Abstract:

Objective To observe the efficacy of pattern scan laser (PASCAL) combined with intravitreal injection of triamcinolone in treatment of diabetic macular edema (DME). Design Retrospective and comparative study. Participants Eighty cases of patients with DME (135 eyes) with either severe non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR), who were treated in Tangshan ophthalmologic hospital from December 2012 to February 2014. Method The treatment group included 40 cases (70 eyes) that were treated with PASCAL laser combined with intravitreal injection of triamcinolone acetonide (IVTA) 2 mg. The control group included 40 cases (65 eyes) that were treated with traditional different wavelength krypton lasers. The two groups had no significant difference in severity of DME before treatment. The patients were examined for best-corrected visual acuity (BCVA), central macular thickness (CMT) and the mean light sensitivity within 10-degree range of the fovea with diagnostic optometry, optical coherence tomography (OCT) and micro-vision (SLO) before treatment and three months after treatment. Main Outcome Measures BCVA, CMT and the mean light sensitivity within 10-degree range of the fovea. Results The proportion of eyes with improvement in BCVA, CMT and the mean light sensitivity within 10-degree range of the fovea three months after treatment in the treatment group were significantly highger than those of control group (88.57%, 91.40% and 85.70% versus 64.30%, 72.30%, 46.15%, χ2=10.60, 8.42, 38.83; P=0.010, 0.005, 0.023 respectively). The value of  BCVA (logMAR) and the mean light sensitivity within 10 degree range of the fovea（dB) three months after treatment was significantly higher than in treatment group than in control group (0.400±0.700 and 16.000±13.500 versus 0.600±0.900 and 12.500±10.000, t=0.612,0.695，P=0.01 and 0.005), the two groups' numerical value(standard deviation) of CMT (μm)　after three months treatment, the treatment group 's numerical value was 325±125，the control group's numerical value was 350±125, they were compare with t test, the results had no statistically significant(t=0.520，P=0.223). Conclusion  IVTA combined with PASCAL laser treatment of DME is better than conventional laser treatment. The combined therapy not only can quickly improve central vision, reduced macular thickness, but also can reduce laser damage to macular visual function. (Ophthalmol CHN, 2015, 24: 332-336)

Key words: diabetic macular edema, laser photocoagulation, intravitreal injection, optical coherence to-mography, scanning laser ophthalmoscope