Comparison of Treatment in Patients with Type 2 Diabetic Macular Edema

Abstract

Objective: In the study, it was aimed to compare the effectiveness of intravitreal triamcinolone acetonide (IVTA), laser photocoagulation (LPC), and the LPC combined with IVTA treatments in patients with diabetic macular edema (DME).
Materials and Methods: The patients were randomly separated into three groups: Group 1 (IVTA+LFC) consisted of 30 eyes of 22 patients, and the average age was 63.2 years. Group 2 (LFC)consisted of 34 eyes of 22 patients and the mean age was 59.9 years. Group 3(IVTA) consisted of 27 eyes of 21 patients with a mean age of 64.5 years. The complete eye examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurements, and the fundus inspection was carried out before and 1. 3. 6. and 9. months after the treatment. P50 amplitudes were measured with the PERG test, and edema map values (EMV) were measured with HRT II.
Results: In Group 1, the BCVA increased in 26 eyes (86.6%), did not change in 3 eyes (10%), and decreased in one eye (3.3%). In Group 2, the BCVA increased in 18 eyes (52.9%), did not change in 10 eyes (29.4%), and decreased in 6 eyes (17.6%). In Group 3, the BCVA increased in 20 eyes (74%) and did not change in 7 eyes (25.9%).
Conclusions: We observed the use of the laser FC combined with IVTA seems to be more effective than using each other of IVTA and laser FC solely. 

Keywords

• Diabetic macular edema
• intravitreal triamcinolone acetonide
• laser photocoagulation

Tip 2 Diabetik Makula Ödemli Hastalarda Tedavi Karşılaştırması

Öz

Amaç: Diyabetik makula ödemi (DMÖ) tanılı hastalarda; intravitreal triamsinolon asetonid (İVTA), laser fotokoagülasyon (LFK) ve LFK ile kombine İVTA tedavilerinde etkinlik araştırması yapmak amaçlanmıştır.
Materyal ve Metot: Hastalar rastlantısal olarak üç ayrı gruba ayrıldı: Grup 1, 22 hastanın 30 gözünden oluşmakta olup yaş ortalaması 63,2 yıl idi. Grup 2, 22 hastanın 34 gözünden oluşmakta olup yaş ortalaması 59,9 yıl idi. Grup 3 ise 21 hastanın 27 gözünden oluşmakta olup yaş ortalaması 64,5 yıl idi. Olgulara tedavi öncesi ve sonrası 1. 3. 6. ve 9. aylarda en iyi düzeltilmiş görme keskinliği, göziçi basınç (GİB) ölçümü ve fundus muayenesini içeren tam göz muayenesi yapıldı. PERG (Pattern Elektroretinografi) testi ile P50 amplitüdü, HRTII (Heidelberg Retina Tomograph II) testi ile ÖHD (Ödem Harita Değeri) ölçüldü.
Bulgular: Grup 1’de (İVTA+LFK) görme keskinliği 26 (%86,6) gözde artarken, 3 (%10) gözde değişmedi, 1 (%3,3) gözde azaldı. Grup 2’de (LFK) görme keskinliği 18 (%52,9) gözde artarken, 10 (%29,4) gözde değişmedi, 6 (%17,6) gözde azaldı. Grup 3’te (İVTA) görme keskinliği 20 (%74) gözde artarken, 7 (%25,9) gözde değişmedi, azalma hiçbir olguda gözlenmedi.
Sonuç: IVTA ile birlikte lazer FK kullanımının, tek başına IVTA ve lazer FK kullanımından daha etkili olduğunu gözlemledik. 

Anahtar Kelimeler

• Diabetik makula ödemi
• intravitreal triamsinolon asetonid
• laser fotokoagülasyon

Kaynakça

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