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Effect of Leaking Foveal Microaneurysms on the Treatment of Center-Involving Diabetic Macular Edema: A Pilot Study.

Authors
  • Hirano, Takao1
  • Toriyama, Yuichi1
  • Iesato, Yasuhiro1
  • Ishibazawa, Akihiro2
  • Sugimoto, Masahiko3
  • Takamura, Yoshihiro4
  • Nagaoka, Taiji2, 5
  • Murata, Toshinori1
  • 1 Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Japan. , (Japan)
  • 2 Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan. , (Japan)
  • 3 Department of Ophthalmology, Mie University School of Medicine, Tsu, Japan. , (Japan)
  • 4 Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Japan. , (Japan)
  • 5 Department of Ophthalmology, Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Tokyo, Japan. , (Japan)
Type
Published Article
Journal
Ophthalmic Research
Publisher
S. Karger AG
Publication Date
Oct 10, 2018
Pages
1–9
Identifiers
DOI: 10.1159/000492005
PMID: 30304729
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Evaluate the effect of foveal leaking microaneurysms (MAs) on the required number of intravitreal ranibiz-umab (IVR) injections in the treatment of center-involving diabetic macular edema (DME) when treated with focal/grid laser. A pilot study of prospective, nonrandomized, multicenter clinical trial. This study enrolled 21 eyes with DME for which pro re nata IVR injections were combined with short-pulse focal/grid laser. At 12 months, best-corrected visual acuity (BCVA), central subfield macular thickness (CMT), and the required number of IVRs to maintain CMT < 300 µm were compared between eyes with or without foveal leaking MAs, termed the MA(+) and MA(-) groups, respectively. Significant CMT improvements (p < 0.0001) and increased BCVA of 4.0 ± 8.5 letters were observed at 12 months. The MA(-) group required significantly fewer IVRs than did the MA(+) group (mean: 4.9 ± 3.0 vs. 8.6 ± 3.0; p = 0.0306). In the latter 6 months of the 1-year follow-up, 50% (4/8) of MA(-) eyes did not require any IVR administration to sustain CMT < 300 µm. A combination therapy of short-pulse focal/grid laser and reduced IVR injections appeared noninferior to previous reports of IVR monotherapy. Further large-scale investigations are warranted. © 2018 S. Karger AG, Basel.

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