Efficacy Analysis Of Retinal Laser Photocoagulation Combined With Intravitreal Injection Of Conbercept In The Treatment Of Different Types Of Diabetic Macular Edema

Purpose:To investigate the efficacy of retinal laser photocoagulation combined with intravitreal conbercept(IVC)on diabetic macular edema(DME)with different optical coherence tomography(OCT)features and the effect of structural features of the macula on DME before and after treatment.Methods:We retrospectively analyzed the clinical data of 54 patients(80 eyes)with retinal laser photocoagulation combined with an intravitreal injection of Compazine in our hospital from September 2019 to January 2022.All patients were divided into 3groups based on OCT: diffuse retinal thickening(DRT),cystoid macular edema(CME),Best-corrected visual acuity(BCVA),and central foveal thickness(CFT)were recorded and compared at baseline before the first treatment and 1 month after completion of the last vitreous injection treatment.The correlation between baseline characteristics such as baseline BCVA,baseline CFT,disorganization of the inner retinal layers(DRIL),external limiting membrane(ELM)disrupted,and ellipsoid zone(EZ)disrupted,and treatment response was also assessed.Results:There was no significant difference in baseline BCVA between the 3 types of DME(P=0.162)and all BCVA was significantly better than baseline at 1-month post-treatment(P<0.05).The CFT at 1-month post-treatment was significantly lower than baseline for all 3 types of DME(p<0.05).The SRD group after treatment had the worst improvement in BCVA and the worst reduction in the CFT The CME group after treatment had the best improvement in BCVA and the best reduction in the CFT(P=0.03 P=0.00).The proportion of baseline EZ disruption and ELM disruption were greatest in the SRD group(P=0.02 P=0.004).The baseline BCVA was correlated with the post-treatment BCVA,baseline CFT and post-treatment CFT improvement rates(p=0.000,0.000,0.003 respectively),however,there was no correlation with post-treatment CFT(p=0.268).The baseline CFT correlated with improvement in baseline BCVA,post-treatment BCVA,post-treatment CFT and post-treatment CFT reduction(p 0.000,0.004,0.000,0.031 respectively).Baseline DRIL correlated with baseline BCVA,post-treatment BCVA,and baseline CFT(P 0.000,0.000,0.018,respectively),whereas it did not correlate with post-treatment CFT and the rate of improvement in CFT reduction(P 0.104,0.854,respectively).Baseline ELM break and EZ break correlated with baseline BCVA,post-treatment BCVA,baseline CFT,and post-treatment CFT(all P < 0.05),whereas they did not correlate with the rate of improvement in CFT drop(all P > 0.05).Conclusion: Retinal laser photocoagulation combined with anti-VEGF therapy can be used as a treatment for different types of DME.different OCT types in DME influence the role of treatment and predict its prognosis.Different OCT types have different pathogenesis of DME and treatment should be individualized.Changes in macular structure on OCT such as ELM/EZ fracture DRIL are associated with poor visual acuity at baseline and after treatment and predict prognosis.