https://doi.org/10.31288/oftalmolzh201331822
Combination of intravitreal injections of ranibizumab and selective laser coagulation of retinal pigment epithelium in the treatment of diabetic cystoid macular edema
N. N. Umanets, Z. A. Rozanova, Maher Alzein
State institution «Filatov Institute of Eye Diseases and Tissue Therapy NAMS of Ukraine»
Key words: cystoid macular edema, ranibizumab, selective laser coagulation of retinal pigment epithelium.
The clinical efficacy of combination of intravitreal ranibizumab (IR) and selective laser coagulation of retinal pigment epithelium in diabetic cystoid macular edema was investigated by macular thickness (MT), foveal avascular zone (FAZ) and best corrected visual acuity (BCVA) during 12 months. There were 51 patient, 57 eyes, mean age — 59,5 (9,1) years with diabetes mellitus type I — 20patients, type II — 31 patient, mean blood glucose 9,9 (1,8) pM/l, mean diabetes duration — 15,0 (7,7) years. 1month after IR MT significantly decreased from (509,5+15,3) pm to 276+87pm and selective laser of retinal pigment epithelium was done to all patients. After 12 months MT was (311311+12,4) pm (p=0,000009 Newman-Keuls test), FAZ diminished from (1,128+0,038) mm2 do (1,037+0,043) mm2 (p=0,000009), BCVA improved from 0,23+0,02 to 0,33+0,03 (p=0,00009). BCVA improved on 23 eyes (40,3 %), stabilized on 14 eyes (24,6) fnd worsened on 20 eyes (35,1 %).
References
1.Науменко В. А. Эффективность нового метода диагностики и лазерного лечения отечных форм диабетической макулопатии [Текст]: дис....канд.мед.наук: 14.01.18: защищ. 25.05.04 / Науменко Владимир Алек-сандрович. — О., 2004. — 131 с.
2.Уманец Н. Н. Интравитреальное введение ранибизума-ба как метод лечения кистозного диабетического макулярного отека / Н. Н. Уманец, 3. А. Розанова, Махер Альзин // Офтальмол. журн. — № 2. — С. (в печати)
3.Berger J. W. Thermal modelling of micropulsed diode laser retinal photocoagulation [Текст] / J. W. Berger // Lasers in Surgery and Medicine. — 1997. — № 20. — P. 409- 415.
Crossref
4.Bhagat N. Diode subthreshold laser for DME: Researchers are assessing this laser option as an alternative to photoco-agulation for diabetic macular edema [Текст]/ N. Bhagat, M. A. Zarbin // Rev. Ophthalmol. — 2002. — № 9. — P.83-89.
5.Bhagat N. Use of diode subthreshold Micropulse laser for treating Diabetic Macular edema [Текст] / N. Bha-gat, M. A. Zarbin // Contemporary Ophthalmology. — 2004. — № 3 (13). — P.1-10.
6.Boulton M. E. Changes in growth factor expression in pig eyes following scatter laser photocoagulation [Текст] / M. E. Boulton, M. Xiao, A. Khaliq // Invest. Ophthalmo.l Vis. Sci. — 1995. — № 36 (Suppl). — P. 95.
Crossref
7.Bresnik G. H. Diabetic maculopathy; a critical review highlighting diffuse macular edema [Текст] / G. H. Bresnik // Ophthalmology. — 1983. — № 90. — P.1301-1317.
Crossref
8.Kearns M. Excessive permeability in diabetic maculopathy [Текст] / M. Kearns, A. M. Hamilton, E. M. Kohner // Br. J. Ophthalmol. — 1979. — № 63. — P. 489- 497.
Crossref
9.Lavinsky D. Randomized clinical trial evaluating mETDRS versus normal or high-density micropulse photocoagulation for diabetic macular edema [Текст] / D. Lavinsky, J. A. Cardillo, L. A. Melo [et al.] // Invest. Ophthalmol. Vis. Sci. — 2011. — V.52. — № 7. — P.4314- 4323.
Crossref
10.Matsumoto M. Increased production of transforming growth factor -Я2 from cultured human retinal pigment epithelial cells by photocoagulation [Текст] / M. Matsu-moto, N. Yoshimura, Y Honda // Invest. Ophthalmol. Vis. Sci. — 1994. — № 35. — P.4645- 4652.
11.Mitchell P. The RESTORE Study Ranibizumab Monotherapy or Combined with Laser versus Laser Monother-apy for Diabetic Macular Edema [Текст] / P. Mitchell, F Bandello, U. Schmidt-Erfurth [et al.] // Ophthalmology. — 2011. — № 18. — Р.615- 625.
12.Murata T. Vascular endothelial growth factor plays a role in hyperpermiability of diabetic retinal vessels [Текст] / T. Murata, T. Ishibashi, A. Khalil, [et al.] Ophthalmic Res. — 1995. — № 27. — P. 48- 52.
Crossref
13.Nguyen Q. D. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE [Текст] / Q. D. Nguyen, D. M. Brown, D. M. Marcus, [et al.] RISE and RIDE Research Group // Ophthalmology. — 2012. — V.119. — № 4. — P. 789- 801.
14.Wang H. Intravitreal ranibizumab (lucentis) for the treatment of diabetic macular edema: a systematic review and meta-analysis of randomized clinical control trials [Текст] / H. Wang, X. Sun, K. Liu, [et al.] // Curr Eye Res. — 2012. — V. 37. — № 8. — P. 661-670.
Crossref
15.Yoshimura N. Photocoagulated human retinal pigment epithelial cells produce an inhibitor of vascular endothelial cell proliferation [Текст] / N. Yoshimura, M. Matsumo-to, H. Shimizu [et al.] // Invest. Ophthalmol. Vis. Sci. — 1995. — № 36. — P.1686-1691.
