Department of Ophthalmology, Gülhane Military Medical School (GATA) Hospital, Ankara, Turkey.
Ophthalmologica. 2012;227(2):95-9. doi: 10.1159/000331322. Epub 2011 Sep 2.
To compare the effects of grid laser (GL), intravitreal bevacizumab (IVB), and intravitreal triamcinolone acetonide (IVTA) in diffuse diabetic macular edema (DDME).
One hundred and twenty-six patients (126 eyes) treated with GL (modified grid), IVTA (4 mg), and IVB (1.25 mg) injections, matched for best corrected visual acuity (BCVA) and OCT-based central macular thickness at presentation, were enrolled. Primary outcome measure was change in best corrected logMAR visual acuity at 1-year follow-up.
Rates of visual stabilization (within ±0.2 logMAR of baseline BCVA) (71.4, 83.3, 78.6%, respectively) were not different between the groups (p = 0.41) at 12-month follow-up. Higher rates of anatomical and functional success, however, were evident in IVB and IVTA groups within 6 months of treatment (p < 0.05 for both). No severe adverse effects except higher intraocular pressure (10 mm Hg from baseline) in one third (14 eyes) of the IVTA cases, who required trabeculectomy in 2 (4.8%) eyes, were observed.
Intraocular injections may give favorable results within the first 6 months, and after 6 months, GL results seem to be more favorable in the treatment of treatment-naïve, acute, nonischemic, and center-involving DDME.
比较格栅激光（GL）、玻璃体内贝伐单抗（IVB）和玻璃体内曲安奈德（IVTA）治疗弥漫性糖尿病性黄斑水肿（DDME）的效果。
共纳入 126 例（126 只眼）接受 GL（改良格栅）、IVTA（4mg）和 IVB（1.25mg）注射治疗的患者，根据最佳矫正视力（BCVA）和 OCT 中央黄斑厚度在就诊时进行匹配。主要观察指标为 1 年随访时最佳矫正对数视力的变化。
在 12 个月的随访中，视力稳定率（与基线 BCVA±0.2 对数视力范围内）（分别为 71.4%、83.3%和 78.6%）在各组之间无差异（p=0.41）。然而，在治疗后 6 个月内，IVB 和 IVTA 组的解剖学和功能成功率更高（两者均为 p<0.05）。除 14 只眼（占三分之一）的 IVTA 病例眼压升高 10mmHg（基线）外，未观察到其他严重不良事件，其中 2 只眼（4.8%）需要行小梁切除术。
眼内注射可能在最初 6 个月内产生良好的效果，在 6 个月后，GL 结果似乎更有利于治疗初治、急性、非缺血性和累及中心的 DDME。
