Lee Ho Young, Lee Seung Yong, Park Jong Seok
Department of Ophthalmology, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2009 Sep;23(3):153-8. doi: 10.3341/kjo.2009.23.3.153. Epub 2009 Sep 8.
To compare the efficacy between macular laser grid (MLG) photocoagulation and MLG plus intravitreal triamcinolone acetonide (IVTA; MLG+IVTA) therapy in diabetic macular edema (DME) patients.
A prospective, randomized, clinical trial was conducted of DME patients. A total of 60 eyes (54 patients) affected by DME were observed for a minimum of 6 months. Thirty eyes of 28 patients who received MLG treatment and 30 eyes of 26 patients who received the combined MLG+IVTA treatment were included in the study. Main outcome measures were BCVA and central macular thickness (CMT) as measured by optical coherence tomography (OCT) at 1, 3, and 6 months after treatment. Additionally, the authors examined retrospectively 20 eyes of 20 patients who were treated with only IVTA and compared with the 2 groups (MLG group and MLG+IVTA group).
Baseline BCVA was 0.53 + or - 0.32 and CMT was 513.9 + or - 55.1 microm in the MLG group. At 1 and 3 months after treatment, the MLG group showed no significant improvement of BCVA and CMT, although there was significant improvement after 6 months. In the MLG+IVTA group, the baseline BCVA was 0.59 + or - 0.29 and CMT was 498.2 + or - 19.8 microm. After treatment, significant improvement of BCVA and CMT was observed at all follow-up time periods. When comparing the MLG group with the MLG+IVTA group, the latter had better results after 1 and 3 months, although at 6 months, there was no significant difference of BCVA and CMT between the 2 groups. Additionally, the IVTA group showed more improvement than the MLG group at 1 and 3 months but showed no significant difference at 6 months. In addition, the IVTA group showed no significant difference with the MLG+IVTA group at all follow-up time periods.
For DME patients, the combined MLG+IVTA treatment had a better therapeutic effect than the MLG treatment for improving BCVA and CMT at the early follow-up time periods. IVTA treatment alone could be an additional alternative therapeutic option to combined therapy.
比较黄斑区激光格栅（MLG）光凝术与MLG联合玻璃体内注射曲安奈德（IVTA；MLG+IVTA）治疗糖尿病性黄斑水肿（DME）患者的疗效。
对DME患者进行一项前瞻性、随机临床试验。共观察了60只眼（54例患者），观察时间至少6个月。研究纳入了28例接受MLG治疗患者的30只眼以及26例接受MLG+IVTA联合治疗患者的30只眼。主要观察指标为治疗后1、3和6个月时通过光学相干断层扫描（OCT）测量的最佳矫正视力（BCVA）和中心黄斑厚度（CMT）。此外，作者回顾性检查了20例仅接受IVTA治疗患者的20只眼，并与两组（MLG组和MLG+IVTA组）进行比较。
MLG组的基线BCVA为0.53±0.32，CMT为513.9±55.1微米。治疗后1个月和3个月，MLG组的BCVA和CMT无显著改善，尽管6个月后有显著改善。在MLG+IVTA组中，基线BCVA为0.59±0.29，CMT为498.2±19.8微米。治疗后，在所有随访时间段均观察到BCVA和CMT有显著改善。将MLG组与MLG+IVTA组进行比较时，后者在1个月和3个月后的结果更好，尽管在6个月时，两组之间的BCVA和CMT无显著差异。此外，IVTA组在1个月和3个月时的改善比MLG组更多，但在6个月时无显著差异。此外，IVTA组在所有随访时间段与MLG+IVTA组均无显著差异。
对于DME患者，在早期随访时间段，MLG+IVTA联合治疗在改善BCVA和CMT方面比MLG治疗具有更好的治疗效果。单独的IVTA治疗可能是联合治疗的另一种替代治疗选择。
