened vitrectomy combined with internal limiting membrane tear addition to surgery can make some of macular edema decreased,visual acuity was improved.However, the duration of macular edema hard exudate, as well as the extent of non-perfusion area if the postoperative outcome of patients after the impact, and its expensive, more complications and long-term effect is not obvious. Therefore, to explore a new method of treatment of DME has been an ophthalmologist at home and abroad continue to explore and research an important issue. In recent years, intravitreal injection into a hot topic in triamcinolone. In this study we used this method to treat DME, and to observe it’s efficacy and safety. Optical coherence tomography, fudus fluorescein angiography, pressure measurement were performed to doment the results.Method:In a total of52cases (60eyes) with DME who underwent routine ocular examination, FFA and OCT were recruited. The30eyes were divided into2groups for IVR once (B1) or IVR consecutively(B2). The other30eyes with laser treatment were comparative group. The change of best corrected visual acuity and central macular thickness at3days,1week,l month,3months,6months follow-up between3groups were compared. Results:In this study,we used intravitreal injection of5mg ranibizumab for treatment of DME. After injection we observed that DME relieved obviously. The eyes treated with IVR displayed significant improvement in visual acuity, both after3days (0.4067p=0.000) and lweek (0.447p=0.000) and lmonth (0.437 p=0.000) of treatment. Significant improvement was displayed also in eyes with MLG after1month(0.271p=0.000) and3month(0.335p=0.000). The difference between group B1(0.456)and group B2(0.375) becomes significant Smonths after the treatment(P=0.018).The difference between IVR and MLG also becomes significant3months after the treatment(t=3.445p=0.002).Macular thickness of the eyes treated with IVR were significantly reduced afterl week (219.8μm p=0.000),1month(230.03μm p=0.000),3months (214.93u m p=0.000)of before treatment. The difference between group B1and group B2becomes significant3months after the treatment(P=0.041).The eyes treated with MLG were also significantly reduced afterl month(271.8μm p=0.000) and3months(241.47u m p=0.000) compare to before treatment.The difference between IVR and MLG also becomes significant3months after the treatment(t=-3.162p=0.004). No new cataract, infection and retinal detachment occurred. Conclusion:The results indicated that damage of retinal function resulting from DME could be reversible to some extent and intravitreal inject ranibizumab is an more effective method for DME than MLG. This therapy is comparatively safe, no local or systemic adverse event were observed in any patients. In conclusion, intravitreal injection of ranibizumab (IVR) for DME is effective, but in a long run its curative effect could not persist. A randomly controlled multicenter clinical trial is necessary. However because ranbizumab can be inject into various cavity directly, and is effective, secure for DME, it is worth to be investigated continuously and combined with other therapy to cure DME. |
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