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Anti-VEGF, laser therapy beneficial in treatment of diabetic macular edema
Ophthalmology. 2010;doi:10.1016/j.ophtha.2010.02.031.
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Combining anti-VEGF therapy with laser appears to be more effective than the current standard of care in patients with diabetic macular edema.
According to a multicenter, randomized clinical trial of 854 eyes of 691 participants in a study organized by the DRCR.net, patients assigned Lucentis (ranibizumab, Genentech) plus either immediate or deferred laser therapy had a gain in visual acuity after 1 year compared with patients who received sham plus prompt laser therapy.
At 1 year, patients in either the prompt or deferred laser plus ranibizumab groups had a statistically significant increase of nine letters in visual acuity, compared with an increase of three letters in the sham arm and an increase of four letters in patients treated with triamcinolone and prompt laser therapy.
According to the study, reduction in central subfield thickness was similar in all three treatment arms and greater than that seen in the sham arm. As well, in eyes pseudophakic at baseline, visual acuity change after treatment with triamcinolone and prompt laser was similar to that after treatment with ranibizumab and laser.
No systemic adverse events were noted in the study. Ranibizumab use was associated with three cases of endophthalmitis, and triamcinolone use with prompt laser therapy was frequently associated with elevated IOP.
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