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Posted by on Jun 18, 2019 in Diabetes mellitus | 0 comments

In a nutshell

This article investigated the effect of minimally invasive laser treatment combined with injection of anti-vascular endothelial growth factor (VEGF) for diabetic macular edema (DME) in patients with diabetes. 

The authors concluded that this combination therapy improved visual acuity (VA; how clear you can see) and alleviated DME. 

Some background

DME is a collection of fluid in the macula (the central portion of the eye). This decreases VA and can even cause blindness. Treatment options for DME include laser treatment or injection of anti-VEGF drugs into the eyes. The laser works by shrinking and removing blood vessels in the eye. The anti-VEGF drugs decrease the formation of new blood vessels in the eye. Therefore, these therapies remove excess blood vessels which take excess fluid off the eye and improves VA.

A downside of injection therapy is that it has to be repeated periodically (as much as 8 per year). An alternative is to combine the laser with the injections to try to decrease the number of injections needed overall. The safety and effectiveness of combined laser treatment and VEGF injection for DME remains under investigation. 

Methods & findings

The study involved 31 patients with DME. 34 eyes were treated in total. Patients received one to several injections of anti-VEGF followed by a laser session within a month. VA and central macular thickness (CMT; how thick their macula was) were measured before and after treatment. 

There was a significant improvement in VA after 1 month from 0.52 to 0.44. VA was 0.40 after 3 months, 0.43 after 6 months and 0.41 after 12 months. The CMT significantly decreased after 1 month from 491.1 mm to 396.6 mm, 385.2 mm after 3 months, 336.5 mm after 6 months and 354.8 mm after 12 months. The average number of anti-VEGF injections needed a year was 3.6. 

The bottom line

The authors concluded that this combination therapy improved VA and alleviated DME. 

The fine print

A larger sample size with a longer follow up would be needed to confirm the findings of the study. 

Published By :

Scientific reports

Date :

May 20, 2019

Original Title :

Minimally invasive laser treatment combined with intravitreal injection of anti-vascular endothelial growth factor for diabetic macular oedema.

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