June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Intravitreal Ranibizumab Treatment of Diabetic Macular Edema in Combination with Focal Laser Photocoagulation under Individualised Treatment Scheme
Author Affiliations & Notes
  • Jan Ernest
    Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
  • Katerina Manethova
    Ophthalmology, Military University Hospital Prague, Prague, Czech Republic
  • Footnotes
    Commercial Relationships   Jan Ernest, None; Katerina Manethova, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 1912. doi:
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    • Get Citation

      Jan Ernest, Katerina Manethova; Intravitreal Ranibizumab Treatment of Diabetic Macular Edema in Combination with Focal Laser Photocoagulation under Individualised Treatment Scheme. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1912.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The goal of this 12-month prospective study was to evaluate the effect of intravitreal Ranibizumab with FAG navigated laser macula coagulation treatment under individualised treatment scheme. The evaluation parameters were the change of BCVA, edema reduction (CRT) and the number of anti-VEGF injections.

Methods : 44 patients with the DME diagnosis were included in the treatment and monitored over 12 months from the first exam. Only patients with good overall diabetes compensation were included. The DME diagnosis was based on clinical examinations, spectral OCT and fluorescein angiography. Examinations were performed at the trial onset and in 1, 3, 6 and 12 months from the anti-VEGF treatment initiation. All patients received 3 initial Ranibizumab doses in monthly intervals and additional intravitreal application on a PRN regime. Laser coagulation was first performed one month from the 1st Ranibizumab injection; all patients underwent a minimum of 2 laser macular treatment sessions. Laser coagulation technique was applied in areas of hypoxia, nonperfusion and leakage as established on fluorescein angiography. Monitoring and data collection (BCVA, IOP, biomicroscopy, OCT/FAG) were performed in 1, 3, 6 and 12-month intervals. Results were statistically analysed.

Results : The patients mean BCVA prior treatment was 63 ETDRS letters (35 to 77 ETDRS letters interval). After 12 months of treatment, the mean BCVA was 71 ETDRS letters (35 to 85 ETDRS letters interval) and a gain of 7.92 ETDRS letters was recorded. The mean retinal thickness prior treatment was 454 micrometres (from 312 to 674 micrometres). The mean retinal thickness post 12-month-treatment was 338 micrometres (from 179 to 480 micrometres). Both BCVA and CRT improvements were statistically significant. The mean number of Ranibizumab injections was 4.3 (from 3 to 8 injections) upon a minimum of 2 laser photocoagulation sessions.

Conclusions : Our study has shown comparable results in visual acuity improvement and macular edema reduction under the combined treatment application (anti-VEGF + targeted individualised laser photocoagulation directed by fluorescein angiography in areas of hypoperfusion and contrast medium leakage) with other clinically prospective randomised studies (6, 7, 8, 9). Results were achieved with a lower mean number of injections (4.3 vs 7.1 injections).

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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