Use of Optical Coherence Tomography for Evaluation of the Results of the Treatment of Diabetic Macular Edema with Laser Coagulation of the Ocular Fundus Tissues and Intravitreal Injection of Ranibizumab (Lucentis)
One of the most informative methods of noninvasive investigation of the retina is optical coherence tomography (OCT). OCT is successfully applied to the diagnosis of diabetic retinopathy especially if there is diabetic macular edema (DME).
The objective of the investigation is evaluating the results of the treatment of DME with laser coagulation of the ocular fundus tissues and intravitreal injection of ranibizumab (Lucentis), on the basis of imaging data derived from OCT.
Materials and Methods. Examination, treatment and dynamic observations were carried out on 108 patients (214 eyes at the stage of proliferative diabetic retinopathy with clinically relevant DME); they included 68 women and 40 men. The patients were divided into three groups depending on the overall term of DME occurrence: group I — up to 1 month (73 eyes), group II — from 1 to 3 months (69 eyes), group III — 3 months or longer (72 eyes). Within each group, all the patients were divided into three subgroups which underwent either intravitreal injection of ranibizumab, or laser coagulation of the eye fundus tissues, or both treatments combined. The effectiveness of the treatment was evaluated on the basis of OCT and visometry data recorded at both 5 days and 1 month.
Results. According to OCT of retina, the effect of the intravitreal injection of Lucentis alone was considerable but unstable. In the case of DME having been present for less than 1 month, the combined treatment was the most effective. In cases where DME had been present for 1 to 3 months or for more than 3 months, both laser-only and the combined treatment are effective.
Conclusion. We have therefore shown that choice of optimum treatment is dependent on the previous duration of DME and that OCT is a highly informative method for evaluation of DME.
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