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· AIM:To investigate the effect of macular focal/grid laser photocoagulation with Ranibizumab on the treatment of diabetic macular edema (DME).· METHODS:Totally 70 patients (99 eyes) with DME treated in our hospital from August 2014 to August 2016 were randomly divided into the observation group and the control group,with 50 eyes and 49 eyes,respectively.Patients in control group were treated with macular focal/ grid laser photocoagulation,and based on this,the observation group was treated with intravitreal injection of ranibizuma at 5-7d before operation.The best corrected visual acuity (BCVA) before and after operation was compared between the two groups.Central macular thickness (CMT) was examined by optical coherence tomography (OCT),and fluorescein fundus angiography (FFA) was used to examine the leakage area of retinal neovascularization (RNV) and macular edema.· RESULTS:The BCVA in both groups increased significantly after operation,and the BCVA in observation group was significantly higher than that of the control group at each time point after operation,the difference was statistically significant (P＜0.05).After treatment,the CMT and leakage area of RNV in both groups significantly decreased,and the leakage area of the observation group were significantly less than those in control group at each time point (P＜ 0.05).There were different degrees of macular edema leakage in the two groups before operation,and the proportion of eye with macular edema and leakage in observation group was significantly lower than that in control group,the difference was statistically significant (P＜0.05).No obvious complications occurred in the two groups.· CONCLUSION:Compared with macular focal/grid laser photocoagulation,the combination of macular focal/grid laser photocoagulation and ranibizumab has better curative effect on DME and RNV reduction.Moreover,the patients' visual acuity improve significantly with a higher safety.
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Objective To evaluate the clinical efficacy of intravitreal injection of ranibizumab combined with panretinal photocoagulation for severe non-proliferative diabetic retinopathy.Methods Sixty-four cases (90 eyes) with severe non-proliferative diabetic retinopathy from July 2014 to June 2016 in our hospital were randomly divided into two groups according to the digital table.The observation group (32 cases,46 eyes) underwent intravitreal injection of reizumab combined with panretinal photocoagulation,and the control group (32 cases,44 eyes) were treated with only panretinal photocoagulation.The visual acuity,fundus,fundus fluorescein angiography and macnlar thickness postoperative 1 month,3 months,6 months were observed and detected.The mean thickness of the retinal neuroepithelium in the macular region and total volume of the 6 mm diameter neuroepithelium in the macular area were compared and statistically analyzed.The laser energy,number of spots and energy density were calculated and recorded.Results BCVA at postoperative 1 month,3 months,6 months in the observation and the control group were better than that before treatment(all P ＜ 0.05),and the observation group was better than the control group (all P ＜ 0.05).In the control group,BCVA had no statistically significant difference between 3 months and 6 months (P ＞ 0.05),and the differences were statistically significant among other time points (all P ＜ 0.05).In the observation group,the differences were statistically significant among all time points after treatment (all P ＜ O.05).In the comparison of mean thickness of the retinal neuroepithelium in the macular region and total volume of the 6 mm diameter neuroepithelium in the macular area in the control group and the observation group before and after treatment,there were statistically significant differences at different time points between the two groups (all P ＜ 0.05).Moreover,the average thickness of the retinal neuroepithelium and total volume of 6 mm diameter neuroepithelium in the macular region at postoperative 1 month,3 months,6 months were better than those in the control group (all P ＜ 0.05).The laser energy,spot number and energy density of the observation group were significantly lower than those of the control group (all P ＜ 0.05).Conclusion Intravitreal injection of ranibizumab combined with panretinal photocoagulation for severe non-proliferative diabetic retinopathy can accelerate retinal neovascularization in a short period of time,reduce macular edema and improve the visual function of patients with less laser energy,the curative effect is better than application of retinal laser photocoagulation alone,is worthy of clinical promotion.