A Study on the Short Term Effects of Grid Laser Photocoagulation and Combination Treatment (Grid Laser With Intravitreal Bevacizumab) in the Management of Diabetic Macular Oedema

Abstract

AIMTo study the short term effect of grid laser photocoagulation in the treatment of diabetic macular oedema. As a comparison, the short term efficacy of combination treatment of grid laser photocoagulation along with intravitreal injection of bevacizumab was studied in the treatment of Diabetic Macular Oedema (DME). MATERIALS AND METHODS74 eyes of 43 patients between the ages of 50-60 years with diabetic maculopathy were selected. These patients were then assigned to either groups of standalone photocoagulation therapy (Group I) or combined therapy of photocoagulation with intravitreal Avastin (Group 2). Best Corrected Visual Acuity and Optical Coherence Tomography findings were done in all the patients during a follow-up done every four weeks up to twelve weeks. RESULTSIn Group I, at the end of 12 weeks, overall 34% patients showed an improvement or stability in visual acuity. 66% of the patients had a decrease in visual acuity. The number of eyes with decline in visual acuity decreased during 4 to 12 weeks. 59.22% of the eyes showed improvement or stability in the visual acuity in Group 2. The mean central macular thickness remained stable or increased in 70.2% of the eyes, whereas the CMT decreased only in 29.8% eyes. But in Group 2, at the end of 12 weeks, 59.3% had a decrease in CMT. Total Macular Volume (TMV) in Group I, decreased in 57.4% of the eyes. On the other hand, in Group 2 at 12 weeks, 59.3% showed a decrease in TMV, which is slightly better than in Group 1. CONCLUSIONThe patients with DME who underwent combined photocoagulation with intravitreal injection of Avastin showed significant improvement in visual acuity, central macular thickness and macular volume as compared to the patients who underwent standalone laser photocoagulation, though neither of the groups showed completely satisfactory improvement. Study with large number of patients and long term follow-up would be considered ideal.