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Repeated intravitreal bevacizumab injection with and without macular grid photocoagulation for treatment of diffuse diabetic macular edema

机译：玻璃体腔内贝伐单抗重复注射，伴或不伴黄斑栅格光凝治疗弥漫性糖尿病性黄斑水肿

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PURPOSE:: To study whether the use of macular grid photocoagulation 3 weeks subsequent to the initial intravitreal bevacizumab (IVB) injection for the treatment of diffuse diabetic macular edema can provide a longer disease-free intervals and reduce the burden of more frequent injections. METHODS:: A prospective pilot study that included 22 patients with bilateral diffuse diabetic macular edema. In each patient, one eye was treated with repeated IVB injections alone (IVB group), while the other eye was treated with repeated IVB injections in addition to macular grid photocoagulation once only 3 weeks after the initial IVB injection (combined group). Before each IVB injection and during the follow-up visits, all patients received a complete ophthalmic examination. The central macular thickness was measured by optical coherence tomography at baseline and during the follow-up examinations. Fundus fluorescein angiography was performed at baseline and before each IVB injection, to detect and assess macular leakage. All patients were followed-up monthly for at least 12 months after the initial IVB injection and for 3 months after the last IVB injection. RESULTS:: By the end of the follow-up duration (14.2 ± 1.91 months), the mean number of injections was significantly lower (P < 0.05) in the combined group (2.36 per eye) than in the IVB group (3.27 per eye). The mean duration between the injections was significantly longer in the combined group than in the IVB group (P < 0.05). Within each group, the difference between the mean central macular thickness at the baseline and at the end of the follow-up duration was statistically significant (P < 0.05). The change in the mean best-corrected visual acuity between the baseline and the end of the follow-up period was not statistically significant in both the groups (P > 0.05). There was no statistically significant difference between the 2 groups of the study as regards the number of patients who gained, maintained, or lost vision (P > 0.05). CONCLUSION:: Repeated IVB injection could provide a long-term benefit for the treatment of diffuse diabetic macular edema. Performing macular grid photocoagulation once only 3 weeks subsequent to the initial IVB injection might provide a longer disease-free intervals and reduces the burden of more frequent injections.
机译：目的：研究玻璃体腔注射贝伐单抗（IVB）最初注射后3周使用黄斑栅格光凝治疗弥漫性糖尿病性黄斑水肿是否可提供更长的无病间隔时间并减轻更频繁注射的负担。方法：一项前瞻性研究包括22例双侧弥漫性糖尿病性黄斑水肿患者。在每位患者中，一只眼睛单独接受重复IVB注射治疗（IVB组），另一只眼睛接受首次IVB注射仅3周后除黄斑栅格光凝治疗外再次重复IVB注射治疗（合并组）。在每次IVB注射之前和随访期间，所有患者均接受了全面的眼科检查。在基线和后续检查期间通过光学相干断层扫描术测量中央黄斑厚度。在基线和每次IVB注射之前进行眼底荧光素血管造影，以检测和评估黄斑渗漏。首次静脉注射后至少12个月，最后一次静脉注射后3个月，每月对所有患者进行随访。结果：在随访期结束时（14.2±1.91个月），联合组（每眼2.36）的平均注射次数显着低于（P <0.05）IVB组（每眼3.27） ）。联合组的平均注射间隔时间明显长于IVB组（P <0.05）。在每组中，基线和随访期结束时的平均黄斑中心厚度之间的差异具有统计学意义（P <0.05）。两组之间基线和随访期末之间的平均最佳矫正视力变化无统计学意义（P> 0.05）。就视力获得，维持或丧失的患者数量而言，两组的研究之间无统计学差异（P> 0.05）。结论：重复IVB注射可为弥漫性糖尿病性黄斑水肿提供长期治疗。初次IVB注射后仅3周进行一次黄斑栅格光凝治疗可能会提供更长的无病间隔时间，并减少更频繁注射的负担。

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