Comparison of the efficacy and safety of anti-VEGF monotherapy versus anti-VEGF therapy combined with subthreshold micropulse laser therapy for diabetic macular edema

Treatment of Macular Edema in Vascular Retinal Diseases: A 2021 Update

“…Although a lower incidence of complications was reported with SML treatment compared with conventional laser treatment, SML treatment has not shown superior effectiveness [31][32][33][34]. However, the use of a combined treatment may be an effective and safe alternative for ME treatment and may reduce the number of intravitreal anti-VEGF injections required [34,35].…”

“…The authors noted that the studies under review varied in treatment protocols and inclusion criteria [33]. Altinel and colleagues compared the efficacy and safety of SML and intravitreal bevacizumab (IVB) injection combined therapy with IVB monotherapy in DME treatment [34]. They concluded that fewer IVB injections were needed when laser treatment was added; however, a significant increase in BCVA was not achieved [34].…”

“…Altinel and colleagues compared the efficacy and safety of SML and intravitreal bevacizumab (IVB) injection combined therapy with IVB monotherapy in DME treatment [34]. They concluded that fewer IVB injections were needed when laser treatment was added; however, a significant increase in BCVA was not achieved [34]. Similarly, Furashova et al reported that patients treated with ranibizumab combined with additional laser treatment experienced greater visual improvement and required fewer ranibizumab injections compared with patients treated only with ranibizumab [35].…”

Intravitreal ranibizumab alone or in combination with Calcium dobesilate (CaD) for the treatment of diabetic macular edema in non-proliferative diabetic retinopathy patients: a 12-month outcomes of a retrospective study

“…Although VEGF inhibitor therapy had been shown to be a cost-effective treatment for DME that had reduced the incidence of vision loss and could reduce the associated economic and social cost[8], continuous intravitreal injection treatment also brings a high economic burden to patients, especially in developing countries. Therefore, intravitreal anti-VEGF agents in combined with other therapy, such as intravitreal triamcinolone acetonide [9], or Rho-kinase inhibitor [10], or methotrexate [11], subthreshold micropulse laser [12,13], macular grid laser photocoagulation [14], sub-tenon steroid injection [15], or switching anti-VEGF treatment to intravitreal dexamethasone implant[6, 16-18], was investigated in DME patients.…”

Effect of Calcium Dobesilate (CaD) on Diabetic Macular Edema Treated by Intravitreal Ranibizumab

“…Although VEGF inhibitor therapy had been shown to be a cost-effective treatment for DME that had reduced the incidence of vision loss and could reduce the associated economic and social cost [8], continuous intravitreal injection treatment also brings a high economic burden to patients, especially in developing countries. Therefore, intravitreal anti-VEGF agents in combined with other therapy, such as intravitreal triamcinolone acetonide [9], or Rho-kinase inhibitor [10], or methotrexate [11], subthreshold micropulse laser [12,13], macular grid laser photocoagulation [14], sub-tenon steroid injection [15], or switching anti-VEGF treatment to intravitreal dexamethasone implant [6,[16][17][18], was investigated in DME patients.…”