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Robert E. Morris, Matthew H. Oltmanns, Gregory M. Lewis; Maculopexy: A New Treatment for Diffuse Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2012;53(14):350.
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To determine the safety and efficacy of maculopexy (the production of microscopic chorioretinal adhesions by grid laser treatment together with gas tamponade) combined with intravitreal triamcinolone acetate (combined assisted maculopexy, CAMP) to permanently increase retinal resistance to expansion as a new treatment for diffuse diabetic macular edema (DDME).
Retrospective, consecutive case series of 10 eyes of 10 patients with DDME that did not have foveal ischemia, all treated by CAMP.
Visual acuity improved significantly (0.43 (20/54) to 0.26 (20/36) logMAR (Snellen), p=0.04) as did optical coherence tomography (OCT) central thickness (433 to 220 uM, p=0.0002). Mean length of follow-up was 43.6 months (range 8-72). Five patients (50%) had 2 or more Snellen lines of improvement, 2 had 1 line of improvement and 3 remained unchanged. Eight of 8 eyes (100%) with foveal cysts had resolution of the cysts with concave fovea at final follow-up.
CAMP appears to be a safe and effective new treatment for DDME, a common and visually debilitating condition that has heretofore had no satisfactory treatment. A larger prospective clinical trial is justified based on encouraging results of this pilot study.
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