Short-term Safety And Efficacy Of Ranibizumab Monotherapy Or Combinded With Laser In The Treatment Of Diabetic Macular Edema

Purpose: To compare the short-term safety and efficacy of intravitrealranibizumab alone or combined with focal/grid photocoagulation for cases with diabeticmacular edema(DME).Methods: In this prospective non-randomized study,32patients(46eyes) withdiabetic macular edema from July2013to January2014were divided into IVR groupand IVR+L group，17patients(23eyes) in Group IVR,15patients(22eyes) in GroupIVR+L。Follow-up visits were conducted every month and for a minimum of3months.IVR group：study eyes were all treated with consecutive intravitreal ranibizumab（Lucentis）0.05ml/0.5mg monthly for3months, then continued to be treated or notdepending on the central macular thickness(CMT).IVR+L group：study eyes receivedIVR as same in IVR group，and focal/grid photocoagulation3～7days after the firstinjection. Sex, age, duration of diabetes, fasting blood-glucose(FBG),blood ureanitrogen(BUN), creatinine(Cr), blood pressure before treatment were recorded. Bestcorrected visual acuity(BCVA）, Intraocular Pressure(IOP）,Central MacularThickness(CMT) before and after treatment were examined. Paired-sample t test,independent sample t test, Wilcoxon signed rank test were used to analysis the data bySPSS17.0.Results: At the end of the visits,5patients(8eyes) withdrawing treatment were excluded, so27patients(38eyes) were included in this study,12patients(16eyes) inGroup IVR,15patients(22eyes).In Group IVR: compared with the baseline mean BCVA(Log MAR)(1.02±0.53),3d（0.91±0.51）,1mo（0.83±0.53）,2mo（0.80±0.48）and3mo （0.79±0.42）after the first injection were significantly improved（P1=0.012,P2=0.010, P3=0.009, P4=0.009）; Compared with the baseline CMT median(520μm),1w(448μm),1mo (400μm),2mo (380μm) and3mo (365μm) after the first injection inGroup IVR were significantly decreased（P1=0.005, P2=0.000, P3=0.000, P4=0.000）;compared with baseline IOP（16.45±2.54mmHg）,3d（17.36±2.54mmHg）,1w（16.64±1.57）mmHg and3mo （16.45±1.81mmHg）after the first injection weresimila（rP1=0.219, P2=0.703, P3=1.000）. In Group IVR+L: Compared with the baselinemean BCVA (Log MAR)(0.84±0.43),3d（0.74±0.39）,1mo（0.68±0.36）,2mo（0.64±0.38）and3mo（0.63±0.34）after the first injection were significantly improved（P1=0.014, P2=0.012, P3=0.011, P4=0.011）;Compared with the baseline CMT median(517μm),1w(440μm),1mo (395μm),2mo (375μm) and3mo (360μm) after the firstinjection were significantly decreased（P1=0.001, P2=0.000, P3=0.000, P4=0.000）,compared with baseline IOP（16.79±2.89mmHg）,3d（15.86±2.51mmHg）,1w（15.93±2.09mmHg）and3mo （15.86±2.28mmHg）after the first injection weresimilar（P1=0.271, P2=0.089, P3=0.121）. There was no significant difference betweentwo groups in BCVA, CMT and IOP before or after the treatment. No ocular orsystematic complications were observed in this study.Conclusions: Intravitreal ranibizumab alone or combinded with focal/gridphotocoagulation can rapidly decease the CMT, improve the BCVA and reduce the riskof visual loss in patients with DME, and these two therapies do not affect the BCVA,CMT or IOP in the lateral eyes. The short-term safety and effect of these twotreatments groups are good; however, the maintained safety and efficacy of thesetreatments need long-term follow-up studies.