Intravitreal triamcinolone acetonide injection combined of macular laser grid photocoagulation and macular laser grid photocoagulation only for treatment of diabetic macular edema: a meta-analysis

Abstract

Objective To evaluate the efficacy and safety of intravitreal triamcinolone acetonide combined of macular laser grid photocoagulation (IVTA/MLG) versus macular laser grid (MLG)photocoagulation only for treatment of diabetic macular edema.Methods A computerized search was conducted in the Cochrane Library, Embase Library, Pubmed,Chinese Biomedical Database,Chinese Journal Full-text Database and Chinese Science and Technology Periodicals Database.Randomized controlled trials (RCT) on IVTA/MLG and MLG only for treatment of diabetic macular edema were selected.After the data extraction,quality of RCT was assessed.The meta analysis was performed by RevMan 5.1.The outcome measures included best-corrected visual acuity (BCVA) and the central foveal thickness (CMT).Results In total,six RCT that fulfilled the eligibility criteria were included in the meta-analysis involving 166 eyes in MLG group and 165 eyes in IVTA/MLG group.The results suggested that there was no significant differences in BCVA (Z =1.27,P =0.20 ), but differences were statistically significant comparing CMT (Z=2.41,P=0.02),incidence of ocular hypertension and cataract (Z=3.62,P＜0.01)between MLG and IVTA/MLG groups at the six month follow-up.Conclusions There is no significant advantage of IVTA/MLG as compared with MLG,but it could reduce CMT.However,a high-quality,large sample RCT should be further investigated. Key words: Triamcinolone acetonide/therapeutic uses; Laser coagulation/therapeutic uses; Macula edema/therapy; Meta-analysis