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Objective To compare the efficacy of intravitreal triamcinolone(IVTA) injection and IVTA combined with macular laser grid photocoagulation (MLGP) to treat macular edema.Methods Consecutive 89 patients (109 eyes)diagnosed with macular edema by examinations of ocular fundus and optical coherence tomography (OCT).The visual acuity was hand moving- 0.8 (0.19±0.13);the intraocular pressure(IOP)ranged from 7 mm Hg to 21 mm Hg(1 mm Hg=0.133 kPa)and the average IOP was 13.78 mm Hg.All the patients received OCT and microperimetry examinations,the central macular thickness was (570±182) μm;the average light sensitivity was (5.07±3.94) dB and the fixation percentage was 70.67% within 4 ° area around the macular fovea.All the patients received IVTA treatment,39 patients (48 eyes)further received MLGP 1 month later (IVTA-MLGP group).The remaining 50 patients (61 eyes) without MLGP treatment was the IVTA group.Best corrected visual acuity (BCVA),lOP,lens,OCT and microprimetry examinations before and after IVTA (1,3,6,12 months) were followed and analyzed.Results On the 12th months,the BCVA in IVTA-MLGP and IVTA group was (0.41±0.20),(0.24±0.19) respectively (P<0.05);the central macular thickness was (309±187) and (487±206) μm respectively(P<0.05);the mean light sensitivity of 4° central macular was (8.24±4.64)and(6.30±3.22) dB respectively (P<0.05);the fixation percentage was (87.01±19.70)% and (78.85±20.41) % respectively (P<0.05).During the follow-up recurrent macular edema was noticed in 28 eyes of IVTA group and 8 eyes of IVTA-MLGP group.Conclusions IVTA combined with MLG was more effective than IVTA to cure macular edema.
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Objectives To evaluate the effect of peeling of internal limiting membrane (ILM) on the post-operative visual acuity in patients with diabetic macular edema, and to detect the role indocyanine green (ICG) plays in the surgery of peeling of ILM. Methods Thirty patients (31 eyes) with diabetic retinopathy at proliferative stage with macular edema underwent vitrectomy. The patients were randomly divided into two groups: 16 eyes in group A underwent single vitrectomy with panretinal photocoagulation and ocular filling with 20% SF6; 15 eyes in group B underwent vitrectomy and peeling of ILM after the posterior pole was stained with ICG. All of the patients were asked to keep the posture of facing down for 10-14 days. The follow-up lasted 3-12 months. Results In 16 eyes in group A, the visual acuity increase of 2 or more lines in 10 (62.5%) and alleviation of macular edema in 9 (56.2%) were found; the postoperative average macular retinal thickness examined by optic coherence tomography (OCT) was 393 ?m. In 15 eyes in group B, the visual acuity increase of 2 or more lines in 14 (93.3%) and alleviation of macular edema in 14 (93.3%) were found; the postoperative average macular retinal thickness was 319 ?m. The postoperative improvement of visual acuity in group B was much better than that in group A ( ? 2=4.210, P =0.05), while the postoperative macular retinal thickness in group B was obviously lower than that in group A ( P