Year :
2020
| Month :
November
| Volume :
14
| Issue :
11
| Page :
NC05 - NC09
Full Version
Intravitreal Bevacizumab Alone Versus Combined Bevacizumab and Macular Grid Laser Photocoagulation in Diffuse Diabetic Macular Oedema
Published: November 1, 2020 | DOI: https://doi.org/10.7860/JCDR/2020/45742.14179
Fawaz Al Sarireh, Hamzeh Mohammad Alrawashdeh, Khalid Al Zubi, Khalil Al Salem
1. Assistant Professor, Department of Ophthalmology, Mutah University, College of Medicine, Karak, Jordan.
2. Specialist, Department of Ophthalmology, Ibn Al Haytham Hospital, Amman, Jordan.
3. Associate Professor, Department of Ophthalmology, Mutah University, College of Medicine, Karak, Jordan.
4. Associate Professor, Department of Ophthalmology, Mutah University, College of Medicine, Karak, Jordan.
Correspondence Address :
Dr. Fawaz Al Sarireh,
Assistant Professor, Department of Ophthalmology, Faculty of Medicine,
Mutah University, Karak, Jordan.
Post code/ZIP code: 61710, PO. Box: 7.
E-mail: fawazsar1975@yahoo.com; fawaz@mutah.edu.jo
Abstract
Introduction: Diabetes Mellitus (DM) is a common disease with multiple systemic complications. Diabetic macular oedema is the main threat to vision in patients with diabetic retinopathy, which results from the increased permeability of the inner and outer blood-retinal barrier. Macular argon laser photocoagulation was the only treatment of diabetic macular oedema in the past. Now-a-days, both intravitreal anti-Vascular Endothelial Growth Factor (VEGF) and macular grid laser photocoagulation are used in the management of diffuse and focal Diabetic Macular Oedema (DME).
Aim: To assess the changes in both visual acuity and Central Macular Thickness (CMT) in patients with DME after intravitreal injection of bevacizumab only or in combination with macular grid laser treatment.
Materials and Methods: A prospective longitudinal cohort study included 89 eyes of 52 patients with DME, who were categorised into two interventional groups. The first group received only intravitreal bevacizumab for the first three months, then Pro Re Nata (PRN), while the second group received intravitreal bevacizumab, similar to the first group, in addition to macular grid laser treatment two weeks after the initial injection. Participants were followed-up at 12 months, and the visual acuity, CMT, and the total number of injections were documented. Patients were followed-up but data was gathered on baseline and at the 12th month were compared.
Results: In comparison to the initial presentation, a significant decrease in CMT was noticed in both groups (163.47±83.60 μm vs. 126.45±52.45 μm, respectively). Moreover, a significant improvement in visual acuity of both groups (p<0.023 and p<0.016, respectively) and significantly fewer injections being required in the second group were noticed.
Conclusion: Combining intravitreal bevacizumab with macular grid laser treatment can lead to stabilisation and improvement of visual acuity with a smaller number of injections which was statistically significant.
Keywords
Argon laser, Central macular thickness, Diabetes mellitus, Diabetic retinopathy, Visual acuity
DOI: 10.7860/JCDR/2020/45742.14179
Date of Submission: Jul 06, 2020
Date of Peer Review: Aug 01, 2020
Date of Acceptance: Sep 22, 2020
Date of Publishing: Nov 01, 2020
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 07, 2020
• Manual Googling: Sep 22, 2020
• iThenticate Software: Oct 15, 2020 (11%)
ETYMOLOGY: Author Origin
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