Cuervo-Lozano Edgar, González-Cortés Jesús Hernán, Olvera-Barrios Abraham, Treviño-Cavazos Ezequiel, Rodríguez-Pedraza Josué, Mohamed-Noriega Karim, Mohamed-Hamsho Jesús
Ophthalmology Department, University Hospital "José Eleuterio Gonzalez" and Faculty of Medicine, the Autonomous University of Nuevo León, Monterrey 64460, Mexico.
Int J Ophthalmol. 2018 Jun 18;11(6):981-985. doi: 10.18240/ijo.2018.06.14. eCollection 2018.
To compare the effectiveness of intravitreal bevacizumab and subthreshold macular photocoagulation (SMP), for the treatment of non-center involved diabetic macular edema (non-CI DME).
Prospective, randomized, controlled clinical study included patients with type 2 diabetes, non-CI DME and best-corrected visual acuity (BCVA) of 0.30 logMAR or better. Each eye was randomized into three groups: group 1, monthly intravitreal bevacizumab; group 2, single SMP; group 3, single SMP and monthly bevacizumab. Main outcome measures were BCVA, and macular thickness measured with optical coherence tomography as macular central subfield thickness (CST), macular area of greater thickness (MAGT) and total macular volume (TMV). Results were analyzed after 3mo.
A total of 32 eyes were included. Group 3 improved in BCVA (0.19±0.16 to 0.12±0.14 logMAR; =0.041) and in TMV (7.90±0.57 to 7.65±0.73 mm; =0.025). Group 1 improved in MAGT (325±26.26 to 298.20±44.85 µm; =0.022) and TMV (7.79±0.57 to 7.50±0.56 mm, =0.047). Group 2 didn't show significant improvement of any variable.
The loading phase of bevacizumab as monotherapy or combined with SMP is superior to SMP as monotherapy in providing short-term visual and anatomical improvement in non-CI DME.
比较玻璃体内注射贝伐单抗与阈下黄斑光凝（SMP）治疗非中心累及性糖尿病性黄斑水肿（non-CI DME）的疗效。
前瞻性、随机、对照临床研究纳入2型糖尿病、non-CI DME且最佳矫正视力（BCVA）为0.30 logMAR或更佳的患者。每只眼随机分为三组：第1组，每月玻璃体内注射贝伐单抗；第2组，单次SMP；第3组，单次SMP联合每月注射贝伐单抗。主要观察指标为BCVA，以及用光学相干断层扫描测量的黄斑厚度，即黄斑中心子区域厚度（CST）、较厚黄斑区域（MAGT）和黄斑总体积（TMV）。3个月后分析结果。
共纳入32只眼。第3组的BCVA（从0.19±0.16 logMAR改善至0.12±0.14 logMAR；P = 0.041）和TMV（从7.90±0.57 mm改善至7.65±0.73 mm；P = 0.025）有所改善。第1组的MAGT（从325±26.26 µm改善至298.20±44.85 µm；P = 0.022）和TMV（从7.79±0.57 mm改善至7.50±0.56 mm，P = 0.047）有所改善。第2组的任何变量均未显示出显著改善。
在为non-CI DME提供短期视力和解剖学改善方面，贝伐单抗单药治疗或联合SMP的负荷期优于SMP单药治疗。
