Clinical Efficacy Of Intravitreal Ranibizumab Injection For Diabetic Macular Edema

ObjectiveTo evaluate the clinical efficacy of intravitreal injection of ranibizumab over18 months for diabetic macular edema MethodsTotally 60 eyes diagnosed of diabetic macular edema were randomized and divided into three groups: 20 eyes receive simple intravitreal injection of 0.5mg ranibizumab,20 eyes receive combined treatment of intravitreal injection of 0.5mg ranibizumab and retinal laser photocoagulation later,20 eyes received simple retinal laser photocoagulation.During 18 months of follow up,we observed the best corrected visual acuity(BCVA),central macular thickness( CMT),changes in fundus fluorescein angiography(FFA) and frequency of injection.Results(1)BCVA: Both the BCVA score of simple ranibizumab group and combined group were superior to baseline from month 2 and better than simple laser group in month3,6,9,12 and 18,but there was no difference between them. While the BCVA score of simple laser group remained stable during the follow-up period and had no statistical significance.The BCVA score of latest observation were54.1±11.6,58.3±15.1 and 45.2±12.8,which increased 8.8,12.1 and 0.6 letters on average respectively.(2) CMT:The mean CMT of simple ranibizumab group and combined group were significantly reduced from base line during the observation period.In addiction,combined group was superior to simply ranibizumab group only in month 9.The mean CMT of simply laser group was similar to base line. The mean CMT of latest observation were 295.8±125.2μm,38.6±104.7μm and 580.1±122.6 μm,which reduced358.7μm,383.2μm and 64.1μm on average espectively.(3)FFA shows leakage of macular edema : The cases that shows leakage of macular edema in the latest observation were 14,12 and 20 in simpleranibizumab,combined and simple laser group. It reduced 6 cases(30%),8 cases(40%)and 0 cases(0%) respectively.(4)The number of intravitreal injection was 6.4±1.3138 times in simple ranibizumab and 5.3±0.9911 times in combined group during 18 months. Combined treatment needed less injection and revealed better efficiency.Conclusion(1)Compared with tranditional retinal laser photocoagulation, ranibizumab has superior clinic efficacy and achieves better BCVA and CMT for DME.(2)Intravitreal ranibizumab injection with retinal laser photocoagulation showsbetter efficacy of both,combined therapy can significantly reduce the numberof injection for patients with DME.