Abstract
Purpose: :
To evaluate the visual acuity (VA) and optical coherence tomography (OCT) thickness results of short duration macular photocoagulation with concomitant intravitreal avastin in the treatment of diffuse diabetic macular edema (DME) due to diabetes.
Methods: :
Consecutive retrospective analysis of VA and OCT data from eyes treated in a modified Early Treatment Diabetic Retinopathy Study (ETDRS) style using a short duration pattern scanning laser in which patients received intravitreal bevacizumab (1.25 mg/0.05 mL) within 2 weeks of the laser treatment.
Results: :
A total of 38 eyes from 32 patients met study criteria. All subjects were treated with the same pattern scanning laser phocoagulation unit. Parameters varied according to media and pigmentation status, but typical settings were: 100 µm spot size, 10 milliseconds pulse duration, 200 mW power, and 29 J/cm2 fluence, yielding a light gray tissue change. At 3 months post-treatment, there was an average improvement in visual acuity (VA) of .097 LOGMar (an improvement from 20/70 to 20/56) and a reduction of central OCT thickness of 66 µm (from 484 to 418 µm), both of which were statistically significant (p = 0.0001 and 0.0002, respectively).
Conclusions: :
Short duration macular photocoagulation in conjunction with concomitant intravitral bevacizumab has a biological treatment effect at 3 months for the treatment of DME. We observed statistically significant improvements in both VA (approx. 9 ETDRS letters) and central OCT thickness (66 µm). Short duration laser photocoagulation in conjunction with intravitreal bevacizumab appears safe and effective in the short term and may have significant long term advantages for the treatment of DME.
Keywords: diabetes • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • diabetic retinopathy