Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Dec 3;6(1):63.
doi: 10.1186/s40942-020-00265-6.

Anatomical and functional outcomes of subthreshold micropulse laser versus intravitreal ranibizumab injection in treatment of diabetic macular edema

Amr Abdelrahman  1 , Wagiha Massoud  1 , Ahmed Mohamed Kamal Elshafei  1 , Mahmoud Genidy  1 , Raafat Mohyeldeen Abdelrahman Abdallah  2
Affiliations

Anatomical and functional outcomes of subthreshold micropulse laser versus intravitreal ranibizumab injection in treatment of diabetic macular edema

Amr Abdelrahman et al. Int J Retina Vitreous. .

Abstract

Background: To compare the therapeutic effects of subthreshold micropulse laser (SML) versus intravitreal injection of ranibizumab in treatment of diabetic macular edema (DME) both anatomically using optical coherence tomography (OCT) and functionally using best corrected visual acuity (BCVA) and multifocal electroretinogram (mfERG).

Methods: his study was an interventional prospective randomized comparative study. The study included 120 eyes classified into 3 groups: Group 1 included 40 eyes of 28 patients treated by SML laser, group 2 included 40 eyes of 32 patients treated by intravitreal injection of ranibizumab, and group 3 (control group for mfERG) included 40 eyes of 20 patients with diabetes mellitus (DM) of more than 10 year duration with no signs of diabetic retinopathy (DR). BCVA measurements, OCT and mfERG were done for the cases before and after interference and were followed up for 6 months RESULTS: By the end of the follow up period, BCVA significantly improved by 31% in group 1 vs 93% in group 2 with a statistically highly significant difference between the two groups (p value < 0.001). There was also a significant decrease in central subfield thickness in both groups with more reduction in group 2 compared with group 1 (p value < 0.001). There was a significant improvement in P1 amplitude of mf-ERG in group 2 (p value < 0.002) with no significant improvement in group 1. There was a significant decrease in P1 implicit time in group 2 (p value < 0.001) while there was no significant decrease in group1.

Conclusions: Intravitreal injection of ranibizumab is a superior treatment modality for DME compared with SML regarding both anatomical and functional outcomes.

Trial registration: This study has been approved by the local ethical committee of faculty of medicine of Minia University and retrospectively registered at the clinical trial gov. with Identifier: NCT04332133.

Keywords: Diabetic macular edema; Multifocal electroretinogram; Ranibizumab; Subthreshold micropulse laser.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
OCT and mfERG a Images of a patient from group1 with baseline OCT revealed diffuse retinal thickness, neurosensory detachment, central subfield thickness of 344um and cube average thickness of 293 um. The baseline p1 amplitude of mfERG was 42.50nv/deg2. b The images of the same patient 6 months after treatment by SML with a reduction of OCT central subfield thickness to 235 um and cube average thickness to 271 um while the p1 amplitude of mfERG increased to 46.22 nv/deg2
Fig. 2
Fig. 2
OCT and mfERG a Images of a patient from group 2 with baseline OCT revealed cystoid macular edema with neurosnsory detachment, central subfield thickness of 357 um and Cube average thickness 314um. The baseline mfERG p1 amplitude was 32.48 nv/deg2. b The same patient 6 months after treatment with IV injections of ranibizumab. OCT revealed resolution of the cystoid macular edema and neurosnsory detachment with central subfield thickness reduced to 274 um and cube average thickness reduced to 292 um. The p1 amplitude of mfERG improved to 49.71 nv/deg2
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Klein R, Knudtson MD, Lee KE, Gangnon R, Klein BE. The Wisconsin epidemiologic study of diabetic retinopathy XXIII: The twenty-five-year incidence of macular edema in persons with type 1 diabetes. Ophthalmology. 2009;116:497–03. doi: 10.1016/j.ophtha.2008.10.016. - DOI - PMC - PubMed
    1. Lung JC, Swann PG, Wong DS, Chan HH. Global flash multifocal electroretinogram: Early detection of local functional changes and its correlations with optical coherence tomography and visual field tests in diabetic eyes. Doc Ophthalmol. 2012;125:123–35. doi: 10.1007/s10633-012-9343-0. - DOI - PubMed
    1. Yamamoto S, Yamamoto T, Hayashi M, Takeuchi S. Morphological and functional analyses of diabetic macular edema by optical coherence tomography and multifocal electroretinograms. Graefes Arch Clin Exp Ophthalmol. 2001;239:96–101. doi: 10.1007/s004170000238. - DOI - PubMed
    1. Fortune B, Schneck ME, Adams AJ. Multifocal electroretinogram delays reveal local retinal dysfunction in early diabetic retinopathy. Invest Ophthalmol Vis Sci. 1999;40:2638–51. - PubMed
    1. Han Y, Bearse MA, Jr, Schneck ME, Barez S, Jacobsen CH, Adams AJ. Multifocal electroretinogram delays predict sites of subsequent diabetic retinopathy. Invest Ophthalmol Vis Sci. 2004;45:948–54. doi: 10.1167/iovs.03-1101. - DOI - PubMed

Associated data