The Diabetic Macular Edema – New Possibilities of the Treatment
Authors:
J. Studnička
Authors‘ workplace:
Přednosta prof. MUDr. Pavel Rozsíval, CSc., FEBO
; Oční klinika FN a LF UK, Hradec Králové
Published in:
Čes. a slov. Oftal., 68, 2012, No. 2, p. 61-63
Category:
Original Article
Overview
The article summarizes data from the literature about new possibilities of the diabetic macular edema treatment. Comparing intravitreal application of triamcinolone and laser photocoagulation, the better effect of the laser treatment with its lower side effects was proven. In combined treatment of triamcinolone and laser photocoagulation comparing with the laser monotherapy, no better effect of the combined therapy was proven. The intravitreal implant releasing fluocinolone acetonide significantly improved the best-corrected visual acuity (BCVA), but caused cataract progression and elevation of the intraocular pressure. Intravitreal application of ranibizumab significantly improved BCVA in the monotherapy, and in the combination with the retinal laser photocoagulation did as well. Intravitreal application of bevacizumab significantly improved BCVA, but its use is off-label only. Aflibercept is in the final stage of clinical trails.
Key words:
laser photocoagulation, triamcinolon, fluocinolon acetonide, ranibizumab, bevacizumab, aflibercept
Sources
1. Arevalo, JF., Sanchez, JG., Wu, L. et al.: Primary intravitreal bevacizumab for diffuse diabetic macular edema: the Pan-American Collaborative Retina Study Group at 24 months. Ophthalmology, 116; 2009: 1488–1497.
2. Do, DV., Schmidt-Erfurth, U., Gonzales, VH. et al.: The DA VINCI Study: phase 2 primary results of VEGF Trap-Eye in patiens with diabetic macular edema. Ophthalmology, 118; 2011: 1819–1826.
3. Early Treatment Diabetic Retinopathy Study Research Group: Photocoagulation for diabetic macular edema: Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol, 103; 1985: 1796–1806.
4. Elman, MJ., Aiello, LP., Beck, RW. et al.: Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology, 117; 2010: 1064–1077.
5. Chen, E., Looman, M., Laouri, M. et al.: Burden of illness of diabetic macular edema: literatura review. Curr Med Res Opin, 26; 2010: 1587–1597.
6. Ip, MS., Edwards, AR., Beck, RW. et al.: A randomized trial comparing intravitreal triamcinolone acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology, 115; 2008: 1447–1459.
7. Massin, P., Bandello, F., Garweg, JG. et al.: Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE study). Diabetes Care, 33; 2010: 2399–2405.
8. Michaelides, M., Kaines, A., Hamilton, RD. et al.: A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT study). Ophthalmology, 117; 2010: 1078–1086.
9. Mitchell, P., Bandello, F., Schmidt-Erfurth, U. et al.: The RESTORE study. Ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology, 118; 2011: 615–625.
10. Pearson, PA, Comstock, TL, Ip, M. et al.: Fluocinolone Acetonide Intravitreal Implant for Diabetic Macular Edema: A 3-year multicenter, randomized, controlled clinical trial. Ophthalmology, 118; 2011: 1580–1587.
Labels
OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2012 Issue 2
Most read in this issue
- Repeatability and Reliability of the Visual Acuity Examination on logMAR ETDRS and Snellen Chart
- Acute Retinal Necrosis
- The Diabetic Macular Edema – New Possibilities of the Treatment
- Evaluation of Bacterial Colonization of the Conjunctival Sac in Ranibizumab Intravitreal Injections Treated Patients