Abstract
Purpose :
To compare the effect of intravitreal bevacizumab (IVB) with modified grid laser on contrast sensitivity, visual acuity, 10-2 automated perimetry and central macular thickness (CMT) in clinically significant macular edema (CSME).
Methods :
Thirty eyes of metabolically stable patients with CMT equal to or less than 350 microns on OCT were included. The patients were randomized (1: 1) into two groups, group I was treated with IVB monotherapy for CSME and followed up on monthly requirement of IVB while Group II was administered modified grid laser treatment and supplement laser treatment as and when required after initial treatment. The follow up was done at 1, 3 and 6 months for all the patients. BCVA was recorded for all patients using ETDRS visual acuity chart. Contrast sensitivity and 10-2 automated perimetry were done at initial and last visits. Fundus examination and OCT were done in all the patients at each visit.
Results :
Outcome parameters were visual acuity, contrast sensitivity, 10-2 automated perimetry and CMT. Mean change in visual acuity was improvement of 6 letters in group 1 and loss of 0.4 letters in group 2 which was statistically significant ( p=0.001). Increase in contrast sensitivity was 3.2 % in group 1 and decrease in contrast sensitivity was 4.1% in group 2 and this change was statistically significant ( p=0.004). Also, final visual acuity directly correlated with contrast sensitivity ( r=-0.849, p=.001). Change in visual field was an increase of 0.39 db in group 1 and decrease of 0.20 db in group 2 which was not statistically significant ( p = 0.09). Statistically significant reduction in CMT was seen in both the groups ( group 1: 0.022 and group 2 : 0.001) but this change was not significant when both the groups were compared. Mean number of injections was 3 in group 1 and supplementary grid laser was required in only 2 patients (12.5%).
Conclusions :
Significant improvement in visual acuity and contrast sensitivity was achieved with IVB versus laser. Also, visual acuity had direct correlation with contrast sensitivity, that is, eyes with better visual acuity had better contrast sensitivity. Improvement in CSME as measured by CMT was observed in both the treatment modalities but none of these did significantly better than the other.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.