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Use of Ranibizumab for evaluating focal laser combination therapy for refractory diabetic macular edema patients: an
Makoto Hatano1, Makiko Wakuta1, Kazutaka Yamamoto2
1Department of Ophthalmology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8585, Japan.
Abstract:
Anti-vascular endothelial growth factor (VEGF) therapy is the first-line treatment for diabetic macular edema (DME), but is less effective in some patients. We conducted a prospective study to determine whether laser combination therapy with anti-VEGF was more effective than Ranibizumab monotherapy in anti-VEGF-resistant DME patients. There was no significant difference in the improvement of the best-corrected visual acuity (BCVA) between the laser combination therapy and Ranibizumab monotherapy groups (3.2 letters and -7.5 letters, p = 0.165). BCVA did not significantly change between visits 1 and 7 (the laser combination group, 64.3 letters 70.3 letters, respectively, p = 0.537; the Ranibizumab monotherapy group, 72.3 letters and 64.8 letters, respectively, p = 0.554), with no significant improvements in central foveal retinal thickness (the laser combination therapy group, 9.3%: the Ranibizumab monotherapy groups, - 7.3%; p = 0.926). There was no significant difference in the number of Ranibizumab intravitreal therapy (IVT) sessions between the groups (laser combination therapy, 5.2; ranibizumab monotherapy, 6.0; p = 0.237). This study did not show that laser combination therapy was significantly more effective for anti-VEGF-resistant DME than anti-VEGF monotherapy alone. Therefore, for anti-VEGF-resistant DME, alternative therapeutic approaches beyond combined laser therapy may be considered.
Insights
Laser combination therapy offers no significant visual acuity or retinal thickness improvement over anti-vascular endothelial growth factor (VEGF) monotherapy for resistant diabetic macular edema (DME). Alternative treatments should be explored for these challenging cases.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Medical Treatments
Background:
- Anti-vascular endothelial growth factor (VEGF) therapy is a primary treatment for diabetic macular edema (DME).
- Some patients exhibit resistance to anti-VEGF therapy, necessitating alternative treatment strategies.
- Diabetic macular edema (DME) is a leading cause of vision loss in diabetic patients.
Purpose of the Study:
- To compare the efficacy of laser combination therapy versus anti-VEGF monotherapy in patients with anti-VEGF-resistant DME.
- To evaluate visual acuity and retinal thickness changes in DME patients resistant to anti-VEGF treatment.
Main Methods:
- A prospective study was conducted comparing laser combination therapy with Ranibizumab monotherapy.
- Best-corrected visual acuity (BCVA) and central foveal retinal thickness were measured.
- The number of Ranibizumab intravitreal therapy (IVT) sessions was recorded.
Main Results:
- No significant difference in BCVA improvement was observed between the laser combination therapy and Ranibizumab monotherapy groups.
- Central foveal retinal thickness did not significantly improve in either treatment group.
- The number of Ranibizumab IVT sessions required was similar between the two groups.
Conclusions:
- Laser combination therapy is not significantly more effective than anti-VEGF monotherapy for anti-VEGF-resistant DME.
- Alternative therapeutic approaches should be considered for patients with DME resistant to anti-VEGF treatments.
- Further research into novel treatments for refractory DME is warranted.
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