Gungor Sobaci, Cuneyt Erdurman, A. Hakan Durukan (Ankara, Turkey)

Purpose:

Controversy exists in the literature regarding the most appropriate method of treatment in diabetic macular edema. We aimed to find out the current best care for selected group of patients who had untreated, acute, and diffuse diabetic macular edema.

Methods:

Patients with acute DDME (1-year) treated by GL, IVTA (4mg), and IVB (1.25 mg) were matched for BCVA and central macular thickness (CMT). They were examined at the 1st, 3rd, 6th and 12th regularly. Reinjections were done according to changes in OCT (> 50 µ or %10) and BCVA (> 0.1 logMAR unit. Those who didn’t respond to 3 successive interventions were accepted as no responder.

Effectiveness / Safety:

In 12-month follow-up, except BCVA in GL (p = 0.58), changes in BCVA and CMT were significant within, and between groups (p = 0.01 for both measures). Rates of stabilization in BCVA (±0.2 logMAR unit) were similar (p = 0.20). Persistent glaucoma developed in 9% of IVTA cases. This study yielded better functional outcomes (BCVA ≥ 0.3 logMAR unit) in IVTA (23.1%) and IVB (27%) than in grid laser (9.2%); whereas rate of stabilization in BCVA was similar (76.5% in GL, 66.7% in IVTA, and 65.1% in IVB) between the groups (p = 0.20).

Take home message:

GL may be treatment of choice for surgeons favoring vision conservation in the long-term.