Clinical effects and safety of treating diabetic macular edema with intravitreal injection of ranibizumab combined with retinal photocoagulation

Abstract

BackgroundThis study was designed to examine the clinical effects of treating diabetic macular edema with an intravitreal injection of ranibizumab in combination with retinal photocoagulation.MethodsSixty-two cases (75 eyes) with confirmed severe proliferative diabetic retinopathy or proliferative diabetic retinopathy in combination with macular edema were randomly divided into the observation group (37 eyes were given an intravitreal injection of ranibizumab combined with retinal photocoagulation) and the control group (38 eyes received retinal photocoagulation only). Vision, fundus condition, central macular thickness, and the macular leakage area were recorded before and after treatment.ResultsThe best-corrected visual acuity and macular leakage area were similar between the observation and control groups (P>0.05). The best-corrected visual acuity in the observation group was higher than that in the control group 3 and 6 months after treatment (P<0.05) and showed a rising tendency. The macular leakage area in the observation group was significantly lower than that in the control group 1 and 3 months after treatment (P<0.05). However, the macular leakage area was similar 6 months after treatment (P>0.05). The central macular thickness of the observation group was lower than that in the control group 1, 3, and 6 months after treatment (P<0.05). The laser energy used in the observation group was also smaller than that in the control group (P<0.05). The intraocular pressure was not significantly different between the groups (P<0.05). No patients in the two groups developed eye or systemic complications, such as glaucoma, cataract, or vitreous hemorrhage during treatment.ConclusionIntravitreal injection of ranibizumab combined with retinal photocoagulation was proven to be effective in treating diabetic macular edema as it improved vision and resulted in fewer complications.

Panretinal Photocoagulation vs. Panretinal Photocoagulation Plus Intravitreal Ranibizumab in High-Risk Proliferative Diabetic Retinopathy

“…The results of the current study are consistent with data from other studies [8][9][10][11][12] regarding the absence of any apparent association between intravitreal ranibizumab injection and increased IOP, cataract development or progression or increased rates of endophthalmitis related to the study drug.…”

High-Risk Diabetic Maculopathy: Features and Management

“…Breach of the posterior capsule from a complicated cataract extraction or even from Nd: YAG laser capsulotomy may allow angiogenic factors to gain access to the anterior segment more readily, accelerating formation of neovascularization. The management of DME in these eyes with intravitreal anti-VEGF provides temporary regression of the iris neovascularization, decrease in the PDR severity and facilitates the panretinal photocoagulation [29]. Early glaucoma surgery significantly improves the visual prognosis of DME in eyes with neovascular glaucoma, however they remain at high risk of IOP decompensation, reactivation of the PDR and recurrences of the macular edema and need prompt, often urgent treatment.…”

Intravitreal anti-vascular endothelial growth factor, laser photocoagulation, or combined therapy for diabetic macular edema: A systematic review and network meta-analysis

“…Additionally, the effectiveness of LP may be improved by LP becoming easier because of the reduction in macular edema caused by anti-VEGF injections. Several studies have evaluated LP as an adjunctive treatment for anti-VEGF agents; however, their conclusions are inconsistent (13)(14)(15)(16)(17)(18).…”