Clinical effect and cost analysis of panretinal photocoagulation combined with Ranibizumab or triamcinolone acetonide for diabetic macular edema

• Main Authors: Zhu-Juan Pan, Zhi-Hui Zhang, Fei-Hong Fan, Xiao-Ke Zheng, Wen-Juan Qi
• Format: Article
• Language: English
• Published: Press of International Journal of Ophthalmology (IJO PRESS) 2018-04-01
• Series: Guoji Yanke Zazhi
• Subjects: diabetic macular edema; ranibizumab; triamcinolone acetonide; intravitreal injection; panretinal photocoagulation
• Online Access: http://ies.ijo.cn/cn_publish/2018/4/201804022.pdf

AIM: To compare clinical effects and cost of panretinal photocoagulation(PRP)combined with Ranibizumab or triamcinolone acetonide(TA)for diabetic macular edema(DME). <p>METHODS: Forty-eight patients(48 eyes)with DME and diabetic retinopathy(DR)receiving PRP were randomly assigned to two groups, which were respectively intravitreally injected ranibizumab(0.5mg)and TA(4mg). Ranibizumab(0.5mg)was intravitreal injected every 4wk for 3 times. The effects of injection for DME were evaluated using best-corrected visual acuity(BCVA), central macular thickness(CMT)and intraocular pressure(IOP). During the follow-up, other injections were performed to eyes which had CMT greater than 400μm. The medical costs were calculated at 12wk and 24wk. <p>RESULTS: BCVA and CMT between 2 groups were not significantly different(<i>P</i>>0.05); BCVA and CMT among different time points were significantly different(<i>P</i><0.05); the treatments and the time points had significant interaction on BCVA(<i>P</i><0.05). BCVA was improved in two groups at all the time after injection(<i>P</i><0.05), except 1wk after injection of TA(<i>P</i>=0.33). There was significant difference between the two groups at 12wk and 16wk on BCVA and that injected with ranibizumab was better(<i>P</i>=0.03, 0.045). CMT decreased in two groups at all the time after injection(<i>P</i><0.05). There was significant difference only between the two groups at 1wk(<i>P</i><0.01). All intraocular pressures were in the normal range, except one needed ocular hypotensive agents. The medical costs(yuan)of the ranibizumab group in 12wk and 24wk were 38 736 and 42 564,which of the TA group were 5 790 and 7 053, respectively.<p>CONCLUSION: Both PRP combined with ranibizumab or TA for DME can effectively control disease progression in short time. Therapeutic effect is not significant between two methods, but PRP combined with TA is more economic.