Evaluation Of The Short-term Therapeutic Effect Of Intravitreal Injection Of Ranibizumab For Refractory Diabetic Macular Edema

Objective:To evaluate the efficacy of intravitreal ranibizumab(0.5mg)in the treatment of refractory diabetic macular edema and compare efficacy and safety differences with the added laser theraphy.Methods:We include 30 patients with type 2 diabetic mellitus and having already accepted grid photocoagulation or panretinal photocoagulation at least 3 monthes ago.Patients suffering visual impairment due to DME were individed into intravitreal ranibizumab(0.5mg)and added laser theraphy.Patients had monthly follow-up for six times after three monthly intravitreal ranibizumab(0.5mg-0.05ml)and added laser theraphy at baseline.Results:1.All average monthly BCVA of group A were superior to group B,there was no statistically significant difference(P > 0.05)for month 1,month 2,while month3?4?5?6 differed(P < 0.05).The average monthly follow-up BCVA of group A had increased comparing with baseline,statistically significant change existed after month 1.The best average BCVA appeared at month 3(0.2933 ±0.11629),Month 2 to month 3 showed the maximum increasing extent(0.0367 ±0.03994).There was no statistically significant BCVA increase at each follow-up for group B.2.All average monthly CSFT of group A were lower than group B,with statistically significant difference for each follow-up.Every average monthly followup CSFT of group A had increased statistically significant comparing with baseline.The best average CSFT appeared at month 5(378.400±39.226?m),Month 2 to month 3 showed the maximum decreasing extent(57.33±29.097?m)?There was no statistically significant CSFT decrease at each follow-up for group B.3.All average monthly CV of group A were lower than group B,with statistically significant difference for each follow-up.Every average monthly follow-up CV of group A had increased statistically significant comparing with baseline.The best average CV appeared at month 5(10.3533±.0.715 mm3),Month 1 to month 2 showed the maximum decreasing extent(0.7200±.0..66676 mm3).CV of month 6 increased again from month 5 statistically significantly.The average monthly followup CV of group B had decreased comparing with baseline,statistically significant changes existed after month 2.4.No serious adverse event was observed during this study.Conclusions:1.IVR can effectively reduce the degree of refractory diabetic macular edema,and increase patients,BCVA for short-term.2.Added laser treatment can reduce refractory diabetic macular edema,the effect is inferior to IVR,But can not benefit BCVA for short-term.3.Both IVR and added laser treatment show well-tolerance for short-term.