MACULAR LASER GRID ALONE VERSUS COMBINED WITH INTRAVITREAL TRIAMCINOLONE PLUS BEVACIZUMAB FOR DIABETIC MACULAR EDEMA

Abstract

Diabetic retinopathy is the leading cause of blindness among individuals of working age in advanced societies, most of the vi sion loss resulting from diabetic macula r edema (DME) . Macular laser photocoagulation or i ntravitreal tiamcinolone or anti - vascular endothelial growth factor injection are modalities of therapy for diabetic macular edema. T his study aim was to present the clinical outcomes of 60 eyes of 41 patie nts with diffuse DME who treated with macular laser grid (MLG) alone or combined with intravitreal triamcinolone (IVTA) and intravitreal bevacizumab (IVB) injection. Thirty eyes (group1) treated with MLG and 30 eyes (group 2) treated with MLG + IVB + IVTA. The values of BCVA, central macular thickness ( CMT ) , intraocular pressure ( IOP ) and complications were compared between two groups. At baseline, BCVA was 0.35 ± 0,18 LogMAR (logarithm of the minimum angle of resolution ) in the group 1 and 0.36 ± 0.36 ± 0. 14 logMAR in the group 2. At 6 and 20 months after initial treatment in both groups had no significant improvement in BCVA, whereas had a significan t improvement in CMT (p < 0.001) compared with baseline. An increase in IOP was present in 13 % and cataract was developed in 6.7 % in the group 2. At 6 th and 20 th month , MLG and MLG + IVTA + IVB provided improvement of BCVA and CMT in the both groups . There was no significant difference in BCVA and CMT betwee n two groups. Increased IOP and devel opment of catar act was recorded i n the group 2 secondary to IVTA . MLG may be preffer ed for treatment of DME because of side events of IVTA + IVB.